Monday, April 23, 2012

Open thread: Assigned reading

What are the best political sites? Who should I read to broaden my thinking?

One request--nothing long. No books. And tell me why I should read someone. What makes it worth your time or mine?

Open thread: What's next for libertarians?

Ron Paul kind of sputtered in this campaign. He was great in the debates, but disappointing at the polls. Although he had a better showing than 2008, his philosophies weren't setting the pace in the primaries. Will libertarians make a difference in this election cycle? What will happen after the election? Your take.

Open thread: (For the brave) Race relations

Is anyone brave enough to talk about race? I've written a bit about race and haven't gotten many comments. Am I really braver than my readers?
  • Maybe I'm braver because I actually live and work with more blacks. I live next door to a black family and we're very friendly because they reached out and I responded. In the medical field, I work with a lot of black folks as patients and as co-workers.
  • Maybe it's because I live in a town that's safe, suburban, fairly integrated, and not a powderkeg of racial resentment and anxiety. 
  • Maybe it's because at the age of 22 when a prospective landlord asked whether I was married to a black or a white, I wasn't brave enough to throw back the question. I decided later that day not to participate in someone else's racism, but confront it. (... And I've lived in those safe, suburban towns where speaking against racism is safe and unridiculed.) 
  • Maybe it's because my exposure reached a critical point that I could start talking. 
How about you? Do you talk about race? Why or why not? If you don't want to use your usual name, click on Name/URL, and choose a temporary one.

Open thread 1: Anything

I'm going to be away for over a week, but maybe there are enough readers and commenters to keep the blog going without me. The response to this short post makes me think it's possible. Please behave. I will be strict about deleting insults and stupid talking points when I return. I've started several threads where I'd like to hear your viewpoints. This one is for anything, so fire away.

Open thread: Predictions

As a scientist, I love the power of theories. Lots of other people do to. In fact, politics is full of people who use political theories to structure their campaigns. Pundits theorize all the time and predict all the time.

So go ahead, theorize, predict, and explain why X will happen.

 Photo credit:

Thursday, April 19, 2012

Paradoxical quote of the day - her money

The comptroller of a small city in Illinois was just arrested. She allegedly embezzled $30 million over several years. The former finance commissioner, when he retired last year, said of her:
"[She is] a big asset to the city as she looks after every tax dollar as if it were her own."
I guess that was true. Kudos to the reporter who found that quote.

Wednesday, April 18, 2012

Short: Two Santa theory

I didn't know there was such a simple encapsulation of the appeal of each of our political parties. But here it is: the two Santa theory. I'll let you guess what it is, with two additional hints--what would Santa Dem give? What would Santa GOP give?

As a bonus, there is quote from Irving Kristol:
"I was not certain of its economic merits but quickly saw its political possibilities."
Translation: It may not work in practice, but it's election gold.

Photo credit:

Update 7/26/12. I want refer to this post so frequently that I can't leave it as mostly a link. I have to say what the Two Santas are:
  • Santa Dem brings all the children lots of government services.
  • Santa GOP brings all the children tax cuts.
  • Both Santas blow huge holes in the federal budget. Fundamentally, they aren't that different.
Now that you know the core of Two Santa theory, I still recommend reading the original column. It's short, readable, and more fun than ... um, two Santas. 

Writing about race - my FAIL

I worked so hard on my response to Derbyshire's thrown-off embrace of the black inferiority theory, but feel that I failed in writing that post. I spent so long arguing about possible interpretations of IQ test data, that I didn't focus on other more important issues. 

Some groups in the US would want the issue to be "Are blacks less intelligent?" but we can't really discern whether that's true or not due to the complicating issues I wrote about. However, straightforward acceptance of the question overlooks a huge issue. The question is insulting. Yet I barely touched on the ethics of singling out a group for that sort of question. I argued it like a factual question, but in reality, it's a whole different kind of question. 

So I've reneged on both my moral duty and my usual goal to talk about solutions. I think I forgot to drill down and look at the deep meaning of the question, not just the superficial meaning. And the deep meaning is best illuminated by the history of assertions that one group of humans is inferior to another group.  

I wonder whether this question is too big for me to grapple with. I worked hard, yet I lost my bearings. I'm somewhat surprised by this. Talking about budget deficits--that's within my capabilities and comfort zone; talking about race--as hard as I try, I'm dissatisfied with my thoughts and with what I write. But I still care immensely. Please accept my explanation for this failure, though I can't promise it won't happen again.

Dog at the foot of the penitent
Photo credit:

Sunday, April 15, 2012

Cheap shot of the day - Dignity

Does Mitt Romney Think His Wife Lacks Dignity?

Does anyone need to read the New York magazine commentary under this headline to find out if there's a shred of truth or insight there. I read it, and you're missing nothing. Slightly interesting is the link to a short post that's dripping with even more disdain for Romney.           This        may       be    a        long        stupid      and         dull        campaign.


Photo credit:

My long response to Derbyshire's glib superiority

This is a difficult follow-up to my post on Derbyshire's insulting racist column that got him fired from National Review. I'm not going to take a standard line that Derbyshire's column was unforgivably racist and leave it at that. I'm going to try to explain what I think about the IQ data that Derbyshire points to in his column.

I hope that readers aren't offended by me writing about this data. It's certainly depressing that there is such an achievement gap between races in our country. We should be able to talk about it, though the way Derbyshire approached it, hurling one insult after another, is not conducive to discussion if you hope to include black folks or non-racists. If you want to discuss the issue with white supremacists, then Derbyshire's method is very effective, because they are almost the only ones defending him.

I'll be open and honest in stating that I'd prefer all races to be equal in intelligence, or nearly so. Claims of the superiority of 'us' and the inferiority of 'them' have led to an extreme amount of bloodshed. But my belief isn't based on wishful thinking and indifference to evidence. There are a number of reasons to question that the IQ data showing that blacks are less intelligent than whites, which is the conclusion Derbyshire and these white separatists seem to subscribe to.

Why this is hard to write
I'm not someone who will be hurt by what I have to say. I have the immunity of my racial/ethnic background (European), and my educational and professional success. I know I'm smart, I've demonstrated it often, and most people who know me acknowledge my intelligence. But if I talk about the intelligence of black people, I can hurt a lot of people who don't have that immunity. There's little doubt that many blacks have had painful experiences of being prejudged as less intelligent, or as shifty, criminal, or "up to no good." I don't want to add another painful experience to this thorny, nasty thicket.

That is why I hesitated to write this post at all. However, I decided to write so I could share what I've learned from the span of my experiences and research. It is a hopeful message.

Reminder: I shouldn't have to write this. The question itself is insulting, degrading, and dehumanizing.

Historical View - We've been wrong before
Think of the ethnic groups who have been accused of being inferior: Irish, Jews, Italians, Chinese, Germans,  and probably every one of them at some time or other. And, of course, women. In earlier times, claims about inferiority didn't have IQ tests to prop them up, so the critics used other criteria, such as lack of technological advancement. So the Romans thought the Germans were inferior because they didn't have architectural works. Two thousand years later, the Germans are bailing out these superior Italians (who are actually descended from eastern slaves, but they did build most of the later Roman architecture.)

The point is that technological superiority moves from group to group. That doesn't mean that declining people have become genetically stupid. Instead, often they've suffered a crisis due to war, famine, disease, or poor political policy. They've been cut off from their old knowledge and the new knowledge is growing elsewhere. Often they've had to concentrate on more basic tasks like fending off or buying off raiders, and trying to get enough food to live. It's hard to do well building a high civilization, or answering multiple-choice IQ questions correctly, in those circumstances. So, low accomplishments don't equate necessarily to low intelligence.

Reminder: I shouldn't have to write this. The question itself is insulting, degrading, and dehumanizing. The history of the world shows this over and over again.

Scientific View - Validity of IQ tests
I've read long ago (no link) that IQ tests are good predictors of success in school. They measure current aptitude for answering multiple choice questions, which correlates for many people to doing well in school or other reading-based jobs.

IQ tests don't actually measure intelligence--they merely try to. Intelligence has been very hard to quantify since it has broad outlines. Someone vastly superior in math may not be able to construct a readable sentence, for example. This has all been known for a long time, so most people dismiss IQ tests. (I certainly do. I scored 144 in my fourth grade IQ test, and I've doubted them every since. So does my brother, with his double-800 SAT scores.)

These were an educated layman's doubts. Then I got to work inside a testing company--one of those places that manufactures the test questions. What an eye-opening experience. The writers, editors, and producers of those tests are overwhelmingly 1)middle-class, 2)white, 3)educated in private colleges or universities, and 4)female. If that's your family background, and your family encourages you to get good grades, you have excellent preparation for test success. Doesn't seem like a level playing field, does it?

Genetics View - Variability
This is not my strong suit because I don't know much about population genetics. My guess is that competitive pressures in Africa ensured intelligence was favored. We've partially undone these competitive pressures all over the world, but only quite recently, and not recently enough to have changed the gene pool.

Here is an argument by someone with some expertise:
"As the population geneticist Richard Lewontin has been pointing out... heritability is a measure of the genetic contribution to a trait within a population, under a given set of environmental conditions. It is the result of many-to-many relationships among genes, environmental variables, and interaction terms." -- Article in online science forum.
I had trouble finding a readable source. Feel free to look for works by geneticists.

Reminder: I shouldn't have to write this. The question itself is insulting, degrading, and dehumanizing. Science (or religion) has been a favorite cudgel over and over again.

Cultural View - Patterns that enhance or undermine performance
This is close aligned to the historical view. How is it that Jews or Chinese were once thought inferior in intelligence, and now do better than average on IQ tests? Changes in barriers, changes in opportunities, and cultural environments that promote learning and test-taking skills.

It is truism, and probably true, that some aspects of US black culture actively works against academic success. It's also a truism that poor people in general do worse academically and have less interest in academic achievement, and proportionally, more blacks are poor than whites. Here is more than enough here to explain most or all of the gap in IQ scores, so this is where I place my bet.

 Reality check - What is my experience?
I've laid out many reasons to doubt that IQ test results equate with potential for intelligence. Perhaps more important to me is my own personal experience. I know statistical studies can be manipulated, so I also test theories against my experience, knowing that I will honestly question my precepts, and accept results even if I don't like them.

I grew up with very few blacks, so my experiences are from college on. Most of my impressions have been formed or tweaked in the past 12 years while working intensively in racially mixed workplaces. The blacks I've met range in intelligence on par with the whites I met, that is, a few highly intelligent, more quite intelligent, and a broad number of average intelligence. The workplaces have demanded a minimal of intelligence, so I don't work with the strata that is far below normal.

I suppose it's possible that I just haven't met many of this supposedly huge pool of lower intelligence blacks. However, I don't think so. Many of the blacks I've met and worked with have been from poorer families, so just the kind of stock that would be in the less intelligent ranks, but they and their children are average and above average.

I think the arguments that people make for the lower intelligence of blacks aren't based on a great deal of interaction with blacks, but instead are based on sparse interaction and second-hand news and impressions. Did Derbyshire actually talk about all the low IQ blacks he'd met over the years? No, he didn't. He probably has very few black acquaintances because he's been making sure that he avoids black hordes. So much for checking first-hand whether his thesis makes sense in light of real-life experience.

Should I believe someone else's statistics, or my own experience? I'm a reflective, thinking, honest person, so I'm going with my experience. But my historical, scientific, and cultural arguments are also a strong support.

Reminder: I shouldn't have to write this. The question itself is insulting, degrading, and dehumanizing. But I write to honor and defend all the wonderful people I've known who would be targets of this kind of attack. That includes my entire family.

Go ahead, play with the curves
 Graphic credit:

A note about race. I used to believe in races. Now I'm convinced by my research that there aren't races. The four racial groups are a convenient social classification that doesn't capture the biological picture. 

Humans can, do, and have interbred forever. However, there are regional differences that are best thought of as ethnic, not racial. For example, we have light-skinned, red-haired Norwegians, Somalis with narrow noses and dark skin, Siberians who are stout and built like furnaces, and lots of gradations and mixes. You can't draw dividing lines and end up with four distinct groups because there are transitions at the borders, and there are a hell of a lot of border regions.  

There is one human race, and we are all part of it. Welcome if you dare enter. . . but you are already here.

"But what comes out in the end is claims like this: you’d have to go through 5 or 10 times as many blacks as whites to find someone who’s mentally equipped to be a teacher or an accountant. I find that very hard to believe."
  • I can't tell if this blogger is a racial realist, as they call themselves, or not. However, he seems to know a great deal about European migration patterns. The net kicks up gems sometimes.
  • My followup to this post is here. Basically, I feel that I was wrong to argue against Derbyshire's conclusion (that blacks are inferior) and not attack the premise. If you've been thinking that as you read this post, I agree--I'm just late to that realization. (I also added those reminders on 5/24/12.)

Short: Catholics in Washington rebel

The Seattle Times reports that many Catholic churches are opting NOT to gather signatures for an anti-marriage-equality referendum in Washington state. Read the link to find out the reasons, and don't skip the comments on the article--usually the best part.

Losing out on a lot of signatures
Photo credit:

Saturday, April 14, 2012

Funny quote of the day - Guess who again

"I assume it's because Murdoch at some point said, 'I want Romney,' and so 'fair and balanced' became 'Romney.' "
"In our experience, Callista and I both believe CNN is less biased than Fox this year. We are more likely to get neutral coverage out of CNN than we are of Fox, and we’re more likely to get distortion out of Fox. That’s just a fact." -- Newt Gingrich
Gingrich keeps pumping the hot air into his colossal bladder of an ego. He's the arbiter of media fairness, and weigher and final authority on factuality.

And, of course, it's not just him. It's Mr. and Mrs. American, him and Callista, the wife he should have had all along. Somehow I don't think her ego is as big as his. Otherwise, they couldn't fit in the same house, car, plane, or state.

After all this time, is he really shocked, SHOCKED! to discover that Fox News isn't fair and balanced? I can't stop snickering. What luscious just desserts.

Oops, the liberal media wasn't the only enemy.
Photo credit:

Friday, April 13, 2012

The Good, the Bad, and the Redemptive

Today I feel surrounded by death. There was another shooting, this time at a Cracker Barrel restaurant in Ohio. On the local news, there was a story about a New Hampshire police chief shot and killed during a drug raid. Four other police officers were also shot.

In the Trayvon Martin case yesterday, Trayvon's mother said that she thought the shooting was an accident, and Zimmerman needs to own up to that and apologize. That huge step in forgiveness and shared humanity was retracted later that day. Does anyone doubt a lawyer was involved in the retraction?

In the meantime, Zimmerman's new lawyer has a sense of the gravity of the case. The new lawyer is not pushing for bail immediately because he understands that Zimmerman needs to spend sometime in jail to assuage the local (or national?) sense that he's not paying any price. The lawyer is also not immediately asking for immunity for his client based on Florida's "Stand your ground" law.

We are better people when we don't grandstand on our rights, as though we (the small we) are the only ones who matter or who know what is correct. We are better people when we humbly acknowledge that we can make mistakes, sometimes horrible ones.

So, today, this story of Corey Booker, the mayor of Newark, New Jersey, floored me. I'm already in an emotional state, and I watched this video where he discusses how he and a detective ran into a neighbor's house, engulfed in fire, and Booker ran though the burning kitchen to save a woman sleeping in the back of the apartment. He carried her back through the flames and outside. She is alive, as is he, the detective, and the other residents.

I'm reminded of the fire fighters on 9/11, who entered the burning towers and were marching up the stairs to try to save those in the upper floors. People can be so fine and heroic. I hope I can do something today and something in my life that is as selfless as these people have done. Wish me luck.

People saving a motorcyclist from a fiery accident
 Photo credit:

Practical note: You should have a fire extinguisher and you should know exactly where it is. This knowledge prevented my neighbor's stove fire from getting out of hand. She didn't know where her fire extinguisher was, but we did. Today, my family gets a quiz on where the extinguishers are. The only acceptable score on the quiz is 100%.

Thursday, April 12, 2012

Ludicrous Attack(s) of the Day

This isn't going to be a regular feature because I try to spend my time of issues of more consequence that the pitiful drivel emanating from various partisans' mouths. But there were two today that are useful as object lessons.

#1. Inventing new stupid reasons to attack an opponent
Maybe you're a low-level peon in a campaign or think tank, but you aspire to higher station. You want to cover yourself in glory by inventing a whole new topic for attacks... since job performance and sanity in policy planning are already taken. You strain your brain, and decide to attack an opponent's staffer over whom she follows on Twitter. Will all staffers now have to scrub their Twitter accounts? Only if stupidity reigns, which happens sometimes.

#2. Insulting how the other half lives
Hilary Rosen was trying to make a point that Romney is out of touch with women, but she managed to prove that she was out of touch with a sizable segment of women. It isn't enough for Romney to listen to his wife, who "has actually never worked a day in her life."

A bit of an unforced error there. She had no need to belittle Ann Romney personally. If Romney is doing badly on women's issues, it's because his wife didn't work? That doesn't seem like an explanation to me. That seems like an obviously fake explanation, and makes me wonder if Romney is actually a pig on women's issues. Maybe this whole attack was a pantomime farce to fill airtime on CNN.

Here's an idea: focus on the real problems, not the ones that have to be plumped up to make them look like problems.

Photo credit:

Wednesday, April 11, 2012

My take on Derbyshire

I've been obsessed by the Derbyshire situation since it broke this weekend. Here is the most offensive quote in his smug, nasty post:
"The least intelligent ten percent of whites have IQs below 81; forty percent of blacks have IQs that low." -- [his link]
But that is just the point where the insults and inhumanity reached their peak. Derbyshire starts the piece by talking about "talk that most black parents give their teenage sons," then he produces a heartless, insulting lampoon of something painful that black parents have to do.

Though I'm not black, I've had such a talk with my son. He didn't have a girlfriend in high school, so we had "a talk" before he went to college. He's well-educated about sexual function, STDs, and contraception, but political-correctness might have kept the school from teaching him this: some girls will trap men by getting pregnant "accidentally." It's a hard truth that I wish wasn't, but I want him to know about it and be wary. So I told him. No, he hadn't heard that information before, so it was important that we had "the talk."

I know "the talk" isn't easy, so how incredibly insensitive of Derbyshire to use that as a vehicle to throw out advice to his kids to avoid blacks in public situations for their own safety. Then, he heaps on many other insults unrelated to crime statistics, such as the quote above. Finally, he closes with his envy of intelligent blacks who are in "high demand." But he doesn't express it that way. He says:
"To be an [intelligent black] in present-day US society is a height of felicity rarely before attained by any group of human beings in history." -- [his link]
I'm practically unhinged over this essay. I have a bit of familiarity with Derbyshire. A commenter in this blog linked to one of his posts. A couple weeks back I decided to read more. I didn't find columns, but I found his radio show ... for about 3 minutes until his pompous, time-wasting jabber became too much.

I have an aversion to a certain kind of high-class drawl that is soooo...    slooow...  and...   deliberate..    that it shoooows...  how serious...    and...    learned...    the...    speaker   is. I can't stand William F. Buckley speaking, or Gore Vidal, or Christopher Hitchens. Well, I found out that I can't stand John Derbyshire either.

So I need you, some of the readers here, to read Derbyshire's column and tell me if it's as bad as it makes me feel.

Please don't speak. (Gore Vidal)
Photo credit:

Extras:  A list of words I used in describing Derbyshire:
  • offensive, smug, nasty, insults, inhumanity, lampoon, insensitive, envy, pompous, time-wasting, jabber, bad.
A list of words Derbyshire used in describing blacks:
  • cumbersome, the 'N' word, geniuses, morons, convicted murderers, investment bankers, hostility, more anti-social, a degree more anti-social, ferociously, inconvenience, harm, passively, racial solidarity, swamped, least intelligent, amulet, status marker, luxury good.
Derbyshire has been undergoing chemotherapy, which often has the effect of dulling cognitive ability for months. This certainly could be mitigation, since none of us humans are as good, smart, or diplomatic as we'd like to be when stressed with a profound illness. 

A different conservative response to Trayvon Martin. More on Derbyshire from Conor Friedersdorf and The American Conservative.

Monday, April 9, 2012

Zimmerman/Martin: This cannot end well

"It took a while to hit me, but I have a terrible sense of foreboding about this case. Zimmerman, at some point, will either be found guilty of manslaughter, or he'll be found not guilty, or charges dropped, or not even charged. Any outcome other than the conviction could ignite a huge cache of anger among blacks in this country."
That is white apprehension talking. This person fears the backlash from blacks more than he fears being in Trayvon's place. I know this because I wrote the quote--that's how I started this post, with my gut sense of foreboding.

I wished that wasn't the first thought that came to mind when I considered the future of this case. But then my thoughts shifted direction: what is it like if you have fear of disrespect or violence all the time, or on a regular basis? A fear that's always there, in your awareness or just below it. This is what it's like to be black in our society.

I suffered from mild prejudice when I was young, but little-to-none in the last 25 years. I've had a quarter century of freedom from prejudice, with very little anxiety about whether I'd be unfairly judged before I even had a chance to do or say something.

 Empathy Lessons
Just one time did I suffer some of the tension from prejudice. My family and I went to a restaurant in Mystic, Connecticut. We were seated, but no waitress came to our table, and they all avoided our glances. This went on 10 minutes, then another 5 minutes. Then I realized that they weren't going to serve us, but they weren't going to say so to our faces. The staff did see us leave, sheepishly. The sting wasn't erased at the restaurant across the street, though the service was friendly and efficient. For that 15 minutes, and for quite a while afterward, I knew what kind of anxiety prejudice can create--the nearly constant gnawing question whether you're going to have to deal with that shit today, or will it be a good day. If you start relaxing, the zinging pain when it happens again.

Some people seem to have no empathy for someone who has suffered from the prejudice of others. I wish they had to deal with it, so they would know what it feels like. People like Rush Limbaugh are probably  never on the receiving end, wondering if he'll be snubbed at the restaurant, or stopped while walking or driving. He's only in the dishing-out business, and business is brisk. Why worry about the saps at the receiving end?

Possible Responses
At this point, I want to pivot from a description of the problem to possible solutions. I think we've legislated what we can on racism. It's illegal to discriminate in hiring, promotion, access to public accommodations, education, rentals, and probably other areas I can't remember. I don't want to make it illegal to discriminate in personal actions and personal thoughts because I cherish freedom to say and do what we want so long as we don't violate the freedoms of others. And our freedoms don't include freedom from viewpoints we don't like.

What needs to change isn't our laws, but our personal lives. We need to evolve into a non-biased society as much as possible. This is happening, but at a pace that is set by the individuals in society, not by government. I think this is appropriate for the sphere we are trying to change-- the sphere of personal relationships. Maybe I'm too optimistic about people, but I also don't know a better alternative. But I'm listening if you have suggestions.

More harmony?
Photo credit:

Postscript: I started writing this before the Derbyshire explosion. I've read the essay. He has the same smug, self-satisfied manner that William F. Buckley had when he made his pronouncements on how people should behave from his comfortable, insular perch. Like Limbaugh, Buckley and Derbyshire never picture themselves on the receiving end of prejudice or misfortune.

Monday, April 2, 2012

Short: Will the Senate go Republican?

The one problem with a sweeping Senate victory is trying to keep all those seats six years later.

So, in 2006, the Dems had a great year, and now, in 2012, they pay the price. I've written before about why I'd like the Dems to hold onto the Senate. But it's not likely. Look at the blue states that would need to stay blue, and then tell me how optimistic you would be.


Interested? Current odds at Intrade, overview at Wikipedia, and an older rundown on some of the races at Reuters.

Romney learns from McCain's mistakes

I have long suspected that the Romney campaign's greatest strength is its caution. A great deal of care and planning goes into the campaign's choices. They also don't react in a scatter-shot fashion to setbacks, such as Gingrich winning S. Carolina or the surging popularity of Santorum in February. Maybe they have dozens of contingency plans in their vault. If something, or anything, happens, they are ready.

If I'm right about this, I also suspect that they aren't going to repeat McCain's mistakes in the 2008 campaign. Neither will they lie to themselves about what those mistakes were. I googled "2008 McCain campaign mistakes" and got several different takes on what McCain did wrong. And just for fun, I'll present it as a quiz:
In 2008, McCain's bid was washed up when he:
a) chose Palin for VP.
b) hurried to Washington to help with the financial crisis.
c) didn't talk about tax cuts in response to Obama's tax proposals.
d) moved further to the right after the primaries.
In my opinion, the answer is (b), but (a) and (d) didn't help either. Just to be safe, Romney won't be repeating any of these errors. He'll choose someone with plenty of experience for VP, he won't run around like a self-proclaimed savior if there's a crisis, he will talk about cutting tax rates (but will be vague about how he'll reduce deductions), and will continue toeing the not-quite-hard-conservative line. He'll resist calls to make additional conservative pledges, like lowering all taxes or shutting down the EPA. He'll stay right where he is. That way conservatives can't prove he's going soft for the general election, but moderates will see that he's not a pawn of the hard right or Tea Party.

He'll also remain measured in his attacks on Obama, challenging the policies and the introduction of European-like programs, but not insulting Obama's personality or patriotism. Those wanting blood on the campaign trail will be disappointed because Romney will keep his Mormon reserve -- no swearing, no heart-pumping stimulants like coffee or Coke, no inhibition-reducing elixirs like whiskey. Romney will handle Obama the way he beat Gingrich in Florida--repeating Obama's own words back at him with hard precision. Both men have a cool, controlled style, so this contest will feel different from any other race. Perhaps it will feel like a Reagan vs. Kennedy match-up, though Romney is a less forceful speaker than Reagan.

With that thought, I'm actually looking forward to the general campaign. Boy have I set myself up for disappointment. (And sooner than I thought. See the comments.)

Squint and he looks like notMcCain  Romney

Other top mistakes:

Sunday, April 1, 2012

Healthcare Tentacles II

 Photo credit:

I must get the team who made Obamaville to film this story of intrusive government and spunky citizens yearning and fighting for an equitable, all-American healthcare system.

Then again, if I want truth, I better try writing it myself. So here goes. In the prequel, I wrote how some board in the Obama administration (set up by ACA) had mandated contraceptive coverage in employee health insurance policies. There ensued a long discussion on health insurance, which I will try to summarize without introducing too many inaccuracies, and throw in some additional points too.

Homework Problem Set--Solve the issues in bold
The American healthcare system suffers from the problem of 'other people's money,' which is the opposite of self-pay or 'skin-in-the-game.'

Interests are not always aligned. Your doctor may, or may not, have your health as his top interest. You may not have your health as your top interest. Your insurance company may not have your health as its top interest.

There's an absence of knowledge of what procedures you need, how much they cost here versus elsewhere, and whether they are cost-effective. Defining 'cost-effective' as it pertains to healthcare is difficult because it's hard to cost all the concerns--the cost of the procedure, the risk to life or disability if you don't have the procedure, what to do if you don't have the money for a life-saving treating, etc.

The situation with cost-efficiency is the same as interest alignment. The doctor probably doesn't have cost-efficiency as a top interest --he doesn't know what procedures or medicines cost, but that's not surprising considering the multiplicity of insurance plans. The doctor may also have a financial interest in ordering more tests. Patients aren't concerned with cost-efficiency when they're spending other people's money either. Insurance companies aren't even cost-efficient because they pass costs on to employers. Employers don't demand cost-efficiency because there are a limited number of health insurance providers and many follow current defacto standards of care that aren't cost-efficient.

If consumers, when they pay directly, can impose cost-efficiency, they may also take undue risks by not getting the medical care they should have. Who is good at evaluating risk? Laymen generally aren't. But even professional panels evaluating risks may put too high or too low a value on lives lost, the pain of treatment at an advanced stage, inconvenience, and anxiety caused by false positives. (Case in point, the panel recommending changes to mammography frequency.)

Ideally we'd like to have a system where cost-efficiency is built in, through competition or some other mechanism. However, if that's not possible, should we impose cost containment by fiat? Lower reimbursements and best practices standards can contain costs if the doctors don't or can't rebel. However, these measures can also inhibit doctors from accepting patients from underpaying groups and inhibit extra care that a doctor deems necessary.

One new issue that I've noticed: the temptation to design a healthcare system that works selfishly for 'me' but is ineffective for other major groups. Healthcare is not one-size-fits-all. Certain populations are harder to fit into traditional commercial relationships, such as the elderly, the poor, the undereducated, and the chronically ill. A system that doesn't address those needs will be acceptable to fewer people.

Finally, how will the mass of people afford healthcare if we don't have someone else paying for it? This is a frightening prospect that fuels a huge wall of resistance to healthcare reform.

 Answer Key. . . in your dreams
Just to recap, these are the issues we must thread to solve our healthcare problems:
  1. Other people's money
  2. Interest alignment
  3. Absence of knowledge
  4. Cost-efficiency
  5. Undue risks
  6. Cost containment
  7. Me (selfishness)
  8. Elderly, poor, undereducated, chronically ill
  9. Resistance to healthcare reform
Here's a solution that addresses problems 1-7, but doesn't do so well for 8 and 9. That's better than most proposals, though.

Chart by Kaiser, solution by ??

Update 4/4/12. A national news story on recommendations by doctors' groups on cutting the number of procedures. A first step in the right direction. Stories: Washington Post Health, WaPo wonkblog, MD newsletter, organization website.