Some interesting comparisons

Forms of government

[from John] One would assume that Fascism (Hitler) and Communism (Stalin) are worlds apart until one examines their definitions from the Encarta Dictionary.

Fascism Any movement, ideology, or attitude that favors dictatorial government, centralized control of private enterprise, repression of all opposition, and extreme nationalism

Communism 2. Any system of government in which a single, usually totalitarian, party holds power, and the state controls the economy.

They sound pretty much the same to me.

Socialism 3.A stage between capitalism and communism. In Marxist theory, the stage after the proletarian revolution when a society is changing from capitalism to communism, marked by pay distributed according to work done rather than need.

Note: pay distributed according to work done rather than need. Also note the implied road to communism.

Republic A political system or form of government in which people elect representatives to exercise power for them.

Does a republic remain a republic if elected representatives do not listen to the people?
Does a republic remain a republic if elected representatives are chosen by two political parties rather than by the people?
Does a republic remain a republic if only half of the people vote?
Does a republic remain a republic if money and lobbying can seriously affect elections and legislation?

Democratic Party one of the two major political parties in the United States, formed after a split in the former Democratic-Republican Party under Andrew Jackson in 1828.

See we were friends once let’s try it again, friendship I mean.

The Market Place

Capitalism An economic system based on the private ownership of the means of production and distribution of goods, characterized by a free competitive market and motivation by profit.

Socialism A political theory or system in which the means of production and distribution are controlled by the people and operated according to equity and fairness rather than market principles.

Socio-Capitalism (my word and definition) An economic and political system that seeks to find a reasonable blending and balancing of a limited free market with the societal need for equity and fairness toward its people.

It seems to me that this is where we are heading and is probably where we should go.

Changing the USPS

[from billlifka, posted with permission] The U.S. Postal Service has provided poor service for a long time. Now it’s failing financially.

Emulating the House’s intended legislation on health care, this essay suggests a tongue in cheek congressional solution to the USPS problems.

An incoherent 1375 page bill would establish the FWCC, Federal Written Communications Commission, to interpret the language of the bill, to enforce interpretations and to fine violators. There would be no provisions for an appeal process. The FWCC would be headed by a Czar. A Czar outranks a Postmaster General, of course

The young prefer E communication to snail mail. That will cost them, and properly so. E mail and the like reduce the market for snail mail and postal workers are an important voting bloc. A tax on E mail will be equivalent to the cost of a first class stamp plus overnight delivery charge. Twitter tax will equal the price of a post card stamp. Seniors present another problem, in their fears about anything electronic. Their communications are by mail; some containing heavy catalogs and prescription drugs. Postal workers labor excessively processing such mail so it will not be delivered, nor will USPS competitors be allowed to provide such service. Old folks can just schlep down to their local retail stores, thus keeping the economy rolling. For folks above a certain age, all mail services will be withheld and replaced with end of life counseling.

Homeless people will be provided with government funded mail boxes in post offices nearest to their favorite street flops. Illegal immigrants will be provided with a similar service except with a feature like “sanctuary cities”; the USPS will, by law, hold alien addresses confidential from any federal agency, especially the immigration service. Providing all inhabitants with equal service is a primary goal, as demonstrated by the features noted. Another goal is to maintain the jobs of USPS workers without making them work too hard. On the maintenance side, UPS, Fed Ex and the thousands of local delivery companies will be required to buy an annual license to compete with the government; after all, it’s the government that owns communications. Similarly, these companies will pay taxes equal to their payroll expense as a penalty for taking jobs away from the public sector. Their deliveries will be restricted to the hours of normal USPS operations as one more means of keeping the playing field level for all.

It’s clear that Post Office locations are not chosen to match population densities. Some in the boondocks service less than 250 households. Others may serve 10,000 or more. Lack of equality is un-American. Also, it is costly. One solution would be to close Post Offices in the boonies but that isn’t acceptable since USPS jobs would be lost. The logical solution is to level load existing Post Offices. Accordingly, the FWCC will reassign citizens from crowded Post Offices to those with few customers. In sync with Medicare practice, these would be located no more than 60 miles away. Dealing with an unassigned Post Office would be a violation subject to fine. It’s not expected that lines in Post Offices will be reduced by this change. Either the clerks will take longer breaks or more clerks will be hired, as may be appropriate to a given location. Long lines is the USPS tradition that replaced the original one about snow, sleet and hail.

This essay is not intended to poke fun at USPS workers, many of whom are dedicated and just as conscientious as those in the private sector. The same can’t be said for a majority of legislators.

billlifka

Health Care

[From John] Maybe as a nation, we should step back and philosophically examine what we are talking about when we discuss universal health care or to rephrase government sponsored health care. On one hand, we wish to provide a universal health care program that will provide an adequate form of protection for all. To fulfill that wish a 1000 page plan has been proposed. Within that plan is the acceptance that we cannot afford to provide universal health care therefore we must ration health care. Does this make sense? We give with one hand and take with the other.

To complicate the philosophical view it seems that 80 percent of the population is satisfied with their current coverage. So it is our desire to provide a universal health care system, I emphasize universal. A health care system that will affect 100 % of the population because 20 % need better protection.

Beyond this, we now have two forms of governmental healthcare, Medicare and Medicaid that seem to work fairly well but are going broke; we cannot afford this level of health care so we must examine and propose a more expansive system that we probably cannot pay for.

Prior to the 1930’ health care was the responsibility of the individual, his family and private charities. In a sense, it worked as well as the proposed system. It rationed healthcare. If you could afford it you got it if not you didn’t.

What is the philosophical difference? The difference is that the government has decided, beginning with LBJ, that it is necessary and appropriate to redistribute an ever-growing portion of the national wealth to provide a form of socialized healthcare that is, admittedly at the outset inadequate and too expensive.

Medicare

[from Joel] I wonder if you folks who are retired have had the same experience as I did. When I reached age 65, I became eligible for Medicare. My private health care insurance told me that I had to apply for Medicare or lose my coverage with them. They then became my secondary provider after Medicare. The meaning of this was that after collecting the insurance premium for about forty healthy years, my insurer was able to transfer the responsibility for my expensive years to the government. This seems like fiscal insanity for the government. No wonder Medicare is going bankrupt! It would seem that it was designed to go bankrupt. Does anyone remember why LBJ did this? Medicare should be secondary instead of primary, or primary for those who have no insurance. -Joel

Health Care

[from John] A previous Topic on healthcare discussed two issues I would like to discuss further. The first Outcome based Reimbursement needs further definition. The first definition, a modification of my proposal in the referenced blog is stated as definition 1.

Definition 1: Outcome based Reimbursement is a measure of whether the cost of treatment is sufficiently beneficial to the nation and the patient to justify payment by the healthcare system, if not the patient must seek his own treatment.

This definition has conflicting priorities - the nation and the patient. I’m sure in a patient’s view any treatment regardless of cost is justifiable as long as a reasonable quality of life is retained and should be paid by the health care system; on the other hand the nation, having many uses for its funds is most interested in optimizing the use of its funds therefore it must weigh the future value of the patient to the nation against the cost of treatment.

I agree that it is not in the best interest of a nation to treat its people cavalierly, still the further remote the decision making is from the patient and his doctor the more likely the decision will be made in favor of conserving funds. Therefore, a national government supervised (controlled) healthcare system is apt to make decisions based on precedence, standards and by rote. Thus, definition 2 seems to be a more probable definition of how Outcome based Reimbursement will be applied.

Definition 2: Outcome based Reimbursement is a measure of whether the cost of treatment is sufficiently beneficial to the nation to justify payment by the healthcare system, if not the patient must seek his own treatment.

If we accept definition 2 as the more probable result, each of us will be assigned a Quality-Adjusted Life Years (QALY) value based on certain criteria that will change over time as we age. How and at what level will this QALY value be defined and assigned? If done at a lower level, by the doctor or the hospital the result would not be much different from the present. However, if the doctor or hospital makes the decision will they be reimbursed by the health care system? Today, Medicare requires doctors to assign a code identifying the procedure performed. Medicare reimburses the doctor based upon this code. If they perform a procedure not covered, they are not reimbursed and must collect from either the patient or his insurance company. Insurance companies in turn normally reimburse the doctor or hospital only if Medicare authorizes the procedure. Thus, Medicare can be considered as a form of Outcome based Reimbursement.

The probability is very high that under OBR we will have a system very similar to Medicare with the exception that the QALY value will be combined with the Medicare code to determine whether the procedure will be reimbursed. Almost certainly, the QALY value will be determined at some national level as are the Medicare codes. Thus to be reimbursed my doctor will choose to perform the procedure not based on need but on a nationally published set of criteria or standards. The patient is only an artifact or a machine to be fixed or junked depending on his value to the nation.

The counter argument that if the system turns me down I can still seek treatment depending upon my net worth is spurious. If I my net worth just exceeds some arbitrary level then the healthcare system disavows me. All my assets may be needed as well as those of my family to obtain treatment or if I exceed that arbitrary level I will have to seek insurance while those just below that level obtain free treatment. Now the decision to perform a procedure and receive reimbursement from the health care system depends upon three factors, Medicare codes, my QALY and my net worth. Bah Humbug!

Lastly I was asked to address “the idea that end-of-life care costs an average of 50% (a number I read for the last year of life under the current system in the US), or could cost as much as 80% (according to President Obama). What do you think the actual number is?”

The objection I have is twofold the first is “the last year of life”. Let me address this first. I will admit that the examples are anecdotal in that they are based on my direct personal experience and not the part of a scientific study. However, they are diverse in their life experience and financial standings. Some poor, some middle class, some male some female. They lived in Minnesota, Texas, Arizona, Oregon, Illinois and Florida.

• A lady dies at 100, I am not sure of the cause. She lived and died at home using a walker and meals on wheels. There was no hospitalization in the last year of her life.



• A man in his nineties, caught phenomena, was hospitalized for about a week and died in the hospital. He was not hospitalized otherwise over the last year of his life.



• A man in his seventies became ill, was treated on an outpatient basis until he had to be placed under hospice care for a week or so before he died.



• A lady in her eighties died in her home of a heart attack. She had not been hospitalized over the previous year.



• A man in his sixties, suffering from several heart related problems has been hospitalized on and off over several years. The combined costs of that hospitalization will certain exceed the cost of his last year of life.



• A lady in her sixties had cancer and was treated, as an outpatient. The cancer went into remission for over a year. When it returned she chose no treatment and ended in an oncology ward for slightly more than a week.



• A lady in her nineties was in a private nursing home when she broke her hip; she died after a short stay in a hospital.



• A man in his seventies died of a heart attack while at home. He was undergoing no treatment at the time.



• A man in his seventies, receiving outpatient treatment was in Hospice care when he died.



• A man in his forties, a farmer, died while at work. He was not undergoing any treatment.



• A lady in her forties died of a heart attack while at home. She was not undergoing any treatment.

With the exception of one man mentioned above, none of these people was receiving extensive treatment in the last year of their life. They are a diverse group of people. I cannot believe that they are exceptions but rather the norm. In their cases, where did the 80% of the cost of health care go?

It is a reasonable assumption that seniors require more health care than the average. We are at the end of our life. We are wearing out and require more care to extend our quality of life. I am not questioning that. Still let’s examine it from another direction. In the paper today, an article stated that the average life span for a male was 78 years and a woman 81 years. Thus, the life span as a senior is from 65 to 80 years of age– fifteen years. If you want to quibble 55 to 80 years of age – twenty-five years. On the other hand, the non-senior life span is 0 to 55 or 65 years of age. To state it differently, a person lives 55 to 65 years of his life as a non senior exposed to work hazards, accidents, birthing, childhood diseases, flu, other adult diseases, etc and then in his last 15 to 25 years to failing health. Considering 55 to 65 years of a lifetime is exposed to the natural hazards of life and 15 to 25 years as a senior, I believe a more reasonable figure for the cost of senior care over 15 to 25 years would be in the range of fifty percent.

End of Life

[From Joel] I agree that there's too much going on in the previous post. Let's look at a single issue. What are the expenses that occur in the last phase of life? Does it make sense to try to cut expenses using some universal formula? Here's a web site that addresses the salient statistics and issues.

http://neurologicalcorrelates.com/wordpress/2008/03/12/about-30-of-medicare-is-spent-on-end-of-life-care-what-should-we-do-about-it/

with respect -Joel

P.S. That's me, a seventy year old, climbing a wall on July 4, 2009 celebration. The National Guard guys who haul the wall around say I hold the old age record for climbing the wall. Hopefully I'll take a swan dive off a cliff when the government starts to evaluate my quality of life for medical treatment.

We Need COST-EFFECTIVE Health Care Reform

Shout it from the rooftops!

WE NEED COST-EFFECTIVE HEALTH CARE REFORM!

This posting details the THREE changes we need in US health care to save the money we will need before we expand the system further.

1) Universal digititized patient data, securely accessible by any doctor chosen by the patient. This part should be easy to sell to both political parties and all medical specialties. It has been technically feasible for a decade an it is past time we do it.

2) Tort reform to eliminate high malpractice premiums and defensive medicine with unnecessary tests that add up to 10% to costs. This will be a hard sell to the majority party that is in the pocket of trial lawyers.

3) Outcome-based reimbursement to eliminate costly surgery and medications that do not yield comparative effectiveness based on quality-adjusted life years. This will be a hard sell to the minority party, some of whose members originally proposed it but who have backed away due to the onslaught of opposition based on "pulling the plug on granny".

WARNING: This posting will make you angry no matter which side you are on in the current debate. Please give it a chance because I think it is the best we can do now to control health care costs and get the best "bang for the buck".

1. Universal Digititized Patient Data

This is the easy one.

Every time I go to a new doctor I have to complete a detailed medical history form. Fortunately, my wife has all the major stuff memorized, but I think most people forget some of their medical history and just guess at the dates for past medical procedures if they do remember, so the new doctor does not have complete or correct information. At each doctor visit I have to update my list of pills. Every time I get my blood and other fluids tested along with a record of my blood pressure, weight, temperature and other information, it is done by computerized equipment, but the records are printed out and sent to my doctor in hard-copy form.

All this is error-prone and a waste of time for the patient. Since the data is hand-written and hard-copy the doctor has to paw through pages and pages of paper records. There is no opportunity for a computer to assist him or her in detecting counter-indications for various medications or procedures.

By now, all hospitals and most doctors store at least some of their data on computers, most of which are networked. We buy our prescription medications from large companies that are fully computerized. Even my non-prescription pills are purchased online so there is a computer record of all those transactions.

There is role here for the government to work with a medical industry organization to standardize the format and contents of universal digitized patient medical data. Of course, with universal patient data there is a security issue. We want only doctors and hospitals authorized by the patient to have access to our medical data, and only to that portion of the data that is applicable to the type of medical procedure being performed.

The government has already specified the Real ID drivers license that is being issued by some states. The security aspects of Real ID have been watered down to something called Pass ID, which is unfortunate in my opinion, but even Pass ID will be secure enough for medical record access. Nearly all adults have drivers licenses. Children could be ID'd via their parent's ID and non-licensed adults could be ID'd by their spouses or adult children's or medical proxy's IDs.

Your regular doctors and hospitals would scan your Real ID or Pass ID to access your records. If you change doctors, or go to an emergency medical facility, they would scan your ID card to get secure access to your medical records. Of course, each doctor or hospital would have a specified set of medical specialties and his or her ID card would limit their access to only those parts of your medical records applicable to that specialty. Periodically, doctor and hospital access would expire and require a new ID scan.

All the government needs to do is: 1) Authorize a medical industry organization to set up the data standards, the rules for secure access, and to certify the competing companies that will securely store the data for patients, funded by fees when the data is accessed, 2) Authorize the use of Real ID and Pass ID for secure access, 3) Require all doctors, clinics and hospitals to adopt the new standards within five years and, 4) Where necessary, subsidize computer equipment and software for doctors, clinics, and hospitals in less affluent areas.

It is estimated that at least 10% of Medicade/Medicare funds are stolen by fake or unscrupulous doctors and medical equipment and service providers. A side-benefit of use of Real ID and Pass ID will be a double check that the actual patient has really been serviced. The government and insurance companies will also be able to check the frequency of use of services by any given patient ID number which will help identify unscrupulous providers who claim to have serviced a given individual with unreasonable or conflicting items.

2. Tort Reform and Defensive Medicine

If passed, this will be costly to the trial lawyers (like former Presidential hopeful Senator John Edwards). The current system is a full-employment program for lawyers. They make emotional arguments and parade the sad cases of patients who have had bad outcomes from medical treatments and expect to be reimbursed for both the cost of the care and "pain and suffering".

Medicine is not an exact science and some patients will have bad outcomes no matter how competent their doctors and hospitals. Trial lawyers can always find an "expert" who, for pay, will testify convincingly that "if only" such and such a test had been done, or a different course of treatment had been followed, the patient might have recovered to full health and vigor. This type of "Monday morning quarterbacking" is easy because, after the fact, the actual outcome is known, and the "expert" is free to speculate on what might have been had a different path been chosen with absolutely no way to prove him or her wrong.

We already have caps on "pain and suffering" awards in some states. This helps the medical malpractice insurance companies a bit. Unfortunately, when a doctor is accused of malpractice his or her time is not compensated, nor is the inner turmoil he or she feels, even if the accusation is baseless and the plaintiff's case fails. I would like to see our legal system more in line with other countries that require the losing side to pay the reasonable legal costs of the winner as a way to discourage frivolous cases.

We need a professional review system that prevents cases from being filed unless the accuser can show not just that he or she has had a bad outcome -all too often juries will award big damages out of sympathy for a seriously ill plaintiff- but that the doctor or hospital has willfully ignored the normal standards of care. A review board should determine if there is probable serious malpractice and not simply a misdiagnosis within the limits of professional practice or ordinary human error. The review board should have the power to dismiss the case or offer some reasonable compromise.

Our current system has doctors ordering unnecessary tests as a form of defensive medicine that adds upwards of 10% to medical costs while inconveniencing the patients.

Medical malpractice is a full employment program for lawyers. Will we get tort reform? Probably not, since trial lawyers control one of the major parties and most of the senators and representatives of the other are also lawyers.

3. Outcome-Based Reimbursement

This should have bi-partisan support. Unfortunately, some of the more extreme conservative talk-radio hosts and opinion writers have blown it out of proportion "pull the plug on granny?" On the other side, proponents of the congressional bills have been ordered not to use the words "rationing" of health care - in other words be dishonest. We need an honest discussion here, so, please, check you emotions at the door for the next few paragraphs.

The main reason health care costs have gone up so much faster than inflation is that health care technology is advancing rapidly. We can now save people with medical conditions that would have been considered terminal only a decade or two ago. That is great news for those people who can be restored to high quality, healthy and productive lives. The problem is that this new technology can also extend the low quality lives of people who will have to be connected to machines for the rest of their lives or be bedridden or undergo expensive periodic medical procedures or take high cost medications, or all of the above.

Last April President Obama gave an interview to the New Your Times Magazine (reported here by Blooomberg) where he said some important things that I agree with.

Some opponents say the Congressional health bill limits expenditures for the elderly. They have been accused of raising "fishy" issues and talking about "rationing health care". But they are correct when they say Pres. Obama has recently favored such limitations.

Obama's opinion is (or was as of last April) that we should limit major cost surgeries for the aged and chronically or terminally ill, BUT, if they have the money or their children or grandchildren are rich (like Obama) it is OK to pay for major cost items with private money! I AGREE!

He said it is NOT a "sustainable model" if paid for out of public money because, in Obama's words “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total healh-care bill out here.”

Now, I assume Obama got that 80% number from some expert on health care. He is not an expert and would not have just made it up. I have heard that the current number is around 50% which means, on average, half of the money that will ever be spent on your health care is likely to be spent in the last year of your life! Of course, that is an average of those people who have very little spent on medical during the last year of their lives, the majority of people who have a moderate amount spent, and the relatively few people who have hundreds of thousands of dollars spent during that period. Perhaps the experts are projecting that, as health care technology advances further to the point where we can extend life indefinitely, the costs of care for the chronically and terminally ill will grow to 80% of the total. We should be spending our limited resources on preventitive care for the young, and on care that will restore health and vigor.

Regarding hip replacement for his terminally ill grandmother, Obama said “I would have paid out of pocket for that hip replacement just because she’s my grandmother.” (Obama's grandmother had her hip replacement mere WEEKS before she passed away - tragically just a couple days before her grandson won election to the highest office in the land).

Based on his statement that major expenditures for the chronically and terminally ill are not a "sustainable model" and that these costs could grow to 80% of the total, it would appear Obama favors some level of rationing of public-funded health care for those who are near the end of their lives.

UNLIKE SOME CONSERVATIVE TALKERS, I TOTALLY AGREE WITH OBAMA ON THIS ISSUE. DO YOU ???

For some reason, Obama and the proponents of the Congressional health care bills -and both the conservative and liberal press- have been absolutely silent on two key concepts:

• Comparative Effectiveness Research (CER), and


• Quality-Adjusted Life Years (QALY)

Have you heard either term and, if so, do you know what they mean?

They are discussed in a 2007 report from the Congressional Budget Office (during the Bush administration, so I am not making points againt the current administration): http://www.cbo.gov/ftpdocs/88xx/doc8891/12-18-ComparativeEffectiveness.pdf

Here are some key quotes from that report [emphasis added]:

More generally, the relative cost-effectiveness of treatment
options is clear when a less expensive treatment yields
comparable or superior health gains. In other cases, however,
determining whether the additional medical benefits
of a more expensive treatment warrant their added costs
is complex. Typically, the benefits of different treatments
are summarized as an increase in life expectancy or, more
commonly, as an increase in quality-adjusted life years
(QALYs) to account for effects on morbidity as well as
mortality. That calculation reflects estimates of how
much people value improving their health or avoiding
various side effects, which are combined to create a single
metric. By convention, cost-effectiveness analyses report
results as the cost per QALY gained, so a lower dollar
amount indicates a more cost-effective service. If that
metric is used to determine whether specific health procedures
are covered by an insurance program, choosing a
cost-effectiveness threshold can be a controversial
endeavor—but that need not be the manner in which
such research is applied.

A variety of evidence suggests that opportunities exist to
constrain health care costs both in the public programs
and in the rest of the health system without adverse
health consequences. Perhaps the most compelling evidence
of those opportunities involves the substantial geographic
differences in spending on health care—both
among countries and within the United States—which
do not translate into higher life expectancy or measured
improvements in other health statistics in the higherspending
regions. For example, Medicare’s costs per beneficiary
vary significantly among different regions of the
country, but much of the variation cannot be explained
by differences in the population, and the higher-spending
regions perform no better on available measures of average
health outcomes than the lower-spending regions do.

As applied in the health care sector, an analysis of comparative
effectiveness is simply a rigorous evaluation of
the impact of different options that are available for treating
a given medical condition for a particular set of
patients. Such a study may compare similar treatments,
such as competing drugs, or it may analyze very different
approaches, such as surgery and drug therapy. The analysis
may focus only on the relative medical benefits and
risks of each option, or it may also weigh both the costs
and the benefits of those options. In some cases, a given
treatment may prove to be more effective clinically or
more cost-effective for a broad range of patients, but frequently
a key issue is determining which specific types of
patients would benefit most from it. Related terms
include cost–benefit analysis, technology assessment, and
evidence-based medicine, although the latter concepts do
not ordinarily take costs into account.
Just last month President Obama gave a hint of his thinking when he said on ABC:



"What I've proposed is that we have a panel of medical experts that are making determinations about what protocols are appropriate for what diseases. There's going to be some disagreement, but if there's broad agreement that, in this situation the blue pill works better than the red pill, and it turns out the blue pills are half as expensive as the red pill, then we want to make sure that doctors and patients have that information available to them."



It is a pity Obama took the easiest case. The blue pill costs half as much and works better than the red pill. That is a "no-brainer" - use the less expensive AND more effective blue pill. But, what if the blue pill is only 90% as effective as the red pill but it costs 50% less? On the basis of CER and QALY, you would use the blue pill even if it is a bit less effective because, based on cost per QALY, the blue pill is much more cost-effective.



What do you think?

Ira Glickstein

PS: Yes, that is me pictured on the roof of our house. A couple days ago I screwed up the courage to go up and clear out some rain gutters that were full of leaves from the live oak tree in front of our home. This was the first time I've been on a roof in at least six years. In my younger days I was more happy using a ladder, going up on the roof of our two-story NY home many times. Of course, the hardest part is getting off the ladder onto the roof and, especially, off the roof and back onto the ladder. My dad, even in his senior years, had no trouble with ladders. I would watch in amazement and envy as he climbed them as if they were a set of stairs. He would step off and onto the ladder with absolutely no hesitation.

Don't believe half of what you see ...

A famous quote says "Don't believe half of what you see and none of what you hear." Do you see "spirals" in this image? They are not there at all, as illustrated by the image below! The small black and white squares are in perfectly round, evenly-spaced, concentric circles.

Thanks to http://www.realityprime.com/articles/another-illusion for this great optical illusion.

Ira Glickstein

We Need a Comprehensive DNA Database

A recent TV newsmagazine featured the story of a woman who was raped some 20 years ago, before DNA was generally available to confirm the identity of the suspect. She testified that she carefully observed the facial features of her assailant and helped the police sketch artist make an excellent drawing. She then picked Ronald Cotton out of a photo lineup and later the same guy out of a physical lineup. On the basis of her certain eyewitness testimony, Cotton was convicted and sent to jail.

About 15 years later, another inmate, Bobby Poole, was assigned to the same jail. Poole looked so much like Cotton the guards sometimes called them by each other's name. Cotton appealed for DNA tests against the rape kit that had been preserved by the police. The tests proved Cotton did not do the rape. They also proved that Poole did. Poole was convicted and Cotton was released after spending a decade and a half in jail for a crime he did not commit. Cotton graciously forgave his mistaken accuser.

Cases like this show how unreliable eye-witness reports may be, even if (as in this case) the victim was highly intelligent, took care to be observant, and she and the police and the trial court were totally honest and professional.

According to the TV program, several hundred wrongly-convicted inmates have been released in the past decade on the basis of newly available DNA technology. That is a tremendous stride for justice!

HOWEVER RAPES AND OTHER VIOLENT CRIMES STILL OCCUR

While DNA tchnology is now available to confirm the identity of the rapist if, as in most cases, a DNA sample can be obtained, rapes and other violent crimes continue to occur with disturbing frequency.

The problem is that DNA is used only to confirm identity. The police have to use far less certain, old-fashioned methods to track down the suspect. They must depend upon eye-witness evidence that is known to be unreliable. They depend upon informants who are often criminals themselves and may have their private agendas. They depend upon stereotypes and -lets admit it- profiling based on criminal history, race, age, neighborhood, and gender.

WHAT IF A COMPREHENSIVE DNA DATABASE WAS AVAILABLE?

When an automobile is involved in a crime or an accident and the license plate number is caught on video surveillance or is reported by a witness, it is easy to identify the owner of the car and investigate further.

Wouldn't it be great if this was the case with rapes and other violent crimes?

Violent assailants often leave some bodily evidence (ejaculate, hair, saliva, blood, skin, sweat, ...) on the victim and/or at the crime scene. Given a comprehensive DNA database, it would be almost as easy as looking up a license plate number to finger the suspect!

Yes, a careful and thoughtful rapist could wear gloves and a hairnet and use a condom and require his victim to douche, etc., and that would defeat the DNA ID method in some cases. However, most assailants are not that clever.

OBJECTIONS TO A DNA DATABASE

The only rational objection to a DNA database would come from potential rapists and other criminals who don't want to be caught - and their criminal defense lawyers who like a steady income - often paid out of public defender tax dollars.

Yes, there is the issue of "privacy". Many people do not want their DNA (or fingerprints) on file at the FBI or other police agency because they are worried about how such identifying data might be used by a rogue government cracking down on dissidents or other non-favored individuals.

That is not a worry for me. I quite willingly had my fingerprints taken as part of a security check to allow me to work on classified military projects. As far as I know, my fingerprints ar still on file at the FBI.

In any case, for most of us who have a well-documented and fixed place of residence, families, employers, sources of income, bank accounts, credit cards, cars, and so on, we are easily found. Those of us who keep our cell phones on at all times are leaving computerized records of exactly where we have been, minute by minute, every single day. The only people who may benefit from "privacy" are the homeless and jobless, and the criminals who may commit crimes while using YOUR stolen car or cell phone or credit card or identity!

Another issue, more serious, is the possible use of a DNA database to identify individuals who may be susceptable to certain genetic diseases, and the possible use of that information by health insurers to refuse coverage or charge a higher premium. (As a utilitarian, I see nothing wrong with the current actuarial system where young men pay higher auto insurance rates, smokers higher health premiums, people living in wooden houses higher fire insurance, those in tornado alley higher storm insurance, and so on based on demonstrated risk levels. Unfortunately, health insurance seems to be moving into a different category even for illnesses that are mostly self-inflicted due to smoking, drinking, or over-eating.)

The genetic ID objection may be dismissed easily. DNA has sufficient markers such that those associated with genetic deseases may be eliminated from the DNA record stored in a comprehensive database. There are plenty of DNA markers available without getting into medical risk levels.

COLLECTING DNA IS EASY

When my son-in-law and I were teaching classes at Brandeis Summer Odyssey several years ago, he wanted his students to do a DNA project. The administrators would not allow him to take samples from students, who were minors of high school age, so they took samples from faculty members, including me. All I had to do was touch the inside of my cheek with a q-tip. Very easy and rapid. The students ran the sample through DNA testing equipment my son-in-law obtained from Harvard University. DNA samples could easily be taken at Motor Vehicle Departments when new driver's licenses are issued. They could also be taken at high schools as part of the driver's ed class.

Ira Glickstein

Audio Illusions

[from Joel] We've previously spoken of optical illusions in the hope of differentiating L/C minds. While dog-sitting at my daughter's house yesterday, we took the opportunity to wash some clothes. While the machine was running, I tried to do some plastering around the new shower. I had to stop after awhile because the washer was driving me crazy. It kept repeating "Running bear. Running bear. ........" I'm sure you've all had that kind of experience. It recalled to me camping in a tent and being awakened in the morning to the cooing of doves that repeated over and over, "You're so damned stupid. You're so damned stupid." If you search the web you'll find among other sites the following one:

http://listverse.com/2008/02/29/top-10-incredible-sound-illusions/

A most interesting one is "Phantom Words", a repeated sound that eventually become a word in your own mind. When I played it this morning, all three dogs snappped to attention and a normally silent dog began to bark.

Although most auditory illusions refer to music, some are based on "defects" in our mental interpretation of sound into words. It would be interesting to be able to separate L-minds from C-Minds in this way, or at least as an IQ test that would distinguish intellect from indigestion. -Joel

On a tree by a river a little tom-tit
Sang "Willow, titwillow, titwillow"
And I said to him, "Dicky-bird, why do you sit
Singing 'Willow, titwillow, titwillow'"
"Is it weakness of intellect, birdie?" I cried
"Or a rather tough worm in your little inside"
-Gilbert and Sullivan (apologies to Ira)

Feynman - He Makes Physics Fun

The seven famous 1964 "Feynman Lectures" at Cornell University are now available in a wonderful new form thanks to Bill Gates and Microsoft's Project Tuva.

Click here (while using Internet Explorer) and a new video player called Silverlight -a Microsoft application similar to Adobe Flash- will automatically install. There are several steps but all you have to do is click OK or Continue when prompted.

Silverlight shows the video in a small box along with the text of the talk in caption form, as shown in the image. The screen includes other boxes where explanitory material and links to relevant information appear. The user may also add personal notes that are keyed to specific parts of the lecture. You can also click to make the image nearly full-screen.

Feynman is great! He conveys somewhat difficult physics and mathematics information in a clear way, with excellent humor. "Project Tuva" refers to an out-of-the-way Asian part of the old Soviet Union that Feynman tried to visit just before he passed away. I have watched three of the lectures so far and plan to watch the others this week. Please watch them and comment!

Each lecture begins with a short video of Cornell University circa 1964. You can see and hear the bell tower chiming their Alma Mater "Far Above Cayuga's Waters" - Cornell sits above Cayuga Lake, less than an hour from were lived in upstate NY. Our daughter Lisa went to Cornell Ag School in Ithaca and we visited often. It was and is a wonderful school and she went on to get her PhD at Cornell's NY City campus. Her unauthorized version of the Alma Mater went like this: "Far above Cayuga's waters / there's an awful smell. / Is it just Cayuga's waters / or is it Cornell?"

Ira Glickstein