humani nil a me alienum puto

random rants about news, the law, healthcare law, economics and anything I find amusing

From Reader: Doctors Inc.: With More Doctorates in Health Care, a Fight Over a Title

When is a doctor a doctor? Wouldn’t state licensure laws handl to make sure that he professional would not confuse patients or practice out of scope of practice?

Doctors Inc.: With More Doctorates in Health Care, a Fight Over a Title

http://ads.pheedo.com/img.phdo?s=a2c2a51b6e540774ade53db44d5c8768&p=1 from NYT > Home Page

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Filed under: Personal Posts

From Reader: A Web Tool That Lets You Automate the Internet

Neat tool?

A Web Tool That Lets You Automate the Internet

http://ifttt.com/images/no_image_card.png from Bits

Filed under: Personal Posts

From Reader: A Web Tool That Lets You Automate the Internet

A Web Tool That Lets You Automate the Internet

http://ifttt.com/images/no_image_card.png from Bits

Filed under: Personal Posts

Another Atlantic Article Critical of our Current Health Care System

This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. “The studies were biased,” he says. “Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there.” Researchers headed into their studies wanting certain results—and, lo and behold, they were getting them. We think of the scientific process as being objective, rigorous, and even ruthless in separating out what is true from what we merely wish to be true, but in fact it’s easy to manipulate results, even unintentionally or unconsciously. “At every step in the process, there is room to distort results, a way to make a stronger claim or to select what is going to be concluded,” says Ioannidis. “There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.”

Lies, Damned Lies, and Medical Science – Magazine – The Atlantic
http://www.theatlantic.com/magazine/print/2010/11/lies-damned-lies-and-medical-science/8269

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Potpouri of Links

Standing while you work… Does it improve health?

In the past few years, standing has become the new sitting for 10 percent of AOL employees at the firm’s Dulles campus, part of a standing ovation among accountants, programmers, bureaucrats, telemarketers and other office workers across the nation. GeekDesk, a California company that sells $800 desks raised by electric motors, says sales will triple this year. It has sold standing desks to the Secret Service and the U.S. Geological Survey. Many firms and government agencies require standing setups in new contracts for office furniture.

Should companies that do business with County government agencies/offices provide political donations?

To the file: Our universe is actually just some kid’s kitchen science experiment.

Rose Mary’s Baby and suitcases of cash?

Filed under: Personal Posts

Fictional paragraph of the day

[Spencer Reynolds] hair was curled but cropped short, his skin bronzed by a benevolent sun…, his clothes…were expensively flamboyant without being outre, and his demeanor proclaimed a relaxed confidence that all men dreamed of and precious few obtained. His wit was obvious, his attention to others sincere, and his sense of humor legendary. I found myself disliking the son of a b*** at once. – Dan Simmons, Fall of Hyperion

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Paragraph of the day

The popularity of [Rube Goldberg’s] inventions series closely parallels the rise of electrification in America. In 1925, depending on where you lived, … power was receding into the walls. The world lost a little explicability. People like to complain that they can’t understand modern cars because of all the fancy parts and electronic doo-dads in them now, but we lost that ability for most things long ago. I think Goldberg’s drawings reminded his contemporaries of a time when they could understand the world’s industrial processes just by looking. No matter how absurd his work was, anyone could trace the reactions involved. They were open to inspection, transparent… Now, you no longer even have to think about where the energy you use comes from. You can forget that your laptop is really plugged into a network of magnets being pushed around by steam created by the heat of burned fossil fuels or the fissioning of atoms.

Rube Goldberg and the Irreducible Strangeness of Electricity – Alexis Madrigal – Technology – The Atlantic. http://www.theatlantic.com/technology/archive/2010/09/rube-goldberg-and-the-irreducible-strangeness-of-electricity/63537/

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It’s that time of the year again…

When do you get to talk about deep scientific inquiry into such bleeding edge research topics such as fellating bats, analgesic profanity, the physics of socks on shoes on ice, remote control helicopters collecting whale snot, slime mold mapping techniques for trains, roller coaster asthma cures and random promotion strategies that increase organizational efficiency.   Why, it must be the Ig Nobel Awards again!  Can’t wait to hear on Science Friday.  Ig Nobels honor research on cursing, bat sex, socks | InSecurity Complex – CNET News.

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Don’t know what to think about this…

The widow of a 413-pound Michigan lawyer who was charged in his death last week was released on her own recognizance Monday after prosecutors said they aren’t sure the forensic evidence supports their theory of the case. Laura Johnson was charged with second-degree murder and unauthorized practice of medicine in the death of her husband Lloyd Johnson, a former lawyer at Geoffrey Feiger’s law firm. Johnson was charged after police searched their home and seized scalpels, possible human tissue in the refrigerator, bloody sheets and a dead dog.

http://www.abajournal.com/news/article/prosecutors_retreat_after_autopsy_of_413-pound_lawyer_dead_dog_was_seized/

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Paragraph of the day

People, you and me, are not trusted. The right doesn’t like us because we don’t do what we’re told by our betters, and the left doesn’t like us because it secretly thinks we would be on the right given half a chance and a lottery win. And both think we should not make our own decisions, because we might make the wrong ones.

Terry Pratchett News April 2010 © PJSM Prints
http://www.paulkidby.com/news/apr2010.html

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Paragraph of the day…

Her nature became his landmark– what Melville would call, with more sobriety than we can now muster, his Greenwich Standard…Most of us, I hope, have some child or spouse or friend like Beatrice, someone by his very nature, his seemingly innate goodness and intelligence, makes us uncomfortably conscious of our lies when we lie. – Dan Simmons, Hyperion.

Filed under: Personal Posts

Sentence of the day

“Coby Schal of North Carolina State said he formerly used condoms filled with rabbit blood, but switched to parafilm because his condom budget raised eyebrows with university auditors.” From today’s NYT’s article on bedbugs.

Filed under: Personal Posts

Potpourri of links

Posner asks if the US Federal Government is insolvent?

Becker, maybe not but we best grow faster.

Bad Astronomy blogger on Discovery’s Bad Universe tonight.

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Ahhh. Grilling season is here…

If all you grill is burgers and dogs, try fresh fruit. Amazing. Check out 101 ideas including “20. Grill pineapple (or anything, really, from pork to tofu to eggplant). Make a sauce of half-cup peanut butter, a tablespoon (or more) soy sauce, a dash (or more) sriracha chili sauce, a handful of basil or mint and enough warm water to thin. (I’m tempted to say, “Throw away the pineapple and eat the sauce,” but the combination is sensational.)”

From NYT Today.

Filed under: Personal Posts

Best sentence read today

“I will roar argon into chlorine, xenon into fluorine, all the noble gases into reactive ones. My lament will terrify even the stars.” Very raw indeed.

Courtesy of Times Book Review of J. Stern’s A Memoir of Terror via Marginal Revolution blog.

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IPad Initial Impressions – a Magical Market

My wife bought me an Ipad (32G 3G) for my birthday. I have an IPod Touch that, like my earlier Nano, I use daily. But I primarily use the Touch for music and — even more — podcasts. I wanted an ebook reader but could not bring myself to get a Kindle because I wanted a device to read books as well as the various blogs and legal feeds I follow. I was thinking that I was going to wait until at least the 2nd generation. But Stephanie heard me talking about it, knew i’d love it if i got one, and ordered one for me. (We had gotten a laptop replacement for her earlier in the year). I have a beautiful wife.

Impression one. This is not a magical device. It’s cumbersome to input. Safari lacks any remote flexibility with add ons I regularly use with reading and tracking like I have with FireFox. The input keyboard is lightyears better than the Touch due to its size, but still forces me to regress back to the days of hunt and peck keyboarding before I learned to type in, oh, about 9th grade. Creating content that requires cut and paste between apps is possible but painfully slower than a laptop. Magical would be a tool that could be a laptop replacement in a meaningful way and offer the dynamite interface and app options that the Touch has only on an HD screen many times the size of the IPhone/Touch. It is not; but in truth I did not expect it to be and have been just testing some of its limits. I am actually writing this not on my laptop but on the WordPress app for the IPad and it is taking me easily 3x longer to do it this way. Of course part of this may be my multi- tasking as I watch the series finale of Lost.

Impression two. This is a magical device. I took it to my in-laws place the weekend I got it. Stephanie has three brothers with a combined niece/nephew mix of 7 (or 9 if you throw in our two daughters). Each and everyone of them used the IPad at some point. Not just them, but Stephanie’s cousin, brothers, sisters in law and aunt even played with it. At one point Stephanie grabbed it to take with her when she was taxi and chaperone for her nephew going to a teen birthday party. The young ones painted on it (Draw Free and Whiteboard Apps), played a block buster game (BClassic Lite); the teens checked Facebook, played some other games I had downloaded, checked out music, and wanted other game apps (for $) that I would have DL’d but their parents nixed (and I only bought the limited 250mb data plan anyway); the uncles checked out iTunes, my movies, YouTube, weather, sports and news apps. I literally did no reading on it the whole weekend, but got a kick out of everyone else using it – for its main purpose as a media consumption, gaming, light interactive input, time killer plaything device extraordinaire.

Impression three. This reinvents YouTube. My kids, who went through a YouTube binge on my Touch. But the IPad with wifi and a HD screen is a game changer. I’ve literally watched They Might Be Giants videos (I’m a Paleontologist, The Mesopotamians, Istanbul, Never Go To Work) with my kids at least 50x over the last week. They also love the old Muppets snippets I can find.

Impression four. Its about the interface and portability. While its input is slower, it’s an on the fly device. I can quickly look things up, do simple tasks (check email; check weather; check Facebook; look something up on the web; make a note in Evernote) quicker than I can with a laptop (if not right there and booted with a browser running). It’s more comfortable in my hand than a laptop is in my, well, lap. Its far more usable for certain tasks than the Touch or a cell phone. While I’m still reticent bringing it along with me when I know I’ll have some time to use it (watching kids at the park play with friends), I can see this use at the same time I couldn’t contemplate a laptop. I can also see this device (or a similar next generation or competing device) being the thing that Newton was supposed to be. I hear an app called Pennultimate with a stylus (photostatic of course) is great for handwritten notes be they not yet optically character recognized. I imagine that will come.

Impression five. It’s about the apps. 200,000. Task focused. Niched. One example – I like amateur astronomy. They have several really good apps including a soon to come one optimized for the IPad called StarMap Pro. I like this one because it has features (e.g., eyepiece view, Telerad view) that even with a Touch is an amazing aid for my dob when I am star hopping. I’m hoping that the HD version will be as visually stunning as the other IPad optimized apps and much easier to see outside with red-light mode of course. Another app I reviewed but have not bought plugs into any computerized telescope (with a necessary wifi interface you can buy for the scope) and shows you the view through the scope from the IPad perspective, skewing across the sky as your scope does. But if you dont care a lick about the night sky (and too bad for you – but it takes all kinds), the specifics of the apps I like are unimportant — there’s probably stuff you like and there’s likely an app for it. For kicks, I searched ‘knitting’. 29 separate apps if that’s your particular poison. Yuck, but it takes all kinds, right?

I think the final impression is the most important. The last decade of this Apple IPod/IPhone/IPad thang has created necessary platforms for a new niche ecosystem of content and now software. Through itunes and its app store Apple has made a distribution and micropayment market for content (music; audio books) and software (app store) function, for the first time, pretty efficiently if not a bit under the control of one monopolizer of the distribution system. The hardware will become a commodity over time. The market, however, oh the market created is the real magic going on here. And now created and sunk into the psychology of consumers, the distribution network won’t be long monopolized by any one company. Especially one whose products start to become a commodity. But Apple will command the high premium of the innovator and first market maker for a while yet. But more important, the tablet and this new market are here to stay.

Viva la tablet and the micropayment content/software market.

Filed under: Personal Posts,

From the file: truth as stranger than fiction

I just finished reading a book by Dan Simmons called The Crook Factory. His ability to write across genres is something I have not encountered in many writers. Contrast the Hyperion series, Summer of Night, Drood and this novel.

This work is an historical fiction account of a year in Ernest Hemingway’s life during May of 1942 to April 1943. What’s utterly fascinating about the book is that a significant portion of it is fact. During this time Hemingway ran an amateur counter espionage ring and sub hunting operation from his home in Cuba. J. Edgar Hoover’s FBI was concerned about unfavorable and potentially embarrassing information that Hemingway was uncovering about Cuba and the Cubans corrupt government officials. But very little else is really known about the period and what Hemingway’s troupe actually did and uncovered – although he was nominally funded and supported by the US State Department.

Perhaps most interesting about the novel is how it integrates the actual events into its plot development. The book discusses how Hoover had been warned of a possible Japanese attack on Pearl Harbor earlier (of course, not by Hemingway, but by the British) but the FBI failed to pass the intelligence on due to in fighting with rival intelligence agencies within the US. The book also weaves in the affair between John F. Kennedy and Inga Arvad, a presume German spy, the illegal surveillance of the vice President of the United States and Eleanor Roosevelt by the FBI, a 300 foot yacht, the Southern Cross, outfitted by a German spy and given to a US nonprofit entity, that was suspected of servicing German subs in the Caribean, vicious infighting between the FBI and rival US intelligence agencies, far more vicious infighting and plots between Hitler’s Nazi SS intelligence organization and its rival Abwehr spies, and inserts the absurd but true account of the landing of Nazi agents on Long Island and the FBI’s refusal to believe the German spies when the were trying to turn themselves in! What’s also true is the FBI ‘s intense interest in Hemingway, its surveillance of Hemingway, efforts of some to paint him in post-war years as a communist sympathizer, and Hoover’s continuing interest in Hemingway until the writer’s suicide in 1962.

While the main plot devices of espionage, violence, double cross and intrigue are obviously fictionally based, there seems to be so much that remains unknown (or still evading a FOIA request) that the real and amazing truths of this time that Simmons integrates into the story make the fictional deep cover antagonist Lucas seem vivid and the “fictional events” more than just plausible.

This was the third “historical” fiction novel I’ve read by Dan Simmons. The first was The Terror. The next was Drood. It’s clear that each book had been meticulously researched. Where fiction (even fantastical) diverges from historical fact is seamless. Simmon’s ability to find the voice of the characters he’s writing about, be they Hemingway or Charles Dickens, is authentic and highly believable. What a joy. This was another fantastic read.

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Sentence of the Day

“Imagine trying to negotiate an agreement on dinner plans with your date, and you suggest Italian and she states her preference would be a meal of tire rims and anthrax.”  Gona use this one some day.  Courtesy of Balloon Juice and paraphrased in Crooked Timber and it all starts with Marginal Revolution, of course.

Filed under: Personal Posts

Genius is Hard Work?

Freakonomics interviews David Shenk about his new book.  Mr. Shenk had some notable observations about genius and the work behind it.

[E]verything about talent is a process. There’s the genetic piece, and then there’s the ability piece. When you look very closely at [Michael] Jordan’s life, you see a rather ordinary teenage athlete with no particularly grand ambition until about mid-way through high school…After the deep disappointment of not making the varsity team, Jordan developed an unparalleled ambition that quite simply dwarfed that of his schoolmates in high school and later his teammates at the University of North Carolina. Jordan’s abilities developed according to what he demanded of himself.

The same is true of other super-achievers. From a distance, it looks like they’ve got something almost super-human about them. But when you look up close, at the moment-to-moment lives they lead, the sacrifices they make, the extraordinary resources they have around them, their abilities actually do make logical sense. If it’s documented closely enough, you can actually see how they went from mediocre to good, from good to great, from great to extraordinary.

He also gives some advice to parents that seem well put.  Persistence is more important than prodigy.  In fact, prodigy can box in young technical achievers into a comfort zone from which they will fear to emerge.  He says:

Show your kids how hard you work, how often you experience disappointments and how you respond to those disappointments. If you blame others for your failures or simply give up, that’s what your kids will learn. If you take on a long-term challenge, show a deep commitment to the process and a refusal to give up in the face of adversity, your kids will pick that up instead.

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Potpourri of Links

Imaging Technology Adoption: The Impact Of Self-Referral via Health Affairs Blog on 4/25/10.  Arguments proposing need to address physician self-referral under in-office ancillary exception.


The Role of Reputation in U.S. News & World Report’s Rankings of the Top 50 American Hospitals — Ann Intern Med via www.annals.org on 4/25/10. Reputation is everything and nothing: “The relative standings of the top 50 hospitals largely reflect the subjective reputations of those hospitals. Moreover, little relationship exists between subjective reputation and objective measures of hospital quality among the top 50 hospitals.”

Hacking Big Brother With Help From Revlon. via Slashdot on 4/25/10.  Cyberpunk with a purpose.
Russian Hacker Selling 1.5M Facebook Accounts. via Slashdot by Soulskill on 4/25/10.   That explains my recent posts.
Cleverest women are the heaviest drinkers – Telegraph via www.telegraph.co.uk on 4/18/10.  That’s why they have a higher pain threshold (Mythbusters).

Filed under: Personal Posts

Paragraph of the Day… or at least one I read with easy computer access to note…

I am reading Anansi Boys by Neil Gaiman.  This paragraph made me pause, re-read it, and think about it a bit:

It is a small world. You do not have to live in it particularly long to learn that for yourself. There is a theory that, in the whole world, there are only five hundred real people (the cast, as it were; all the rest of the people in the world, the theory suggests, are extras) and what is more, they all know each other. And it’s true, or true as far as it goes. In reality the world is made of thousands upon thousands of groups of about five hundred people, all of whom will spend their lives bumping into each other, trying to avoid each other, and discovering each other in the same unlikely teashop in Vancouver. There is an unavoidability to this process. It’s not even coincidence. It’s just the way the world works, with no regard for individuals or for propriety.

Filed under: Personal Posts

Just Like This


Filed under: Personal Posts

Reading the Fine Print

Do you actually read all the click through contracts?  Do you read the privacy policies?   When I went to test drive a car recently I signed a waiver of liability that had typos and grammatical errors.  One actually read to make the dealer liable when it was clear they wanted the driver to be liable.  I pointed them out and was told that I couldn’t drive the car if I made any change to their form.  This was by the same guy that asked if I could afford the car I was test-driving.  I grinned and signed it.

But this one takes the cake.  Fail to read the UK’s Gamestation terms of service this past April 4, 2010, and you might have sold your immortal soul.  Ok – maybe not.  I think I could nullify the contract for you.  (And Gamespot later did waive any enforcement of this provision – nice guys).  But here’s the full text of the contract.  Here’s the provision:

By placing an order via this web site on the first day of the fourth month of the year 2010 Anno Domini, you agree to grant Us a non transferable option to claim, for now and for ever more, your immortal soul. Should We wish to exercise this option, you agree to surrender your immortal soul, and any claim you may have on it, within 5 (five) working days of receiving written notification from gamesation.co.uk or one of its duly authorised minions. We reserve the right to serve such notice in 6 (six) foot high letters of fire, however we can accept no liability for any loss or damage caused by such an act. If you a) do not believe you have an immortal soul, b) have already given it to another party, or c) do not wish to grant Us such a license, please click the link below to nullify this sub-clause and proceed with your transaction.

They allowed customers to click to remove this provision.   So, what’s going on here?  A little social experiment.  Nearly 90% of those entering into this click-through agreement failed to remove the provision (and received a rebate voucher).   Amusing in the specific, disturbing more broadly.

ADDENDUM:  After thinking about this, perhaps this is not so surprising.  Generally, people know the terms and conditions for most online sites are adhesion contracts.  Either you agree to them (excepting only the check-out box regarding what types of communication you might receive) or you do not use the site.  The economic stakes are, perhaps, low.   Customers make the implicit calculation that there’s nothing in the fine print that’s going to raise the economic cost of the underlying service to a point that the service would not be worth it.  Those that are particularly sensitive about privacy issues will look closely and may decide the service is or is not worth it, or look to other providers if those provider’s terms are more to their liking.   But most of us just click through.    For bigger economic arrangements, such as buying a house or entering into a morgage or purchasing a car, one would expect consumers to actually take the time to protect themselves by reading the contracts (or hiring an attorney) since the stakes of those terms may be much more important to the transaction.  Maybe not, considering the role of mortgages/housing purchases in our current economic troubles.

It seems that sometimes this is not a good thing.  If someone does not even read the terms, there could be something that would raise the economic cost to a point you would not use the service.  Recent examples may be the ‘games’ on Facebook and terms requiring you to purchase other services (or needing to affirmatively opt out not to be charged for those other services) in undisclosed or unappreciated tying arrangements.  See for example Farmville.  In any event, as always, buyer beware.

Filed under: Personal Posts

A Hodgepodge Bends the Curve?

In the health care reform season, this seems to be another necessary read.  As I have posted before, I think that Dr. Gawande is channeling many of the administration’s views — or at least those views of Mr. Orzag (see December 7, 2009 post).  I don’t mean, at all, that Dr. Gawande is taking a lead from the administration or that he is not the intellectual owner of many of the ideas in this article — particularly the analogy in this article with the U.S.D.A.   I mean that it seems that he is simpatico with at least some of the administration’s views on health care reform and deserves thoughtful review for that reason.

The article can be summed up with this paragraph:

There are, in human affairs, two kinds of problems: those which are amenable to a technical solution and those which are not. Universal health-care coverage belongs to the first category: you can pick one of several possible solutions, pass a bill, and (allowing for some tinkering around the edges) it will happen. Problems of the second kind [e.g., bending the health care cost curve], by contrast, are never solved, exactly; they are managed. Reforming the agricultural system so that it serves the country’s needs has been a process, involving millions of farmers pursuing their individual interests. This could not happen by fiat. There was no one-time fix. The same goes for reforming the health-care system so that it serves the country’s needs. No nation has escaped the cost problem: the expenditure curves have outpaced inflation around the world. Nobody has found a master switch that you can flip to make the problem go away. If we want to start solving it, we first need to recognize that there is no technical solution.

via How the Senate bill would contain the cost of health care : The New Yorker.

He’s saying that to bend the curve, significant but micro/local involvement and almost ‘federal’ (in the political sense – giving great authority to subunits to find better solutions) problem solving is necessary.  There is no elegant single panacea by legislative fiat to address the problem of escalating health care costs .   Ergo, the Senate bill’s reliance on a ‘hodgepodge’ of pilot programs coupled with an agency, the new Medicare advisory commission, that can expand pilots that work, may be an organic and evolving mechanism to ‘manage’ the challenge.  This, at least, is the thesis.

Dr. Gawande believes that the U.S.A.D.’s experience is a good analogy to the current health care industry challenges.  I’m not convinced of the analogy made here to the U.S.A.D.’s initiatives of early last century (and on to today).  It does seem to have some merits, while simplifying the unique economic distortions in the health care market.  Individual farmers, once they experienced the production benefits that modern techniques (and access to capital machinery) could yield, had every economic incentive to pursue these.   First, because they could make much more crop; second, that if they did not do what their neighbors did, they’d soon be unable to compete as market prices declined.  He does make the point that continuing government ‘help’ – particularly to individual farmers with limited resources, continues today.

To make my own metaphor, the farmers’ trucks were stuck in the mud on a downhill slope with the government giving them some assistance to get them out.  Once out of the mud’s inertia, the market took over.  But query what type of mud the ambulance of health care is stuck in and what’s the grade of the health care market’s hill?

But in any event, given the number of pilot programs and experiments in health care payment and quality measures in both the Senate (see recent amendments proposed by Warner – D Virginia – BNA access only) and the House’s bills, we’re in for an interesting period of experimentation in health care payment systems.  As always, those that can quickly react to this change will be in a far better position than their competitor organizations.  It will be particularly important, if Dr. Gawande’s vision is correct, for organizations not participating in these pilots to closely monitor them, identifying what seems to be working and plan how to adapt to them if they are put more widely into use.

In any event, a necessary read.

Filed under: Health Law, Reform, ,

Potpourri of Links (Mostly Healthcare Reform Related)

Health Affairs has a  blog post that integrates  recent Atlantic and New Yorker articles and challenges the wider applicability of a recent study’s finding of of a forward-looking coorelation between spending/utilization and quality…

And Atul Gawande (author of the New Yorker article above) has another New Yorker article worth a look at.

A post on possible gender bias in scientific writing anthology by Richard Dawkins.

Health Wonk Review with sausage.

A discussion (from October) of the Medicare buy-in now being proposed; Insurers, AMA and AHA oppose.

Big money in pharmaceutical sales data.  Will it be restricted?

Behavioral intervention to bring about a positive change in cortico-cortical white matter tracts.

Filed under: Health Law, Personal Posts, Reform, ,

Disturbing Paragraph of the Month

I read an article entitled “Eight Ways In-Vitro Meat will Change our Lives“, courtesy of Marginal Revolution.  (A blog that is now one of my favorites).  The article contains the most disturbing paragraph I’ve read this month. (The overall article being quite interesting).   The article discusses the emergence of in-vitro meat (mass produced, as the article describes it: “tank steak, sci fi sausage, petri pork, beaker bacon, Frankenburger, vat-grown veal, laboratory lamb, synthetic shmeat, trans-ham, factory filet, test tube tuna, cultured chicken, or any other moniker that can seduce the shopper’s stomach”).  The article goes through a number of potential implications of mass-produced, cheap IVF, including #6:

Humans are animals, so every hipster will try Cannibalism. Perhaps we’ll just eat people we don’t like, as author Iain M. Banks predicted in his short story, “The State of the Art” with diners feasting on “Stewed Idi Amin.” But I imagine passionate lovers literally eating each other, growing sausages from their co-mingled tissues overnight in tabletop appliances similar to bread-making machines.

We shall see.  (Burgers compliments of Red Robin.)

via Eight Ways In-Vitro Meat will Change Our Lives | h+ Magazine.

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A Picture is Worth…

I’ve given some thought to how to better visually present information since seeing a recent TED talk (post here) setting forth graphical representations of changing economic, public health and other information over time.  Here’s another great example showing the growth and decline of the British, Spanish, French and Portuguese maritime colonial empires over the 19th and 20th centuries.

Visualizing empires decline from Pedro M Cruz on Vimeo.

Filed under: Personal Posts

Health Care Reform

The one good thing about the debate thus far has been my ability to procrastinate.  Frankly, I’ve been happy that nothing definitive has passed either the House or the Senate.  Not for any particular partisan or ideological reason, but simply because once it does, I, and a lot of attorneys I know, will have a lot of primary source reading to do.   Summaries suffice until laws are passed and language must be parsed.  That time may be about here with the vote yesterday on H.R. 3962.

Recently a client, who is also taking an MBA course, asked if I had any useful information about the health care reform debate.   She wanted less highly technical materials; she wanted materials she could use to understand the debate and that were not completely uninteresting.   I told her I had a few decent links of materials I’d read over the last six months or so.  Some I’ve highlighted here.

  • This American Life.   In two programs, “More Is Less” and “Someone Else’s Money”  they spend a couple hours, in TAL’s original ‘explain it through an anecdote’ kind of way, exploring factors influencing health care inflation and how our employer driven health insurance system evolved into what it is today.   They did the programs with NPR News and specifically the Planet Money folks that helped with their amazing programs on the financial crisis — “The Great Pool of Money” and “Bad Bank.”
  • How American Health Care Killed my Father, by David Goldhill (Atlantic, September 2009).  A very readable and personalized discussion of distortions in the American healthcare system.  Final argument is that health care insurance reform should look at forcing more financial obligations on patients and move toward catastrophic coverage.   David Brooks mentioned this article in an op-ed piece he wrote.
  • The Cost Conundrum, Atul Gawande (New Yorker, June 2009).   I discuss the article here.  This is important since it was very widely discussed and it’s themes regarding variations in health care spending (many arguing as necessary to fix to “bend the curve”), has gotten a lot of attention.  I also noted a recent HHS-OIG settlement in McAllen; of interest due to my discussion.
  • Health Care Inflation Trends.  Since one major component of health care reform is ‘bending the curve’, what of health care inflation?  I pointed out one post from a blog I follow that succinctly summarizes Medicare, Medicaid projections.  I also suggest a private analysis discussing health care spending inflation and the impact on reform concluding “given that the current path of GDP and consumption appears to be sustainable for only another decade, reform of the federal health care programs and a realignment of the health care sector will occur soon.”

If I were giving to her today, I’d probably add:

 

Filed under: Health Law, Reform, , ,

Brooks on Healthcare Reform

David Brooks recently added a couple editorials on health care reform.  While still remaining carefully agnostic on this issue, I enjoy the way he turns a phrase and his moderate to slightly right vantage.  In one of these editorials, he recommends to the President a recent Atlantic article (that I mentioned in an earlier post as necessary reading in this health care reform season).

From “The Obama Slide,” August 31, 2009

The administration…has joined itself at the hip to the liberal leadership in Congress… The result is the Obama slide…. The public has soured on Obama’s policy proposals. Driven by this geneneral anxiety, and by specific concerns, public opposition to health care reform is now steady and stable…Amazingly, some liberals are now lashing out at Obama Some now argue that the administration should just ignore the the ignorant masses and ram health care through using reconciliation…This would be suicidal. You can’t pass the most important domestic reform in a generation when the majority of voters think you are on the wrong path…The second liberal response has been to attack the budget director, Peter Orszag. It was a mistake to put cost control at the center of the health reform sales job, many now argue. The president shouldn’t worry about the deficit. Just pass the spending parts. But fiscal restraint is now the animating issue for moderate Americans. To take the looming $9 trillion in debt and balloon it further would be to enrage a giant part of the electorate…This is a country that has always been suspicious of centralized government. This is a country that has just lived through an economic trauma caused by excessive spending and debt. Most Americans still admire Obama and want him to succeed. But if he doesn’t proceed in a manner consistent with the spirit of the nation and the times, voters will find a way to stop him…  The president’s challenge now is to halt the slide. That doesn’t mean giving up his goals. It means he has to align his proposals to the values of the political center: fiscal responsibility, individual choice and decentralized authority.” via Op-Ed Columnist – The Obama Slide – NYTimes.com.

From “Let’s Get Fundamental,” September 3, 2009

If I were magically given an hour to help Barack Obama prepare for his health care speech next week, the first thing I’d do is ask him to read David Goldhill’s essay, “How American Health Care Killed My Father,” in the current issue of The Atlantic. That essay would lift Obama out of the distracting sideshows about this public plan or that cooperative option. It would remind him why he got into this issue in the first place.The essay is about the real problem: the insane incentives…Goldhill is especially good on the way the voracious health care system soaks up money that could go to education, the environment, economic development and a thousand other priorities. Health care, he writes, “simply keeps gobbling up national resources, seemingly without regard to other societal needs.” Then I’d ask Obama to go to the Brookings Institution Web site and read a report called “Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth.” …This report also focuses on the key issue: perverse incentives. It’s got a series of proposals on how to restructure insurance markets, reorganize provider payments, change the way effectiveness-research findings are implemented and cap the employee tax deduction…If I had a magic hour with the president, I’d tell him he can shift back to the core issue: the perverse incentives that make this system such a mess. He can embrace proposals—like the Brookings proposals or, more comprehensively, the Wyden-Bennett bill — that address the structural problems instead of simply papering over them…There are many people telling him to go incremental. They’re telling him to just enlarge the current system a bit and pay for it by pounding down a few Medicare fees. But did Barack Obama really get elected so he could pass the Status Quo Sanctification and Extension Act?  This is not the time to get incremental. It’s the time to get fundamental. Reform the incentives. Make consumers accountable for spending. Make price information transparent. Reward health care, not health services. Do what you set out to do. Bring change.  via Op-Ed Columnist – Let’s Get Fundamental – NYTimes.com.

Filed under: Health Law, Reform,

Spread the Light

I’ve been a big fan of the TED Talks (here, here, here).  I’ve also started reading the Marginal Revolution blog after reading Brooks article not long ago that reference an idea that the blog posted.  I think I made a quip about having enough reading on my blog list and that they better impress or I’d drop them like week old kung po chicken in my fridge.  The blog’s still in my fridge and it’s still tasty.

In any event, I read that Alex Taborrak, one of the authors of the blog and holder of the Bartley J. Madden Chair in Economics at George Mason University,  had been invited to make a TED Talk about globalization.  The talk, which I very much liked, is posted below and worth a watch (or listen — podcasts on itunes) since it is looking like we might be slouching off the hang-over from our last several bubbles and this so-called Great Recession.

His theme — economic development in other counties increases the most important marketplace, that of ideas which benefits all nations and peoples — is, I think, optimistic, forward thinking and (the sunnier part of me cries out) ‘spot on’.  He likens the world’s population to a massive computer whose CPUs have been mostly off for lack of wealth driving education maximizing people’s potential.  In other words, if all Einstein could have done would be to work in a farm field, would he have been able to develop and allow us all to benefited from his illuminating ideas?

In the last half the the 20th century, wealth creation throughout the world has been driven by the implosion of trade, communication and political barriers.  This has been particularly robust for the peoples of China and India.  And this explosion has transformed and expanded marks in human ideas — and certainly every other conceivable economic market.   Even Africa is seeing a better future.  (cf a related post of mine that discusses lost opportunity even in the United States educational system (here)).

And yet, another cynical part of me also looks back at the other history of the 20th century and I wonder if the walls and barriers to development could not go up again as fast as they have fallen.  If you want to wallow in gloom, take a listen to Dan Carlin’s Hardcore History podcasts of the WWII eastern front battles Ghosts of Osfronts I, II, III – available on itunes or here.  But I, for one, won’t be Eeyore tonight.  Check out his talk.

Alex Tabarrok on how ideas trump crises | Video on TED.com.

Filed under: Personal Posts, , , , ,

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