Monday, August 31, 2009

Dramatic Pictures

Here are two dramatic pictures of the LA wildfires that were posted on the Discover Magazine's Cosmic Variances blog site:


and this...


You can't get much more dramatic than these two pictures.

I've driven down I-5 during a wildfire. It was pretty scary because you are coming through mountains seeing big ugly black smoke up ahead hoping that the road will turn and take you away. In my case, no. I drove through while a wildfire was cresting the adjacent mountains. Acrid smoke was everywhere. Seeing flames a few thousand yards away is pretty disconcerting.

Lies, Damn Lies, and Statistics

Greg Mankiw, an economist at Harvard, is busy proving that people with high salaries and high test results are that way because they are just plain smart, i.e. high IQs. Not because wealth buys better education. Nope. He firmly believes that cream rises to the top, so good test results and big incomes just naturally come to those who are "smart".

In his blog, he presents this graph:


Then he makes the statement:
It would be interesting to see the above graph reproduced for adopted children only. I bet that the curve would be a lot flatter.
David Cesarini, an economics professor at MIT, provides him with the desired graph:


Which Mankiw takes as evidence of his claim.

But if Mankiw were truly honest with himself, he would expect the line for the adopted children to be absolutely flat, i.e. completely uncorrelated with income because adopting is about as close to a fair lottery as you can get.

Instead, where he sees a "lot flatter" curve, I see a curve that looks pretty highly correlated with wealth. Yeah, it is kind of flat for the middle 4 deciles, but the overall curve is very strongly correlated with the level of wealth and has the same shape as the ordinary children.

So where I see evidence that wealth buys you good test results, Mankiw sees confirmatory evidence that the smart are just naturally rich and get good test results. Funny.

They say "beauty is in the eye of the beholder" but I think this proves that economic "truths" are also in the eye of the beholder.

There is more info on at Wikipedia on nature versus nurture. And it gets more complicated because of epigenetics where experience changes gene expression. From my perspective, the best approach is probably "nature through nurture" as in...


In other words, the two factors are inextricably intertwined.

Update 2009sep02: In the comments you will find that I am caught out on too quickly reviewing the graphs and not getting the details straight. So look at the comments to see what went wrong.

The more important point is that the debate goes on. There is a very interesting blog by Alex Tabarrok on the Marginal Revolution site. It has this graph:


That appears to be the graph that Greg Mankiw should have presented because it has the "flat line" for adoptees.

Here's some of Alex's commentary:
The graph shows how parent income at the time of adoption relates to child income for the adopted and "biological" (non-adopted) children. The income of biological children increases strongly with parental income but the income of adoptive children is flat in parent income. What does this mean?

The graph does not say that adopted children necessarily have low income. On the contrary, some have high and some have low income and the same is true of biological children. What the graph says is that higher parental income predicts higher child income but only for biological children and not for adoptees.

Now what about education? Sacerdote looks at that as well. He doesn't have a child SAT-score, parent-income correlation but he does find:
Having a college educated mother increases an adoptee's probability of graduating from college by 7 percentage points, but raises a biological child's probability of graduating from college by 26 percentage points.
The effect for father's years of education is even larger; about a ten times larger effect on biological children than on adoptees. Similarly, parent income has a negligible effect, small and not statistically significant, on an adoptee completing college but an 8 times larger and statistically significant effect on a biological child completing college (Table 4, column 3).
So... is the debate over? No.
  • Not if you look carefully at Tabarrok's comments. Note that he doesn't have the SAT or IQ scores that Mankiw really wants. But he does have data about scholastic achievement, and it isn't a flat line. In other words, wealth of the family translates into better academic success. That is not what Greg Mankiw wants the data to say.

  • Not if you look at the comments to Alex's posting. A lot of people jump all over him with alternative interpretations of "the" data. That's what makes science so interesting. The facts don't "speak for themselves". You have to interpret them. And your theory is your filter through which you see the facts.

This debate of nature/nurture is very old. It won't go away quickly. But it is an interesting debate that merits time looking at it and understanding your own position/prejudice.

Update 2009sep21: There is a very interesting discussion of the shortcomings of Mankiw's interpretation of the data in a posting by Mike Konczal on his blog Rortybomb. Go read the posting!

Self Deception

Here is a presentation of the US Government's argument that its enhanced interrogation techniques are not torture...



The above is an ACLU video with various people -- including film director Oliver Stone -- reading from one of the infamous Bush administration legal memos used to justify the use of torture.

For a different perspective, here's Rachel Maddow on Dec 18, 2008:



That was 8 months ago. Dick Cheney is still running around claiming torture worked and was necessary. Indeed, Cheney claims that Obama has put the US into imminent peril. Well... I don't believe a word Cheney says. And 8 years from now when there has been no attack, I'm confident that Cheney will claim that there were many planned attacks during the 8 years of Obama, but thank God Cheney had the good sense to run around telling people that torture worked because that these very words were the only thing that kept America safe!

And yet another viewpoint from Physicians for Human Rights (PHR)...

The Last Word on Torture

When you want a definitive answer, you have to go to the experts. Here's The Onion on torture...



Now... if that doesn't settle matters about the necessity of enhanced interrogation by cloven hoofed fiends, I don't know what will.

As and aside... when you are the butt of jokes like these, you shouldn't show your face in public... right Dick Cheney?

Putting Faces to a Name

This is an interesting video of a conference of economics bloggers. I enjoy the video because it lets me put faces to some of the names I've encountered in my reading. What I don't like is that this is a mostly right wing group of people, so the portion where the foundation talks about its "survey results" are very skewed. You ask a bunch of right wingers what they want to do and it will be "fix banks", "cut corporate taxes", "cut payroll taxes", etc. These are not the things that most people would think of and they are certainly not the things that most left wing economists think are critical. So, if you ignore the propaganda, this video is fun because it lets you meet some names that you may have heard of and never seen:

The U.S. vs the World

There is a very nice article in the Washington Post by T. R. Reid that examines myths about health care. It uses facts about systems around the world to explode the myths. I've picked out just the topics he addresses. You need to read the article to get the details, that is, all the facts that contradict the myths.
1. It's all socialized medicine out there.

2. Overseas, care is rationed through limited choices or long lines.

3. Foreign health-care systems are inefficient, bloated bureaucracies.

4. Cost controls stifle innovation.

5. Health insurance has to be cruel.
To give you a taste of the facts he provides:
The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000. ...

Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)
If you want to get a broader perspective, and some facts, on health care, read this article.

Cutting Consumption

One way to reduce consumption is to make it more expensive. Here's a picture that shows that the world's governments are taking that to heart with gasoline taxes:

Click to Enlarge

It is interesting that Canada is one of two countries that have decreased taxes on gasoline. (But not here in BC where the provincial government has added a carbon tax which is currently 3.52 cents/litre and headed toward 7.02 cent/litre by 2012, see here.)

Jewish Satori?

I found this on Barry Ritholtz's The Big Picture blog. his is meant to be the ancient wisdom of the East with a bit of a Jewish twist:
Be here now. Be someplace else later. Is that so complicated?

Wherever you go, there you are. Your luggage is another story.

There is no escaping karma. In a previous life, you never called, you never wrote, you never visited. And whose fault was that?

Zen is not easy. It takes effort to attain nothingness. And then what do you have? Bupkis.

The Tao does not speak. The Tao does not blame. The Tao does not take sides. The Tao has no expectations. The Tao demands nothing of others. The Tao is not Jewish.

Breathe in. Breathe out. Breathe in. Breathe out. Forget this and attaining Enlightenment will be the least of your problems.

Let your mind be as a floating cloud. Let your stillness be as a wooded glen. And sit up straight. You’ll never meet the Buddha with such rounded shoulders.

Deep inside you are ten thousand flowers. Each flower blossoms ten thousand times. Each blossom has ten thousand petals. You might want to see a specialist.

Be aware of your body. Be aware of your perceptions. Keep in mind that not every physical sensation is a symptom of a terminal illness.

Drink tea and nourish life; with the first sip, joy; with the second sip, satisfaction; with the third sip, peace; with the fourth, a Danish.

The Torah says, Love your neighbor as yourself. The Buddha says, There is no self. So … maybe we’re off the hook?

A Blight Across the Land

Here is a key bit from an excellent article by Paul Krugman in the NY Times:
... surveying current politics, I find myself missing Richard Nixon.

No, I haven’t lost my mind. Nixon was surely the worst person other than Dick Cheney ever to control the executive branch.

But the Nixon era was a time in which leading figures in both parties were capable of speaking rationally about policy, and in which policy decisions weren’t as warped by corporate cash as they are now. America is a better country in many ways than it was 35 years ago, but our political system’s ability to deal with real problems has been degraded to such an extent that I sometimes wonder whether the country is still governable.

As many people have pointed out, Nixon’s proposal for health care reform looks a lot like Democratic proposals today. In fact, in some ways it was stronger. Right now, Republicans are balking at the idea of requiring that large employers offer health insurance to their workers; Nixon proposed requiring that all employers, not just large companies, offer insurance.

Nixon also embraced tighter regulation of insurers, calling on states to “approve specific plans, oversee rates, ensure adequate disclosure, require an annual audit and take other appropriate measures.” No illusions there about how the magic of the marketplace solves all problems.

So what happened to the days when a Republican president could sound so nonideological, and offer such a reasonable proposal?

Part of the answer is that the right-wing fringe, which has always been around — as an article by the historian Rick Perlstein puts it, “crazy is a pre-existing condition” — has now, in effect, taken over one of our two major parties. Moderate Republicans, the sort of people with whom one might have been able to negotiate a health care deal, have either been driven out of the party or intimidated into silence. Whom are Democrats supposed to reach out to, when Senator Chuck Grassley of Iowa, who was supposed to be the linchpin of any deal, helped feed the “death panel” lies?

But there’s another reason health care reform is much harder now than it would have been under Nixon: the vast expansion of corporate influence.
Go read the whole article. There are more details about lobbyists and the corruption of politics.

In American history the ground has shifted many times, but it is so slow that most don't see it. In the mid-19th century, the Democrats were the party of racism while the Republicans held a higher moral standard and gave a home to the abolitionists. But during the Goldwater/Nixon years the ground shifted and the solid Democratic South became the solid Republican South as the Republicans became the racist party and the Democrats moved from being big city machine and Southern racists to a more liberal inclusive party.

But as Krugman points out, it isn't just that the party positions change over time, you can have eras in which the big tent parties overlap and consensus is possible. But you can also have times when ideology is rampant and compromise is impossible. Prior to the Civil War fights in the Congress were not just pyrotechnics of words, Congressmen beat each other and called for duels to the death. It was ugly. Today is once again an ugly time. Fanatics have seized the Republican party. This has poisoned the political arena.

As Krugman points out:
There was a lot of talk last year about how Barack Obama would be a “transformational” president — but true transformation, it turns out, requires a lot more than electing one telegenic leader. Actually turning this country around is going to take years of siege warfare against deeply entrenched interests, defending a deeply dysfunctional political system.

Meritocracy

For those who believe the Horatio Alger myth that anybody, by dint of hard work and honesty, can rise from the very bottom of American society to the very top, here is an article by Glenn Greenwald in Salon:
It's time to embrace American royalty

We're obviously hungry to live with royal and aristocratic families so we should really just go ahead and formally declare it:
Bush daughter Jenna Hager becomes 'Today' reporter

NBC's "Today" show has hired someone with White House experience as a new correspondent — former first daughter Jenna Hager, the daughter of former President George W. Bush. . . . She "just sort of popped to us as a natural presence, comfortable" on the air, [Executive Producer Jim] Bell said. Hager will work out of NBC's Washington bureau.
They should convene a panel for the next Meet the Press with Jenna Bush Hager, Luke Russert, Liz Cheney, Megan McCain and Jonah Goldberg, and they should have Chris Wallace moderate it. They can all bash affirmative action and talk about how vitally important it is that the U.S. remain a Great Meritocracy because it's really unfair for anything other than merit to determine position and employment. They can interview Lisa Murkowski, Evan Bayh, Jeb Bush, Bob Casey, Mark Pryor, Jay Rockefeller, Dan Lipinksi, and Harold Ford, Jr. about personal responsibility and the virtues of self-sufficiency. Bill Kristol, Tucker Carlson and John Podhoretz can provide moving commentary on how America is so special because all that matters is merit, not who you know or where you come from. There's a virtually endless list of politically well-placed guests equally qualified to talk on such matters.

UPDATE: Just to underscore a very important, related point: all of the above-listed people are examples of America's Great Meritocracy, having achieved what they have solely on the basis of their talent, skill and hard work -- The American Way. By contrast, Sonia Sotomayor -- who grew up in a Puerto Rican family in Bronx housing projects; whose father had a third-grade education, did not speak English and died when she was 9; whose mother worked as a telephone operator and a nurse; and who then became valedictorian of her high school, summa cum laude at Princeton, a graduate of Yale Law School, and ultimately a Supreme Court Justice -- is someone who had a whole litany of unfair advantages handed to her and is the poster child for un-American, merit-less advancement.

I just want to make sure that's clear.
There is some social mobility in the US, but the joke is that there is more mobility in Europe today than in the US. They myths of crusty aristocracy in Europe and a vibrant immigrant society of upwardly mobile social climbers in the US are just that, myths.

Every society has to fight the tendency of the elite to entrench themselves and especially their idiot sons and daughters. The US is failing that test.

I still can't believe that there was a very good chance in 2008 that the Bush's would hand over the family patrimony, the Presidency, to the Clintons to be held for eight years before this patrimony would be returned to the Bushes. I was amazed that nobody found it odd that in a country of 300 million there were two families with a lock hold on the presidency.

When I was a kid and watched the Kennedy's build a dynasty (destroyed by assassins) where JFK was to pass the Presidency to RFK then to Ted then to John-John, etc. That made me puke. But that was a prelude to the ascension of the Bush/Clinton clans and their two-step dance that passed the top job between themselves. Thankfully the electorate broke this dismal 20 year "legacy".

Update 2009aug31: Here's a bit from an article on The American Prospect by A. Serwer:
I have a lot of friends who spent a great deal of money, and went into a lot of debt, to learn how to be professional broadcast journalists. They are now struggling to find work in a profession that is -- to put it bluntly -- contracting. So when I first heard that Jenna Bush Hager, the former President's daughter, was getting a job with The Today Show, I wondered what her qualifications were.
Hager, a 27-year-old teacher in Baltimore, said she has always wanted to be a teacher and a writer, and has already authored two books. But she was intrigued by the idea of getting into television when Bell contacted her.
Oh. She "always wanted to be a teacher," and was "intrigued" by television, so I guess that qualifies her to be an education reporter over all those journalists with actual experience and education who are struggling to find jobs.

As Glenn Greenwald writes, there's unlikely to be any outrage on the right over Hager getting a job she's manifestly unqualified for simply because she's the former President's daughter, despite right-wing affectations toward "meritocracy." There's something revealing here about the right's attitude towards those who succeed despite not being privileged -- the only way they can make sense of someone like Sonia Sotomayor rising to excellence from modest beginnings is through "preferential treatment," because what does it say about their own privilege, intelligence, or ability if that's not the case?

Does This Pass the Smell Test?

I'm amazed how scientists can discover "truths" which end up being not just misleading but dangerous. Think of all the eugenicists at the turn of the 20th century who claimed scientific validation for the peril of "breeding with inferior types". I'm afraid that the following is an example of a scientist rushing over a cliff without taking time to really examine his premises and data.

This is a post by Satoshi Kanazawa on his Psychology Today blog:
In an earlier post, I explain why virtually all stereotypes are empirically true. Stereotypes come from the aggregation and generalization of the daily experiences of millions of people, so they cannot possibly fail to be true. Stereotypes are based on massive empirical data, and empirical data don't lie. However, I also explain that one of the very few stereotypes that are not empirically true is the aphorism "You can't judge a book by its cover." Contrary to popular belief, you can very accurately judge people's character just by looking at them.

There have been a large number of experiments conducted in recent years to show that altruists (people who tend to cooperate in situations where self-interested behavior might benefit them personally) and egoists (people who tend not to cooperate in such situations) genuinely look different, and people can tell them apart simply by looking at them. These studies show that people pay more attention to the faces of cheaters, and later remember their faces more accurately, even when they don't know who are cooperators and who are defectors. The latest in the series of such experiments has just been published in the September 2009 issue of the journal Human Nature, with the very descriptive title "Altruism Can Be Assessed Correctly Based on Impression."

The study, conducted by Ryo Oda of the Nagoya Institute of Technology and his colleagues, clearly demonstrates that you can judge a book by its cover. ... In their study, a large number of male undergraduate students complete a self-reported altruism scale. Those in the top 10% on the altruism scores are designated as "altruists," and those in the bottom 10% are designated as "egoists." These "altruists" and "egoists" are then individually videotaped during a normal conversation with a blind confederate in a closeup shot. The first 30 seconds of the videotaped conversation are then shown to different groups of students at a university more than 800 miles away (in order to eliminate the possibility that the perceivers may personally know the targets). The video clips of the targets are shown to the perceivers without sound, to prevent the targets from betraying their level of altruism by verbal cues.

Their study shows that the perceives, when asked to estimate the targets' levels of altruism, can accurately guess who are altruists and who are egoists. Interestingly, even though perceivers who are themselves altruists tend to think that others are more altruistic in general than perceivers who are themselves egoists, both types of perceives can nonetheless accurately judge who are altruists and who are egoists among the targets. Surprisingly, men and women in their study are equally good at estimating the altruism level of total strangers. (There are theoretical reasons to believe that women are better judges of character than men in general.) Further, altruists are judged to be significantly more active, more generous, more responsible, friendlier, kinder, more extroverted, and as giving better impression than are egoists, but altruists are not judged to be more discreet, more hurried or more intelligent. Further analyses of Oda et al.'s data show that the key to detecting altruists is genuine smile, which is under involuntary control and is therefore difficult to fake. Altruists genuinely smile more frequently than egoists during natural conversations.

Oda et al.'s study is only the latest in the series of experiments which demonstrate that we can indeed judge a book by its cover. Nice, altruistic, and cooperative people look nice, altruistic, and cooperative; nasty, egoistic and uncooperative people look nasty, egoistic, and uncooperative. And we (both altruists and egoists, both men and women) have the capacity to tell them apart, after looking at them for only 30 seconds without sound! In retrospect, this should come as no surprise. We have been dealing with potential cheaters throughout evolutionary history, and being duped and deceived by them has always carried tremendous costs. In other words, the presence of cheaters has exerted strong selection pressure on our ancestors. It would be a miracle if a capacity to judge people's character based on their appearance did not evolve sometime during the course of human evolution.
First of all, the necessary disclaimer: I am not a scientist and don't have background in the above fields. But the above doesn't pass the smell test.

If it is so obvious by just "looking" at a person, then how did Bernie Madoff manage to create so many victims? How does any con man succeed? They have an air about them, a look, a self composure, an assuring air that lures people into trusting them and getting duped. If the world were as simple as Satoshi Kanazawa presents it, then no con man could ever thrive.

There are well know experiments where various people are put on trial using the same "facts" but we get different results. The ugly, the different, the poor, and the outcast are more likely to be judged "guilty" while the pretty, the well-dressed, the successful, and the socially elite tend to be judged innocent: on the very same set of facts. We are more favourable to the beautiful than the ugly so we get miscarriages of justice. Here the stereotype simply ignores the facts.

I think an element of truth can be found in Kanazawa's claims. I am willing to accept that people with a lifetime experience of altruism and collaboration may develop traits that we can read. Similarly, those who have had a lifetime of failure and rejection (as well, maybe those who have spent a lifetime of manipulation and greed) have acquired traits -- mannerisms, presentation of self, etc. -- that we can sometimes read. But from here the leap to the simplistic generalization that you can "read a book by its cover" is unjustified.

I accept that stereotypes can be useful. But they are not always the "the aggregation and generalization of the daily experiences of millions of people". Stereotypes can be "taught" and that is exactly what racists do. So how do you distinguish between (a) an "unbiased" stereotype learned from examples and (b) a "biased" stereotype that is unfounded but which you were taught as if it were a valid generalization? I don't think many people are perceptive enough to clearly distinguish the two cases. Worse, I don't believe the world is black-or-white. All of our stereotypes are some kind of mixture, part honest generalization, part learned prejudice. The exact proportion varies both by the specific stereotype and by specific individual. Generalizations here can be dangerous.

In the late 19th century there were "scientists" like Kanazawa teaching the view that there was a criminal type, that you could spot a criminal from his features. We laugh at such views today. Similarly we should laugh at Kanazawa's views. Life is just too complicated for such simple "truisms" to be true.

I do believe that you can read some facts from a face. I accept the work of Paul Ekman. I believe that he has both a sound theory and the practical data to back up his views. Kanazawa is an armchair "sociobiologist" (or evolutionary psychologist) who is making claims with no data and which no sound theory could support.

At the very least, Kanazawa should tone done his generalization to match empirical reality: the skills by which people can "read" and distinguish altruists from cheaters may be statitistically significant, but it is not a 100% right-every-time skill and it most certainly is a "skill" that varies from individual to individual. So you can run a test and get the result that Kanazawa claims, but this would not lead to the conclusion that one person can "read" another. And it certainly doesn't lead to the idiotic generalization that you can "read a book by its cover".

Anybody who, like Kanazawa, says "stereotypes come from the aggregation and generalization of the daily experiences of millions of people, so they cannot possibly fail to be true" is telling you something that is untrue. That's my stereotype. So take that Kanazawa!

If you believe Kanazawa, I have a bridge in Brooklyn which I swear is a really, really good deal and I'm willing to part with it cheap! Just look at me... with a face like this, could I be lying to you? And if you don't trust me, my buddies Bernie Madoff and Ted Bundy are willing to vouch for my character!

Sunday, August 30, 2009

Krugman's Pet Peeve

Krugman wants reporters not stenographers or relationship consultants.

Here is a bit from his post on his NY Times blog where he complains about the failure of reporters as "journalists", you know, the job of reporting what is going on, the inside story, the actual implication of events. Instead he sees them talking about a political issue as if it were a beauty contest or a horse race. They report "he said/she said" and "who's winning" and "crowd reaction" but nothing about the substance of the event:
Why does this happen? I suspect several reasons.

1. It’s easier to research horse-race stuff. To report on policy, a reporter has to master the policy issues fairly well. That’s not easy, especially for journalists who have specialized in up close and personal rather than wonkery...

2. It’s easier to write horse-race stuff. Even if you know the policy issues, writing them so you don’t totally lose your audience is really tricky — I’ve spent years trying to learn the craft, and it still often comes out way too dry. On the other hand, horse-race stuff can be full of personal details.

3. It’s safer to cover the race. If you cover policy, and go beyond dueling quotes, you have to make some factual assertions — and people who prefer to believe otherwise will get mad. ... Much safer to report on ups and downs in the conventional wisdom.

The upshot, of course, is that we’re having a crucial national policy debate in which the great bulk of the news coverage tells people nothing at all about the policy issues.
So that's why you can have a "health care" debate and nobody knows what the issues are in health care!

Your Brain on Drugs

Whoa! Wrong title... maybe something like:

Your Future in the Hands of Robots

Take a peek.

Here's what's coming down the pike...



Wow! I wouldn't want this lil' feller to chase me around the room trying to tickle me!

I can picture it working over my body in milliseconds, putting me into a paroxysm of stimulation overload. How would you defend yourself for a quick hand like this?

So... I have seen the future and it is a dexterous manipulator!

I want to see War of the Worlds re-filmed with thousands of little guys with these hands chasing down humans and torturing them until they hand over the keys of the kingdom.

Can you believe working in a factory competing with this kind of robot?

Fact Not Fiction

I enjoy how Dean Baker tweaks the nose of the media. He points out that their "facts" don't add up. He shows how they are providing a propaganda service and not a news service. Here's his latest posting:
There Are Not Many Rich People Who Lack Access to Doctors

One often repeated comment in the health care debate is that doctors/hospitals can't get by on Medicare's compensation rates. They argue, as reported in the Post today, that if a large public plan offered Medicare-type reimbursement rates, they would be forced to just abandon public sector programs and work for rich people.

That should be a serious concern in the health care debate, if there were a lot of rich people who do not currently enjoy access to medical care. However, that does not seem likely. All the rich people I know are able to get all the health care they want.

What this means is that if doctors in large numbers were to abandon their current hospitals to serve the rich, most would find themselves unemployed. The rich are already being served. While some doctors may have the connections or skills to find employment providing boutique treatment to the rich, for the most part they would be displacing doctors who already serve the rich. These displaced doctors would then have no choice but to work for inadequate pay in hospitals serving the public health care plans.

(There is also the threat that doctors will leave medicine altogether for another profession, But since physicians are already the top paid profession, they can only go down from there. It is unlikely that many doctors want to become shoe salespeople.)

In short, the scare story pushed by the hospitals and doctors might be useful to advance their ends (high public compensation for their services) but they have no basis in reality. Responsible reporting should point this fact out to readers.
Not much to add to this. He nails it: a "scare story" pushed to advance the interest of doctors and hospitals to keep their income & profits high.

If you liked that Dean Baker "gotcha", then you will really enjoy this one where he points out that the Washington Post is misleading its readers about the real problems in the economy.

A Blast From the Past

If you are nostalgic for those heady days of the pre-crash dollars everywhere and greed rampant, then his video will salve your wounds...



I pulled that from a posting on the Calculated Risk web site.

It really was "more fun" back in the days when money grew on trees and greed knew no limit!

Demographic Disaster

Malthus had a point but his doomster scenario didn't occur because it was made just on the cusp of the Industrial and Scientific Revolutions which empowered humans to provide themselves with a better standard of living and more reproductive control. Africa, however, is something altogether different. From an article in the Economist:
Africa is still something of a demographic outlier compared with the rest of the developing world. Long berated (or loved) as the sleepiest continent, it has now become the fastest-growing and fastest-urbanising one. Its population has grown from 110m in 1850 to 1 billion today. Its fertility rate is still high: the average woman born today can expect to have five children in her child-bearing years, compared with just 1.7 in East Asia. Barring catastrophe, Africa’s population will reach 2 billion by 2050. To get a sense of this kind of increase, consider that in 1950 there were two Europeans for every African; by 2050, on present trends, there will be two Africans for every European.

There are three main reasons for pessimism. The first is that even today it struggles to provide for its people. ... Africa today produces less food per head than at any time since independence. Farms are getting smaller, sometimes farcically so. Dividing village plots among sons is like cutting up postage stamps. The average smallholding of just over half an acre (0.25 hectares) is too small to feed a family—hence the continent’s widespread stunting. Africa’s disease burden extends to its animals and crops. ...

... the second reason for pessimism: Africa’s families are under greater strain than Asia’s or Latin America’s were when their demographic transitions first began. That means, pessimists fear, that African countries may fail to navigate the virtuous cycle of industrialisation, growing employment, increasing productivity and prosperity. ...

The third reason for pessimism is Africa’s political violence, corruption and weak or non-existent governing institutions. ... In the worst cases, civil war has meant that the demographic transition has not even begun. Fertility in Congo, Liberia and Sierra Leone—all torn apart by internecine fighting—has barely fallen. In Congo the rate is still six, just as it was in 1950. In the worst places, fecundity tends to track instability. Africa’s highest fertility rates are in the refugee and internally displaced camps in Sudan and Somalia, then in those countries recovering from war, then in famine-pocked patches of desert and scrub stretching from Mauritania to Kenya.
Go read the article. It has interesting details and facts.

If you can't feed yourself, you certainly shouldn't be multiplying your population. Africa is a mess. Decades of "relief" have produced nothing. There needs to be an indigenous revolution, new ideas, that drive those populations toward a new vision of the future. The current path is a disaster.

Instead of all the talk about "help" and "relief", the only real help the developed world can offer Africa is to drop all tariffs on every kind of Africa product whether agricultural or industrial or even services. It is hypocritical to offer "aid" and then put up barriers that inhibit growth. The rest of the world needs to drop barriers and offer education to future leaders, but otherwise stand back and let Africans solve their own problems. It should police its own population to make sure no person from a developed country exploits Africa by selling weapons or doing "oil deals" or even "aid projects".

The developed world really needs a "hands off" policy. Sadly, China is now busy "developing" Africa like the West has done, i.e. exploiting Africa by doing deals with political elites to the disadvantage of the local population.

My personal viewpoint is that Africa will collapse because of demographic explosion, government corruption, and rampant disease. I'm pessimistic.

Sayonara to Japan Inc.?

The great wars of the 20th century were between corporatist politics (namely Fascism, communism as a clique running a country for their own benefit, and the Japanese zaibatsu) and democratic societies. Maybe that era is passing.

Here is a news report from the BBC on the Japanese election:
The opposition Democratic Party of Japan (DPJ) is set for a massive election victory, exit polls suggest.

The DPJ has won 300 seats in the 480-seat lower house, ending 50 years of almost unbroken rule by the Liberal Democratic Party (LDP), NHK TV says.

The DPJ says it will shift the focus of government from supporting corporations to helping consumers and workers. ...

The DPJ leader, Yukio Hatoyama, has promised to boost welfare, reform the bureaucracy, and seek a more balanced relationship with the United States.

Mr Hatoyama is the wealthy grandson of the founder of Bridgestone tyres, whose other grandfather was a former LDP prime minister. ...

Unemployment is at the highest level it ever has been and by the end of next year Japan will no longer be the second biggest economy in the world - that will be China.

Almost a third of the people here will be pensioners and therefore there will be fewer taxes coming in, more money going out.
This is long overdue. The strength of democracy is the ability to "throw the rascals out", i.e. not allow one clique to get too great a stranglehold on society. Turnover is good. Fresh blood. New ideas.

The future is not clear. China is rising and it is run by a "dictatorship of the proletariat" (nix the "proletariat", this is a dictatorship by a political class that has sandbagged itself into power, a lingering "corporatist" society).

Japan was a strategic chip nurtured by the US after WWII to "stabilize" Asia. Having a more democratic Japan is actually a plus, but this election symbolizes the exhaustion of Japan. Much like the US, Japan is a society that has not been able to face the future honestly and lives on the laurels of the past. Real change is needed.

Hopefully the DPJ is offering a "change" which is more genuine that the pretended "change" that Obama campaigned on but hasn't delivered.

Saturday, August 29, 2009

Behind the Veil

I always enjoy different viewpoints. Here's an interesting lecture by an Egyptian journalist addressing an audience at the University of Delaware. She will give you a glimpse into her world view, a liberal Muslim who lives in Manhatten and sells articles to a number of leading newspapers.



Mona Eltahawy has a blog and describes herself:
Mona Eltahawy is an award-winning syndicated columnist and an international public speaker on Arab and Muslim issues. She is based in New York.

Before she moved to the U.S. in 2000, Ms Eltahawy was a news reporter in the Middle East for many years, including in Cairo and Jerusalem as a correspondent for Reuters and she reported from the region for The Guardian and U.S. News and World Report.

She is one of a few writers whose essays appear regularly in both the western and Arab press. Her opinion pieces have been published frequently in the International Herald Tribune, The Washington Post, the pan-Arab Asharq al-Awsat newspaper and Qatar’s Al-Arab.

In 2006, the Next Century Foundation awarded Ms Eltahawy its Cutting Edge Prize for distinguished contribution to the coverage of the Middle East and in recognition of her “continuing efforts to sustain standards of journalism that would help reduce levels of misunderstanding”.
As you can tell from the above talk, she is refreshingly straightforward.

Here's an interesting article about sex in Saudia Arabia.

Here's an article on head scarves and how she seems to always out of kilter with her times.

Canadian Health Care

Here are Canadian health care professionals responding to the propaganda coming out of the US about how "socialized" medicine doesn't work...

What a Depression Means

I ran across this bit in a posting by Brad DeLong:
Average wages in manufactuing stood at $0.55 in 1930, at $0.51 in 1931--an 8% cut--and $0.44 in 1932--a 20% cut. Coal miners' hourly wages went from $0.66 in 1930 to $0.63 in 1931 to $0.50 in 1932--a 25% cut. Skilled male manufacturing workers' wages went from $0.66 an hour in 1930 to $0.63 in 1931 and $0.56 in 1932. You had the same 20% cut in nominal wages over 1930-1932 as you had over 1920-22 (but a 50% decline in industrial production in the 1930 and only a 30% decline in industrial production in the 1920s).
Add to the above the fact that unemployment hit a 25% rate:


This gives an appreciation for an activist government like Obama's. One that is leaning into the wind by spending, stimulating, bailing out, and coming up with 'cash for clunkers' gimmickry. The Republicans may rant that there is "too much government" but compared to the devastation of the 1930s, this re-enactment of the Great Depression has been much more mild exactly because of so much government action. The Republicans made a disaster of the Great Depression I, thank goodness they didn't get a chance to do a repeat performance with Great Depression II.

By the way, the blip up in unemployment in the above graph occurred because Roosevelt listened to his conservative critics and decided to rein in spending and balance the books of government. He got a mini-depression inside the Great Depression. This very impulse worries modern economists. Obama is under a lot of pressure from Republicans to rein in the projected $9 trillion debt. But this may trigger a mini-depression like the one Roosevelt experienced.

As for those conservative economists who want to blame "activist" government for causing the Great Depresion and argue a laissez faire approach to deflation, DeLong proposes a thought experiment:
Ask yourself: if everybody's salary in America were to be cut right now by 25 percent -- but everyone's mortgage payment, everyone's credit card balance and interest payment, and every corporation's debt interest payments remained the same--would we see a recovery or another chain of financial bankruptcies that would push the economy down further?
Economies are not "self-correcting" and don't have an "optimal set point". They are dynamic entities that can go up or down and settle at many different local minima. The argument for an activist government policy is to encourage the economy to settle at a better set point than a worse one. We've seen what a "hands off" deregulationist government can do to wreck an economy (George Bush). Why don't we give the alternative a decent go at it, say eight year, and then decide which is better.

Consultation Canadian Style

The Canadian government preens itself on being open and accessible. In this spirit it has convened a number of townhalls throughout Canada to "listen" to what the public has to say about changes to copyright law (changes the big corporations want, not changes that the public wants).

When these meetings appear to actually spark public interest with the possibility that a number of citizens will attend and provide opinions that the government/corporations don't want to hear, then they muzzle them. Here's an example from a post by Michael Geist:
The Canadian Federation of Students has issued a press release disclosing a disturbing incident just prior to last night's townhall in Toronto. CFS says that students attempted to distribute a flyer outlining the organization's position on fair copyright outside the townhall. The students involved were approached by private security guards who threatened to remove them from the hotel if they continued to do so. The CFS decided to distribute the flyers specifically because of the limited number of speaking slots and the fear that they would not be called upon to speak (they were not). It is hard to understand how distributing relevant materials outside a public, government-run townhall is viewed as grounds for ejection. As the chair of CFS-Ontario notes, "it is ironic that while students are concerned that new legislation may allow copyright owners to lock up information, the government is locking up its own consultations."

Update: NDP MP Olivia Chow reports that she faced the same threats when she tried to distribute documents outlining Charlie Angus' position on copyright.
The Canadian government under the Conservatives believes in a Potemkin village style of public consultation. Lots of fanfare, save the seats for the big corporate interests, and if any real people show up gag them and hustle them quickly out the back door. (At least they don't yet have the police beat them in the back alley and throw them in jail while throwing away the key. We can thank the heavens for the gentle soul of Stephen Harper who feels those measures are not yet needed to "manage" the on-going public "consultation".)

Here is a Michael Geist post talking about the initiation of the "consultation" and the strange preference the government has for A-list attendees:
There has been some criticism over the past week about perceived "A" lists for those invited to roundtables and those excluded. My view is that the only list that really matters is the list of people who take the time to make a public submission. That process is open to everyone and this is the ideal opportunity to ensure that Canadians voices are heard.
You can see public submissions at the government web site here. Read through these and draw your own conclusions about where the public stands on the proposed changes to copyright law.

This an $5 will get you a Cup of Coffee

Here's a NY Times article about an Obama pledge -- hand over heart, cross his fingers, hope to die -- that it won't torture prisoners, well, not torture them as much as Bush did.

While Obama is promising a "kinder, gentler" version of Bush, he will stick to flying "suspects" to third world countries that specialize in specialized "interrogation" techniques, you know, like Kazakstan that boils its interrogees alive in oil in order to extract "actionable" intelligence or Syria which buries you alive in a casket-sized hole for years with only brief breaks where they drag you out and beat you to within an inch of your life...
The Obama administration will continue the Bush administration’s practice of sending terrorism suspects to third countries for detention and interrogation, but pledges to closely monitor their treatment to ensure that they are not tortured, administration officials said Monday.

Human rights advocates condemned the decision, saying that continuing the practice, known as rendition, would still allow the transfer of prisoners to countries with a history of torture. They said that promises from other countries of humane treatment, called “diplomatic assurances,” were no protection against abuse.

“It is extremely disappointing that the Obama administration is continuing the Bush administration practice of relying on diplomatic assurances, which have been proven completely ineffective in preventing torture,” said Amrit Singh, a lawyer with the American Civil Liberties Union, who tracked rendition cases under President George W. Bush.

...

Though the Obama administration previously signaled that it would continue the use of renditions, some civil liberties groups were disappointed because, as a presidential candidate, Mr. Obama had strongly suggested he might end the practice. In an article in Foreign Affairs in the summer of 2007, Mr. Obama wrote, “To build a better, freer world, we must first behave in ways that reflect the decency and aspirations of the American people.”

Mr. Obama continued, “This means ending the practices of shipping away prisoners in the dead of night to be tortured in far-off countries, of detaining thousands without charge or trial, of maintaining a network of secret prisons to jail people beyond the reach of the law.” In January, the president ordered secret prisons run by the C.I.A. to be shut down.
So much for the political slogan of Change You Can Believe In. What I've come to believe is that politicians are all alive: say what it takes to get elected, the stick a thumb in the eye of the electorate.

Burning White Hot

This Czech physicist is burning hot over the upcoming European Union ban on incandescent bulbs. Here are some key bits from a posting by Lumo:
Starting from Tuesday, September 1st, 2009, the EU companies won't be allowed to produce and the shops won't be allowed to sell any conventional light bulbs with a milky or otherwise obscured surface as well as the transparent classic 100-Watt incandescent light bulbs - or any light bulbs above 80 Watts: see e.g. UPI. In one or two years, the cutoff will be lowered and new light bulbs will be banned, and so on. In 2012, only "efficient" light bulbs will be allowed and by 2016, they want to ban even the halogen lamps.

While Fidel Castro had some rational economic justifications for his decision (well, he simply wanted to reduce recurring blackouts), the reason behind the same policy in Europe is that the Eurocratic wise men think that American imperialist Thomas Alva Edison is causing a catastrophic global warming. ;-) Well, there are cases in which Fidel Castro looks relatively sensible, moderate, friendly to America, and pragmatic.

It's pretty clear that the total "warming" that classic light bulbs may have contributed since the birth of Edison was less than 0.01 °C, i.e. also less than a one-day fluctuation. Only a relatively small portion of the "man-made" CO2 comes from electricity production; only a very small portion of electricity is used for light (most are electric motors): this reduces the figure by more than an order of magnitude; only a part of light came from these light bulbs; only a part of the electricity is produced in coal-burning plants. ...

As he was christening his new book, Klaus [the Czech President] explained that it is a fatal silliness for the political leaders to dictate the citizens what they should do, what they are allowed to buy, and how many times a day they should turn on the light bulb: video in Czech.

Klaus said that this conclusion is self-evident and if he were a normal citizen, he would go to a shopping mall before September 1st and he would buy a sufficient reserve of the good old Edisonian light bulbs, in order to have enough of them - a sustainable supply - until the end of his, surely "no longer so long", life. Because he's a president, he will probably kindly ask someone else to do this job for him.

Well, even before they heard Klaus's recommendation, the Europeans already began the hoarding of the soon-to-be a scarce commodity, as the retailers have observed. ;-) This is so similar to the hoarding of various products during the communist era! And it has the same underlying reason, too: arrogant imbeciles who think that they're able to control the society in a better way than its own mechanisms. ...

As a conscious citizen of Europe, I have filled my stocks with the 100-Watt "standard light" sources, as they're still being called. The clerks claim that they will be able to order them even after September 1st. There's some confusion because some sources indicate that only bulbs strictly above 100 Watts (not 100-Watt ones) will be banned since Tuesday.
Lumi, as a citizen of an ex-Communist country, knows what it is like to have bureaucrats decide for you what you can and can't do, when, how much, where, and in whose company. Nuts! I detest the "greens" because they are moral bullies. They think they have a stranglehold on morality, but they are extremists (OK, some of them are decent people, but they belong to a movement that has lost contact with reality).

Personally, I think the world will turn green as we get wealthier and value a healthier planet more (I've seen huge changes in my lifetime). Poor people have very little time for "green" arguments from rich people who want to dictate how others live. (Remember Al Gore's flood lit jumbo mansion with a whooping big carbon footprint who jets around the world spewing CO2 to tell everybody else to tighten their belts to save the planet. That's the kind of hypocrisy I'm talking about.)

The world is also turning greener as we direct more resources toward better technology. The solution of the wood shortage in 1500 England wasn't to ration wood and tell people to crowd more into a room and huddle closer to the fire. It was to move to coal technology. Well, today we can more to newer technologies with smaller carbon footprints, if we invest. But by putting all the hot air into moralisms and berating fellow citizens, we are metaphorically telling everybody to live with less wood, crowd more into a room, and huddle closer to the fire. Nutty.

What really, really bothers me is that usually moral crusades are run by borderline personality types with megalomaniac tendencies. These Chicken Littles are hysterical (which would be OK if they kept it to themselves) who want to bludgeon the rest of us into their vision of the future. The old maxim of Jesus applies: before you try to remove the speck out of your neighbor's eye, remove that goliath-sized plank stuffed up your own eye.

Friday, August 28, 2009

Dean Baker Catches Republican in Their Bluster

This is just too funny...
Republicans Complain Obama Will "Bury" Our Children With Reagan Era Debt Burdens

That could have been the headline of an article on the new economic and budget projections. After all, the article included a quote from John Boehner, the leader of of the House Republicans: “the Democrats’ out-of-control spending binge is burying our children and grandchildren under a mountain of unsustainable debt.”

If we look at the latest projections from the Congressional Budget Office (CBO), they show that the interest burden of the debt in 2019, the last year for their projections, will be $722 billion. That comes to 3.4 percent of projected GDP.

If our children will be buried under this burden, then their parents must have been comparable strangled by the debt burden created in the Reagan-Bush presidencies. The interest burden from the debt run up in these years peaked at 3.3 percent of GDP in 1991.

It would be helpful for readers to put these budget and deficit projections into some context. Unlike reporters, most readers do have other jobs. Therefore they may not have the time to look up the data that shows Mr. Boehner's complaint is just empty rhetoric.
I find it funny that most people can't connect the dots. Big deficits under Reagan/Bush and Bush II were OK. They cut taxes for the rich. But budget deficits by Obama to save the economy and provide work for the unemployed. Well, that is pushing every over the edge into the Abyss.

Give me a break! The Republicans are just plain nutty. They can't keep their stories straight.They lie with statements that they used to swear to with hands over their heart. Funny!

The View from the Top

On the Global TV channel tonight they announced that BC now has the lowest minimum wage in Canada while being the province with the highest cost of living.

There has been no change in the minimum wage since 2000. During that same time, the premier of BC had his wage increased by 109% to something in the $260,000 range.

So... the view from the top is fine. Don't let the wailing and gnashing of teeth of the little people bother you. Heck, if they get noisy enough, lets bring back the days of the galley slaves and chain them to the benches with task masters with whips who can make them really put their shoulder to the oar. You know, those guys at the bottom of the heap are just a bunch of slackards. Not the upstanding members of society with high ethical ideals like a premier:

Mug Shot
Drunk Driving in Hawaii

Everybody knows that if you give the poor more money they will simply throw it away on drink and drugs. Not like the premier who was judicious in his use of intoxicants and only used them to excess while on holidays in Hawaii where reckless driving would kill worthless Americans while keeping his driver's license in BC clear of any demerits. Yep, he's a smart cookie.

I guess that's why he feels his salary should be doubled while those who earn their living by their sweat of their brow deserve nothing. Not a cent.

Electronic Profile

I ran this blog through the personas tool at MIT to "profile" the blog. Here's the result:

Click to Enlarge

It isn't clear to me that it captures any clear understanding of the "personality" of the blog.

Using Wordle I get the following:

Click to Enlarge

This is not a very representative expression of this blog, but it is a pretty good representative of the blog entries from today. It is heavily influenced by one blog posting which I did on my Mother's death.

Obama's Deficit

If you want to understand why Obama is running a huge deficit and why there will be a $9 trillion debt as the US struggles to get out of its economic collapse, look at this...


The tax receipts for individual income have fallen off a cliff, far worse than the 2001 recession. This collapse of tax receipts reflects unemployment, under-employment, job sharing to avoid layoffs, and shorter work weeks.

Notice when this started... mid-2008, the last year of Bush's presidency. This is the real Bush legacy: he smashed the economy with his right wing deregulation and "government's the problem, not the solution" political philosophy.

If you don't collect taxes, and if you have to spend more to cover those falling through the social safety net and you have to spend to stimulate the economy... well, you end up with a $9 trillion hole. Thanks to Bush. Thanks to the Republicans. Thanks to ideologues who don't understand economics and used their political philosophy as a bulldozer to run over, back up, and run over again the economy until they pretty well squeezed the life out of it.

Only when the economy recovers, which will start in this quarter and slowly build steam throughout 2010, will you get tax revenues back up and start to cover the deficit. It will be a long haul. Will the voters remember that this wasn't Obama's problem. This was Bush's when they go to the polls in November 2010 and November 2012?

Reining in the Federal Reserve

Here is some good news. Barney Frank says he will rein in the powers of the Federal Reserve by putting in place rules for consumer protection:



He mentions Ron Paul. I think Ron Paul is an idiot. But at least he is an honest man. But he is a man you never want the power of government to fall into the hand of. I don't trust Ron Paul to know what he is doing and he could trigger catastrophe by trying to implement some of his stupid views.

On the other hand, I have very high regard for Barney Frank. He is a very smart man. I think he works hard for his constituents and, more importantly, for the citizens of all of America. I trust him.

Men Who Stare at Goats

The book...


is excellent.

The movie...



appears to be a typical Hollywood rip-off.

The book is serious (though funny in a bizarrely disconcerting way).

From the preview, it looks like Hollywood has taken the book and turned it into a joke. That's a shame. Because a government who sponsors the kind of idiotic military "thinking" that Jon Ronson documented, needs to be carefully watched and controlled. This movie will make the whole thing look so silly that nobody would even bother to think about the very real fact that in the real world the U.S. military funded this kind of stuff.

Medical Professionals

It is coming up to the one year anniversary since my Mother was killed by a Tucson brain surgeon [see update at bottom]. Of course he will say he didn't kill her, this was merely an unfortunate unexpected side-effect of the surgery. She died of a hematoma (bleeding in the brain that kills the brain cells it invades).

At the request of my Mother I talked to the surgeon to try and decide whether surgery was the right treatment. I remember asking him repeatedly if there would be any "mental deficit" or "loss of function". He assured me that my mother was healthy for an 85 years old and that the surgery would be simple. He left me with two thoughts:
  1. He claimed that there was no way to provide any statistical information about treatments and outcomes. This was frustrating because without any background in medicine and nothing on brain tumours, I found a site that gave me some statistics. The surgeon simply ignored this possibility and kept telling me "each case is individual so we can't talk about statistics."

  2. The operation would be "simple" and that he really couldn't think of any possible negative outcomes. As a surgeon he really had no option to offer other than surgery.
So I told my Mother to go ahead with the surgery.

To my shock, when I arrived after the surgery she had Left Neglect and other cognitive impairments. I had to diagnose this for myself since nobody on the hospital staff took the time to talk to my Mother, my Father, or to my brother or myself about her condition. It had taken me 3 days to drive 2000 miles to be at her bedside, I arrived 36 hours after her surgery. When I tried to talk to the surgeon he was "too busy" and had me chase after him as he left the hospital. He did confirm that she had Left Neglect but really said nothing about her condition, what caused it, or what her prognosis might be. I -- and the family -- were left completely in the dark.

While she was at the hospital it was a continuous effort on my part to try and find somebody who would take the time to explain what happened, describe her condition, or talk about what could be done. It took four or five days before a family physician (somebody from the office, not her regular doctor) to pull me aside and tell me it was a hematoma. At first I was ecstatic because this meant to me she would improve as the blood clot dissolved. It took several before I was again pulled aside and told that hematoma in the brain is unlike a hematoma elsewhere: the brain cells die and do not come back. Her deficits were permanent.

The surgeon never explained any of this. Never apologized.

I can accept that not all surgeries will be successful. Even after failing to warn me of bad consequences, if he had come in contrite and said "I'm sorry, this is not the outcome we expected..." and then proceeded to explain what happened and what could now be done. I would have been appeased.

But the only time I saw the surgeon after the surgery, some 6 days after the surgery when he "dropped by", I mentioned that I had asked if if there was any possibility of "mental deficit" or "loss of function" and that he had assured me that there was none. He shot up and said "You have insulted me!". Not a word about the physical insult he had done to my Mother. In his mind it was all about "me, me, me" and how his ego was insulted. So he stormed off. I -- and nobody in the family -- saw him again. My mother died within two weeks of this. Nobody in the hospital told us to "expect her to die".

Instead we were treated like lepers and she was hustled between "treatments". First they sent her off to a "rehabilitation" hospital at which they put her into an exhausting regime that gave her an H. Influenzae infection. From there she was sent back the the Emergency Ward and when she recuperated a bit, they sent her back into the regular ward. At this point she was at wits end about her treatment by hospital staff:
  • She had Left Neglect so was completely unaware of things on her left, but they would often leave the service button on the left so she had no way to call staff.

  • The hospital would serve food and cutlery encased in plastic wrap that would take two good hands to open, but she had use only of her right hand, so she was left to stuggle alone. Even when they helped set her up to eat, staff didn't have time to make sure she saw all the food or encouraged her to eat it. Instead things would get pushed to the left where they were as good as gone for her.

  • A "modern" hopsital is a very inhospitable environment. It is noisy. Lights are on day and night. Loud conversations go on despite signs everywhere reminding people to keep quiet to let the sick hear. Staff constantly disturb you to run tests that they don't explain. You feel like a lab rat being experimented on.
In the end my Mother said "get me out of here!". The only option was via a hospice. So we moved her there.

The hospice staff immediately got on our case telling us that rooms in the hospice were only for those who are "actively" dying and that we had to find a nursing home to move her into. So, not being residents of the town, my brother and I spent most of the days left in my Mother's life on the road visiting nursing homes trying to find a good one. Meanwhile, my Mother died within 6 days of being moved into "hospice". The night before she died she had tossed covers off and when I arrived in the morning I found her body temperature down in the low 80s and she was unresponsive. I put covers over her and within four hours she could respond to simple questions. But she died only a few hours later.

The previous day I had fought with her old family doctor's staff all day long. I was requesting that he drop by to visit her because she wanted urgently to talk to him. I ended up threatening the staff before they finally got the doctor to call me. He showed up at my Mother's bed before his other visits at the hospital. This is the morning of her last day when I had found her unresponsive and cold. I thought "I've got a doctor here, he'll know what to do to bring her out of this". All he did was what I did: call out to her and jostle her trying to awake her. He pulled me aside and began talking about the need to plan radiation treatments. This was within 10 hours of her being dead. In short, he had no clues about the signs of imminent death. Thankfully the hospice staff notice a change in breathing indicating near death so I and my brother were able to be at her side during her last hour.

On the whole, I found "modern medicine" to be absolutely useless. The surgery killed her. It was not a "treatment" other than operating on the Medicare budget to move funds from the public purse to the purses of various medical personnel and institutions. The hospital was geared up for all kinds of "high tech" treatment, but overlooked simple care. The last days of my Mother's life were uncomfortable and terrifying because everything was strange and nobody took time to comfort her. The family was with her as much as visiting hours permitted. But she spent long hours alone.

The worst was when they left her on a metal bedpan for six hours. From that she developed a bedsore because she was very think and bone one metal caused a bedsore. Staff simply didn't take the time to check on the patients. They were either rushing from room to room promising to be back "in a second" or they were busy gossiping about weekends or after work activities in the hallways. Besides, these medically trained people were expensive. The hospitals need to cut back a bit in high tech gear and expensive medical staff and hire some minimum wage people whose job it is to be "patient advocates", i.e. bring a little humanity to the cold indifference of a modern hospital.

My Mother died at the hands of a medical system that spent a small fortune "treating" her. But it was a system that didn't honestly lay out options. That didn't face up to mistakes when made. That didn't respond to problems when they were pointed out. In short, it was a horror story. This is "modern" American medical care. (And Canada isn't much better. It is an institutional problem, not a cultural problem. It is the institution of "professionalism" and hierarchies like a hospital.)

Here is my bottom line:
In choosing a surgeon I had less information to go on than a typical sports fan has on a player. In baseball you get all kinds of stats to help you evaluate the player. In modern medicine, the professional societies and the hospitals refuse to disclose any facts on with a rational decision can be made. You have no information about experience and outcomes in selecting a surgeon. The surgeon is under no constraints to give you real options. The hospital is not required to disclose how many "accidents" or failed treatments they have had. In short, you have to make life-and-death decisions in a void. The professional societies and the medical organizations refuse to give you the kind of basic information that you can get from an innocuous pastime like baseball. It is shocking.

These professionals and institutions have an interest in keeping things opaque. A surgeon makes a living selling surgeries. Why discuss other treatment options. A hospital makes its money "treating" you and if it doesn't have to explain what it is doing or any options you might have, then they can set up things to meet the hospital's needs. Of course the hospital thinks this is best for the patient, but is it really? Just like the police shouldn't investigate police misconduct. A hospital is not really set up to monitor quality and effectiveness. Nor is the medical society. But in both cases, governments have given these institutions -- because they are "professionals" -- a self-regulatory power. That is just plain crazy. Why would they give themselves a hard time? Why would they look for a "better way". It is all too cozy for the incumbents.
Addendum: My Father died within a month of my Mother. He caught the H. Influenzae that my Mother caught at the hospital. In fact my brother and I caught it as well. This was too much for my 87 year old father, so he had to be hospitalized. He spent two weeks in hospital, two weeks in nursing home care, and was released and had one week at home before he died. I put his death down to "treatment" by modern medicine. He had been doing just fine until he was swept up in the maelstrom of "modern medicine" and driven to his end. I just hope that I can avoid the "care" offered by modern medicine.

I do believe that modern medicine has some real skills. Unlike the early 20th century when medicine was finally free of the mumbo-jumbo of blood letting and was getting onto a scientific footing but had no real medicines, by late 20th century modern medicine has much to offer. The problem is that the institutions of hospital and medical societies have failed to come into the future and open up and recognize their shortcomings and seriously try to address these problems. Instead they hunker down in a protective stance more concerned with protecting their "professionalism" than in serving the community.

Update 2009aug29: I removed the surgeon's name. I did send in a complaint to the Arizona Medical Board. I can see that the surgeon was named in a "proposed consent agreement" (see here, and the interpretation of a consent agreement is here). But these meetings are held in private. When I filed my complaint I thought I would get to work with the committee to shape the complaint. No. You get one shot and once you hit the "submit" button that is it. I get no say in the process. In later telephone conversations I was told "you only get to submit once and can't refine or amplify the submission". Additionally, I get no visibility into the deliberations. I get no details other than a thumbs up or thumbs down at the end of the process.

In short, the system is geared to protect the doctors from complaints. As far as I can tell there is no mechanism to track licensed "professionals" to ensure quality. Instead there is this one-shot-in-the-dark complaint system that will, on very rare occasions, allow the public to knock down a malfeasant doctor. But too often, it means that the profession protects its own.

As I told the hospital, I'm not interested in suing anyone. I'm interested in improving the medical system. I tried to work with the hospital's "patient's relations specialist". I sent many long e-mails with many details about deficient procedures and ineffective systems. I got nowhere. And finally gave up.

As for the surgeon, again I wasn't interested in lawsuits. I simply wanted the guy to be aware of the fact that he mislead me and that -- from my perspective -- he did an incompetent surgery (or the fact that he negligently went on holiday immediately after the surgery and didn't instruct staff to watch for a hematoma and deal with it). I wanted some recognition that things went wrong. I can accept that outcomes are not always what you desire. But the fact that before the operation I couldn't get him to admit to any problem enrages me. I want him to face up to the fact that this surgery did not have a happy outcome. But I got no satisfaction from him, nor from the Arizona Medical Board. The system closed ranks and protected their own. This is tragic because it means others will suffer tragic outcomes before someday, somehow, somebody is able to crack this system and shine some daylight in and clean up this self-protective "professionalism".