Tuesday, December 18, 2012

Global Warming Predictions FAR Too High

The animated graphic above is based on a figure from the most recent draft Assessment Report (AR5), currently under review by the Intergovernmental Panel on Climate Change (IPCC). The AR5 draft has been leaked by a reviewer, see  http://wattsupwiththat.com/2012/12/14/the-real-ipcc-ar5-draft-bombshell-plus-a-poll/ 

The graphic is based on Figure 1-4 from the AR5 draft document and it clearly indicates something is and has been seriously wrong with the analysis methodology and computer models utilized by the IPCC researchers. It turns out that ALL FOUR IPCC reports, from 1990 to 2007 have seriously over-stated likely Global Warming, by factors of  TWO to FIVE. When actual observations made over a period of up to 22 years substantially contradict predictions based on a given climate theory, that theory must be modified or discarded completely.

The animation shows the central estimates of Global Warming from 1990 to 2012, from the First Assessment Report (FAR), the Second (SAR), the Third (TAR), and the Fourth (AR4). They are all high by a factor of two to three.

Actual Global Warming, from 1990 to 2012 (indicated by black bars in the base graphic) amounts to between 0.12 to 0.16˚C (indicated by the black arrow in the animation),  yet the central predictions from the four reports (indicated by the colored arrows in the animation) range from 0.3˚C to 0.5˚C.

The colored bands in the base IPCC graphic indicate the range of uncertainty above and below the central predictions claimed by the IPCC when they issued the assessment reports. Please note that the colored bands, wide as they are, do not go low enough to contain the actual observations for Global Temperature reported by the IPCC for 2012.

The colored bands indicating IPCC 2012 predictions extend above the 1990 Global Temperature by as much as 1.04˚C. Even the minimum range of uncertainty bands for 2012 are above 1990 by 0.51˚C, which is nearly five times the actual measured 2012 warming of 0.12 to 0.16˚C.

Thus, the IPCC predictions have errors that are multiples of what they thought they were predicting!

The final AR5 has not yet been issued, and it is uncertain if the above base graphic will make it through the final cut due to its honesty. We shall see.

Ira Glickstein

Monday, November 19, 2012

Political Conservatives Give Thanks

The First Thanksgiving at Plymouth
by Jennie A. Brownscombe. (1914) A mythologized painting showing Plymouth settlers feasting with Plains Indians.

[From Billlifka] The Presidential Election is Over. Now What?

As Thanksgiving Day, 2012 approaches, some followers of the political scene will give fervent thanks while others remain mired in the gloom that follows a defeat of their chosen standard bearer. A majority doesn’t give a damn one way or the other. Arguably, the latter group has it most wrong. The election results will make a huge difference in their lives and the younger they are, the more difference will they experience. One hopes they will remain happily in ignorance to celebrate with those whose candidates won, at least for Thanksgiving.

Downcast political Conservatives are the focus of this essay. May it help them reflect on the blessings that still remain, those which could return and the role citizens could play in causing a return. Some are moving from the United States and others are checking the possibilities of their doing so. Many who are less financially well off and more combative are promoting secession proposals. There are worse reactions but, also, better ones that provide more personal satisfaction and a likelihood of success. First, one might recall the blessings that remain.

60% of state governors are Republican. Typically, they’re not at the rightmost limit of the political spectrum but they’re far removed from the other limit, especially on Constitutional issues and fiscal constraint. (Thank you for this blessing.) A majority of the U.S. House of Representatives is Republican with such members sharing the values of the Republican governors. (Thank you for this blessing.) Like the title of their organization, legislators in the lower House are the most representative of high officials with the roots of their constituents closest to them. That these governors and representatives remain seated suggests a very different “mandate” than that brandished by the president and his cohorts. (Thank you for this blessing.)

The U.S. Constitution remains the fundamental law of the country. (Thank you for this blessing.) It’s being weakened and disregarded, but it’s there. When Obama appoints more Supreme Court justices, major damage will be inflicted, no doubt. That won’t happen without loud protests from a minority in the senate that might draw attention to real issues rather than flaky debating points of the campaign. (If so, we will give thanks for that blessing.) The economy remains weak and it may “go south” again if Obama plays political games in “fiscal cliff” bargaining in December or in a resumption of his regulatory and redistribution extremes in his first term. Consequences of these could reach catastrophic proportions and Americans of all economic levels would suffer immensely, especially those at the lowest levels. On the other hand, that might awaken citizens to the dangers of big government moving the nation away from individual freedom and a market economy. (If so, we will give thanks for that blessing.)

If more citizens remember to whom we are giving thanks there may come a time when religion will be on the rise rather than on a decline. People have a way of turning to God when in trouble. (If that happens, we will give thanks for the blessing.) Republicans have two years to get their act together. There’s not much wrong with their platform, if they stick to high impact matters. They must learn how to talk to Hispanics and young women. They must jettison the few really dumb candidates who somehow get on the ballot. They must set aside petty squabbles. It’ll take great effort but it’s possible. (If it happens, we will give thanks for the blessing.)


Saturday, November 3, 2012

Go and Do the Right Thing - VOTE

You are on the Board of Directors of a large enterprise in severe financial trouble. Will you vote to stick with the current executive team or hire a new one?


The current team admittedly inherited a tough situation four years ago, but all they have done is spend more than they could ever take in on schemes that are not economically viable. They wasted our money rewarding their cronies with “stimulus” schemes that have not panned out.

The leader of the current team is a charming and engaging speaker who had no leadership or economic experience when he took office, and does not seem to have learned anything in those departments in the past four years. He has sold us a bill of goods of “hope and change” and all he can promise is four more years of the same.

His sidekick has no visible qualifications except having fed at the political table for decades (which explains his “gravitas”). He seems to stick his foot in his mouth whenever he opens it (which explains his clean feet and dirty mouth).

The new team under consideration offers an alternative vision based on solid business principles and demonstrated leadership and achievement.

Sadly, when it comes to campaigning, the leader of the new team  is a bit lacking in the charm department. He sometimes gets into trouble for speaking the plain truth directly and in clear language. However, he is an experienced executive with tremendous business and leadership knowledge and a sterling record of success in turning troubled enterprises around.

His sidekick is a bit of a “policy wonk” with a great deal of legislative experience. He may be the only lawmaker who has actually read and understood most of the bills he supported or opposed. He has detailed knowledge of the budget but also the ability to explain it in plain language we ordinary people can understand.

The new team has an economic plan that is admittedly a bit painful, but it is the only hope (short of Divine Intervention) of getting our enterprise out of the ditch and back on the highway to progress towards economic viability.

It is your choice. Now, go and do the right thing! VOTE!

Thursday, October 25, 2012

Uncle Sam's Illness

"Dr. Mitt", Uncle Sam, and "Dr. Barry"
A Responsible Approach vs Hopey Changey Happy Pills

[from billlifka[ I have a deceased uncle (let’s call him Sam) who was a heavy smoker. He was feeling poorly and a doctor diagnosed his condition as an advanced case of lung cancer. Sam didn’t want to hear that so he went to several other doctors who delivered the same verdict, along with the prognosis of an early, painful death.
One of these, Doctor Mitt, was quite experienced in the field and had cured many cancer patients before. He promised Sam that he could be cured if he were willing to undergo treatment that would be very uncomfortable for a time but would return him to robust health as he had enjoyed before he became addicted to smoking. The treatment would require that Sam cease smoking immediately and submit to chemotherapy and radiation. His hair would fall out, temporarily, he’d be extremely nauseous most of the time and he’d lose much weight. On the other hand, Dr. Mitt would prescribe modest doses of pain killers and a special diet of food and food supplements that would build up Sam’s total body to offset much of the damage to the localized cancer area.
Sam considered this advice but sought an easier solution. 

In all professions, there are practitioners who tell their clients what they want to hear. Usually, they are successful in their practices since most humans want to hear what they want to hear. And so it was that Sam was able to find other doctors who told him just the opposite of what Dr. Mitt and others of his persuasion had told him.
Principal among these was Dr. Barry who was a glib, handsome devil who was very popular with his patients, especially the ladies. Dr. Barry said all that discomfiture was unnecessary and, most likely, was bad; even a little bit of suffering caused patients to lose hope and hope was known to be the best medicine for any kind of ailment. Giving up smoking, according to Dr. Barry, was also bad; resultant unhappiness was another cause of the loss of hope. He prescribed stronger pain killers that produced a euphoric feeling in Sam for several months. 

After a few months, the stronger pain killers and the continued smoking didn’t make Sam any better. In fact, his condition steadily worsened and he spent an extremely painful eight months until his early death. To the end he recommended Dr. Barry to friends and associates as a doctor who cared deeply for his patients. 

This is a true story but I’ve changed the names of my uncle and the doctors to protect the guilty and the innocent. You might have noticed the similarity between my real uncle’s story and the on-going story of our Uncle Sam. My uncle’s immediate family members were enablers to him in his choice of a comfortable short term over a successful long term cure. Currently, Americans have the opportunity to enable their Uncle Sam to continue in his rotten habits that feel good in the very short term but will lead to his painful death in the slightly longer term. They have an alternate opportunity to restore him to full health and a long life. Which will it be? 

This analogy may offend some but it’s dead on. Just because one is a lemming doesn’t mean that one must follow one’s leader over a cliff. Many lemmings are credits to their species and have the intelligence to know a cliff is ahead and it’s time to ease themselves to the sides of their pack and not get swept over in the crowd. It will allow their species to survive, which should be high on their list of instincts. Their next step should be to select a leader with more common sense.

Monday, October 1, 2012

The Problem with High-Intellect Twits (HITwits)

[Added 05 Nov 2014] The posting below, from 2012, may help to explain President Obama's fall from popularity, and the GOP gains in their majority in the US House of Representatives, and newfound majority in the Senate.]

There are four kinds of people in the world:
  • High-Intellect Twit - A HITwit is a smart person who excels at some intellectual pursuit and foolishly thinks that makes him or her an expert on everything, despite pitiful lack of experience. These are the most dangerous people to have around, particularly if they use their intellect to rise to high positions and impose their foolish ideas on the rest of us. (Two prime examples of HITwits are sketched above).
  • High-Intellect Wise - A HIWise is a smart person who excels in a range of practical pursuits and is serious in his or her outlook on their place in society. These are the best people to have around because they are responsible for most of the great ideas and advances in science, technology, and business, helping to create jobs and the wealth of nations. We need HIWise leaders but, unfortunately, they are often criticized by the main-stream press for telling us painful truths, and they sometimes lack the personal celebrity and warm charm people find attractive.
  • Limited-Intellect Wise - A LIWise is a person of average intelligence who is serious about doing the best they can for themselves, their families, and their communities. These dutifully do nearly all the necessary work of the world, are good neighbors and friends, and add tremendous value to the lives of all around them.
  • Limited-Intellect Twit - A LITwit is a person of average intelligence who is also foolish. These are pretty much useless in terms of accomplishing anything, but at least they do not cause any trouble beyond requiring public assistance and charity, which they accept gracefully.
Fans of the hilarious Big Bang Theory sitcom will recognize the Dr. Sheldon Cooper character who is portrayed as a brilliant theoretical physicist with an eidetic (photographic) memory. This nearly ideal example of a HITwit knows everything about everything he deems to be important, and continually spouts little known, true but useless information to prove his high opinion of himself. Of course, Sheldon is incapable of actually accomplishing anything of use to human civilization. When he makes what he thinks is a clever joke, he cries "Bazinga!" and when the other characters suggest he may be out of his mind, he says "I'm not crazy, my mother had me tested!"

The second example of a HITwit is a brilliant public speaker who excels at inspirational rationalizations for his failure to deliver on his promise of "Hope and Change". He is so clever and lacking in any real experience in business that he actually believes his own foolish retoric. Despite the failure of trillions of dollars borrowed from the Chinese and wasted by his political allies in big business and big labor and big government to stimulate the economy, he has doubled down on more of the same. His major accomplishment and goal in life is taking money from those who have earned it by hard work and inspired enterprise and doling it out to those who, for whatever reason, have not. If a politician takes money from Peter to pay Paul, he can depend upon Paul's vote. Sadly, many of our fellow citizens are mesmerized by this HITwit's warm and charming personality and mislead by his shameless cheerleaders in the major media. They appear to be buying another four-year boatload of the same old "Hope" hokum he sold them in 2008. When will we ever learn?

That's the problem with HITwits!

Ira Glickstein

Tuesday, September 25, 2012

Affordable Food Care Act

Now that the Affordable Healthcare Act (aka "Obamacare") has been declared constitutional by the US Supreme Court, and has gone into effect, it is high time we move into the even more important realm of FOOD CARE.

After all, most of us EAT three times a day (some five times or more) while most of us only require health care a few times a year. If we are deprived of health care, most of us will live on for years, but, if we are deprived of food, even the strongest of us we will survive for only days (or three weeks max).

Having established that FOOD CARE is more critical than Healthcare, let us come up with a solution that will reduce costs and improve quality. Let us take the unfair profits away from the blood-sucking supermarkets by establishing a single-payer food program that will assure the healthiest foods at the lowest possible cost to us and our fellow citizens (and legal and illegal aliens as well, of course).

For example, there are dozens of supermarkets in my Zip Code, all of them profit-based and all making fat profits selling food that is often unhealthy and that has made many of my neighbors sickly and obese. Each of these supermarkets is earning exorbitant profits by jacking up their prices to the highest levels possible. Why should there be more than one food supplier in any given Zip Code? Why should we, the consumers, have to pay the bloated overhead of all these duplicated stores?


The advent of email, and unfair competition from profit-making UPS and FedEx, has nearly destroyed the United States Post Office. Most of their buildings are underutilized and they require large subsidies to continue operation and pay their employees.

The FOOD CARE solution is OBVIOUS. Turn FOOD distribution over to the real delivery experts at the US Post Office and FOOD acquisition over to the real nutrition experts at the US Agriculture Department. Make fresh, healthy food available for free, delivered seven days a week directly to every home in America. Letter Carriers will once again have full mailbags. Since they already deliver mail six days a week, adding a seventh day will not raise costs by more than 15%.  By eliminating profits, costs will go down, and by eliminating unhealthy foods, there will be large savings in the public health care system.

Everyone will be required to purchase Food Care Insurance and those who refuse to do so will be charged a $500 tax per year (but only if they can afford it). In that way:

- Everyone in our great country will be assured three square meals a day!

- Fresh food will be delivered daily, eliminating the cost of weekly trips to the supermarket and the expense of household refrigerators and freezers as well as the Global Warming imposed by the energy demands imposed by unnecessary travel and household appliances.

- And disabilities due to unhealthy, fattening and sugar-filled foods will be a thing of the past!

- And health-care costs will go down as life-expectancy goes way up!

- And, the US Post Office, a cherished memory of government services at their best, will survive and prosper!

What could possibly be wrong with this plan?

Ira Glickstein

UPDATE 27 Sep 2012 
Howard Pattee posted a comment on 26 Sep regarding US Health Care costs, and why they are so much higher than other countries. I did some research on why US health care costs have risen so fast and concluded that about half the increase is due to medical technology advances that were not available in the past and that are both increasing lifetimes and are very expensive.

However, it appears (see chart below) that the other half of the rapid increase in costs is driven by government programs where a third-party (US Taxpayer) is paying and the consumer gets the care for "free" so they have no reason to shop around or limit their consumption and, as a result, suppliers have no incentive to contain costs. This almost completely eliminates normal market forces that balance supply and demand according to cost and affordability.

My (sarcastic) example of "free" food supplied by the government was meant to show how ridiculous it would be to remove market forces that improve quality and convenience and keep costs affordable.  Milton Freedman said that if the government was put in charge of the Sahara Desert, within six years there would be a shortage of sand! And the cost of sand would skyrocket as the quality declined.

In other countries, notably the UK, medical costs are contained by rationing care based on a limit of about $40,000 per additional Quality-Adjusted Life Year (QALY). If a given procedure would increase the lifetime and quality of life of the recipient, but exceeds the cost limit per QALY, an alternate, less expensive procedure, such as palliative care, will be provided.

For the record, I wrote about the QALY concept way back in 2009 see http://tvpclub.blogspot.com/2009/09/end-of-life-honest-brokers-not-death.html and I support it for public medical expenditures in the US.

(More recently, see http://tvpclub.blogspot.com/2011/02/runaway-trolley-applied-to-end-of-life.html, and http://tvpclub.blogspot.com/2012/08/quality-of-life-and-health-related.html for my views. Unless we thoughtfully address End of Life and rationing of health care for people with chronic and terminal conditions, we will never be able to control overspending on health care. A false sense of "compassion" and "fairness" and "caring" will continue to bankrupt the USA.)

Thursday, August 23, 2012

Once I was young and a Democrat

[from billlifka] It was a fine time and a good thing to be. I had many friends and relatives who were Democrats. In fact, most were. Now, most of them are dead but I have new friends and relatives who are Democrats, although not so many.

I was a Democrat longer than I was Independent and that longer than I was Republican. However, I wasn’t registered as a Democrat which may be like Bill Clinton’s having smoked pot but not inhaling. Barack Obama has inhaled with pleasure, which may explain a lot. The point is that my credentials as a past Democrat may be questioned but, I assure you, Democrats of my age would recognize me as a kindred spirit. I was born as a Democrat as I was born as an American and a Catholic, all being quite compatible at the time. I chose to be a paper boy and a Cub Scout at the age of nine. These were the first observable signs I had started to think on my own although there’d been covert outbreaks of latent Libertarianism from the age of three.

I never thought much about why I was a Democrat other than as a blessing of birth. When FDR ran for his second term as president, my mother explained that all should vote for Roosevelt because, “He was for the poor people, like us.” Being six years old, I always accepted what my mother told me so long as it didn’t interfere with my plans for that day. Even then, I thought it was a strange argument since I didn’t feel particularly poor. Starting with my being a paper boy, it seemed even stranger since all I needed to do to have money in my pocket was to do a little work and just doing the work made me feel good about myself, also. Then too, I found it hard to understand why FDR was great if he was for losers. At the time, I was for the Chicago Cubs but in those days the Cubs won two pennants so I didn’t think of them as losers until I got a little older. If my mother had said FDR was going to turn losers into winners I would have understood it was like hiring a new manager for the White Sox.

Despite my confusion at an early age, I did come to understand why people would vote for FDR even if they weren’t born as a Democrat. In fact, I think I would vote for him, if I were over twenty one at the time because he did talk a good story and engaged the federal government in a lot of activity, especially for a guy who needed to operate out of a wheelchair. Now I know that activity shouldn’t be mistaken for progress, but in those days it caused most people to feel better even though the depression just went on and on until the war. When it came to the war, FDR was one of the better presidents because of his ability to convince Americans all would turn out well in the end. It also helped that he picked an outstanding leader for the military forces and was convinced, mostly by his wife, to let businessmen lead industrial mobilization. Like his cousin, an earlier president, FDR was not comfortable with the private sector and distrusted all who were in it; they just wouldn’t kowtow to his economic ideas and lack of experience in their field.

By the time Harry Truman came along, I was learning things that caused doubts about FDR but, still a born Democrat, I would have voted for Harry if I were twenty one because Tom Dewey’s moustache made him look sneaky to my eyes. On the other hand, it seemed clear that Harry was straightforward and outspoken and I liked the sign on his desk, “The buck stops here!” He was a guy who took responsibility for his actions and had made tough decisions without flinching over what people might say about him. Even then, I knew those were important traits for a leader. He made some mistakes but if I were transported back in time with my present knowledge, I’m sure I would vote for him and not because I was born a Democrat.

My family never got anything from the Democratic Party, even though FDR was for poor people. Mostly, the Party functioned in the large cities, like Chicago, and they got people work. This was a good thing that people had to work for their money, like being a garbage man. It was true that higher ups might be building inspectors and depended on bribes for extra money but they had to support their families and come election time they had to work hard for no pay in “getting out the vote” which meant getting people out to vote. This is harder than it might seem, especially when some people lived in cemeteries. On a national level, FDR did find work for many in the CCC where they built forest preserve shelters and other public works. My relatives found work for each other like when my father introduced his brother and two brothers-in-law to his boss. That didn’t stop them from being good Democrats even if they made a living on their own

Even though I was a born Democrat, Ike seemed to be an obvious choice over Adlai Stevenson. Adlai was a very bright guy and witty speaker but had the real world depth of a driveway puddle. With Eisenhower, I drifted away from my Democrat birthright but only to that place in between called Independent. I don’t blame Independents for giving up on both Political Parties. Both have earned that treatment. On the other hand it’s sort of like the idea of Purgatory, a place neither heaven nor hell. I can understand why one might choose hell for all the fun that comes before or heaven for all the fun that comes later. Choosing the in-between is hard to fathom. Nevertheless, I felt comfortable there and then John Kennedy came along.

In retrospect, I should have suspected all wasn’t right about Kennedy. But he looked so good, had such an endearing family and talked so convincingly, it was easy to succumb to his charm. By that time, I had forgotten I was born a Democrat, but not that I was born a Catholic and was offended that the presidency had eluded Catholics and the previous one who had tried had been rejected primarily because of his religion. JFK was assassinated and, therefore, deserves to be an “American Saint.” If he had served a full two terms, he might well be remembered differently.

Ronald Reagan came upon the scene. Admittedly, he was running against a guy who had failed in his first term miserably. Nevertheless, he was dismissed as an actor, forgetting his success as Governor of California and as President of the Actor’s Guild, a working job. As an Independent, I had no problem voting for him and became converted to the Republican Party during his time in office while retaining the right of occasional dissent over peripheral items of dogma. I think I have learned how to judge an effective leader of my country based on his past performance in responsible jobs and his character traits as displayed in those positions. I listen to what he says he will do and strongly discount what others say he will do, especially those who have reason to lie about him. I give no thought whatever to whether we share a political party, religion, ethnicity or the many peripheral social preferences that exist in abundance.

Most importantly, I imagine how this blessed country of ours will fare under his leadership. I’ve been around for the great depression, being totally unprepared for WWII, engaged in five other major military adventures and countless minor ones and many social and economic crises. All has not yet been manifested, but we are in the midst of what I believe will be the greatest testing of America in its history. The foundations of our government, economic system and social structure are under siege without restraining influence of experienced leaders with the prudence and wisdom to chart and navigate safe passage through dangerous reefs for the ship of state.

My purpose in this writing is to convince those who choose the Democratic Party as theirs to vote for the opposition candidates, Mitt Romney and Paul Ryan and that, in their doing so, they will act to save their Democratic Party as well as their country. I write as one who once shared membership in their party, although in simpler times, and one who has voted for rational reasons and for not-so-rational reasons, for candidates of my party and for candidates of another party.

Like many Republicans, I disagree with some opinions of my fellow Republicans. I believe most Republicans respect members of the Democratic Party and accept that contention between the two major Parties is important to the well-being of America. I believe most Republicans accept that elected officials from the two parties must find a way to conduct the business of the country in a manner that addresses major needs of the country without violating reasonable and critical beliefs of either Party. It goes without explanation that many of the less important desires of both Parties may not be agreed upon but can be subjected to continuing debate. Such debate should be open and with courteous regard for opposing beliefs. I believe that Democrats in my youth displayed many traits that are consistent with my beliefs and exist today in many members of the Democratic Party. These include patriotism, importance of the U.S. Constitution, belief in open debate and legislative process, personal responsibility, the value of work, the opportunity for all to improve their status in life and that it’s wrong to set one group of people against another group of people in open warfare. If you share these beliefs, you should vote for Romney and Ryan and for legislators who have demonstrated the same beliefs, regardless of their party affiliation.

It’s dangerously foolish to assume Barack Obama, in a second term, will change his stubborn march to turn America into a second class nation subject to domination by world organizations. He will continue to violate the Constitution as necessary to further his totalitarian ambitions. His acolytes in Congress will continue to block open debate to provide the excuse for government by executive order and bureaucratic mandate. He will continue to pit one group of Americans against another and seek majority backing through mindless wealth transfers that drive the country ever faster into bankruptcy. It’s dangerously foolish to assume that a very large minority of the public will accept this without resisting in ways that will result in widespread violence. At least worst, the Democratic Party would lose it’s acceptability as a governing body. At the very worst, the country would be torn by violence that would rival that in the American Civil War.

On the other hand, there is Romney and Ryan. Romney has proven he can govern effectively in an overwhelmingly Democratic State and obtain support from egotistical foreign Olympic czars. Ryan has proven he can work across the aisle and prefers reasonable compromise to mindless contention. Both know the solution to America’s critical problems lies in economic actions of the type in which both are highly experienced. They are good people, just like most Democrats.

Saturday, August 18, 2012

VP Candidate Paul Ryan talks Medicare at The Villages

Paul Ryan (center) with his mother and Lee Greenwood who introduced him with his famous "Proud to be an American" song this morning in The Villages, FL. Video available at http://www.realclearpolitics.com/video/2012/08/18/paul_ryan_addresses_the_villages_with_his_mother.html
It was my pleasure to cheer Congressman Paul Ryan as he addressed an enthusiastic audience at "Florida's Favorite Hometown", the retirement community of The Villages, in central Florida, where my wife and I have lived for the past nine years. The banner behind him and in front of the podium said "Protect and Strengthen Medicare" and a good part of Ryan's talk had to do with that topic.

He introduced his mother, a snowbird who lives in Ft. Lauderdale, Florida and he reminded us that the Romney/Ryan plan would not affect current recipients nor anyone 55 years of age or older, which, at a show of hands, included at least 80% of the crowd. He said that President Obama had taken $716 billion out of the Medicare trust fund and that could cause one in six hospitals and nursing homes to close. In contrast, he said, the Romney/Ryan plan would save the program for those at or near the eligibility age, and strenghten it for the next generations by offering choices based on competition between private plans and the government plan.

A video of his complete talk is available at: http://www.realclearpolitics.com/video/2012/08/18/paul_ryan_addresses_the_villages_with_his_mother.html

Just to be sure both sides of the Medicare issue were represented, a yellow airplane flew over and around the square pulling a sign that said: "PAUL RYAN: HANDS OFF OUR MEDICARE!"

Also see this ABC News report on Ryan's talk that includes a contrary view of the $716 billion dollar Medicare cuts:  http://abcnews.go.com/Politics/OTUS/paul-ryan-defends-medicare-plan-accuses-president-obama/story?id=17034339

As we say down here "It's a beautiful day in The Villages" and this day was no exception. My friend Jerry and I arrived via golf cart and passed through the airport-like security cordon without much delay into Lake Sumter Market Square where Lee Greenwood was entertaining the crowd. We found a good standing position on a raised wooden platform about 100 feet from the podium. We enjoyed several more songs and then we heard from some local politicos.

From where we were standing we had a good view of the building Ryan and his party would exit to get to the square. Security and coordination people walked between the square and that building and then we saw Ryan, in a dark blue shirt, standing at the ready with his mother, in bright yellow, and other dignitaries. Then we saw them cross the street to the square and out of our view.

I noticed "Campaign Carl" Cameron to the left of the podium broadcasting to his Fox News audience. Then Greenwood sang his famous and very moving "Proud to be an American" song and introduced Ryan and his mother to lots of good-natured cheers. (See the video at http://www.realclearpolitics.com/video/2012/08/18/paul_ryan_addresses_the_villages_with_his_mother.html)

I found Ryan's talk very well done, and even better than the talk I saw Mitt Romney give here in the same square back in 2008 during the GOP primaries that he lost to Sen. McCain. At that time, the crowds were smaller and security more relaxed and I had the priviledge of shaking hands with Romney after his talk. My wife and I also attended the talk given by VP candidate Sarah Palin in our square in 2008. Although we arrived hours early, over 40,000 other people showed up and we couldn't get into the specially secure area of the square that afforded a direct view and had to watch the proceedings on large "Jumbotron" TV displays set up around the square.

By contrast, we arrived for Ryan's appearance less than an hour before he gave it and were able to get into the standing room only part of the secure area. Thousands of others, who brought folding chairs which were not allowed in the secure area, chose to watch via "Jumbotron" on the streets around the square. Of course, the "Jumbotron" view is much clearer and better than the direct live view, and sitting is much better than standing for an hour, but, by some strange quirk of human psychology, a direct view is preferred.

At one point, near the beginning of his talk, Ryan noticed that someone had a medical emergency and he interrupted his talk to be sure the medics were on the way. Given the August heat, and the fact that residents of The Villages are beyond retirement age, medics are always at the ready. Later in Ryan's talk I saw a woman in a stretcher being whisked out of the secure area.

The crowds were very polite and supportive, with absolutely no pushing to get the best view. We did crowd together, and sometimes a standing supporter waving a sign did block the view, but it was all done in a festive spirit.

After the talk was over, a light rain began to fall. We sauntered out of the secure area, along with over a thousand others, which took some time given that we are mostly retirees and some of us have trouble walking. We remembered where we parked my golf cart and followed the traffic through happy people walking to their carts and cars in the light drizzle, and, with a minimum of delay, got back home in good humor.

All in all, a great way to spend part of a Saturday morning.

Ira Glickstein

Friday, August 3, 2012

Quality of Life and Health-Related Quality of Life

What is Quality of Life and how is it related to Standard of Living? How should Health-Related Quality of Life play into decisions by individuals, health insurance plans, and government subsidized health care decisions?

These are important questions that can have no definitive answers. However, they are well worth discussing in a collegial, rational, and fact-based way.

I presented this Topic to The Villages Philosophy Club today and had the nearly 50 people who attended, mostly retirees in their 60's, 70's and 80's, select what they judged to be the most important factors leading to high Quality of Life. They also used a questionaire called "EQ-5D" to estimate their individual Health-Related Quality of Life levels. We then discussed the results and the implications for making individual Health Care decisions.The results of our selections and evaluations are posted below.

You may view and download the PowerPoint slides here: https://sites.google.com/site/iraclass/my-forms/QualityOfLife3Aug2012.pptx?attredirects=0&d=1


After researching this question on the Internet, and thinking about my own country, community, family, and life, I came to the conclusion that Standard of Living is only one contributor to a high Quality of Life. It is definitely possible to live at a moderate Standard of Living so long as you have other beneficial factors in your life. I came up with a list of some 21 beneficial factors, seven having to do with Personal aspects of our lives, seven with People in our lives, and seven with Things in our lives, as follows:
⃝ Higher Education and Knowledge
⃝ Honest, Hard-Working Reputation
⃝ Satisfying, Rewarding Career
⃝ Travel, Hobbies, Recreation and Leisure Time
⃝ Robust Health and Long Life
⃝ Emotional Well-Being
⃝ Strong Religious Faith

⃝ Loving Parents, Grandparents
⃝ Loving Spouse, Children, Grandchildren
⃝ Loving Siblings and Extended Family
Great Teachers, Clergy, Bosses, …
Loyal Friends and Good Neighbors
Cooperative, Competent Co-Workers
⃝ Competent and Friendly Service People

⃝ Freedom and Human Rights
⃝ Stable and Secure Finances
⃝ Comfortable, Safe Home and Community
⃝ High-Tech Electronics and Entertainment
⃝ Fine Food, Fancy Furnishings, High Lifestyle
⃝ Excellent Healthcare
⃝ Golf, Swimming and other Sports Facilities


During my presentation to The Villages Philosophy Club today, nearly 50 people participated in the survey. Each member was asked to vote for his or her top ten items and the scores are tallied and graphed below to determine the most important two in each category and the most important ten in the whole list.
The top "THINGS" items were:
-Freedom and Human Rights, and (tied for second place)
-Stable and Secure Finances, and
-Excellent Healthcare

The top "PERSONAL" items were:
-Robust Health and Long Life, and
-Emptional Well-Being

The top "PEOPLE" items were:
-Loving Spouse, Children, Grands, and
-Loyal Friends, Good Neighbors

The overall top ten items were the ones with their numbers highlighted in pink:

They are:
1-Robust Health and Long Life
2-Freedom and Human Rights
3-Stable and Secure Finances
4-Excellent Healthcare
5-Loving Spouse, CHildren, Grands
6-Comfortable/Safe Home/Community
7-Emotional Well-Being
8-Loyal Friends, Good Neighbors
9-Travel, Hobbies, Recreation, leisure
10-Loving Parents, Grandparents


The Human Development Index (see
http://en.wikipedia.org/wiki/File:2011_UN_Human_Development_Report_Quartiles.svg) is a 2011 UN publication that considers life expectance, literacy, education, standards of living, and other aspects of Quality of Life to come up with a score for each country. Not surprisingly, the highest levels are found in the US, Canada, Western Europe, Japan, Australia, Chile, and Argentina. The lowest in Central Africa and parts of Asia.

The Quality of Life Index (see http://en.wikipedia.org/wiki/Quality-of-life_index) was put out in 2005 by the respected British magazine The Economist and they consider:
Healthiness: Life expectancy at birth
Family life: Divorce rate

Community life: High rate of church attendance or trade-union membership
Material well being: GDP per person
Political stability and security: Political stability and security
Climate and geography: Latitude (warmer and colder climates)
Job security: Unemployment rate
Political freedom: Political and civil liberties
Gender equality: Average male and female earnings

Again, the US, Canada, Western Europe, Japan, and Australia get high scores, but, surprisingly, the top country is Ireland. The US comes in 13th, just after Finland and ahead of Canada.

The Happy Planet Index (see http://en.wikipedia.org/wiki/File:Happy_Planet.PNG) is a 2006-2012 effort that "is not a measure of which are the happiest countries in the world: [but rather a]
Measure of the environmental efficiency of supporting well-being in a given country, and of the Subjective life satisfaction, life expectancy at birth, and ecological footprint per capita. 

The US comes in at a dismal  #114 in the 2009 rankings, and is in the worst category along with much of Central Africa and Russia. The best three countries in the 2012 ranking are Costa RIca, Vietnam, and Columbia which each have a "Happy Planet Index" that is twice that of the US.


How should Quality of Life impact health care decisions? Government agencies, including the US Centers for Desease Control and Prevention (CDC) and the UK National Institute for Health and Clinical Excellence (NICE) have considered this question for decades, and their decisions are currrently affecting your health care availability, and will do so more and more in the future.

The US CDC website (see http://www.cdc.gov/hrqol/concept.htm) has links to many Health-Related Quality of Life pages, as does the UK NICE website (see http://www.nice.org.uk/).

Health-Related Quality of Life is measured by several different questionaires, inluding the SF-36 and EQ-5D. The SF-36 (see http://www.anapsid.org/cnd/files/sf36.pdf) consists of 36 multiple-choice questions. The EQ-5D (see
http://www.medicine.ox.ac.uk/bandolier/painres/download/whatis/QALY.pdf) has five multiple-choice quesitions. The result is a personal score that ranges from 1 (for perfect health) to 0 (for death). It is possible to score as low as -0.5 (worse than death).

The members of The Villages Philosophy Club took the EQ-5D survey and the average personal score was 0.88, indicating a pretty healthy group. Around 40% of us reported PERFECT HEALTH with a score of 1.0. About 30% reported NEAR-PERFECT HEALTH with a score of 0.88. About 22% (including me) reported the next level down with a score of 0.76. About 4% reported a score of 0.62, and about 2% each reported 0.47 and 0.33.

When a health care decision is to be made between alternative treatments, consideration is given to an estimate of the level of Health-Related Quality of Life that will most likely result from each treatment alternative, as well as an estimate of how long the patient is likely to live if given that treatment. The result of multiplying Health-Related Quality of Life by Years of Life is called the Quality Adjusted Life Years (QALY).

In the UK, if a given treatment alternative costs less than about 30,000 pounds per QALY, and if the doctor and patient want that alternative, it is approved and paid for by the National Health Service. If the desired alternative is more expensive than about 30,000 pounds per QALY, it is denied, and a lower cost (and more cost-effective) alternative is approved. 30,000 pounds is equivalent to about $47,000.

Ira Glickstein