Government - Run Health Care (GRHC)

[from Stu, images added by Ira]

This began as an email I sent to several friends, including Ira:

"An interesting article and also,as an aside, a good argument for govt-run health care..."

http://www.nytimes.com/2009/11/08/magazine/08Healthcare-t.html


And I got the following response from Ira:

"I read the article through and saw no good argument for government run health care.

"Indeed, one of the mentions (bottom of page 7) had to do with reducing charges for use of a medical device that recently cost thousands of dollars less. Nope said the finance guy, as long as MEDICARE (i.e., the taxpayers) is paying the old higher prices, we should not cut our prices, even though we are non-profit!

"As I made clear in http://tvpclub.blogspot.com/2009/09/end-of-life-honest-brokers-not-death.html I favor Comparative Effectiveness Research (CER) and Quality Adjusted Life Years (QALY) which is what the star of the article is actually doing, but I do not think the US government can successfully pursue that path in the current climate. Look what happened to the breast cancer screening recomendations this week. They are based on CER and, when women and doctors screamed, the govenment back down almost immediately. I think private insurance companies are in a better position to push CER and QALY-based reforms that save real money.

"Where did you see good arguments for government-run health care in this article? "

My response to Ira is the same as my response to Dennis (not on this blog).
First, Dennis' comment follows:

"G-RHC is always attractive to those who believe in big-bigger government, something for nothing (or so it seems) and the philosophy of entitlements (regardless of costs or the negative realities of socialist experiments in other places). Good or bad the reality is our country is broke and cannot afford its current "entitlements" not to speak of its mounting debts and deficits or future entitlements. At some point reality crashes the illusions of the masses and the politicians who feed them. "


So, finally, here is my response to both of my staunchly conservative friends:


"OK, let the (respectful) discourse begin! While the proposition that, " G-RHC is always attractive to those who believe in big-bigger government, something for nothing (or so it seems) and the philosophy of entitlements (regardless of costs or the negative realities of socialist experiments in other places)." may be true, it is indubitably not true that all who believe in G-RHC want something for nothing regardless of the true costs (I know this because I am one of them).

However, the main point of the article was that you can't improve health care protocols without most of the participants adhering to the protocol. It is a statistical fact that you should minimize the variance of the behavior of the doctors if you want to change the protocol for the better. If every doctor tries different treatments then it's impossible to know which of them are really responsible for patient improvement or decline while, on the other hand, if you have a specified treatment plan that all follow and it isn't working then you know just what needs changing. You can't have many variables changing to determine which ones are producing the good results. This is simply what is known as the "scientific method".

Now the above is easier to do with the govt running the health care system than the way we have it now not only without centralized control but rewarding inefficiencies and expanding costs as the article explains. Some things work better if they are centralized and yes, even (shudder) collectivized; e.g. fireman, policeman, soldiers, national parks and interstates, and it appears to me (somewhat on the basis of other countries experience (like Holland)) that health care should be nationalized. No solution is perfect but the benefits, to me, outweigh the costs.

There will always be a tradeoff between the needs of the individual and society; the trick is to find the correct balance."

And finally, finally, here is Dennis' reply to me:

"Theory and abstractions are seductive - as are the plans of mice and men. The reality always proves more elusive and sometimes tragic. Americans may have to experience their own tragedy as they fall prey to the allure of socialist solutions - as the rest of the world discards them. An irony of our times.

I am more attracted to real experiences - and those I am aware of through friends, relatives, and others who have the experience of centralized medical systems is not encouraging (to me at least). Worst of all - is the destruction of the doctor-patient relationship and the need to finagle ways of getting attention (if not bribery then trips to other countries or high-cost private insurance when the state allows it). And - most important - how does a bankrupt system pay for it? The destruction of a system that works for most and that has been the most dynamic in terms of medical advances should not be undertaken lightly. There may be many regrets - as I think many are now realizing as they coalesce in opposition to some dangerious social experimentation. "

I now open the question to this blog.

Stu

The Rest of the Picture

For many, many years, starting during WWII, the late great Paul Harvey broadcast The Rest of the Story - a factual story with a twist at the end.

Well, the photo to the left has a twist at the end.

It appeared yesterday in our local newspaper and seems to show a woman with a cigarette dangling from her lips.

It was an ilustration in a story about the "Clay Arts Club" whose members fashion pottery out of clay.

Why would a woman pose with a cigarette in her lips and why would the newspaper print such a photo?

Well, things are seldom as they seem, and further investigation of the photo shows quite a different story. Look at the second photo, which shows more of the photo that was published.

You can see the "cigarette" is merely the leg of a chair that happens to be behind her. The upper part of that chair leg is above and behind her neck and the other leg can be seen behind her hair.

And, as Paul Harvey would say, "Now you know the rest of the picture!"

Ira Glickstein

The Central Limit Theorem (CLT)

[From Stu. Images added by Ira from this source.]

OK,OK Ira, you have guilted me into action and so I will share something that has been bothering me lately. As many of us may know, the CLT is, next to the Law of Large Numbers, the most important principle in Statistics and is used to justify many a research study. So, I am thinking it behooves us all to try to understand this CLT so we can become more discerning citizens, n'est pas?

Here is the way I understand it. Given a random variable, X with mean mu and standard deviation sigma (X may or may not be normally distributed). Now we do the following m times: We draw n samples from X and compute the mean X-Bar giving us m X-Bars which will have their own particular probability distribution, PD. Finally the CLT promises that as m and n approach infinity, PD will approach a Normal distribution with mean mu (the mean of our original random variable X) and a standard deviation of sigma divided by the square root of n (the sigma of X and the n of the n samples). Pretty amazing actually. Please correct me if my understanding of this is incorrect as I'm going from memory here.

Now here's the problem that is bothering me. Say a research study is done where the researcher does not know the actual probability distribution so he or she can use the CLT to draw inferences about the population but precisely how? From what I understand they want to use as large an n as possible but surely do not use a large m (repeated sampling). And while I understand that once you have a normal/Gaussian probability distribution, it's easy to compute deviations from the mean and confidence intervals, just exactly what is the procedure used. Can anyone give me a useful easy-to-understand example?

Bewitched, bothered and bewildered,
Stu

Lawyers Have Not Changed Since the 1700's

Our recent discussion of the current movie, The Invention of Lying, about a modern society where there was no concept of a lie, led me back to the story of a similar society, written in 1726 by Jonathan Swift. One of best tales in Gulliver's Travels is his adventure in the country of the Houyhnhnms, a society of cultured horses where lying is also unknown.

I was struck by Gulliver's description of the lawyers of his time and how similar they are to many of today's lawyers (and judges and, especially, professsional politicians)!

Here are some excerpts where Gulliver explains, to his Houyhnhnm host, how justice works in his native England:

There [is] a society of men among us, bred up from their youth in the art of proving, by words multiplied for the purpose, that white is black, and black is white, according as they are paid.

To this society [of lawyers] all the rest of the people are slaves.

For example, if my neighbour has a mind to my cow, he has a lawyer to prove that he ought to have my cow from me. I must then hire another to defend my right, it being against all rules of law that any man should be allowed to speak for himself.

Now, in this case, I, who am the right owner, lie under two great disadvantages: first, my lawyer, being practised almost from his cradle in defending falsehood, is quite out of his element when he would be an advocate for justice, which is an unnatural office he always attempts with great awkwardness, if not with ill-will.

The second disadvantage is, that my lawyer must proceed with great caution, or else he will be reprimanded by the judges, and abhorred by his brethren, as one that would lessen the practice of the law. And therefore I have but two methods to preserve my cow. The first is [bribery of] my adversary's lawyer [or] for my lawyer to make my cause appear as unjust as he can, by allowing the cow to belong to my adversary: and this, if it be skilfully done, will certainly bespeak the favour of the bench.

... these judges are persons appointed to decide all controversies of property, as well as for the trial of criminals, and picked out from the most dexterous lawyers, who are grown old or lazy; and having been biased all their lives against truth and equity, lie under such a fatal necessity of favouring fraud, perjury, and oppression, that I have known some of them refuse a large bribe from the side where justice lay, rather than injure the faculty, by doing any thing unbecoming their nature or their office.

It is a maxim among these lawyers that whatever has been done before, may legally be done again: and therefore they take special care to record all the decisions formerly made against common justice, and the general reason of mankind. These, under the name of precedents, they produce as authorities to justify the most iniquitous opinions; and the judges never fail of directing accordingly.

[Lawyers have] a peculiar cant and jargon of their own, that no other mortal can understand, and wherein all their laws are written, which they take special care to multiply; whereby they have wholly confounded the very essence of truth and falsehood, of right and wrong; so that it will take thirty years to decide, whether the field left me by my ancestors for six generations belongs to me, or to a stranger three hundred miles off.

[Lawyers and judges,] in all points out of their own trade, [are] usually the most ignorant and stupid generation among us, the most despicable in common conversation, avowed enemies to all knowledge and learning, and equally disposed to pervert the general reason of mankind in every other subject of discourse as in that of their own profession.

Well said and so true, so true!

Ira Glickstein

Cross-Dressing for Halloween

HAPPY HALLOWEEN!

For the second weekend in a row, and the first two times in my life, I have been cross-dressing!

Last week it was for a comedy at our synagogue where I was asked to play a bridesmaid. The maid of honor was also a bearded man, the groom a woman, the bride a man, etc. I looked pretty darn good in my wife's long black dress with a pink top and a flowered hat. My falsies were so realistic the woman who directed the play said she wished she had a pair like mine, so I took them out and gave them to her!

This week it was for a Halloween party where I was a Hooters Girl wearing an Ogre mask. (Double-click the photo for a larger image.)

In both instances, I was congratulated for my "hooters", and my nice legs of course. Surprisingly (for me) I felt comfortable in my newfound role, something I would not have considered five or ten years ago. Color me a contented cow.

Ira Glickstein

PS: My falsies were made of liquid-filled cooler packs. I put each in a plastic newspaper sleeve and formed them into a ball by twisting the excess plastic and tying a knot in it. Fortunately my wife wears a bra size that fits me fine.

PPS: Wedding photo added 19 November 2009

Arctic NOT Ice-Free till 2060 at the Earliest!

According to the UK Met Office the Arctic will NOT be ice-free by the summer of 2020 as many climate "experts" continue to predict. Nope, it will be at least 2060 before that happens. Mark it on your calendars!

Also mark my prediction that "pigs will fly" in 2060, and "hell will freeze over" in the same year :^) Seriously, I have made predictions for 2052 and beyond in my free online novel. The beauty of making predictions fifty years in the future is that most of us will be dead by then and those who are alive will have forgotten.

Good news for the polar bears! Not so good for the shipping companies that planned trans-Arctic routes for transporting oil. Or for Global Warming alarmists.

The full text of the UK Met Office October 15th release is here. Key excerpts (with emphasis added):

"Modelling of Arctic sea ice by the Met Office Hadley Centre climate model shows that ice invariably recovers from extreme events, and that the long-term trend of reduction is robust — with the first ice-free summer expected to occur between 2060 and 2080. It is unlikely that the Arctic will experience ice-free summers by 2020.

"Analysis of the 2007 summer sea-ice minimum has subsequently shown that this was due, in part, to unusual weather patterns. ..."

"The high variability has made it difficult to attribute the observed trend to man-made emissions of greenhouse gases, ...

"About half of the climate models involved in the Intergovernmental Panel on Climate Change fourth assessment report, show that ice declines in steps — failing to recover from extreme years. The observed temporary recovery from the 2007 minimum in 2008 and 2009 indicates that the Arctic ice has not yet reached a tipping point, if such exists."

In other words, the low point for Arctic ice in 2007 was mostly due to Natural Cycles in the ocean currents and solar phenomena, and not Anthropogenic Global Warming (AGW) due to human release of formerly sequestered carbon. About half of the most recent IPCC climate models are wrong about Arctic ice. We are nowhere near any kind of tipping point.

Don't get me wrong, I'm still concerned about the continuing rapid increase in atmospheric CO2. However, we have decades to figure out how to deal with it most effectively without further wrecking our economies via the Cap and Trade scam. I hope the coming decades of stable temperatures, and perhaps a bit of Global Cooling, will allow cooler heads to prevail and chose something like a revenue-neutral Carbon Tax. That kind of Carbon Tax would require minimum government enforcement and political chicanery. It would be hard to cheat on. Most importantly, it would actually work to reduce carbon emissions over time, harnessing market forces to do so.

Ira Glickstein

Grand Illusion of Motion (NOT!)

Double-click on the image to make it larger.

The wheels appear to be turning but I assure you it is a static picture.

If you stare at a black dot, the movement stops in that area.

I don't know what logical or philosophical point this makes.

Perhaps that some politicos claim to be making things happen and change but are not too successful at it. (But, I'm not complaining. Some of the best Congresses have been those that did the least damage!)

Ira Glickstein

The Invention of Lying

This philosophical movie asks the question:

When a society invents the idea of lying, can religion be far behind?

My wife, Vi, and I saw it yesterday and it is highly recommended!

What if there was a society exactly like ours but with absolutely no lying?

Of course, no society could develop, exist and survive without lies - even chimp societies have the equivalent of lying. However, once you get over the basic premise of a society where there is not even a word for "lie" (or "truth") the rest follows naturally.

The main character, played by British comic Ricky Gervais, is a classic loser. He works as a writer for Lecture Films. Since there is no lying there is no fictional dramatization. All films are rather dry recitations of historical facts. Gervais's character has been assigned the 13th century and all he has to work with historically is the Black Plague - not a very inviting subject for a factual movie.

He gets a pity date with Jennifer Garner's character and admits that he is about to get fired and his finances are so poor he is behind on his rent. She tells him frankly that she has superior looks and genes and he is way out of her league financially. She cannot marry him because their children would be stub-nosed pudgy losers.

HOW LYING GETS INVENTED

Gervais goes to the bank to withdraw the $800 rent money. The bank's computer system is down but the teller implicitly trusts him (no one has ever lied). She gives him the $800. A moment later the computer comes back up and reveals he has only $300, but she assumes it is a computer error. He goes along with he "error" and slowly realizes that he can say things that are not true that everyone will believe. For example, he tells his friend that he invented the bicycle, his hand is artificial, he is wearing a wig, and so on. His friend believes him! He goes to a casino and distracts the dealer and moves his bet after the roll. He puts his roulette winnings in a game of chance worth $1,000,000 and claims he won but the machine malfunctioned. They give him the money and an apology! He is rich and buys a mansion!

He is the only person in the world who knows how to lie and he can get anything he wants! But, can he get Jennifer Garner's character? Is he willing to lie to her and suggest that wealth can change genes? Sadly, no.

I don't want to give away the whole story, but there are a few events worth mentioning.

1) Since he can lie, he finds it easy to forge a document from the 13th century and use it to write a blockbuster Black Plague movie. He gets his job back with a promotion!

2) His mother is dying. To comfort her, he tells her that there is a "Man in the Sky" and that dead people go up into the clouds and are restored to full health and vigor and are reunited with relatives and friends who have passed on.

3) His "Man in the Sky" story is picked up by the news media without question. No one has ever lied so this must be the absolute truth! He becomes a media sensation. To satisfy their curiosity and interests, he writes ten commandments (like Moses) to guide society. They are written on the backs of two pizza pie boxes. An image of him holding the two boxes with outstretched arms becomes a cross-like icon worn by believers.

4) Despite his success and surprising charm for a loser, Jennifer Garner's character is still unwilling to marry him because of his inferior genes. Rejected and dejected, he grows long hair and a beard (like Jesus).

How does it all end? GO SEE THIS MOVIE!

Ira Glickstein

More DEMOCRATS watch Fox News than CNN or MSNBC!

Could it be? YES IT BE!

Analysis of ratings data from respected Pew Research and Neilson
shows that more Democrats watch Fox News than either CNN or MSNBC.

Fox News has come up on this Blog several times. The data in this posting sheds more light on the situation.

THE PIE CHARTS ARE NOT TOO SURPRISING

The first pie chart shows the distribution of the MSNBC audience. As one would expect, 45% are self-declared Democrats and only 18% are Republicans. The remainder are Independents (27%) and "Don't know" (10%).

The second pie does the same for CNN, with the only surprise being that a higher proportion of Democrats (51%) watch CNN than MSNBC. 18% of Republicans watch CNN.

The third pie does the same for Fox News. 39% of their viewers claim to be Republicans and 33% Democrats.

It might be surprising to see the Fox News "balance" between Republicans and Democrats. 39/33 = 1.18. MSNBC has a balance between Democrats and Republicans of 45/18 = 2.5. The balance at CNN is 51/18 = 2.83.

THE REAL SURPRISE

Fox News has a considerably higher viewership than either CNN or MSNBC. I combined that (from the 2009 Neilson data) with the data from the most recent (2008) Pew Research report, to generate the graphic.

The bars show the number of viewers using Total Audience (all ages) and averaging over the Entire Day. The Blue bars are MSNBC, the Red Fox News, and the Yellow CNN. The surprise is that more Democrats choose Fox News than either MSNBC or CNN. Indeed, if you combine the Democrats who watch MSNBC and CNN, they total only a bit more than Democrats who watch Fox News. If you consider Independents, more of them watch Fox News than CNN and MSNBC combined!

BUT, WHO IS "FAIR AND BALANCED"

Of course, what appears "fair" or "balanced" to one person on MSNBC may appear biased to another person, and vice-versa on Fox News. This is a subjective issue that each person needs to resolve for him or herself. My personal opinion is that MSNBC leans way to the left and Fox News a bit to the right. CNN appears to me to go right down the middle, or a bit to the left of middle.

The above data indicates that, given a free choice, people who seek out cable TV news and talk tend to choose Fox News over the competition. If you add the presumably "fair and balanced"-minded Independents to the presumably left-leaning Democrats, you find that more of that cohort watch Fox News than CNN and MSNBC combined. And that is true despite the fact that Fox News is available to fewer households.

BUT READ THE "FINE PRINT" BELOW

In the above analysis, I used Total Audience averaged over the Entire Day. I did that because the Pew Research data was for all ages and did not ask people when they watched cable TV. Fox News tends to have a slightly older audience, so had I used the 25-54 year old demographic, the results would have been a bit less surprising. However, they would still have shown that more Democrats and Independents watch Fox News than CNN or MSNBC.

The statistics for Prime Time are also a bit different from averages over the whole day. However, Fox News is also ahead on that measure. For example, for the 25-54 demographic, Fox News leads with 446,000 to MSNBCs 250,000 and CNNs 143,000. For the Total Audience including us old folks, Fox News leads with 2,036,000 to MSNBCs 753,000 and CNNs 621,000.

Ira Glickstein

BBC NEWS: What Happened to Global Warming?

OK, if you don't trust me on Global Warming, how about the good old BBC NEWS? (09 Oct 2009).

**********************************

"What happened to global warming?

"By Paul Hudson
"Climate correspondent, BBC News

"This headline may come as a bit of a surprise, so too might that fact that the warmest year recorded globally was not in 2008 or 2007, but in 1998.

"But it is true. For the last 11 years we have not observed any increase in global temperatures.

"And our climate models did not forecast it, even though man-made carbon dioxide, the gas thought to be responsible for warming our planet, has continued to rise.

"... last month Mojib Latif, a member of the IPCC (Intergovernmental Panel on Climate Change) says that we may indeed be in a period of cooling worldwide temperatures that could last another 10-20 years. Professor Latif is based at the Leibniz Institute of Marine Sciences at Kiel University in Germany and is one of the world's top climate modellers. But he makes it clear that he has not become a sceptic; he believes that this cooling will be temporary, before the overwhelming force of man-made global warming reasserts itself. ...

"One thing is for sure. It seems the debate about what is causing global warming is far from over. Indeed some would say it is hotting up."

**********************************************************************************************

I've been on this case for quite a while. See my postings that go back over a year.

Ira Glickstein

Leadership

[from John] One of my sons is taking a course on leadership and motivation. The instructor assigned a research paper on "Why do bad leaders hire bad managers". The instructor believes, or teaches, there is just as many bad leaders as there are good leaders, he wants to expand on the leadership topic by including bad leaders. The instructor gives three examples of bad leadership. First are the leaders that only hire managers that are yes men so that he/she can promote their own agenda. The next is the leader that will only hire managers that are under skilled so nobody can make them look bad. The last is the leader that is self-absorbed and they only hire managers that will make them shine, but the managers do not have the skills to manage the employees. The class agrees that the number one reason for the lack of motivation is a result of bad management.

I find the theme strange. It seems a negative approach to teaching leadership and motivation. Still, as we have been discussion motivation it may be a subject to pursue.

"Why do bad leaders hire bad managers?" Obviously because they are bad managers themselves.

While I agree somewhat with the instructor’s examples, I suspect that poor leaders hire poor managers, if they do; it is because they are poor managers themselves. I am also not sure I agree with the instructor that there are as many bad leaders as good leaders. I suspect that bad leaders fall by the wayside while bad managers may stay in their job but not advance.

We must separate leadership from management. A good leader inspires people. He motivates them to perform at their best. A good manager is a good organizer. He motivates people because they are comfortable with their boss and with their jobs and know they will be rewarded for their efforts. Two different things. Let’s explore this further.

Does a poor leader hire poor managers or does he make poor managers?
This is an important question, to use the army, as an example, you must work with the people assigned, good or bad. The task is to make do with what you were given by training, supervision and by making sure, he or she understands what is expected of them.

In the military, or at least the army, where I have my experience, progression up the ranks in interesting. Leadership is the key during the early stages, at the squad, platoon and company levels. As one advances he is assigned staff positions where management skills are developed and as he reaches the higher levels he combines the two skills of leadership and management as do successful CEO’s.

In civilian life, you have the opportunity to interview applicants. You can match your needs against his or her resume. You then chose what appears to be the best applicant. Even with the best applicant, a good leader must train the newcomer. Teach him what is expected of him.

A poor leader may chose the applicant for wrong reasons, but more than likely the applicant will become a poor manager because the leader does not do his job of training and integrating him into the job.

It is also possible that a good leader has a bad manager foisted on him. Internal politics does exist and he may have no choice. A good leader will be aware of the internal politics and work to avoid the problem. A poor leader may be fearful for his job and accept a lesser qualified person.

We have been discussing motivation a lot lately. A person is motivated because he or she can see and achieve some goal. It may just be compliments from your boss or it may be more, but motivation will not exist if the individual cannot derive some benefit from his effort. A poor leader who criticizes and badmouths his employees, who also criticizes his bosses and the company will not have motivated people including the managers below him.

Amazing High Speed Robot Hand-Eye Coordination

WOW! Click for a great video of Three-Finger Robot Hand-Eye Coordination.

My still video captures do not do justice to the amazing performance.

The photos show:

o Tossing and catching a cell phone

o Bouncing a ball faster than the eye can see

o Throwing a ball into a basket

This is a video well worth watching!

See more information and videos at Ichikawa Komuro Laboratory (University of Tokyo).

We have become used to machines that are stronger than we humans, and computers that are faster and have greater memory capacity.
However, this Robot Hand-Eye Coordination system is an example of dexterity that will greatly exceed the speed and precision of anything a human hand and eye (and eventually entire human body) can do.

Our Eye/Brain/Muscles cycle no faster than 1/10 second. This thing can go at 1/100 or 1/1000 second. Order of magnitude improvements that will only continue to accellerate.

Ira Glickstein