Map of life expectancy at birth from Global Education Project.

Wednesday, April 26, 2017

Al Gore keeps getting fatter


Back in 2013 (remember the good old days?) Joe Romm wrote about the consequences to South Florida of sea level rise of 2 meters or a bit less. That was the consensus expectation at that time for the end of this century. Okay, you and I don't expect to be around that long, but with just a three foot rise, half of southern Florida will be under water. By the time we hit the six foot mark, Miami Beach will be completely gone, as will most of Miami. Past the turn of the century, sea level will continue to rise, ultimately by 70 feet if the Antarctic ice sheet largely vanishes -- which, at the rate we're going, it will.

Well, it looks like it's happening even faster. New projections say that 3 meters in sea level rise is possible by the turn of the century. That's about 10 feet. So Miami Beach will be gone long before then. By the way, so will Mar-a-Lago, which sits about 3 feet above present sea level. Whaddya know.

Saturday, April 22, 2017

This is amusing . . .


Someone (an anonymous coward) wrote this in a comment:

Imagine trying to explain to a bunch of liberal professors that in the history of the world, no other economic system has created more wealth for more people than capitalism. It just goes against their deeply held socialist and political beliefs.
It's fascinating what people think goes on in universities. In all of my travels through Tufts, Brandeis,  Boston University and Brown University as a graduate student and faculty member, I have never met a single liberal (or other) professor who does not know that economies that fall broadly into the classification of capitalist have become the wealthiest. As a matter of fact (funny thing here!) Karl Marx believed that capitalism was the most dynamic economic system for creating wealth. Nowadays, there are very few professors anywhere in the U.S. who think that Marx mostly had things right, but even if there are a few, they do not need to be convinced that "no other economic system has created more wealth than capitalism." All those liberal professors, with their briar pipes and leather patches on the elbows of their tweed jackets, believe it or not, actually know this.

However, economists -- and other people who think about the economy, such as sociologists, political scientists, and historians -- have various viewpoints about how best to organize and manage complex, modern economies. Capitalism, as I have suggested, is quite a broad concept and there are many capitalist economies in the world today, and in history, that have had differing characteristics. I should also add that the term "socialist" has come to be conflated with Soviet communism, which leads to much misunderstanding.

In Europe, the term "democratic socialism" as most people use it refers to advocacy for a program in which government assures certain standards of welfare within an entrepreneurial, market economy. As in the U.S., there is also some amount of government enterprise and economic activity -- perhaps our correspondent has noticed that someone maintains the roads, puts out fires, educates children and so on. People who call themselves socialists may want to see government do more to invest in human, physical, and intellectual capital than it does now. But socialism as it is commonly used today really refers to a form of capitalism.

Economists today -- even respectable conservative economists -- understand that markets are not forces of nature. They are social constructs. They require various forms of regulation and public infrastructure to function. The question is how best to structure and regulate them, not whether they ought to exist.

If you are interested in what liberal professors really think and argue about the economy, you might check out the blog of Bradford DeLong, a Berkeley (I know) professor, which is very active and has all sorts of interesting material pretty much daily. He's an economic historian, so there's a lot of emphasis on that, but there's plenty of other stuff as well.

Educate yourself, is always my advice.

Friday, April 21, 2017

Science and Politics

I would imagine I don't have to tell you that I think objections to the March for Science on the grounds that science shouldn't be "politicized" are absurd. Science is already politicized, which is exactly the point. Here's one take that's worth reading from Tim Requarth.

We eggheads get all scrambled trying to understand why people just won't listen when we 'splain the scientific truth to them. As Requarth explains, the problem isn't that they have a knowledge deficit that we can plug with our smart words. It's that they are motivated to believe by particular interests or loyalties. Scientists spend years getting their brains trained to apply certain standards of evidence and to change their conclusions when the evidence calls for it. But that makes us weird.

Here's Dave Levitan on the ways politicians deny and distort science. One pull quote I like:

Q. The “I’m not a scientist” line has become all-too-common, and it’s the basis of your book title. Why is this refrain bullshit in your view?

Dave Levitan: The basic reason is it's absurd for politicians to have to tell us what they're not an expert in. They don't say I'm not an economist. They don't say I don't have a degree in Middle Eastern studies or civil engineering, yet they're still perfectly willing to opine on these issues. So it's sort of a bizarre subset that they think it's a reasonable thing to say.

Here's why this is hard to talk about. We do claim to be experts in our fields, and we do make a privileged claim to truth. Cosmologists do not consider the age of the universe to be subject to debate (within a margin of error); biologists do not consider the fact of evolution and the antiquity of life (again, within a range) to be matters of opinion; climate scientists state that anthropogenic global warming is a fact, no longer a hypothesis. An if you disagree, you are just wrong. We know more than you do.

People don't like to hear that. However, as Levitan suggests, they commonly make exceptions. They respect the expertise of their physicians, plumbers and auto mechanics. On the other hand, I have to agree, all three categories of professional are capable of corruption, and of fudging or even lying in the service of a bigger paycheck. People might think that scientists are doing the same, to get grants or whatever.

Here's what's wrong with that. We aren't one auto mechanic trying to sell you a transmission rebuild that you don't really need. Science is a community of millions of investigators, graduate students, research assistants, and administrators. There is nothing that a scientist wants more than to prove that everybody else was wrong and get credit for a breakthrough. And there is no way that all those people are somehow going to successfully conspire to fool the entire world, and nobody is going to blow the whistle on them.

But it's also hard to explain to people that errors do happen -- in fact, we think that in some sense, everything we think we know is wrong because we can ultimately find a more precise answer. But the errors get fixed, the precision increases. Newton's theory of gravitation has been supplanted by Einstein's. In a sense Newton was "wrong," but he was a lot closer to the truth than Ptolemy. There is some question now about whether general relativity is exactly correct. Maybe physicists will improve on Einstein some day. They're trying really hard! But relativity works well enough for the Global Positioning System and robot probes to Jupiter, so you'd be a fool to deny it.

So I'm not sure what to do. Trying to explain stuff to people that they are motivated not to understand isn't going to get us very far, especially if they feel they are being talked down to or what they think is their own expertise isn't respected. Well sorry, but if you aren't an expert in physics and biology then no, you don't know as much as somebody who is. You should try to learn more if you are interested, but you need to approach that learning with a truly open mind. And if you can't be bothered, that's fine too, but then you need to stop thinking you know better.





* Mine is policy and practice related, so it's factual basis does inevitably get mixed up with values. But I find a lot of critics here don't succeed in separating out my factual assertions -- they end up arguing against facts because they are unwilling to state their value disagreements.

Tuesday, April 18, 2017

Too Long, you don't have to read . . .

. . . because I'll tell you, as a follow-up to my previous post. David Gorski has good things to say, as he does here, but if brevity is the soul of wit Dr. Gorski is not at all witty. (I think he already knows that but he can't help himself.)

Anyway, so-called "Right to Try" legislation has passed in 33 states, and an effort is underway to pass a federal version. This is one of those policy ideas that looks great on a bumper sticker and is impossible to refute in 30 words or less. Since the voting public gets turned off by wonkery, politicians who know better duck and cover when these proposals come along, so they pass.

The idea is that terminally ill people should have the right to try experimental treatments. Maybe they haven't been proven safe and effective yet, but they got through the first round of trials so it appears they might work, and what have you got to lose? You're dying! Why would the nanny state deprive people of a chance to extend their own lives if that's what they want to do?

Okay. First of all you need to know that the formal process for drug approval consists of three "phases" of trials. Phase one just consists of giving small and gradually escalating doses to a small number of patients, maybe 30, just to establish a level that doesn't produce acute toxicity. Passing this stage is all that is needed for the "right to try" to kick in.

But these drugs may not even have passed phase II trials. These are somewhat larger and last longer. They are underpowered to prove that a drug is safe and effective. They are intended to establish that the trends are in the right direction and that no obvious safety issues emerge in longer term use, so that the much larger investment in a Phase III trial can be justified. Only after successfully completing at least one Phase III trial can a drug be considered for approval.

It turns out that only 30% of drugs that enter Phase II trials even go on to Phase III, let alone win ultimate approval. So the first thing you need to know is that the likelihood that people could benefit from "right to try" is lower than you probably thought. Since the ostensible beneficiaries are already terminally ill, it's actually extremely low. Even safe and effective drugs are almost never miracle cures -- they might extend life for cancer patients if used early enough, but they almost never reverse advanced cancer. And yes, they can indeed harm people.

Terminal illness is actually a pretty loose concept. Doctors are very bad at predicting how long people have to live; it's very common to outlive a prognosis of 6 months to live, by a lot. So it's possible to significantly shorten the life of a person with a supposedly terminal illness. It's also possible to make them sicker. So gambling with an unproven treatment is not a no-cost bet.

And "right-to-try" legislation forbids insurance companies paying for these treatments, at their own insistence. That means the legislation affects only people with the means to pay out of pocket; and the drug companies can charge whatever they want, which is probably a lot. So you're handing over your kids' inheritance for something that is more likely to harm you than to help you.

Finally, the existence of "right-to-try" may deter people from participating in clinical trials in which they might get the placebo. Which means it will be harder for us ever to know for sure whether the stuff works. The proposed federal legislation is even worse because it actively forbids the FDA from taking adverse events in "right-to-try" patients into account in evaluating the treatment. The only point of that is to relieve the drug companies of all risk.

This is nothing but a cynical move to take money from desperate people and give it to drug companies, under cover of fake compassion and the usual nonsensical libertarian arguments. The FDA already has the authority to approve "compassionate use" of experimental medications on a case-by-case basis. That's how it should stay.

Thursday, April 13, 2017

Libertarian pharmacy policy


It's a famous story. Thalidomide is a sedative which was prescribed for morning sickness in pregnant women, starting in about 1960, in countries around the world. Not, however, in the U.S., because an official of the Food and Drug Administration named Frances Kelsey felt the application had insufficient data on safety, including whether the drug crosses the placenta. Turns out it does, and it can cause severe birth defects in which babies are born with flipper-like limbs.

At that time the FDA did not oversee clinical trials, and it pretty much took the drug companies' word for it about safety. As the linked article says:

The tragedy surrounding thalidomide and Kelsey’s wise refusal to approve the drug helped motivate profound changes in the FDA. By passing the Kefauver-Harris Drug Amendments Act in 1962, legislators tightened restrictions surrounding the surveillance and approval process for drugs to be sold in the U.S., requiring that manufacturers prove they are both safe and effective before they are marketed. Now, drug approval can take between eight and twelve years, involving animal testing and tightly regulated human clinical trials.

Drug companies don't necessarily like this. Some do, because they feel they depend on their reputation for safety, although as we have discussed here many times they frequently game the system by keeping unfavorable trial results hidden, and other unsavory practices. Recent efforts at reform have aimed at improving the system, by requiring registration of clinical trials and public availability of all results, among other reforms.

Comes now a reality TV star who wants to appoint as FDA commissioner a man with no research experience or academic background who is an investment adviser and member of pharmaceutical company boards. As Daniel Carpenter informs us in NEJM, "The Trump administration’s approach to the Food and Drug Administration (FDA) is guided by a libertarian belief in markets over science, and Gottlieb apparently shares this view." The idea is that bad drugs will be driven out of the market by consumer experience.

Of course, if your baby is born without arms it will be a bit too late for you, but that isn't the only problem with this philosophy. Lots of diseases and symptoms get better on their own. You can't necessarily tell whether the medication helped or not. Nor do you necessarily know that an adverse effect is attributable to the drug. You should read Carpenter's essay, but here's how he finishes:

The medical community and the Senate should greet this nomination with scrutiny. To this end, I propose some questions for Gottlieb. Perhaps the most important is one that can be answered only by his behavior: Will Gottlieb, if confirmed, listen more to FDA scientists or to his Trump administration superiors, corporate-board colleagues, and think-tank associates? At stake is not just the FDA, but the scientific regime of clinical pharmacology and the credibility of American therapeutics.

Questions for Scott Gottlieb.

  • • You will have to recuse yourself from decisions about certain companies’ products because of conflicts of interest. How many companies, and which ones?
  • • You have argued that there are “interim endpoints that can be used to more quickly gauge a medicine’s benefit.” Under your leadership, how would the agency commit to restricting the use of a drug or removing it from the market if later-stage evidence turns out to present a much weaker benefit profile?
  • • You have argued that the FDA has an “unreasonable hunger for statistical certainty.” How, then, do you explain the fact that the FDA approves new drugs and devices more quickly than any other regulatory agency? Do you see accelerated approval, compassionate use, and breakthrough designations as inadequate, and if so, why?



Wednesday, April 12, 2017

Saint Ronald


Iraq and Iran fought a horrific war from 1980 to 1988. Saddam Hussein was unquestionably the perpetrator. He repeatedly used chemical weapons against Iranian troops, then in 1988 he attacked the Kurdish village of Halabja, in northern Iraq, with mustard gas, killing thousands of civilians.

The president of the United States was conservative demi-God Ronald Reagan:

In 1983, President Reagan sent a special envoy to Baghdad. He was Donald Rumsfeld, and that visit resulted in the now famous picture of Rumsfeld shaking hands with Saddam Hussein. This was in December of 1983. This was at a time when the US was secretly aware that Iraq was using chemical weapons against the Iranians almost daily. There's evidence that the battlefield intelligence provided to Iraq helped the Iraqis better calibrate their gas attacks against the Iranians. Around this time, the administration concluded that Iraq's defeat in the war would be contrary to US interests in the Persian Gulf. The economic aid to Iraq started in 1983, and by the end of the war amounted to more than a billion dollars. . . .

Near the end of the war when Saddam Hussein used chemical weapons against his own citizens, the Kurds. We know a great deal about this now. At the time, the United States prevented a move in the UN to impose economic sanctions against Iraq, saying that the sanctions would be useless or counterproductive. So in effect, the United States defended Saddam Hussein's use of chemical weapons even as late as 1988, and this kind of a relationship continued through the Reagan administration and into the first President Bush administration until the very day that Iraq invaded Kuwait in early August 1990.
Just so you know.

Thursday, April 06, 2017

Gas Schmas


It's interesting that the Assad regime's nerve gas attack on a village in Idlib has generated sudden outrage, including from people who thought Assad was just peachy until yesterday such as the White House resident. We're having an emergency meeting of the UN Security Council and the U.S. is threatening to take unilateral action -- presumably meaning bombing some things and people -- if the UN doesn't act.

I agree that it is bad to attack civilians with poison gas. It is also bad to blow up 3,800 people using rockets and artillery shells, summarily execute tens of thousands in mass hangings, blow up hospitals and mosques, and starve people to death. The Assad regime did all of that, and more, before the nerve gas attack, which was apparently okay.

Look, I'm against all kinds of war. But to freak out over chemical weapons in this way is to imply that bombing, torturing and starving people is okay. This is an idiotic, meaningless distinction. We need to get over it.

Thursday, March 30, 2017

More simple proof that libertarianism is a crock

The right to ride a motorcycle on public highways without a helmet is a classic liberty claim. So what if it's risky, or the nanny state thinks it is? It's my right to make the choice -- it's my life.

As the linked essay by Busko, et al demonstrates, it is in fact risky, although opponents of helmet laws will often proffer alternative facts. In 1967, under the oppressive rule of Communist president Ronald Reagan, the Department of Transportation issued a program standard making helmets mandatory for motorcyclists, and congress voted to withhold federal highway funds from states that didn't enforce the guidelines. Soon, all but three states had helmet laws. There ensued a sharp decrease in motorcycle fatalities and head injuries.

All glory to Her Holiness Ayn Rand, freedom again prevailed in 1976, when people's choice president Gerald Ford signed legislation repealing the mandate. The following year, motorcycle-related fatalities increased by 23%. Free at last, thank God almighty we're free at last! By the way, just so you know, motorcycle fatalities are 14% of traffic deaths, even though motorcycles account for less than 1% of miles traveled; and motorcyclists are 27 times as likely to die in a crash as automobile occupants. Have fun!

Now maybe you think it's just fine if fools want to kill themselves and it's no business of the government to tell them not to. (I won't speculate about what freedoms you don't want people to have, I'll stipulate for the sake of argument that you aren't an outrageously blatant hypocrite. But do think about that.)

Here's the problem.  Two thirds of the cost of treatment for motorcycle-related injuries are borne by the public, mostly Medicaid. Bikers who are disabled cannot work, and usually become public charges. They, along with the dead ones, no longer pay taxes and their families are deprived of support, may also become public charges, and in any event their children and other loved ones will suffer. While your liberty to be a moron is at stake, so is my liberty not to have to pay for your foolishness.

This is the fundamental problem with libertarianism. All decisions involve tradeoffs between one person's liberty and another's. Your liberties don't stop with you.


Tuesday, March 28, 2017

Ratcheting up


Here's a long form piece in the Gray Lady about the history, present and likely future of Medicaid. I think you should read the whole thing but I'll give you a couple of pull outs.

Medicaid started small, as a minor add-on to Medicare. Originally, it was coupled to what was generally called "welfare," Aid to Families with Dependent Children, and hardly anybody noticed. But over the years, bit by bit, Democrats managed to expand its scope to include people with disabilities, elderly people in nursing homes, and low income families that were not on welfare. By now, the assumption that able-bodied adults should be able to afford health insurance is decisively false.

In fact, far from creating a culture of dependency and discouraging people from working, Medicaid makes work possible for people with children with disabilities and/or severe health care needs; or elderly relatives who need care. And it keeps people in the labor force who need health care to be able to work. So part of the cost is recouped in taxes. Anyway, people generally don't seem to understand that government spending isn't like household spending. Every dime spent on Medicaid is income for health care providers, pharmaceutical and medical device manufacturers, and related services; and profit for shareholders.

Medicaid pays for half of all childbirths in the U.S. A large majority of Americans either benefit from it themselves, or have friends and relatives who do. The Republicans' disastrous American Health Care Act would have taken Medicaid away from the population that benefited from the ACA expansion, and then gradually reduced funding over the years forcing the states to spend more of their own money, or drop beneficiaries and services. That turned out to be politically impossible.

The Republicans aren't going to take away Medicare or Social Security either. Once people got these benefits, and realized how much better they made life for everybody, eliminating them became politically impossible. He was obviously lying, as he always does, but when Ronald T. Dump was campaigning for president, he promised to protect Medicare, Medicaid and Social Security, and even to provide health care for all. He knew he needed to speak those lies in order to have a chance. Of course, in reality, he supported Paul Ryan's bill that would have destroyed Medicaid. But they failed. Now we can go about the business of continuing to expand Medicare and Medicaid, providing a public option on the ACA exchanges, and one day --

Universal, comprehensive, single payer national health care. That is our right.

Monday, March 27, 2017

Reclaiming Truth


When the Internet, and particularly the World Wide Web were young, many people had a utopian vision of a global free market of knowledge and ideas. Everyone could contribute to the total mass of truth, logic and debate, and we would ultimately enter an age of enlightenment.

Something like the opposite seems to have happened. Lots of people have gone through the looking glass into their own alternate realities. We have a "president" who lies so habitually that it's a surprise if he says anything that's true. Yet his true believers enthusiastically follow him into opposite world. We have the outlandish pizzagate, global climate change denial, birtherism  . . .

A partial explanation is this concept of blue lies. (Apparently that's supposed to be somewhere between white and black but I think it's horribly kludgy term.) The idea is that lies that don't hurt your own tribe or in-group, but are directed outward, strengthen group solidarity. It overlaps somewhat with confirmation bias, because deciding we were wrong about something doesn't only threaten our own ego, it may threaten our group identification.

I don't claim to be completely immune from these afflictions, but I think I'm less susceptible than most, because I am trained as a scientist and I make a conscious effort to practice critical thinking. I work hard all the time to evaluate evidence and not to come to firm conclusions that don't have strong support. And I do change my mind when confronted with good evidence that contradicts my previous beliefs. That is why, for example, I am now an atheist after once preparing for confirmation.

We are in desperate trouble if we can't get more people to think critically and start basing their beliefs on good evidence. The first thing people need to do is put more trust in the scientific enterprise. Yes there is scientific fraud and there are unreproducible findings. Scientific claims lie along a continuum of credibility. Don't believe the hype about a single clinical trial or a finding in laboratory rats -- it's a long way from initial observations and hypotheses to strong scientific consensus.

However, there is a great deal that we know. The universe is more than 13 billion years old. Life on earth is more than 3 billion years old and we got here by way of evolution. People are burning so much fossil fuel that we are putting carbon dioxide into the atmosphere at a rate which is causing the climate to warm, storms to become more violent, and the seas to rise. Cutting taxes on wealthy people does not make working people better off. And so on. We need to accept a common reality, or we are doomed.

Friday, March 24, 2017

The Art of the Fail


Orange Julius spent the campaign, the transition, and the first month of his occupancy of the office of president proclaiming that his great new health care plan would cover everybody, with better health care, at lower cost. Only a few fringe lunatics like Paul Krugman and Cervantes had the audacity to claim this was not possible.

After 8 years of screaming about death panels and socialism, and passing -- what was it, 36? -- bills to repeal the ACA, secure in the knowledge that president Obama would veto them, Republicans suddenly found themselves in the untenable position of actually being able to do what they had campaigned on for the past 8 years. What we learned from the exercise is that they do not in fact know anything about health care policy.

There is no such thing as a free market for health care, there are no free market solutions, and the only way to secure liberty for people is through a market that is structured and regulated by government. The best way is universal, comprehensive single payer national health care; but some countries manage to do it with kludgier solutions. Switzerland, for example, has Obamacare +. It has private insurance companies competing for customers, selling tightly regulated policies. They cut out the middleman with the individual mandate and subsidies, and instead give everybody a voucher to buy insurance, funded by taxes. Britain has real socialized medicine, with physicians as government employees. Canada's physicians are mostly private entrepreneurs, but their customers have insurance provided by the government.

There are a few ways to do it but the reality is:

  • Every affluent, capitalist democracy on earth spends less -- a lot less -- on health care than the U.S.
  • Every one of them covers 100% of their citizens and legal residents, with good, comprehensive insurance.
  • Their populations are healthier than ours and live longer.
  • Their people are more content with their health care systems than we are.
  • They all enjoy freedom or liberty or whatever you want to call it more than we do, because they don't live in perpetual fear of being wiped out by serious illness or dying on the street. 
This is reality. It is the truth.  There are no alternative facts.


Sunday, March 19, 2017

Nuts

Really, fucking nuts. The news media and politicians of all stripes are struggling with how to respond to a "president" who is manifestly insane.

To be clear, I have absolutely no interest in this ridiculous debate over whether psychiatrists should apply a diagnostic label to him. The very idea that there are entities called "personality disorders" that constitute specific, identifiable diseases is nonsense, as far as I'm concerned. Some people behave in ways that create unnecessary difficulties for themselves and/or others. There is nothing to be gained by declaring that this person has "narcissistic personality disorder," or "psychopathy," or whatever word you care to sling.

But, he does what he does, which is to habitually assert preposterous falsehoods and then refuse to back down in the face of overwhelming evidence and reason; and order his flunkies to participate in his alternative reality. That is insane, in the vernacular use  of the word.

Here is one take from the estimable Josh Marshall. "The real story here is that the President, by force of his office and audacity, was able to inject into the national conversation a preposterous claim which the country has spent two weeks debating. . . . I would say that this ability - both the President's pathological lying and our institutions' inability to grapple with it - is the big, big story." He concludes that "this is a warning case of people in power deciding what's true and false which is a harbinger of free government dying." (I draw to your attention what I believe is the relatively new motto of the Washington Post: "Democracy dies in the dark.")

However, I am more inclined to Simon Malloy's view. The fact is that nobody except for Trump's equally deluded juggalos credits his fantasies. The spectacle of Republican politicians trying to evade forthright comment, or of reporters unable to find the letters l, i and e on the keyboard is disheartening, but none of this will lead to any sort of concrete result. In other words the Justice Department isn't about to prosecute Barack Obama and the U.S. isn't going to recall the British ambassador. (No doubt about that -- there isn't one.)

So for the immediate term, this is basically a distraction. The real danger is that we have a "president" who nobody with any sense will believe about anything. So what happens when there is a crisis of some sort and the nation, and the world, depend on presidential leadership? Congress doesn't have to pass the worst atrocities in his budget proposal, and they won't, but the time will come when a president with no  credibility will be catastrophic.

Monday, March 13, 2017

And another outrage you probably never heard about

A component of the Affordable Care Act which doesn't get a lot of attention is called the Prevention and Public Health Fund. Most of the money goes to CDC which uses it to track disease outbreaks and get vaccines to places where they are needed and vaccinate people who can't afford to pay. It also sends $625 million a year to the states, which using the money for vaccination and other preventive services. The bill in congress to "replace" the ACA eliminates all of this funding.

The BMJ asked the Dept. of Health and Human Services whether this has anything to do with "president" Trump's belief that vaccination causes autism, but got no response.

Now, if you're a Republican, you think that government spending is evil a fortiori because it requires taxation. But you might consider the following information from the linked article:

The $1bn funding also covers all of CDC’s lead exposure testing and risk reduction efforts. CDC estimated that the current rate of lead exposure, with at least 535 000 children with toxic blood concentrations, will cost America $59bn in lost lifetime productivity. Research has shown that each dollar spent on reducing exposure to lead delivers a return of $17 to $221.5

CDC has estimated that vaccination among American children born from 1994 to 2013 would prevent around 21 million admissions to hospital and 732 000 deaths over the course of their lifetimes, with a net savings of $295bn in direct costs and $1.38 trillion in total societal costs.6
But it's more important that rich people not pay taxes.

Tuesday, March 07, 2017

Okay, so why Trumpcare?

Ezra Klein is puzzled. Why are the Republicans in congress proposing an Affordable Care Act replacement that will:

  • Balloon the federal deficit;
  • Take insurance away from maybe 15 million people; and
  • Make it more costly for millions more
  • Destroy the market for individual insurance
Klein says: :

It is difficult to say what question, or set of questions, would lead to this bill as an answer. Were voters clamoring for a bill that cut taxes on the rich, raised premiums on the old, and cut subsidies for the poor? Will Americans be happy when 15 million people lose their health insurance and many of those remaining face higher deductibles? 
Well, the voters weren't clamoring for cutting taxes on the rich, but that's all the Republicans in congress actually care about. But Krugthulu has one additional point:

Obviously, Republicans backed themselves into a corner: after all those years denouncing Obamacare, they felt they had to do something, but in fact had no good ideas about what to offer as a replacement. So they went with really bad ideas instead.
Not to worry, it isn't going to pass as it is. But I still expect something bad to happen.

Monday, March 06, 2017

The worm Ouroborous


We don't expect the reporters who work for the corporate media to be very intelligent, so let me help them out.

Donald Trump is the president of the United States. If he has information that Barack Obama ordered somebody (presumably the FBI) to "tap his wires," as he put it, for political reasons, he can produce it. It is within his power to declassify and make public any information at all. For him to call for a congressional investigation of this charge is ridiculous. The congress would simply subpoena records which are, at this very moment, in his possession. He is asking them, in other words, to investigate himself in order to force him to produce what he can already produce if he so chooses.

Ergo, no such records exist and he is a big fat liar. But we already knew that. The problem is that our "journalists" can just say so. Oh yeah, then there are those Republicans in congress  . . .

Then there's the case of James Comey, who is screwed, but I have no sympathy for him, it's his own fault. Expect him to be fired shortly. Then the DoJ Inspector General's report will come out . . .