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They come in threes?

Wow - Farah Fawcett and Michael Jackson on the same day. Nobody did the moonwalk like MJ.

Edit: CNN still not confirming death of MJ. In addition to TMZ, a few places on Twitter saying he's dead.

Edit at 6:21: CNN now saying he's "in a coma".

Edit at 6:28: CNN now saying CBS and LA Times saying he's dead.

Thriller defined the generation during which I learned to love music. For a solid two years, it was pretty much all my buddies and I listened to.


Americanese

I was just watching an old Scrubs episode and while watching a soap opera during her lunch break, the nurse said to J.D., "Can't you see I'm watching my stories?" I've heard "my stories" used a few times now referring to soap operas. Has anyone else heard this phrase used?

(Edit: Coincidentally, I just heard Sock on Reaper refer to One Life To Live as "my stories".)

My friend from Jersey laughed at me when I told him I needed new tennis shoes. He says "tennis shoes" must be a Southern thing because he's only ever heard them called "sneakers". A bit of research (which I can no longer find) revealed that "sneakers" is limited to the Northeast down to DC, whereas "tennis shoes" dominates the rest of the country.


Verghese: Spend Less Money!

Abraham Verghese says that preventative medicine won't necessarily limit health care costs, something which I also argued previously.

My wife tried to tell me the other day that she had just ‘saved’ us money by buying on sale a couple of things for which we have no earthly use. She then proceeded to tote up all our ‘savings’ from said purchases and gave me a figure that represented the money we had generated, which we could now spend . . .she had me going for a minute.

I mention this because I have similar problems with the way President Obama hopes to pay for the huge and costly health reform package he has in mind that will cover all Americans; he is counting on the “savings” that will come as a result of investing in preventive care and investing in the electronic medical record among other things. It’s a dangerous and probably an incorrect projection.

Prevention of a disease, we all assume, should save us money, right? An ounce of prevention . . . ? Alas, If only such aphorisms were true we’d hand out apples each day and our problems would be over.

It is true that if the prevention strategies we are talking about are behavioral things—eat better, lose weight, exercise more, smoke less, wear a seat belt—then they cost very little and they do save money by keeping people healthy.

But if your preventive strategy is medical, if it involves us, if it consists of screening, finding medical conditions early, shaking the bushes for high cholesterols, or abnormal EKGs, markers for prostate cancer such as PSA, then more often than not you don’t save anything and you might generate more medical costs. Prevention is a good thing to do, but why equate it with saving money when it won’t? Think about this: discovering high cholesterol in a person who is feeling well, is really just discovering a risk factor and not a disease; it predicts that you have a greater chance of having a heart attack than someone with a normal cholesterol. Now you can reduce the probability of a heart attack by swallowing a statin, and it will make good sense for you personally, especially if you have other risk factors (male sex, smoking etc).. But if you are treating a population, keep in mind that you may have to treat several hundred people to prevent one heart attack. Using a statin costs about $150,000 for every year of life it saves in men, and even more in women (since their heart-attack risk is lower)—I don’t see the savings there.

Or take the coronary calcium scans or heart scan, which most authorities suggest is not a test to be done on people who have no symptoms, and which I think of as the equivalent of the miracle glow-in-the-dark minnow lure advertised on late night infommercials. It’s a money maker, without any doubt, and some institutions actually advertise on billboards or in newspapers, luring you in for this ‘cheap’ and ‘painless’ way to get a look at your coronary arteries. If you take the test and find you have no calcium on your coronaries, you have learned that . . . you have no calcium on your coronaries. If they do find calcium on your coronaries, then my friend, you have just bought yourself some major worry. You will want to know, What does this mean? Are my coronary arteries narrowed to a trickle? Am I about to die? Is it nothing? Asking such questions almost inevitably leads to more tests: a stress test, an echocardiogram, a stress echo, a cardiac catheterization, stents and even cardiac bypass operations—all because you opted for a ‘cheap’ and ‘painless’ test—if only you’d never seen that billboard.

Coronary artery calcium scans are the perfect example of the ambiguity of "preventative medicine". Other than at the margins of results, nobody really knows what they mean. Yet, health care consumers want them.

Verghese's solution to health care costs? Spend less money!

Which brings me to my problem with the president’s plan: despite being an admirer, I just don’t see how the president can pull off the reform he has in mind without cost cutting. I recently came on a phrase in an article in the journal “Annals of Internal Medicine” about an axiom of medical economics: a dollar spent on medical care is a dollar of income for someone. I have been reciting this as a mantra ever since. It may be the single most important fact about health care in America that you or I need to know. It means that all of us—doctors, hospitals, pharmacists, drug companies, nurses, home health agencies, and so many others—are drinking at the same trough which happens to hold $2.1 trillion, or 16% of our GDP. Every group who feeds at this trough has its lobbyists and has made contributions to Congressional campaigns to try to keep their spot and their share of the grub. Why not?—it’s hog heaven. But reform cannot happen without cutting costs, without turning people away from the trough and having them eat less. If you do that, you have to be prepared for the buzz saw of protest that dissuaded Roosevelt, defeated Truman’s plan and scuttled Hillary Clinton’s proposal. The good news is that the AMA, representing perhaps 15% of active practicing physicians, is not as powerful as it was in Truman’s time, and in the eyes of the public and many in medicine, it’s identity in the reform debate, is that of a protectionist, self-serving, organization; as a result, even their most progressive statements are viewed with suspicion. I’ve found the views of the American Medical Student Association particularly exciting—the next generation of physicians I sense has a deeper commitment to affordable health care for all than ours; they are, simply put, better people.

Though I disagree with the proposed solution, at least Verghese is realistic. To save money you actually have to spend less money. That means fewer tests, imaging studies, procedures, and surgeries. So far, Americans have been sold on the idea that the way to save money is to be vigilant and prevent disease before it happens. As I've said before, I have little reason to believe this is a good strategy to lower costs. The only real way to save money is spend less of it.

Americans won't like this idea.

Doctor: "Bob, we could put a stent in your coronary artery, but there's no real proof that it helps over the long term."
Bob: "So you're saying we should do nothing? What about my clogged arteries?"
Doctor: "We should definitely do something. Specifically, we should eat less and exercise more. And by 'we', I mean 'you'."
Bob: "I want the stent."

My prediction: if and when Americans realize this, they will revolt against any health care reform plan like they've done every time it has been proposed over the past century.


Stallworth vs Vick

Donte Stallworth will receive a 30-day jail sentence for killing someone while driving drunk.

The relatively lenient sentence received Tuesday by Cleveland Browns wide receiver Donte' Stallworth — 30 days in jail, followed by two years of house arrest — after he pleaded guilty to DUI manslaughter for killing a pedestrian while driving drunk in Florida was made possible by his cooperation with authorities and the victim's family's wishes to move forward.

Stallworth, who had faced up to 15 years in jail, will also be on probation for eight years and must undergo drug and alcohol testing and perform 1,000 hours of community service. He will have a lifetime driver's license suspension, too.

"I accept full responsibility for this horrible tragedy," said Stallworth, accompanied at the hearing by his parents, siblings and other supporters. "I will bear this burden for the rest of my life."

Contrast his punishment with that of Michael Vick. Is there any doubt that something has gone astray in our notions of justice?

In my admittedly simplistic view of justice, law is a social contract to keep the peace between humans. Locking someone up is serious business. It's essentially barbaric in nature: instead of a human being able to walk freely, eat, make choices, and pursue the good life, we put him in a cage. Only someone who is a danger to other humans warrants such a barbaric punishment. Animals are not a party to this social contract.

Yet Stallworth's punishment pales in comparison to Vick's.

Related:

No Rights for Animals by Constant
We Are All (or Mostly) Mike Vick by C. J. Trillian (I have it on good authority that someone gave up meat after reading this post)


Preventative Care does not Necessarily Save Money

One of the common solutions proposed for the increasing cost of health care in the US is "preventative care". The argument supposes that if we prevent illness, we will save money. I think that's too simplistic.

The least costly patient is one that is apparently healthy his whole life, pays into the system, whether it be private insurance or government program, and drops dead suddenly of a heart attack.

A few years ago, there was a study that showed that smokers are net contributors to insurance programs because most lung cancer patients die within a year or two of being diagnosed. Little money is spent at the end of their lives. A cost-saving strategy might be one that encouraged smoking. (Unfortunately, I can't remember where or when I saw the study.) I imagine that the same is true for other deadly diseases such as pancreatic cancer.

Whether preventative action X or screening test Y actually saves money in the long run is an empirical question that can only be answered by performing scientific studies. The answer is in a constant state of flux because of the development of new drugs and technologies.


Little Boy and Fat Man

We've talked about Hiroshima and Nagasaki before on this blog. Bill Whittle argues against Jon Stewart's assertion that Truman was a war criminal in this video clip that I just ran across. Some points Whittle made that I thought have bearing on the analysis are:

  • The US made some effort to warn the Japanese citizens about what was coming.
  • Hiroshima and Nagasaki were, in some ways, military targets.
  • Conventional bombing of Hiroshima and Nagasaki would have cost as many lives, if not more, than the atomic bombing.
  • Dropping the bombs killed fewer people than not dropping them would have killed on both the American and Japanese side.
  • The Japanese citizenry were probably not ready to surrender anytime soon before the bombs were dropped.

Classical Music

I'm one of the people in Benjamin Zander's third group: those who essentially never listen to classical music. To me, classical music has always seemed like brief moments of greatness interspersed with long periods of boredom. I'm too impatient to wade through the doldrums to reach the brief climaxes.

Zander tries to sell his audience on the beauty of classical music and does an admirable job.


Sotomayor Speech

This excerpt from a speech given by Sonia Sotomayor has been getting a lot of play.

Whether born from experience or inherent physiological or cultural differences, a possibility I abhor less or discount less than my colleague Judge Cedarbaum, our gender and national origins may and will make a difference in our judging. Justice O'Connor has often been cited as saying that a wise old man and wise old woman will reach the same conclusion in deciding cases. I am not so sure Justice O'Connor is the author of that line since Professor Resnik attributes that line to Supreme Court Justice Coyle. I am also not so sure that I agree with the statement. First, as Professor Martha Minnow has noted, there can never be a universal definition of wise. Second, I would hope that a wise Latina woman with the richness of her experiences would more often than not reach a better conclusion than a white male who hasn't lived that life.

It's funny how if you're a minority--at least, a minority of the non-asian persuasion--your life is "rich" and "vibrant", and you add "diversity".

I'll leave the dissection of the meaning of the quote to the commentariat.


Renewals

Ausiello is reporting that both Dollhouse and Chuck are back for 13 episodes next season.

SPOILERS

Dollhouse's first season ended with a whimper, which is a shame since it had been growing stronger every week. "Man on the Street" and "Briar Rose" were examples of its potential, but the Alpha plot resolution ruined the ending. I was anticipating Alpha to have some moral worth, perhaps as a crusader fighting for what he believes to be a just cause against an unjust institution. Nope. He's just a psycho. And the reason for his obsession with Echo? She looks good. That's it. Frankly, Amy Acker is more pleasing to these eyes than Eliza Dushku. Maybe ten years ago when she first appeared on Buffy, she had the presence to carry the part of Echo, but no longer. There were plenty of times I felt like the director was trying to show off her curves, but there was little bootay to be seen. What exactly was she shakin'? She's no Yvonne Strahovski.

Speaking of Dushku, I really wish the Whedonites would stop recycling actors from other series. Why did Alpha have to be Wash? Alan Tudyk is not someone I'd recruit to be a "doll". I knew Tim Minear's Drive was on thin ice when I found out Nathan Fillion was the lead. In my ideal TV world, every series would have fresh actors.

The best actor on Dollhouse was Enver Gjokaj, who convincingly spoke with Russian and Southern accents, imitated Lawrence Dominic's subtle mannerisms, and conveyed the innocence of a blank slate doll.

It's too bad Chuck isn't getting a full season. The new intersect has a lot of potential. I generally don't like network television, but Chuck is a show I don't have to think much about and can simply sit back and enjoy. Blame Jay Leno--he's going to suck up five hours of NBC primetime programming weekly next season.


Demise of old media

From an article from Bill Roth on the Virginia Tech athletics website:

According to the Audit Bureau of Circulations, in the past six months, circulation at The Washington Post fell 1.6 percent daily and 2.3 percent on Sundays. USA Today fell 7.4 percent. The Boston Globe plunged 13.6 percent and The Miami Herald was down 15.8 percent. That has led to dramatic revenue decreases across the board and has challenged news organizations to re-think the way they cover teams.

As someone who stopped reading newspapers about 15 years ago, I'm surprised it's taken this long. Then again, I'm also shocked that people expect me to mail stuff to them. Affixing a stamp to a letter seems so...primitive.

“You’ll see more content-sharing,” Harris predicted. “My goodness, The Washington Post took a story from The Baltimore Sun on the Kentucky Derby and those once-rival papers share baseball coverage. Instead of Richmond and Lynchburg having their own staff writers do game stories, notebooks and columns, you’ll see combined efforts where all the work appears in both papers. Is it ideal? No. But the readership overlap isn’t that high and it allows - where space is available - for extra content you used to be able to provide by sending several writers.”

Television stations around the Commonwealth share video as well. A Roanoke station might videotape part of a practice or conduct an interview, and then share the footage with stations in Richmond, Norfolk or Washington.

“Absolutely,” said Grant Kittelson, sports anchor for WDBJ-TV in Roanoke. “We’ll share our stuff with CBS affiliates in Richmond and Norfolk.”

Why does any news organization need their own stories anymore? It seems like you need a small number of people physically covering news, and the whole world can share that news under various models of dissemination.

On a related note, why does Google News give me 800 stories on a topic which say the exact same thing?


Can the gigantic committee practice Wu Wei?

If you're anything like me, you've been wondering that your whole life. Mencius Moldbug comes out with an emphatic "No!" in his response to Will Wilkinson's labeling of democratic skepticism as a mental disorder.

Related: A Thousand Nations


Masks

It's never too early to start thinking about Halloween, but I'm talking about facemasks worn to protect oneself against the swine flu. I took a plane trip this past weekend and saw a few people wearing masks, including the guy sitting next to me on the return trip. He also wore bright orange corduroy pants and an Indiana Jones hat. I think many people wearing masks are doing it as a fashion statement-- "Look at me."

My brother told me he saw someone wearing a mask who pulled it aside to sneeze and then put it back in place.


May Day 2009

Every year for the past five, we have taken time on May 1st to remember the victims of communism. Because of our busy personal lives, we did not have the time to put together any original articles this year. For that, I apologize. Instead, I will link to a few of our articles from previous years. We hope to bring it back next year bigger than ever.

The Red Plague by Professor R. J. Rummel
The Road To Hell Was Paved With Bad Intentions by Bryan Caplan
Cambodian Year Zero by Jonathan Wilde
Torture and Tyranny: The Real Che by Randall McElroy
Hoeryong: Peering Inside a Death Camp by Rainbough Phillips
Trofim Lysenko: Ideology, Power, and the Destruction of Science by Matt McIntosh
Ecocide: The Murder of the Aral Sea by Brian Doss
Remembrance by Jonathan Wilde

We hope you remember the victims of communism in your own way today on your own blogs.


The 1930s Bear Market

There was an interesting article in the NY Times a few days ago which claims that the 1930s bear market wasn't as bad as it appears after adjusting for deflation, dividends, and market breadth.

Historical stock charts seem to show that it took more than 25 years for the market to recover from the 1929 crash — a dismal statistic that has been brought to investors’ attention many times in the current downturn.

But a careful analysis of the record shows that the picture is more complex and, ultimately, far less daunting: An investor who invested a lump sum in the average stock at the market’s 1929 high would have been back to a break-even by late 1936 — less than four and a half years after the mid-1932 market low.

It seems obvious to me that if are to have a recession, I'd rather have one in which my money is worth more at the end of it (deflation) than less (inflation). Most economists, at least those who advise governments, believe the opposite.

One thing that bugged me was that the title compared the 25 years number (prior peak to recovery) vs 4 1/2 years (trough to recovery). Using different comparisons seems like an attempt at sensationalism.


Thiel's response

Peter Thiel has a succinctly argued response to Patri's lead essay at Cato Unbound. The part about the race between politics and technology caught my eye right away:

A better metaphor is that we are in a deadly race between politics and technology. The future will be much better or much worse, but the question of the future remains very open indeed. We do not know exactly how close this race is, but I suspect that it may be very close, even down to the wire. Unlike the world of politics, in the world of technology the choices of individuals may still be paramount. The fate of our world may depend on the effort of a single person who builds or propagates the machinery of freedom that makes the world safe for capitalism.

I can't help but think that some neurons in Thiel's brain were subconsciously reminiscing Heinlein's words when he wrote that:

I suspect that our race's tragedy has been played endless times. It may be that an intelligent race has to expand right up to its disaster point to achieve what is needed to break out of its planet and reach for the stars. It may always -- or almost always -- be a photo finish, with the outcome uncertain to the last moment. Just as it is with us. It may take endless wars and unbearable population pressure to force-feed a technology to the point where it can cope with space. In the universe, space travel may be the birth pangs of an otherwise dying race. A test. Some races pass, some fail . . .