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Mail 570 May 11 - 17, 2009
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May 11, 2009
The expense reports of Members of Parliament were leaked, and they're running for cover, threatening police retaliation. <http://tinyurl.com/oare4h > <http://tinyurl.com/oeydok> <http://tinyurl.com/p69e64> <http://tinyurl.com/oyg689 > <http://tinyurl.com/q524rw> <http://tinyurl.com/p9lqb4> <http://tinyurl.com/ptoous >
The Home Office decided to stonewall the court decision that they had to remove the DNA data of innocents from their database. <http://tinyurl.com/dbeab4 > <http://tinyurl.com/obwmep> <http://tinyurl.com/q623xr>
Question for Jerry: will it be a repeat of last summer's fire season? <http://tinyurl.com/pky648 >. I have family in California, and I'm worried about their health.
During my visit last July, it was intolerable.
If we knew what it was we were doing, it would not be called research, would it? (Albert Einstein) Harry Erwin PhD
The fire season looks to be bad again this year. And the state has no money. We grew the government by 40% in five years of boom, and now we can't pay for any of it, but the cubicle workers have "no layoff" guarantees; the firemen do not. Welcome to democracy.
I agree that DODDS, as a government bureaucracy, is essentially pretty effective in the job it does educating the dependents of the U.S. military. There are corollaries to your own "Iron Law," however, that would prevent DODDS or a similar organization from repeating that same success in D.C. Three features of DODDS that are part of its success: priority in funding, choice of qualified staff from a cadre of volunteers, and a close relationship to a military command hierarchy. It is unlikely that a stateside civilian community would establish such a combination of features, or that a political entity would impose them. Without these features, and outside of the military environment, IMHO it is unlikely that it would work in D.C.
Also IMHO, much the same could be said about applying models based on military healthcare to the general public.
Changing subjects, your correspondent who was trained as a military interrogator got it right with the statement "...when the interrogator with a conscience is forced to use it [violent questioning methods], he must accept the moral and legal consequences, sacrificing himself." While it is questionable leadership to put one's own interrogators into such a position, again IMHO, it is questionable loyalty to expose the followers of one's duly elected predecessor to prosecution for behavior from which they were legally absolved. ..but there' probably nothing new there, it's been done before.
Your reference to the torture case of a WWII Luftwaffe pilot is pertinent to cases that involve those who can be classified as combatants under the Geneva convention. Could you comment on the internment and similar treatment of the captured German saboteur/spies by the U.S. during the same conflict?
Changing subjects again, I always thought Lee Atwater, for all his youth, had an important role in the conservative political movement. Even though he repented some of his political excesses before his death, he was extremely effective in getting his party elected and in keeping it on message. The man played some decent guitar, too. It is interesting to speculate on the course of conservative politics had he survived his illness, which slightly resembled your own (and I am very glad we didn't lose you, too). I expect that his passing, in some part influenced Newt's fall from grace.
This week you stated that it is now official that dissent on the subject of CO2 as a cause of global warming is not politically acceptable, ending with "We stagger toward totalitarianism." I do not disagree with any point, except possibly to substitute "canter" for "stagger," but I can't come up with a specific event that would have caused you to say so on Wednesday. Did I miss a news item?
I agree. I doubt that anything will make the DC school system work properly; my point was that Congress has the undoubted authority to try, and plenty of money to do it with. It they can't do it there, why should there be a department of education? It's known that it can't do anything useful.
I agree also. The federal education department is firmly bound by the Iron Law, and can't be fixed. Replacement with a different system is the only possible course to gain improvement in performance.
Two of our children had special needs. We ended up homeschooling them, not out of any particular religious conviction, but more because of the lack of consistent and useful support for our children's needs from public systems. Our experience with DODDS averaged high, but it was not funded for special needs and was not available everywhere we were stationed. Today, one of the two has completed a bachelor's degree, with honors, and the other will finish next year -- the latter working his own way through, mostly self-financed, at his own pace.
Several admired relatives, and other acquaintances who I respect, work as primary, high, or middle school teachers in public systems. Personal opinion again: all have the talent, skills, and dedication that would seem to allow them to be effective at teaching. All express frustrations in dealing with regulations, administration, student preparation (e.g. senior students who can't read or do not know how to study), school boards, and frequently their own unions. From professional experience, they are typical of otherwise competent members of an organization that is predisposed to failure. Rather than "hoping that they fail" (as someone has said in a slightly different context), my experience and observation tell me that the quickest and cheapest way out of this kind of organizational quagmire is failure and replacement with another system. "Quick" and "cheap" are relative characterizations, and depend totally on the replacement system working in the first couple attempts. Absent outright failure, internal repair of such a system is rarely effective and is often more expensive. Both alternatives, evolution and revolution, are usually equally traumatic.
Also, Congress has never done well by its responsibilities to the citizens of D.C. On my first trip to the area, I noted that the local license plates include the motto "taxation without representation," which pretty much sums it up.
Enjoy your weekend, to the extent the colds allow it. We also have just been recovering from some circulating crud here (not the porkulus flu), and wish you both a swift recovery.
The taxation without representation was built into the Constitution for a reason. That was in the days before welfare, and it was assumed that those who chose to move to foggy bottom would do so for a reason. Until 1943 Washington was a sleepy little town in Maryland. The purpose of Congressional sovereignty was to prevent the kind of mob rule that had been seen in Paris in previous times.
Had DC been kept as the Canal Zone was -- you couldn't just decide to live there, you had to have a reason to be living there -- it would have been different. But as it is, DC is a mess. It doesn't have enough money to support the costs of government, and the notion of "representation" with access to the Federal Treasury is a bit of a joke. But Congress has the undoubted right to reform the DC schools. If it cannot do that, then why on Earth do we pay any attention to the Federal Department of Education? If it can't make things work where it is sovereign, why assume it knows what it is doing.
Mother of the Year.
- Roland Dobbins
I've grown up, how about you?
So do you believe that CO2 is a not a pollutant, that the rise in concentration is not anthropogenic and so therefore should be ignored, or that we as a species are destined to die out anyway, so therefore it should be ignored?
As a young man I was thrilled by your writing, but after reviewing your blog, I see that even educated men can become petrified in unenlightened thought patterns.
I consider your viewpoint on the federal government as right wing libertarian, and that is OK with me; however, you are quite wrong on your tone regarding anthropogenic global warming. CO2 is a pollutant, if you don't believe me you can look it up for yourself, and another fact is that most of the increase is anthropogenic. Even if this increase in CO2 does not cause global warming, which it most certainly does, it is still an issue as CO2 is a pollutant. Go ahead, look it up for yourself, or just try breathing some.
This is a serious issue for us and our progeny, much more important than the fact that we have eaten all the good fish. The cost of cleaning up the pollution will be much higher than the profit make by creating it, and in the mean time, the ongoing cost (early death) will be born most heavily by the poorest among us. Perhaps this is OK, I believe that there are too many "homo sapiens" here already, but seeing the top oil company executives benefit by selling a product that pollutes everyone's air galls me as does your apparent denial of the cause and effect of anthropogenic CO2.
I call bullshit on your opinion about anthropogenic CO2. You are a smart man, so ignore what the right-wing drumbeat and go find out for yourself.
In any case I still have respect for your writing, and thank you for the entertainment in Byte magazine and in the SF novels that I consumed as a youngster.
Thanks and Regards, - Chris Reaka
If doubting that the evidence for man-caused global warming is the definition of unenlightened thought patterns, then I have no defense. Moreover, I am as subject to the pressure of "consensus" as anyone. Wendell Johnson, from whom I took General Semantics at the State University of Iowa, used to say "If the psychiatrist, two nurses, and the orderly all tell you that you are not covered with bees, you may was well stop trying to brush them off your coat."
But the man-made global warming hypothesis -- it is only a hypothesis -- grows from models that everyone knows are inadequate, and which have never -- repeat never -- made a successful five year prediction. As to CO2 being a pollutant, it is also a fertilizer -- tropical fish keepers inject CO2 into their aquariums in order to encourage plant growth. I will agree that we ought to be looking at ways to reduce the accumulation of CO2, because we don't want to run an open-end experiment until we have some understanding of the effects; but there is scant evidence that the increases in CO2 have in fact produced global warming, and for that matter, there's not much evidence that the Earth is warming at all. It probably is -- we know for certain that Earth has been warming since the Little Ice Age. We know that the Hudson froze solid enough to drag cannon across it in December, 1776, and it hasn't frozen solid enough to walk across since the mid 19th Century. There is certainly a long term warming trend that may or may not be continuing; but the evidence that it is caused by human activities is small, and the physics that ascribes it to increased CO2 is very likely wrong. As Freeman Dyson points out, CO2 can only affect temperatures in cold, dry places; where it's moist the IR reflecting from the ground is already absorbed on the way back up because of the water vapor, which is a lot more efficient as a greenhouse gas than CO2.
On that score: I don't claim to be a great physicist. I will claim to be a passable operations research professional, which means that I have some understanding of models and modeling. Freeman Dyson, on the other hand, most certainly is a great physicist, and when he says the CO2 theory doesn't make much sense, to me that's the equivalent of, if not the psychiatrist, then at least one of the nurses, telling me there are too bees all over me. . . if that metaphor is not too mixed.
I thank you for your kind words about my previous works. I wish you had paid more attention to what I was trying to get across, which is that one must go with the evidence; that models must be falsifiable and repeatedly tested before one bets the farm on their predictions; and that the fact that someone may profit from a scientific hypothesis does not make that hypothesis false. As to profits, the CO2 Global Warming position has made a lot of money for a number of very wealthy people, as well as ensuring employment for a lot of bureaucrats whose entire lives are now invested in the truth of the theory. That doesn't make the CO2 Global Warming hypothesis true nor does it falsify it.
My position remains: before we start wrecking the economy -- and believe me, making energy cost the equivalent of $150/bbl and above will wreck the economy and have horrible effects on the poorest among us -- we should understand what is happening a lot better.
Incidentally, my proposal for answering problems in the mid-East and the oil supply was to invest $120 - 250 billion in nuclear power plants, and another $100 billion in developing low cost access to space and Space Solar Power Satellite technology, neither of which contribute CO2 to the atmosphere.
As to its status as a pollutant, I breathe in -- and breathe out -- CO2 every minute of my life. So do you. Yes, you'll die if you are in an atmosphere where the percentage of CO2 gets high enough, but for the moment it is far less than 1%; less than argon, in fact.
As to toxicity:
Regarding pollution: look at satellite pictures of the atmosphere. Note the enormous brown cloud that engulfs parts of India and China, and which is carried eastward by prevailing winds. Realize that China and India have invested trillions in coal-fired power plants, and ask yourself whether reducing the US contribution to atmospheric CO2 is likely to make much difference other than bankrupting the American people.
"Sow the wind" seen in the wild?
Up until yesterday, you were the only person I'd ever seen use the phrase "sow the wind".
-- Mike T. Powers
Hosea 8: 1-14
May 12, 2009
Subject: Pixel Qi
Even since the One Laptop Per Child project, I've been waiting for someone to adopt the technology to make a cheap laptop for adults. Sounds like we could be seeing some products this year:
-------- Mary Lou Jepsen is a tech necromancer who battled the odds to conjure up a product that most experts said couldn’t be built: a $100 laptop (give or take a few twenties). Now she’s back, with plans for low-cost, low-power, super-readable, LCD-based screens that will go into everything from e-book readers to netbooks and computers.
“We are creating e-paper with color and video capability, but on high volume, standard, mass production lines, so they will be available easily,” says Jepsen, founder of Pixel Qi (pronounced Pixel Chee), a San Bruno, California-based startup. The company plans to have samples of its display out within the next two months, “and we are pulling all-nighters now to get the product ready.”
Jepsen was the chief technical officer and first employee of the One Laptop per Child’s XO computer, and she was charged with making the cheap computer technically feasible. A low-power LCD was the cornerstone of that effort. Now, Jepsen wants to take her OLPC experience — and her 48 display-related patents — to market with a for-profit company.
Pixel Qi’s displays called 3Qi will operate in three settings: a full-color, bright, conventional LCD mode; a very low-power, sunlight-readable, reflective e-paper mode; and a low-power, basic color transflective mode. The screens are initially expected to be available in 10.5-inch and 7.5-inch screen sizes. -------
Imagine this screen technology combined with a low powered netbook where the screen could swivel around to create a tablet/ebook reader. It could be the convergence device we've been waiting for.
Eventually they will be like ball point pens ($15 when I saw my first one in about 1942) or transistor radios...
Where does the carbon dioxide come from"
Chris Reaka wrote: "CO2 is a pollutant, if you don't believe me you can look it up for yourself, and another fact is that most of the increase is anthropogenic." If you take the long-term view, carbon dioxide was one of the original atmospheric gases and oxygen is the pollutant—dumped into he environment by rapacious life forms with devastating effect on most existing species.
Roy Spencer has looked at the relationship between changes in atmospheric CO2 and ocean temperatures (which do oscillate) since 1958 and finds that the data can be explained if 90% of the increased CO2 observed at Mauna Loa comes from the oceans and 10% from other sources, including human activity:
It's only another model, but it accounts for 50% of the observed variability and fits the data. That's more than some of the other models floating around can do.
Subj: Economics textbooks: is GM too big to fail? 8-)
May 13, 2009
I worked for about a year at a health insurance company which provided health insurance for individuals and small businesses. The entire purpose of everyone I ever met at that company was claims processing. Basically this meant taking a claim from a doctors' office, looking at it and, depending on who the doctor/hospital/clinic etc. was, deciding how much the company would pay out for what treatment, everything from a box of tissues to brain surgery, based on a contract signed months or years before. Most of this was automated, but when the automation broke down there was a huge group of employees who entered these claims into the system by hand while the IT staff got things back up and running. Bypassing the automation often also bypassed the repricing of these charges from what the doctor charged to what the doctor and insurance company had worked out up front. While most claims were small, ( < $1000) some would be multimillion dollar claims for hospital stays, surgeries, cancer treatment, etc. Missing one reprice on one of these claims could result in the insurance company paying out hundreds of thousands of dollars more than they were legally (or otherwise) required to. This would then of course be passed on as higher premiums to the consumers.
My point in all of this is that there must have been at least 100 employees devoted solely to the purpose of dealing with repricing claims from one price to another based on deals made with the doctors. I was happy to take the paycheck, but how much more efficient would it be if this wasn't an issue?
This is where Japan comes into play. Everyone in Japan is legally required to have some sort of health insurance coverage. That can come from your employer, a self paid plan, or a plan through the government, but you have to have insurance of some sort. Fair enough, that's what everyone seems to be clambering for here in the US, so I see no problem with making it a requirement. I have to have car insurance if I want to drive and I have to have home insurance if I want a mortgage. Having health insurance if I want to use the health care system seems reasonable. But here's the kicker in Japan. Every few years a panel comes together with representatives from the medical community, the insurance companies, and the government health organizations. Based on input from doctors on what things cost and the insurance companies on how much they're willing to pay the panel comes up with prices for everything. And by everything I mean everything from a band-aid to prosthetic limbs to open heart surgery. All of the prices are set up front, in advance and they stay that way for a few years until the next panel comes together.
One of the big (and often looked over) issues here in the US is those contracts. Most people are aware of in and out of network doctors, but they don't really understand what it means. If you have insurance you may pay $50 for a doctors visit (between your copay/deductible and the insurance company's coverage). If you don't have insurance, you haven't had high priced lawyers to make those contracts, so you may pay $300. This becomes worse with things like CAT scans and MRIs. After the initial (admittedly substantial cost) of the machine, running an MRI basically costs the hospital the cost of paying a tech and the electricity. Based on your contract status you may pay anywhere from $500 to $5000 for the exact same test.
Japan does away with this issue, while maintaining free market influences. Everyone pays the same price in the end, one guaranteed to be fair to the medical professionals providing the service, but you still have some decision as to how much coverage you want, who you want to go with, etc. You can determine copays, deductibles, etc and pick your own insurance company, but there's huge amounts of overhead that's removed from the system. Likewise, advertising for treatments doesn't have quite as much punch if your drugs prices are pegged for years at a time.
It's not a perfect system, but it seems a lot more logical than what we have here, and it does away with a large amount of the overhead inherent in gaming our system.
I know little about the Japanese system or how well it works. I do know that liberty and equality are enemies. They can coexist and agree on many things but fundamentally free people are not equal, and equal people are not free; and absent a fairy godmother with infinite resources that will always be true. I am not sure how one requires paupers to have insurance? And how one deals with the pauper whose child needs a liver transplant. Of course hard cases make bad law. They are also what drives political decisions.
The next is more typical of the mail I get on this.
We appear to be rapidly losing sight of what has made our Country Great and been a magnet attracting people from all parts of the World. Of course, if we continue on the path that the current Administration in Washington seems determined to take us, there will, most likely be one benefit. We will no longer be a magnet for people in other countries and our illegal immigration problems will be solved.
The thing that has made our Country Great has been the opportunity for everyone to rise to the highest level that his abilities and industriousness allow. True, there have been ignoble periods in our history where this has been denied to some through discrimination, but the concept has prevailed and steps have been taken to reduce and ultimately eliminate discrimination.
There is an unfortunate trend in our society to confuse Rights with Privileges. As an example take the holding of a Driver's License. This is not a Right, but a Privilege to be granted when certain prerequisites have been met. This is also true of a License to practice Law or Medicine. In the case of one who wishes to eat Lobster, there are also prerequisites, the availability of Lobsters and the ability to pay for them. If the Government were to Legislate that everyone should be granted a Right to eat Lobster several problems should be immediately apparent. There needs to be sufficient incentive to Lobster men to attempt to meet the demand and there needs to be enough Lobster to meet the demand. While the Government has the power to provide the former, it does not have the power, given present Lobster culture technology to provide the latter.
The same problems are associated with any good or service that the Government may choose to Legislate as a Right rather than a Privilege. No matter how much we may wish it to be otherwise, there is, given current technology, no way to provide everything to everybody.
Our system has provided bounty beyond belief to every resident of our Country. Do not forget that all boats in the harbor are lifted by the tide.
The standards of health care currently enjoyed by those at the lowest economic levels were not available to anyone less than 100 years ago. Are there problems with our current health care system? Certainly, but many of these problems have been caused by the unintended consequences of Government action. Most prominent among them is the deductibility of Health Insurance Premiums for Companies, but not for individuals.
If we are concerned about the problems of the poor among us or the status of our local educational institutions where should we look for answers? We seem to be choosing to look to Washington to solve these and other problems when the real solutions will be found locally. There was a time when almost all men's long sleeve shirts were available in sleeve lengths in one inch increments. It took some effort for chain stores to ensure that all sleeve lengths were in stock in all stores, so the chains asked the manufacturers to reduce the number of choices. Lo and behold we found 34-35 et al as sleeve lengths. There was also a time when men's socks were sold in 1 size increments. No longer is this so in the interest of less effort to keep all sizes in stock. Once men's bath robes were available in a variety of sizes. Now we have "one size fits all." Of course the reality is that one size fits none. The same is true of solutions promulgated in Washington. There in lies the root of our current problems not the solution.
You write: "If the private health care outfits can cut cost, what took them so long?"
Well, the problem is that there's too much money floating around the health-care industry. People don't think rationally about it. It's the same kind of jealousy-driven class warfare that the Democrats so often espouse and exploit. People don't look at health-care executives and doctors and think "that person is involved in a multi-trillion-dollar industry and taking the tiniest part of the profit"; they think "that rich bastard has more money than me, why does he get to have so much money, someone should take all his money away and give it to me!"
The big issue that nobody wants to talk about is that the only way to cut health-care costs is to deny service. For example, people over age eighty would be considered far less worthy of receiving thousands of dollars in radiation-based cancer treatments. They've had their time, they've made their contributions, they're far less likely to do anything useful even if we give them another ten or twenty years. Just hand them a big bottle of morphine pills and an estate planner's business card; MUCH cheaper that way.
Nobody wants to talk about that. (And, just for the record, I'm not suggesting that we SHOULD act that way.) But a quick statistical analysis shows that 95% of health-care money is spent on maybe 10% of the population. Wouldn't a rational, pragmatic, intellectual policymaker conclude that the maximal benefit to society would involve some degree of denial of care?
Look for rhetoric, in the coming years, about "wasteful excess procedures" and "needless complexity" and "just how many CAT scanners does a country NEED" and "experimental, unproven, unreliable". Preparing the ground for telling people that their lives aren't worth saving because it's just too darn expensive--but that this is okay, because letting people die from disease is laudable when it's the government doing it for the good of all society, but reprehensible when it's a private concern doing it for the good of the rest of their customers.
-- Mike T. Powers
As I understand it, 80% of health care services go to people in their last year of life. Of course that includes emergency services and such like, but it is still true that much of the cost goes to prolonging life of the elderly. We will always have this dilemma: should we put the resources into keeping a 90 year old Nobel Prize winner going for another year at most, or in taking care of a 16 year old IQ 90 diabetic? Of course that was put as an extreme choice; more usual is the choice of a liver transplant: to whom shall it go?
These are choices that no one wants to make. (Actually, there are those who do like making such choices. They often get the job because no one wants it. Another of the consequences of the Iron Law of bureaucracy.)
How shall we make such decisions? One, of course, is to leave it to individuals. Those who made no preparations have not equal rights as those who did. This is of course hard on the unprepared. That's what charities are for. Of course those are not infallible. There are the deserving poor and Alfred Doolittle.
The letter you posted today illustrates the stupidity of many Americans when it concerns health care. We have the best system in the world. Where else could you have received the care you received in the last year without a long wait while some uncivil non-servant parasite decided if you really needed the treatment. Where else in the world could you have received such prompt treatment?
These idiots want "free" medical care. There ain't no such thing as a free lunch. One way or another, you will pay with higher taxes, slower medical care, rationed care, and/or poorer care. What is needed is to control the cost and the federal government is the worst possible agency to tackle that task.
I agree that the cost of shyster insurance has to be the thing that has to be tackled but there is little hope of improvement there since almost all elected officials are also shysters. The second major cost of coverage is the number of employees necessary to process the extremely large amount of paperwork required by Medicare. The third is the extremely high cost of supporting the uncivil non-servant parasites running medicare. Not much hope there either since "Civil Service" employees are the ones really running the country.
You put it more strongly than I would but the basic truth is that someone must pay. See View.
The Egregious Frum: Reading out of party considered harmful
"David Frum: Look, Dick Cheney is a great man and one of the most effective and knowledgeable people in the Bush administration and all of Washington. The country owes him a great deal. But this kind of dispute reminds me of those t-shirts you sometimes see at boot camps and things like that… the beatings will continue until morale improves. The firings from the Republican Party will continue until the party gets bigger. I don’t think what we need is a fight between Dick Cheney and Colin Powell. A Republican Party that’s not big enough to include Colin Powell – well that’s not a very big party… "
If only he had thought of that years ago, when the reading out of party members started. First they came for the realists, and then the paleocons, and then the libertarians...
"Frum: Well look, we’ve got a breakdown here in some of the conventions and etiquette of one administration to another."
It turns out that etiquette and protocol are actually functional, and should not be thrown aside in favor of convenient clubs to bash in your ideological opponent's head. Who could have guessed?
--Catfish N. Cod
The purpose of movements is to teach. The purpose of political parties is to win elections. From pretty well destroyed Frank Meyer's fusionism for the benefit of the neocons. The neocons once in control made common cause with the Country Club Republicans to ignore the fiscal conservatives and bring about Big Government -- which is of course pretty consistent with the Trotskyite origins of many of the neocons. It was predictable and predicted.
The failure of conservatives to hang on and teach had vast consequences. Some of us tried. I apologize for note being more effective.
Escape From Hell, Lucifer's Anvil
I just wanted to say I really enjoyed Escape From Hell, especially how you guys took it in what I interpreted as a more poetic direction when compared to the original.
I'm hesitant to ask, since it doesn't seem polite to ask an author for elaboration, and I apologize if you are offended and don't answer if you don't feel comfortable with it, but I was a little unclear on how the suicide bombers were able to operate in Hell apparently without permission from Hell's bureaucracy. Was it sanctioned by God?
I am also ridiculously excited that you guys are doing a pseudo-sequel to Lucifer's Hammer, which is my favorite book of all time, I re-read it every couple years. I'll be buying the new book day one. It's going to be a difficult wait.
Thank you for all the wonderful stories, Jerry.
I hope you continue to feel better.
Carpenter has concluded that God's Will prevails in Hell. He also concluded that he (Carpenter) would never have perfect understanding of how that works.
Thanks for the kind words.
CO2 As Fertilizer
You didn't say this exactly, perhaps because it is so plonkingly obvious, but CO2 isn't merely a fertilizer. It is essential to the life of every green plant, as essential as water.
I once heard a caller to a radio show assert, with invincible ignorance, that the CO2 in tailpipe emissions is toxic, unlike "natural" CO2.
As a chronic depressive, I am prone to despair, but as you say, despair is a sin.
What happens when it gets too low? I recall a SF story by your esteemed late compatriot Dr Asimov which suggest in an atmosphere without CO2 you would forget to breathe? Dr. Asimov was good at being true to science in his novels, so I wonder if this was Science Fact?
I seem to recall that it is fact. Indeed I am pretty sure I used to know a good bit about that when I was in human factors in aerospace. I probably have the numbers in the Human Factors Handbook or the Flight Suregon's Manual. All that was in the 1960's and I'd have to look it up to have any confidence in an answer, though.
Charles Murray: On Being a Killjoy.
---- Roland Dobbins
Like Murray I rejoice when true, but am skeptical.
Cory Doctorow: “I really feel like my problem isn’t piracy. It’s obscurity.”
A bit of unintentional honesty, perhaps.
--- Roland Dobbins
The article also quotes the current president of SFWA. The copyright problems remains.
The new, improved Mother of Parliaments.
---- Roland Dobbins
Hello again Dr. Pournelle,
Subject: What is Conservatism.
In a recent View, you gave a short history of the conservative movement in the US that I found interesting, moreso since I've been lately having a discussion with a very good friend of mine who is an evangelical theologian. Back in the mid 1980's, he introduced me to conservatism through the National Review. The movement was a natural fit for me, a recent enlistee in the Army, vocal opponent of gun control laws, drug addicts, drunk driving, and excessive taxation, and a recent convert to evangelicalism from the rather bland strain of United Methodism in which I was raised. I was a perfect fit for the big tent conservatism that you describe under Ronald Reagan. When I asked my friend what opinion conservatives had of judeo christian tradition, he gave me a quote attributed to Buckley, something to the effect of "well, what did you think it was that we're trying to conserve?"
Fast Forward 25 years:
My friend and I are both of the opinion that recent history shows disastrous results when evangelical christianity strives for political power, and he has adopted a political position that emphasizes the social works commanded by the gospel message, and has come to believe that conservatism largely does not support such values anyway. I have argued that lower taxes and less government interference give greater room for churches and individuals to render assistance to the less fortunate.
This does raise some rather thorny questions: If the Buckley quote about judeo-christian tradition is accurate- "what did you think it was that we're trying to conserve" - am I left to believe that the conservative movement wants evangelical christians for their zeal and loyalty, but would rather not discuss the gospel message? Can the GOP afford to alienate the folks who were largely responsible for its electoral success? Though it has a long way to go before it matches the animosity shown by the Left, various commentators on the Right are beginning to display a troubling level of disdain for evangelicals.
I may be in a minority of evangelicals inasmuch as I have no interest whatsoever in dictating to anyone else how to live their life. However, I will not give up my rights guaranteed by the Free Exercise clause of the First Amendment, and believe this strongly enough that if necessary, I will exercise my Second Amendment rights in order to secure the First. I will also gleefully ridicule the humanistic faith of those people who choose to ridicule my religious faith.
Am I about to be "read out" of the conservative movement?
Thanks again for all you do, and best wishes for your continued recovery. Christian Johnny had Lysander to whom he could pledge allegiance. I find no one on this earth to whom I could, in clear conscience, bend my knee. (except maybe you) ;-)
The original Constitution allows the States to have Established Churches. The Federal Government was forbidden to interfere with an established religion: whether to establish a national church or to disestablish the state churches in Virginia, Massachusetts, and elsewhere. Note that the Protestant Episcopal Church -- the US version of the Church of England -- was established in Virginia, and the Puritans held New England. The states on their 0wn initiative disestablished the state churches before the Civil War; but their basic attitudes prevailed. (And yes, antidisestablishmentarianism referred to a real set of beliefs. Given the consequences of disestablishment and the fresh new 'rights' that the courts have found in the establishment clause, I suspect disestablishment was a bad idea, and I rather wish that at least one State had an established church just to shut the courts down).
The conflict with evangelicals comes when they want to impose their views on others not by conversion but by law. Most evangelicals I know mostly want to be left alone, and would be rather satisfied if the courts didn't keep finding new rights. As for example on gay marriage: when a state legislature adopts gay marriage one may call that bad -- even evil -- law, but law it is, and the state has the power to do it. When a court finds the 'right' of gay marriage in the establishment clause that is simply ideological usurpation of power.
Many of our national problems would not exist if the courts stayed to their proper spheres. Abortion is a state matter (Congress has authority in DC and overseas military bases). It's a matter for the States, not for the courts or Congress and had it been left to that we would not have one of the conflicts that tear both movements and country apart. Frank Meyer's fusionist movement was a delicate thing, and in Philadelphia Society meetings I tended to act as a mouthpiece for Russell Kirk who had much better manners than I do and thus didn't like to interrupt; but both Kirk and I understood what Meyer was trying to do. Movements are to teach, but they sometimes require compromises (usually known as agreements to disagree).
The figure Cochran cited is probably pretty accurate, actually. You are assuming that there is a rational connection between the price of malpractice /insurance/ and the amounts paid out by the insurers. Unfortunately, that's not generally the case. Where there IS a significant correlation is in the performance of the insurance companies' investment portfolio. That relationship is inverse.
There is a lot of talk about "defensive medicine" -- unnecessary tests performed out of the doctor's fear of a malpractice suit -- but very little about the "defensive medicine" that is required by health insurers before authorizing procedures. When the insurer requires that and MRI or CAT scan be on file before they will authorize a surgery (even though imaging is a poor indicator) that is another unnecessary cost to the system.
It is easy, and popular, to blame the woes of the system on trial lawyers, but the actual numbers just don't bear that out. As to your pediatrician, he was a victim of what has become a a policy among malpractice insurers--to drive out the occasional surgeons. Hospitals have joined in that effort. The reasoning is that a surgeon who does surgery every day is less likely to have adverse outcomes than a doctor who only does surgery occasionally. It's why you almost never see a General Practitioner in a surgical suite these days, even though it used to be fairly common.
2% figure for malpractice costs
The 2% figure cited by Gregory Cochran is from a footnote in the document he linked to (the document was prepared by the Congressional Budget Office -- CBO). The text of footnote 3 reads:
(3) The 2 percent figure is a CBO calculation based on data from Tillinghast-Towers Perrin (an actuarial and management consulting firm) and the Office of the Actuary at the Centers for Medicare and Medicaid Services.
So, in order to evaluate the 2 percent figure, one would have to find the actual calculations and source data. I'm looking.
The document is dated January 8, 2004, and is based on 2003 data. I've seen claims that malpractice premiums have risen in the past five years, and other claims that they have gone down. Need to find some hard data.
The CBO document rather airily dismisses indirect cost drivers related to "defensive medicine" (excessive procedures ordered by doctors to avoid malpractice suits), saying without even a footnote that "However, evidence for those other effects is weak or inconclusive." I would like to see the data behind that statement as well.
I have no dog in this hunt. I'd be astonished if the legal system added that low a cost to the system, but I'm glad to hear it if it's true.
You ask (rhetorically, I know): "So which industrialized country has the system we ought to emulate?"
The founders of the British NHS were fond of saying that it would become "the envy of the world".
They continued saying this until perhaps fifteen years ago.
Those of us who actually have to use the system (tellingly, most politicians have private health insurance), are in no doubt that it is not the envy of anyone, anywhere; it is in fact, by far the worst healthcare system in use in the First World. But it has become a sacred cow, and nobody dares make any real changes.
Don't go there, Americans!
Subject: Health Care
Here's a conservative analysis of the European experience: <http://www.heritage.org/research/healthcare/hl711.cfm > . Based on personal experience, the NHS in Britain is not a good model. It provides basic health care, but it's poorly managed, there's a post-code lottery, and services are capped at a level lower than what most middle-class Americans would expect.
Harry Erwin PhD
-- If we knew what it was we were doing, it would not be called research, would it? (Albert Einstein)
Subject: free medical care
Dear Dr. Pournelle,
I do know of one country where free medical care works quite well. The United States could never succeed in emulating or imitating it for reasons shown below.
The country is Saudi Arabia. I received free treatment for nasty allergies, free dental care, and a free necessary operation during contract service there. All citizens of Saudi Arabia and legal visitors are entitled to free health care, but read on.
Quality of health care and health facilities is governed by status of the person. This is decided by a number of factors Royal family gets the best. Saudi Arabian citizens and those visitors with European status come next. Third country nationals rank last. Muslims get an automatic priority. Women share the status of their husbands. Unaccompanied women are generally treated as third country nationals, or worse. The King can alter any person's status at will. So can the Saudi Arabian sponsor of any contract labor. All legal visitors carry an Igama, a Saudi Arabian ID document similar in appearance to a passport. No Igama means no medical care, and instant arrest. Muslims carry white igamas, everyone else carries green.
In my case, I was a European status, college degree, Christian, working for a US firm on a contract to support the Royal Saudi Air Force. We were sponsored by a Saudi Arabian firm that monitored all interaction with Saudi Arabians. For medical or dental problems, I would contact the camp doctor, a contract MD, who would treat me or route me to a local clinic or national hospital as appropriate. I was asked to show my igama every time, and always received prompt, courteous, and able assistance, My one operation rated a private room and bath, with as many as three nurses on constant call. As promised, a sponsor representative checked with me to make sure I was being treated properly.
This status business is at the discretion of the King or his designated representative, such as my sponsor. I know of three men elevated from third country to European status for good education and exceptional skills. Also, Benazir Bhutto visited without needing her husband as an escort because she was a guest of Prince Abdullah.
It is easy to see why the USA will never adopt this system. Class distinctions, differences ue to religion and national origin, arbitrary assignment at the whim of the government, sexual discrimination, and other items that stir discontent in the USA. But it does work, and work well in Saudi Arabia.
As you say, it's not likely that the US can afford this...
Hi Jerry, If you want to look at the best healthcare systems in the world, look to Sweden or France. There your chances for survival are the best even with complicated diseases, and waiting for service is almost non existing.
From family experience I know how the treatment similar to yours work in Denmark:
Time from diagnostic to first radiation treatment: 20 days. Treatment given 30 days, weekends off. The machines where similar to what you experienced: Very modern (although radiation treatment in itself has some positively medieval aspects). The healthcare system do have an X-Knife system, which is an alternative way to radiate, but still not proven better. But the doctors were still training with it. No particle beam treatment yet in Denmark (the machines cost 150+ million USD). They are only found in Germany and Japan.
Price for treatment: None. Everybody living (legally) in Denmark is covered. No insurance necessary. Paid by taxes.
What we did see, was that the follow up appointments with the doctors, meant waiting half a day in the hospital waiting room. A lot of patients, but the doctors were very professional, and took the necessary time to talk.
I can understand the point of view that healthcare ought not to be a federal issue. It's not the most cost-effective decision, but it does leave room for systems of a workable size, and for different local preferences. But how do you prevent, sick people to move to states which give better care? And what about older people moving to states with free healthcare late in their lives? They pay low taxes in no-healthcare states while young and healthy, and move to high service states late in life, to enjoy what has been paid by the taxes of others?
Of course one wants some migration among the states. The traditional control on such matters was restricting benefits to residents, and having a one year physical residency requirement to be a legal resident. The courts threw those out as somehow unconstitutional, although they had been in place for 80 years or so at the time. Fresh new rights.
I am glad that Denmark and France can afford such plans. Why do they work better than Britain's? But in the US at the moment we can't afford the government we already have. Is a depression the right time to greatly expand government? At least we have -- assuming that all works as well as you say -- a goal.
I do not believe that the present system of earmarks -- more in number now than in previous years, and hugely more in dollars -- is likely to create a national health care system that works; but perhaps I am wrong. In any event the experiment is likely to be tried.
The anti-military attitudes on college campuses and the resulting cultural gap between the US military and the society it serves has long been one of my concerns. This article indicates that, at long last, the tide may be turning.
Of course most of the land grant universities were founded specifically to provide education for future officers of the state militia and possibly the national army. Many of those have now denounced ROTC on their campuses. O tempore o mores...
The split in the conservative movement used to be called Wall Street vs. Main Street, or Freedom vs. Virtue, or Rockefeller Republicans vs. Goldwater Republicans. To some conservatives it came down whether Lincoln was a hero and the greatest Republican President, or not a real conservative because of his expansion of federal power. Perhaps winning elections will come down to proving that national prosperity and security depends upon scientific and technological innovation and advancement, and that limited government, free market capitalism, and good government (reform and law and order) are the best ways to achieve those goals. The GOP will win in 2012 if there is 10% inflation, or 10% unemployment or 0% GDP growth, or some mix of bad numbers on the economy, or if Al Qaeda in America sets off car bombs or IEDs in our country.
From Darryl Miyahira, Honolulu, Hawaii.
At the end of Carter's 4 years the misery index -- inflation plus unemployment -- was about 20%. Given the massive deficits and decreasing employment, it's hard to see how it will be lower in 2012. Estimates of inflation vary, but given the continuing deficits it is sure to rise -- the worry is not to keep it from rising at all, but to keep it from going catastrophic. Inflation is a tax on savings and those living on fixed incomes. It is a very effective task on those who scrimped and saved, sometimes amounting to confiscation.
Did I hear Angels Falling?
We can very much hope that the ice is not coming back. It's harder to live under ice than with hotter weather.
Cap-and-trade' 'deadly' to elected officials? - Arctic no warming since 1958! - 'Psychosocial' effect on health!
Get the latest climate news and entertainment at www.ClimateDepot.com
'Is Cap-and-Trade Deadly to Elected Officials?...Dems are getting scared of being too close to the Waxman-Markey bill'
Danish Meteorological Institute records show: No Arctic Warming Since 1958! - 'Arctic was warmer in the 1940s than now'
'Charge your iPod, kill a polar bear?...Environmental alarms raised over consumer electronics'
Did the Obama administration put a knife in cap-and-trade intentionally?
Claim: Global warming biggest public health threat of 21st century -- 'eclipsing infectious diseases, water shortages and poverty!'
Doctors fear climate change will have a 'psychosocial' effect on health!
Arctic Comedy: Global warming trek 'makes it less than half way' to North Pole due to temps dropping below -40C!
Green Groups to Bail on Climate Bill?! 'We are extremely troubled...by compromises' - declare Greenpeace, Friends of the Earth, and Public Citizen
Is Obama's climate-change plan getting sabotaged from within?
US forecaster may cut Atlantic hurricane outlook 'because sea temperatures are cooling'
Climatologist: 'Solutions being offered don't provide any detectable relief from this so-called catastrophe'
Not so sustainable: Eco-friendly election posters 'split and disintegrate'
WSJ: Even With a Climate-Change Deal, Some Democrats Uncommitted
Rep. Barton: 'We are not prepared to accept unilateral economic disarmament of the U.S. economy'
GOP Mocks: 'Quick, Pass Cap-and-Trade! --Before a suspicious public takes notice'
Democrats waver on greenhouse gas emissions bill: 'I'm still not prepared to vote for a bill'
Marc Morano ClimateDepot.com
I believe Morano used to be a Congressional (Republican) staffer. This is the first I have seen from this organization. I find the site too busy and a bit hard to get information from, but there are headlines and leads.
Gee, climate scientists must be upset (Ocean Circulation Doesn't Work As Expected)
Color me surprised, it turns out the model doesn't match the actual data! In this study, the ocean currents defy the computer model: <http://www.physorg.com/news161439846.html> . So, how long before the climate-change barnstormers decide that humans have already changed the ocean circulation and action must be taken right away with no questions asked?
Cynical in Cleveland, Jim L.
The important news is that actual research has falsified a long accepted model. We don't yet have a replacement for the theories that went into constructing the model. As Helmholtz noted, the more practical thing in the world is a good theory. We could use some in climate modeling.
The problem is that politics trumps science now; there are just too many people whose entire life's work as well as income are at stake here.
CBO is supposedly nonpartisan; and in 2004, if anyone controlled them, it was the Republicans. It was headed by Holtz-Eakins, one of Bush's economic advisers and later McCain's chief economic adviser. Admittedly, he's a liar.
\ The idea that tort lawyers have played a significant role in medical inflation is not correct. You might as well look for all the supply-side reasons that caused eggs to go for a dollar each in San Francisco in 1849. It's a demand thing, other people's money.
Here are current (2007) average malpractice premiums for US, by specialty. Family practice, 12,500. GPs, 7,500 Internists, 12,500. Ob/gyns, 55,000 Pediatricians, 12,500 All primary care: 17,500 . There are about 750,000 MDs in the country : a ballpark number for total malpractice premium costs is going to be (0.75 x 10 e 6) x (~2 e 4) = 15 billion. But that might be low - maybe specialists pay a lot more. Since total premiums were about 10 billion in 2000, let's say that they're paying 20 billion total now - that's reasonable, since nothing I've seen suggests that rates have doubled over that period. We're on the same page. . Total health care costs for the US passed 2 trillion (2 e 12) in 2006. Malpractice premiums account for about 1% of total healthcare costs. . Here's the breakdown:
As for defensive medicine, the only part I object to is the part that has low payoff. I don't think anyone has been able to come with a decent estimate of those costs. As for the idea that any argument can be won by citing some unmeasurable factor - well, I'm not from Missouri, but I grew up near there.
Well, of course it's a demand thing. The demand for a free good is infinite. As to CBO and nonpartisan government agencies, my experience has been mixed, and most of the permanent CBO staff has been there a long time. But if malpractice costs are not a major contributor to the high costs of health care, and tort reform is not so high on the priorities as I had thought, that's a good thing and one less thing to worry about. I mentioned it largely because the lecture I heard from Lester Thurow on health care systems devoted considerable time to the subject; his father in law is a physician. This was several years ago, but he emphasized that malpractice insurance premiums had skyrocketed.
I am not as interested in winning arguments as I used to be. I have found that one way to find out something is to assert it here: someone who knows more may come up with data I don't have.
Hubble has photographed the Mote in God's Eye.
"[I]n tribute to Hubble's longest-running optical camera, a planetary nebula has been imaged as the camera's final 'pretty picture.'
"Known as Kohoutek 4-55 . . . [t]he entire system is . . . surrounded by a faint red halo that looks like an eye in the sky."
Live long and prosper h lynn keith
May 15, 2009
I asked Anderson about Danish health care
Hi Jerry, good questions. Designing a healthcare system which is both good quality, efficient with resources and socially just, is evidently quite difficult, and copying (successful) systems from other countries with different traditions and culture is not a guarantee for success in the USA.
1 year is far too little to make a system based on single states workable. The US has much fewer barriers for moving from one state to another than Europe. Legally it is as easy to move from one member country in the EU to another, as it is to move from State to State in the USA. But administratively, culturally and language vice it is much, much harder. By the way, the restriction in benefits for new movers in Denmark, is 3 months for healthcare and 40 years! for pension.
The systems in Europe are much more different from one another, than what is understood when the "European socialized health system" is mentioned in the US debate.
France dedicates much more money to healthcare than both Denmark and Britain. I also suspect that their civil service ethics are much different from Britain's - but I really don't know.
Denmark and Britain spends comparable sums (in % of GNP) on health care. So why is the Danish system better?
Denmark has one system where everybody gets treated. Everybody from the Queen, to the local alcoholic on the bench get treated by the same system. No insurance, no papers, everything paid by taxes which comes from the general national budget (no special "health" tax). Yes, there are a small private system, mostly for elective procedures, where getting free service from the public system is either slow or impossible. Dental care is private, which has resulted in Danish teeth being much worse than in the other Scandinavian countries, where Dental care is also public.
That means that there is pressure on the politicians and professionals to have a world class system. If a large part of the middle class turns to private care (as I suspect in Britain), your Iron law prevails. The system gets worse, but not cheaper.... Also Britain (and the NHS), seems fond of modern management, where a special management class lords over the professionals, with tons of measurements and micro management. A similar system has just been implemented for the Danish police as part of the "Police Reform", which has increased cost (and the number of police officers), but decreased service. The standard answer when you call the Danish police is now: "Deal with it yourself - we are busy". If you build a system without requiring common sense and good judgment from all participants, no measure of management can fix it.
I wish the US the best of luck with designing a new healthcare system. The current US system is by most measures a failure, but I am not sure Obamacare will be better. We will watch with interest.
Bo Andersen, Denmark.
So, I suspect, will we.
No one I know wishes ill health and misery on others, and everyone I know wishes there were a magic formula for providing free health care to everyone while keeping physicians happy and giving the incentives to the best and the brightest and most honest and trustworthy to enter the health profession. I do not know how to do this.
Dear Dr Pournelle,
The French health care system is an interesting combination of public and private systems. Medical care is provided general practitioners and nurses backed up by a combination of public and private hospitals and clinics; these operate as quasi-independent financial entities whose services are paid for by their patients.
A compulsory public medical insurance system covers between 40% and 60% of medical costs; this cover may go up to 100% for young children or for diseases requiring prolonged treatment. The patient is responsible for the remainder of the costs, either directly or through a complementary private insurance; however, the premiums for a complementary insurance are relatively low because the state system carries the worst risks.
The advantages of this system are that it combines universal coverage with a large amount of freedom of choice for the patient. In addition, the patient's financial involvement helps to restrict the time spent on trivial complaints, keeping some measure of control on overall costs.
Peter D Morgan
Health Care - comparisons
The Canadian health care system is often compared to the US system, particularly when the future of health care in the US is discussed. Problem: when people speak of the Canadian health care system, they often think of it as a monolith. It isn't, and so bad conclusions (one way or the other) might be drawn from the comparison. Health care constitutionally falls within provincial jurisdiction, with reasonably equal health care levels maintained between provinces via the Canada Health Act (http://en.wikipedia.org/wiki/Canada_Health_Act) by the federal government through monetary transfers. The *provinces* determine how care is delivered, and so it is actually a collection of individual provincial systems. The system is provincial in origin: certain individual provinces initially instituted universal medical insurance for "medically necessary procedures" (as determined by each province), and the practice spread. The federal government mainly became involved to provide some level of funding to some provinces that would not necessarily otherwise be able to afford coverage, the federal government did not become involved to administer the system. The point is the system is largely controlled by the provinces, and it's evolution was mainly dictated by the provinces. Also, a problem in one jurisdiction might not exist in the next, and so a story from only one part of the country might not be representative of the true state of the system across the country.
So, for people on either side of the debate in the US, if you're trying to draw lessons from the Canadian experience, make sure it is being applied in the correct context, which would be to a health care system largely controlled by individual states, not by the federal government.
Halifax, Nova Scotia, Canada
Regarding the data on malpractice insurance from Dr. Cochran, note that high outlier -- OB/GYN insurance is something over 4 times the average of the values quoted. So there are some fields where high rates significantly perturb the results -- and availability of service -- within the field.
Note also that it's not clear whether these figures include other factors of insurance which impact medical costs -- e.g. product liability for pharmaceutical companies, hospital liability (which may or may not be classified as malpractice but which does not appear to be counted in the physicians malpractice figures that Dr. Cochran quoted). So the total contribution of insurance to medical costs is probably somewhat higher than the 2% quoted from the 2004 report for malpractice alone, and one would infer it to be on the order of 5%.
Another contributor to increased medical costs with time is the simple aging of the population. A check of the US Census web site (obtained by google of "mean age US population") shows that the population mean age is increasing at about 1 year per decade. That doesn't sound like it should have a significant effect, but because of the increased use of medical resources with age it should have a disproportionate impact on costs. The increased fraction of obese persons (further deponent sayeth not) is also a factor, probably a larger multiplier. (OK, I need to work on that one myself.)
Note that I also grew up near Missouri (about as far from there as you did, all told...)
Idaho once had a health care plan that worked pretty well - much like the walled community parable - perhaps Roberta Pournelle remembers the days when it worked.
Idaho once had a health care plan that worked pretty well - much like the walled community parable - perhaps Roberta Pournelle remembers the days when it worked.
Grossly oversimplifying of course but pretty correct in a nutshell - each county seat had a county hospital - sometimes the county hospital was combined with another organization or an otherwise affiliated hospital was designated. County residents went to the county hospital - Those who could pay did and the County Commission would remit charges to county residents who were never going to pay anyway. Free interchange across county lines with the county of domicile paying. Worked just fine so long so the standard of care at the county hospital covered things. Premature babies born to migrant worker families, among other things, and helicoptered to Salt Lake or Spokane which gave a county of 5,000 total population, man, woman and child, a bill for $5,000,000,000 broke the system.
Nothing meaningful replaced it.
Clark E Myers
Roberta's family moved to Seattle in World War II. Neither of us had known of the County Resident system. I note that it was for residents, and I suspect there were definitions of who was a resident.
It is often said that the US spends more and gets less than other countries. Finding adequate definitions of what we get -- and who "we" are -- is not easy.
We first need a goal with definitions. We secondly need to understand that there are limits: not everyone will get a heart transplant. How do we allocate that resource? At what point does equality cease to be the only criterion? For instance: some people are wealthy enough to treat a cold's symptoms with various medicines, folk remedies, escapist books and TV, and bed rest. Others have to just gut it out. Do we insist on equality? Does everyone get a couple of days off and lots of cold remedies for free?
I lost 40 pounds to hard x-rays. It worked. I don't regain the weight and I look pretty good. I don't recommend the treatment, but it did work. Should that be offered to everyone?
We are almost certainly going to get "health care reform." If it's done by ideology and not data we will not like the results. Some won't like the results whatever we do. The goal here is a system which doesn't outrage anyone, understands that medical education is expensive and the number of bright people willing to go through it without expectation of large rewards is insufficient. We might induce them to join Holy Orders, but we aren't trying that. Exhorting people to go out for a lifetime of Doing Good is traditional, but hasn't been effective for nearly a century.
All these matters need to be considered in designing a "system", but it need to be understood that given open borders any system will be overwhelmed. Any system. No one wants to discuss that.
The comparison of various developed country health systems has already been done in not too bad a fashion by our buddies at PBS.
You can even watch it online--it's worth it.
It boils down to the fact that there is no free lunch. Japan has cheap hospitals--but almost all of the hospitals are near bankruptcy. Germany has cheap costs as well--but the doctors are on strike for low wages. Etc, etc. Suisse and England come off looking pretty well, tho. The US has coverage problems, overspends on the ER for uncovered and the elderly, but has a much higher standard of care and better economic freedom and higher growth rates generally.
There is no free lunch.
The same guy did a more recent doc for Frontline called "Sick around the USA" or something that was of some value as well...but not quite as fair.
Also: read "Best Care Anywhere" and see how the VA and their EMR called VistA should be the heros saving the day. VistA (not the MSFT OS) is open source, and being deployed and marketed by several companies. Congress shoudl mandate it as the interchange format, at minimum.
Check this link as well...the open source community is way on board...and it's a shame hospitals keep falling for the rubbish that Fortune 100 companies put out at zillions of dollars a patient.
Jay R. Larsen
Re: National Health Care
Regarding two of today's letters about national health care, citing the examples of Saudi Arabia and Denmark. While the the potential ill-fit of each of these systems was pointed out, there are a couple of points yet to be mentioned. Regarding the Saudi Arabian system, it is of course paid for by oil exports. The government(/royal family?) pretty well owns the oil and the proceeds from the exports. We have no such windfall. Neither would the Saudi's if those exports alone did not provide such profits.
The letter regarding the system in Denmark clearly stated "Everybody living (legally) in Denmark is covered." (Bold is mine.) While I believe denying coverage to those illegally in the country is proper, I also doubt there is a snowball's chance in hell of that happening right now. As you have pointed out many times, when it's free and anybody in the world can come here to get it...
Of course 'free' means paid for by many of us here in the US (not everybody even pays taxes). I seriously doubt there would be any payment of funds from source nations to the US to cover illegal immigrants, would there?
I am not entirely convinced of the objectivity of PBS as a data source, but this one isn't bad. And we know that the English system has its major critics.
Our problem is simple: no system we establish is immune to being swamped by those who "need" but cannot pay. Think of my analogy of a health care clinic/hospital in a gated community. The demand for a free good is infinite.
Back in form...
I frequently browse the WSOJ page... generally moderate conservative opinions, well written, and informative to the extent that any media outlet is these days. I'd always enjoyed Peggy Noonan's eloquent insight, but for a while now she seemed to have been caught up in the "hope" bandwagon of the new administration... perhaps some wishful thinking, a touch of graciousness overextended maybe... quite well-written, but a tad rose-colored in cautious optimism that the "change" might be refreshing at least.
The main gist of the article is the increasing political penchant for argument by obfuscation. Something the current crop is particularly adept with... all things couched in academ-ese... double-speak a la 1984 in the making.
This part in particular sounded rather familiar from following your discussions here:
"The second great fear is that the balance between those who pay taxes and those who need benefits will be left, after the great flurry, all out of whack. When this balance is deeply disturbed or distorted, when the number of those who need to take truly overwhelms those who need to make, a tipping point occurs. People become disheartened. Generations become resigned. Tiredness steps in. We will miss irrational exuberance."
Worth the quick read, I think.
Regards, J. Scott Cardinal
The demand for a free good rises without limit.
Here is a recent study by the Massachusetts Medical
Society estimating the cost of defensive medicine in that state:
Some have advocated capping compensation in malpractice suits to reduce the cost of malpractice insurance. The trouble with that is that when a physician or hospital makes a serious mistake, the result can incapacitate a patient for the rest of his life. Some arbitrary upper limit on compensation could result in such a patient receiving an unjustly low compensation if they are young and will be unable to work for the remainder of their lives as a result of a "therapeutic misadventure".
A much better alternative would be a loser pays system like most of the rest of the world has: http://www.pointoflaw.com/loserpays/overview.php This would disincentivize frivolous lawsuits and the quest for "jackpot justice" that are driving forces in the rising cost of malpractice insurance.
Bob Newbell, M.D. Huntsville, AL
Even "Loser pays SOME" would make things work better...
Minimum limit for CO2
Your correspondent wrote:
"What happens when it gets too low? I recall a SF story by your esteemed late compatriot Dr Asimov which suggest in an atmosphere without CO2 you would forget to breathe? Dr. Asimov was good at being true to science in his novels, so I wonder if this was Science Fact?"
The number I am finding is 55mm/Hg arterial partial pressure of CO2 is essential to stimulate the breathing reflex. The number is approximate, and varies by individual. If you don't get it, you pass out. If you're under water or breathing tri-mix when you black out, you don't wake up. It is what sometimes causes death in those who suffer with apnea, many drownings, and might be one cause of crib death.
Besides Asimov, for SF references to this read Arthur C. Clarke stories that include scuba (death of David Bowman's brother, I think), Heinlein's "Have Spacesuit, Will Travel," (among others -- also "Farmer in the Sky," I think), and Niven's story about Svetz and the Roc. All three have/had the background to know about hypocapnia, and included it in their works. Of the four, Asimov's biochemistry background probably gave him the best professional qualifications, and Clarke's avid diving would have made him aware of the facts.
CO2 is good for you. I recommend that anyone who advocates destruction of the economy in order to reduce the CO2 footprint for environmental reasons should first voluntarily reduce their own footprint to 0 for about 10 minutes -- in the same spirit as "Earth Hour." It will provide a wonderful demonstration of green unity and permanently solve the problem from at least one perspective. As you and Niven put it, "Think of it as evolution in action."
Hopefully, cynicism is a lesser sin than despair, or I'm really in for it!
About what I remember. Thanks
A couple of weeks ago, Dennis Prager interviewed Ian Plimer, author of a book titled Heaven and Earth: Global Warming -- The Missing Science.
Among the many points he made in the interview was that the effect of atmospheric CO2 on global temperature tops out at 20 parts per million. At that concentration, I gather the opacity to infrared (in the bands where it is opaque) is close to 100%. Once you're blocking all of a certain band of IR, you're not going to block any more by increasing the concentration. An analogy I heard was that once you're wearing a nice, heavy cap, you're not going to block any more heat loss by putting more insulation on top of your head. If you want substantial change, you'll have to put on a coat.
I understand the book is a bestseller in Australia, and due to be published quite soon in England and America.
'While authors like Cory Doctorow like to argue that the author’s real enemy is obscurity, there was no real uptick in the sales of my book when these pirated versions appeared.'
- Roland Dobbins
May 16, 2009
Coverage of the Madoff scandal made extensive reference to his prominent role in the Jewish community. How has this affected public perception of Jews and the financial crisis?
"Among non-Jewish respondents, a strikingly high 24.6 percent of Americans blamed "the Jews" a moderate amount or more, and 38.4 percent attributed at least some level of blame to the group.
Interestingly, Democrats were especially prone to blaming Jews: while 32 percent of Democrats accorded at least moderate blame, only 18.4 percent of Republicans did so (a statistically significant difference)"
Identifiably Jewish precincts overwhelmingly vote Democrat.
Realistic appreciation of the energy problem
This article by University of Cambridge professor David MacKay has some sobering points regarding switching to both “sustainable” and “green” energy. He does some simplistic math that lumps together several inefficient practical concerns such as distribution losses into an overall average consumption number, but his numbers appear conservative and useful to get the point he is making. Here is a sample…
“As a thought-experiment, let's imagine that technology switches and lifestyle changes manage to halve American energy consumption to 125 kWh per day per person. How big would the solar, wind and nuclear facilities need to be to supply this halved consumption? For simplicity, let's imagine getting one-third of the energy supply from each.
To supply 42 kWh per day per person from solar power requires roughly 80 square meters per person of solar panels.
To deliver 42 kWh per day per person from wind for everyone in the United States would require wind farms with a total area roughly equal to the area of California, a 200-fold increase in United States wind power.
To get 42 kWh per day per person from nuclear power would require 525 one-gigawatt nuclear power stations, a roughly five-fold increase over today's levels.”
Note that he doesn’t even start into the problems of power distribution and load balancing, yet even without those considerations the conclusions illustrate of the scope of the problem.
I am fascinated by the number of nuclear plants required. I seem to be off by an order of magnitude on the requirements (I advocated that instead of invading Iraq we build 100 1000 megawatt nuclear power stations; I figured that 100 of them would cost between 100 and 200 billion dollars, with the first one being fairly expensive and the 100th being well below a billion bucks).
Energy price correlates high negative with economic growth. Low energy costs solve nearly all problems including pollution (given the energy I can take pollutants apart to their constituent elements). See Survival with Style...
Telescopic Photograph Of Shuttle In Flight Silhouetted Agaisnt Sun Buffy Willow
Stunning indeed. Note that the web site is Coast to Coast, the former Al Bell show, now hosted by my long time friend George Noory. George has the ability to host this show: meaning that he can, temporarily, believe in six incredible things before breakfast, three of which contradict the other three.
Information Warfare: China Turns Unix Into A Weapon,
An update on the trials and tribulations of computers in China, and what the government is doing about it:
I must admit, though, that when one reads, "A government survey found that, in 2003, 87.9 percent of Chinese PCs connected to the Internet were infected," one has a certain sense of "turnabout is fair play," since so much of the software used there has been pirated.
Their response? "The most serious aspect of all this is the number of government computers that are using Windows, and are infected. The government has found that switching to Linux is difficult, as there are not enough computer experts to carry this out. Microsoft Windows is much easier to install, and maintain, than Linux."
As you point out, Unix and its children represent full employment for IT workers: "China got around this by subsidizing Linux training for Chinese engineers and computer technicians." As if that will be enough.
A botnet Is captured and studied, and the findings aren't good:
“We have no leverage.”
--- Roland Dobbins
“We’re not a big dealer, no, but we were selling enough to be profitable. But it didn’t matter what you did. You’re just out of luck.”
-- Roland Dobbins
THE FOLLOWING RELEASE WAS RECEIVED FROM THE SETI INSTITUTE IN MOUNTAIN VIEW, CALIFORNIA, AND IS FORWARDED FOR YOUR INFORMATION. (FORWARDING DOES NOT IMPLY ENDORSEMENT BY THE AMERICAN ASTRONOMICAL SOCIETY.) Rick Fienberg, American Astronomical Society: firstname.lastname@example.org, 1-857-891-5649.
May 14, 2009
Contact: Karen Randall SETI Institute email@example.com 1-650-960-4537
EARTH SPEAKS: SCIENTISTS GATHER MESSAGES TO THE COSMOS
Mountain View, CA -- For nearly fifty years, the Search for Extraterrestrial Intelligence (SETI) has used radio telescopes to scan the heavens for signs of alien technology. But scientists still do not agree about whether we should reply to an extraterrestrial signal, and if we do, what we should say. To help answer these questions, on May 15, 2009, Dr. Douglas Vakoch, Director of Interstellar Message Composition at the SETI Institute, will launch Earth Speaks, a research project to collect messages online from people around the world.
“Earth Speaks invites people to ponder the question, ‘What would you say to an extraterrestrial civilization?’” said Thomas Pierson, Chief Executive Officer of the SETI Institute in Mountain View, California. “By submitting text messages, pictures, and sounds from across the globe, people from all walks of life will contribute to a dialogue about what humanity might say to intelligent beings on other worlds.” he explained.
The occasion for the launch is the visit to the SETI Institute by Kamau Hamilton, a sixth-grade student from the Central Harlem Montessori School, whose winning idea for the Kids Science Challenge (kidsciencechallenge.com) inspired the SETI Institute to invite other children to submit their own “Sounds of Earth.” (Hamilton’s sounds include the jangling of bracelets and the squeak of sneakers over a hardwood floor). Kamau will be a special guest at the Institute’s annual open house, Celebrating Science, on May 16th, 2009 from 2-4 pm. The public is welcome.
Now all people can submit their messages to Earth Speaks at http://messages.seti.org, where they also enter labels or “tags” to help researchers categorize the messages. “By studying the tags used by many different people, we can capture the major themes that run through thousands of individual messages,” said Vakoch “That sets the stage for creating interstellar messages that begin to portray the breadth and depth of the human experience.”
“Earth Speaks uses technology of the twenty-first century to understand human aspirations around the globe in ways not possible before,” said Dr. Jill Tarter, Director of SETI Research at the SETI Institute. “This is a potentially a huge resource that can be explored to look for cultural universals.” Questions about message content take on increased importance as the SETI Institute’s Allen Telescope Array (ATA) begins a new phase of research with its galactic plane survey for radio signals from other civilizations. As search technology becomes more powerful, the chances of detecting distant civilizations beyond Earth increase.
The SETI Institute currently has no plans to transmit messages into space. “The question of whether we should send intentional messages to other civilizations is too important to be answered hastily,” said Pierson. “Through Earth Speaks, the SETI Institute also hopes to foster an open and thoughtful debate about the pros and cons of sending messages to other worlds.”
Although radio and televisions signals are leaking from Earth into space continually, such signals are weak in comparison to focused transmissions aimed at specific stars. Thus, any future intentional messages could provide extraterrestrial civilizations with their first direct evidence of life on Earth. “First impressions matter,” said Vakoch. “The initial messages we send to an extraterrestrial civilization could set the tone for a conversation lasting hundreds or thousands of years.”
The SETI Institute
The SETI Institute is a unique team of world class scientists dedicated to understanding the origin and nature of life on Earth and its possible existence throughout the universe. The Institute accomplishes this via:
Research - Fundamental and significant investigations into the workings of life, and how and where it might have arisen.
Exploration - Examining life in its most extreme forms and locations on Earth, exploring our solar system for evidence of microbial life, and searching the cosmos for indications of distant life, especially intelligent life.
Education - Education and Outreach programs inviting students to participate in our search for life in the universe, and sharing the wonder of our science with the public.
The SETI Institute is bringing together some of the best and brightest minds in science today to unlock the mysteries of the cosmos.
Do note that the SETI Institute is not a world spokesman, and in fact doesn't represent the entire US SET community. Still, it's an interesting thought.
[I hope no one finds this shocking. Frank]
In almost all cases, for any definition of success, the single most effective predictor of success among the individuals of nearly any group will be IQ, except in situations in which particular skills dominate (such as sports and music performance). That isn't controversial among those who measure such things. The problem is the implications, since IQ is between 40% to 60% inherited. All this was made pretty clear in The Bell Curve by Murray and Herrnstein, but the implications are so politically incorrect that the book remains nearly forbidden in academia. I was present at a AAAS meeting at which they had a special session to denounce The Bell Curve, led by a professor who chaired the meeting -- and began by announcing that he was proud to say he had not read the book they were about to review. The horror that ran through Big Science because of The Bell Curve has remained, even though the refutations have mostly be denunciations. The data indicate that Murray and Herrnstein were correct in general.
Murray has since attempted to be a bit more politically correct by de-emphasizing many of the implications and conclusions of The Bell Curve. His The Truth About Education is, in my judgment, a fairly vital book on many of the implications of the existence of the "g" factor which IQ imperfectly measures.
Success in intellectual activities requires education; success in education depends greatly on IQ. About 40% of the population is unlikely to profit from "education" in the sense of the 4 year liberal arts education that seems to be the goal for everyone. That means that about 40% of the population don't get a lot from the schools. They could. They could learn how to make a living. There are many skills they could learn that don't require intellectual education. There are also work habits and temperaments that are important to making a living.
We don't much address these matters in discussing school funding.
Middle class slavery
I have read with great interest the debate on health care "reform" on your web site. I have determined, as you apparently have, that health care "reform" is coming and there's not much you or I can do about it. I have also been intrigued by the reviews of various health care systems from around the world. As a seasoned world traveler, I have been subjected to the health care systems in Saudi Arabia, England, France, Italy, and even Japan. I have found nothing that compares in both quality and quantity to the present system in the U.S. That we intend to "adjust" this system to "help the poor" is a matter of some concern for me, but as you say, there is not much we can do but write out Congress-critters and complain bitterly as they take health care and do to it what they have done to education.
My question throughout all of this is where did the idea originate that health care is a right? I understand the idea that access to health care might be argued as a right since it would fall into the "life, liberty, and the pursuit of happiness" ideal that has been so abused by the courts, politicians, and other hucksters throughout our history. But where did the idea originate that I and my children must toil and earn money to pay for those who do not in order to provide them with health care, food, housing, etc? How does their "right" to free stuff trump my right to the free use of the fruits of my labor?
The idea sounds patently close to slavery to me. Am I missing something and why don't others also see it the same way? Is the country really ready to enslave the middle class and businesses to the indigent masses?
Thanks for all you do. I'm really looking forward to Mamelukes.
When I was young, many friends of mine without any resources were greatly helped by Charity Hospital in New Orleans. One was a grad student without insurance who slipped walking up the stairs in her apartment and shattered her orbital bone around the right eye. Painful, debilitating, and unless carefully fixed disfiguring. She was thrilled with the care she got, as far as the doctors and nursing staff was concerned. She was cared for by one of the best reconstructive surgeons in the city, and you cannot tell she was ever injured. Many, if not all of the top doctors volunteered on day a week or every other week Pro Bono, so there was no shortage of talent for the tough cases.
Over all, it was more what you might see from the 30's or 40's. Out of date building with tile walls and linoleum floors rather than drape and carpeting (care to guess why they had a lower than normal infection rate?) She had to share a ward with nine other beds, with one rather busy nurse to take care of all them. It was best to have a friend or relative with you to take care of the inevitable snags and screwups, but you really need to do that in more high end hospitals these day. But bottom line, you got care as good as any in the city. As for payment, the charge insurance if you have it, medicare or medicad to whatever extent they could, then bill you, but go no farther than that if you ignor them and not pay. Some people with pride wanted to pay something, and they get a chance, but they don't hound patients or ruin credit unless checks reveal they really do have money and are looking for a free ride My friend paided nothing for her care.
Charity was one if the finest teaching hospitals in the country. Sadly, it has not reopenned since Katrina, and show no signs of coming back. But I've felt a charity hospital system, with satellite clinics, is a good approach, and it must be callled a "charity" hospital and have very plain building not as comfortabe or as private as private hospitals. They can be teaching as well as charity hospital, and might fill important civil defence rolls if new hospitals are up underground, much as the swiss do. It could be a teaching environment for military medics (Charity Trauma was renouned dealing with gunshot wounds...which was a real problem for the hospital when half the trauma staff was called up for the 1st Gulf War).
Shocking, really, to see such a system in NO that actually worked pretty well for a long tme.
sjv from no
Of course I immediately thought of the silhouettes against the star in The Mote in God’s Eye.
Dear Dr Pournelle,
Several (mostly) unrelated items for you, that I will attempt to link together.
First and foremost, thanks for taking the time to sign some extra copies of Escape from Hell while you were in San Diego. I was out of town, but I was able to purchase a copy in advance which you and Mr. Niven were gracious enough to sign. With any luck, I will get to see you on a signing visit for Mamelukes, whenever that may be.
Don't pay too much attention to those that question you about release dates for Mamelukes and/or anything else you're working on. Somebody just asked Neil Gaiman to comment on George R.R. Martin taking so long to finish HIS book. Neil basically told the person that the creative process cannot be rushed and that authors are not servants of their readers--a sentiment I agree whole-heartedly with. He didn't use those exact words, he put it rather more plainly. You can see his full comments here: http://bit.ly/F73W2 <http://bit.ly/F73W2> .
Which leads to my last item--Twitter. You asked us a few days ago what we thought of it. I found out about Neil's blog report because somebody I follow on Twitter linked to it. That, I think is the real power of Twitter, you use your 140 characters to give a precis, and then you link to the larger item where you can elaborate at length. If you were to start using Twitter, I don't think you would be best served by tweeting 'taking Sable for a walk,' but you might tweet, 'book signing this Saturday for #EscapefromHell' and provide a link to an informational page, or, you could tweet, 'my thoughts on the #bailout plan' and again, provide a link back to your blog page.
Twitter provides a means to drive traffic to your blog page, or anywhere else that you want your followers to visit. Twitter also allows the use of hashtags, so even people that don't follow you can find out about something you are tweeting on.
That's MY take on Twitter, I am sure that others will give various opinions.
with best wishes,
My problem is that I'd be so little likely to tweet that no one would be looking for one...
Forgetting to Breathe
“Shallow water blackout, according to the Naval Safety Center, is caused by oxygen starvation. By hyperventilating before going under water, Scofelia had inadvertently manipulated her brain’s automatic breathing-control device. Hyperventilation, according to the center, washes carbon dioxide out of the lungs. Carbon dioxide signals the brain to breathe. Without the signal, Scofelia never got that bursting feeling in the lungs that sends underwater swimmers to the surface gasping for air.”
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IF YOU SEND MAIL it may be published; if you want it private SAY SO AT THE TOP of the mail. I try to respect confidences, but there is only me, and this is Chaos Manor. If you want a mail address other than the one from which you sent the mail to appear, PUT THAT AT THE END OF THE LETTER as a signature. In general, put the name you want at the end of the letter: if you put no address there none will be posted, but I do want some kind of name, or explicitly to say (name withheld).
Note that if you don't put a name in the bottom of the letter I have to get one from the header. This takes time I don't have, and may end up with a name and address you didn't want on the letter. Do us both a favor: sign your letters to me with the name and address (or no address) as you want them posted. Also, repeat the subject as the first line of the mail. That also saves me time.
I try to answer mail, but mostly I can't get to all of it. I read it all, although not always the instant it comes in. I do have books to write too... I am reminded of H. P. Lovecraft who slowly starved to death while answering fan mail.
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