Later On

A blog written for those whose interests more or less match mine.

Archive for May 20th, 2013

What snake venom does to blood

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Written by LeisureGuy

20 May 2013 at 10:56 am

Posted in Daily life, Science

Is the future of American health care in Oregon?

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Very interesting column by Ezra Klein in the Washington Post:

“The governor has a notion that you can move away from medical billing and towards a more flexible approach to health-care spending that makes more sense for the community,” John McConnell, a health economist at Oregon Health and Science University, is telling me. Then he stops. “You’ve heard the air conditioner story, right?”

As it turns out, I have heard the air-conditioner story. Oregon Gov. John Kitzhaber (D) loves to tell the air-conditioner story. He loves to tell it so much, in fact, that it has become something of a running joke in Oregon health-policy circles. At this point, even Kitzhaber is in on it. Before he repeats it to me, he says, “I probably shouldn’t bore you with my air conditioner story.”Here’s the air conditioner story: There’s a 90-year-old woman with well-managed congestive heart failure who lives in an apartment without air conditioning. That’s actually the whole story.

Kitzhaber, a former emergency room physician, sees this as the perfect example of what’s wrong with our health-care system. “A hot day could send the temperature in her apartment high enough that it strains her cardiovascular system and kicks her into full-blown congestive heart failure,” he said. “Under the current system, Medicare will pay for the ambulance and $50,000 to stabilize her. It will not pay for a $200 window air conditioner, which is all she needs to stay in her home and out of the hospital. The difference to the health-care system is $49,800. And we could save that $49,800 without reducing her benefits or her quality of life.”

Oregon’s Two Experiments

The past few years have seen two remarkable health-care experiments in the Beaver State. One is the Oregon Health Insurance Experiment, the first randomized, controlled trial comparing Medicaid — or any kind of health insurance — with being uninsured. The other is Kitzhaber’s effort to rebuild the state’s Medicaid program around community health rather than individual fee-for-service treatments. The health-insurance experiment has gotten all the attention. But it’s the Medicaid reforms that really matter.

The Oregon health insurance experiment didn’t begin as an experiment. It began as a budget cut. From 2002 to 2008, Oregon threw 93,000 people out of its Medicaid program. In 2008, the state found it had enough money to add 10,000 of them back. The only fair thing to do, state officials figured, was draw straws. So 90,000 of the poorest residents of the richest country the world has ever known entered a lottery to win health insurance.

The 10,000 Oregonians who got Medicaid weren’t the lottery’s only winners, though. Early on, a group of eminent health economists realized the lottery offered a chance to conduct a study no one in their discipline had ever managed but everyone had always wanted: a randomized, controlled experiment comparing those who received Medicaid with those who remained uninsured. This would enable researchers to isolate the effects that insurance — at least as delivered by Oregon’s Medicaid program — had on the uninsured.

“It’s hard to overstate how excited we were,” said Amy Finkelstein of the Massachusetts Institute of Technology. “We thought it was a once-in-a-lifetime opportunity to bring the gold standard of experimental design to this question.” . . .

Continue reading.

Written by LeisureGuy

20 May 2013 at 9:55 am

Posted in Government, Healthcare

The backstory to the Tea Party

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Connections between the tobacco industry, third-party allies and the Tea Party, from the 1980's (top) through 2012 (bottom). The thick black line connects CSE with its direct successor organisations. Online supplementary tables S1 and S2 provide more details on the linkages depicted in this figure.

Connections between the tobacco industry, third-party allies and the Tea Party, from the 1980’s (top) through 2012 (bottom). The thick black line connects CSE with its direct successor organisations. Online supplementary tables S1 and S2 provide more details on the linkages depicted in this figure.

The above diagram (click to enlarge) shows some of the connections described in this (peer-reviewed) article ‘To quarterback behind the scenes, third-party efforts’: the tobacco industry and the Tea Party. Pam Martens in Wall Street on Parade discusses the article and why the DoJ is uninterested in pursuing the matter:

The Justice Department is investigating the investigators of the Tea Party at the IRS while leaving a 29-year criminal conspiracy against the American people by the Tea Party cabal untouched. That’s not surprising, given that the U.S. Attorney General, Eric Holder, and the former head of his criminal division, Lanny Breuer, came from the law firm Covington and Burling which played a seminal role in the conspiracy.

On February 8 of this year, the peer-reviewed health professionals’ journal, Tobacco Control, published an exhaustive study of the roots of the Tea Party dating back to the 1980s.  Researched and written by Amanda Fallin, Rachel Grana and Stanton A. Glantz, the study was funded by the National Institute of Health (NIH) and titled ‘To Quarterback Behind the Scenes, Third Party Efforts’: The Tobacco Industry and the Tea Party.

The authors explain how Citizens for a Sound Economy (CSE), which split into Americans for Prosperity and FreedomWorks in 2004, “was co-founded in 1984 by David Koch, of Koch Industries, and Richard Fink, former professor of economics at George Mason University, who has worked for Koch Industries since 1990.” According to the study, “CSE supported the agendas of the tobacco and other industries, including oil, chemical, pharmaceutical and telecommunications, and was funded by them.”

Long before the Tea Party had gained traction in the media, CSE started the first online Tea Party in 2002, calling it the US Tea Party. The federally funded NIH study shows that between 1991 and 2002, Philip Morris and other tobacco companies gave CSE at least $5.3 million.

CSE, a Koch created organization, was considered an integral part of Philip Morris’ strategy to thwart Federal regulation of cigarettes and second hand smoke. The authors write that Philip Morris  designated CSE a “Category A” organization for funding and it was assigned its own Philip Morris senior relationship manager. They cite a 1999 internal email at Philip Morris which asked if CSE was worth its current level of funding. Philip Morris’ vice president of federal government affairs, John Scruggs, replied: . . .

Continue reading.

Written by LeisureGuy

20 May 2013 at 9:38 am

Will a banker finally go to prison for his misdeeds?

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Richard Eskow writes at Campaign America’s Future:

Will California Attorney General Kamala Harris hang tough in her new lawsuit against JPMorgan Chase, the first to target individual bankers accused of defrauding the public? If so, it would be the first time in five years that executives at a major bank have personally paid a price for their misdeeds.

Weekend at Jamie’s

Recent revelations have shown the world that JPMorgan Chase comes as close as any institution in America to embodying all this is corrupt, contemptible, and criminal about today’s megabanks.  This is gratifying, at least on a personal level, since that was not a popular position when we first started writing about JPM and CEO Jamie Dimon a few years back. In those days Dimon was held up as the “good banker” by President Obama and the press. His institution was considered well-managed and ethical by some of the more shallow members of the popular press, despite a plethora of scandals and crimes, such as the Alabama bribery case.

Since then we’ve had a variety of Chase revelations: the “Burger King kids” details behind its massive foreclosure fraud; its confessed criminal mistreatment of active duty military personnel; its deeds in fraudulently propping up a failed mortgage lender (it was like a financial “Weekend at Bernie’s”); and (speaking of “Bernie’s”) its negligence (at best) in the handling of the fraudulent Madoff accounts, which should have triggered all sorts of red-flag warnings.

Now there’s the London Whale scandal and what appears to be a subsequent case of investor deception.

The bank wound up paying a staggering $16 billion in fines and settlements over a four-year period, more than 12 percent of its net income during that time.

The Scandal of Our Time

An ethically healthy society would never have lionized a CEO like Jamie Dimon or an institution like JPMorgan Chase. That’s why we’ve called it “the scandal of our time.” What explains Dimon’s inability to stem the lawbreaking and correct his organization’s broken ethical system? The most generous interpretation is that he’s an incompetent manager – so incompetent that, even after numerous suits, revelations, and settlements,“Jamie didn’t know” about all the illegal and unethical behavior that continued unabated in his institution.

Needless to say, there are more plausible explanations.

And yet, in those cases where the bank has been called to account with fines and settlements, it has been shareholders and not the wrongdoing bankers themselves,who have paid cost. Ironically, that even happens when the shareholders themselves are the ones who were defrauded. That’s why we say that bank fraud is the only crime on Earth in which the victims make restitution on behalf of the wrongdoers.

Is this ugly pattern finally changing?

Meet the Does

Blogger and finance expert Yves Smith thinks so. California Attorney General Kamala Harris is suing JPMorgan Chase and individual bankers (named as “Does 1 through 100”) for “commit(ting) debt collection abuses” against Chase credit card holders, “flooding California’s courts with … collection lawsuits based on patently insufficient evidence.” . . .

Continue reading.

Written by LeisureGuy

20 May 2013 at 9:18 am

Posted in Business, Government, Law

Never agree to a polygraph (lie-detector) test

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First, it’s been found that agencies use the occasion of the test to ask completely inappropriate and prying questions. Second, and perhaps more important, the tests often give false results. Marisa Taylor reports for McClatchy:

Police departments and federal agencies across the country are using a type of polygraph despite evidence of a technical problem that could label truthful people as liars or the guilty as innocent, McClatchy has found.

As a result, innocent people might have been labeled criminal suspects, faced greater scrutiny while on probation or lost out on jobs. Or, just as alarming, spies and criminals may have escaped detection.

The technical glitch produced errors in the computerized measurements of sweat in one of the most popular polygraphs, the LX4000. Although polygraphers first noticed the problem a decade ago, many government agencies hadn’t known about the risk of inaccurate measurements until McClatchy recently raised questions about it.

The manufacturer, Lafayette Instrument Co. Inc., described the phenomenon as “occasional” and “minor,” but it couldn’t say exactly how often it occurs. Even after one federal agency became concerned and stopped using the measurement and a veteran polygrapher at another witnessed it repeatedly change test results, the extent and the source of the problem weren’t independently studied nor openly debated. In the meantime, tens of thousands of Americans were polygraphed on the LX4000.

The controversy casts new doubt on the reliability and usefulness of polygraphs, which are popularly known as lie detectors and whose tests are banned for use as evidence by most U.S. courts. Scientists have long questioned whether polygraphers can accurately identify liars by interpreting measurements of blood pressure, sweat activity and respiration. But polygraphers themselves say they rely on the measurements to be accurate for their daily, high-stakes decisions about people’s lives.

“We’re talking about using a procedure that has a very weak scientific foundation and making it worse,” said William Iacono, a University of Minnesota psychology professor who’s researched polygraph testing. “I already don’t have very much confidence in how government agencies conduct these tests. Now, they might as well be flipping a coin.”

Despite the scientific skepticism, intelligence and law enforcement agencies see polygraph as useful in obtaining confessions to wrongdoing that wouldn’t otherwise be uncovered. Fifteen federal agencies and many police departments across the country rely on polygraph testing to help make hiring or firing decisions. Sex offenders and other felons often undergo testing to comply with probation or court-ordered psychological treatment. Police detectives and prosecutors rule out criminal suspects who pass and scrutinize those who don’t.

In its ongoing series about polygraph use by government agencies, McClatchy found that such testing has flourished despite being banned for use by most private employers 25 years ago. . .

Continue reading. It’s a long article, and the lack of cooperation from Federal agencies, plus the company’s completely ignoring reports of the problem, are troubling.

My own feeling is that, if a job requires a polygraph test, get a different job. (Easier said than done, I realize, but it’s worth some effort to avoid the false charges and life-changing effects of a false polygraph result.)

Written by LeisureGuy

20 May 2013 at 9:01 am

Posted in Government, Technology

The military’s suicide scandal

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Nancy Goldstein writes in The American Prospect:

What a drag it’s been these past few weeks to watch the military brass—those kings of accountability, at least when it comes to other people’s behavior—huffing and bluffing and outright lying about what they knew and when they knew it. First we had to endure the sight of them gaping over the news that the sexual-violence crisis they’ve done nothing to squelch since the assault of 83 women and seven men at the Tailhook Air Force convention in 1991 has worsened. Now those same Pentagon officials are shocked, simply shocked, by the military’s spiking suicide rates, despite the fact that those numbers, which have been rising steadily for the past 12 years, come from their own reporting system (and some claim are still an undercount).

The only thing worse than the Pentagon’s faux surprise has been the complicity of news organizations willing to echo its talking points. Shame on The New York Times for last week’s “Baffling Rise in Suicides Plagues the U.S. Military.” Disturbing, yes. But there’s nothing “baffling” about the news that more active-duty troops killed themselves in 2012 than were killed in combat in Afghanistan in the same year, and that the number of suicides has doubled from a decade ago.

As the Government Accountability Office (GAO)—Congress’s nonpartisan investigative wing—and a variety of media outlets attest, there’s been only one thing better documented than the military’s unwillingness over the past 25 years to throw any real muscle into ending its culture of widespread sexual assault. And that’s the military’s unwillingness to acknowledge the prevalence of post-traumatic-stress-disorder (PTSD) and other mental-health issues plaguing service-members and to enact serious reforms aimed at curbing and treating mental illness in its ranks. The military’s systemic incompetence on this issue continues despite years of analysis and criticism, not only from service-member advocacy organizations, but also from within the Beltway.

Consider the drubbing administered to both the Department of Defense (DOD) and the Veteran’s Administration (VA) by the GAO last November. The report cited “a lack of leadership, oversight, resources, and collaboration” as contributing to the military’s “inability” to “address a host of problems for wounded, ill, and injured servicemembers as they navigate through the recovery care continuum.” All of those issues came under greater congressional scrutiny in the wake of the public uproar that followed the Washington Post’s 2007 Pulitzer Prize winning investigative series on conditions at Walter Reed Army Military Center, the VA’s flagship in D.C. The GAO concluded that the military had utterly failed to rectify the conditions the series had cited: Mold-stained and cockroach-filled outpatient facilities; byzantine paperwork mazes and overlong wait times to receive care; inadequate resources for soldiers with diagnoses of PTSD.

Despite the fact that Walter Reed has the largest psychiatric department in the Army, the Post’s reporters found it still lacked “enough psychiatrists and clinicians to properly treat the growing number of soldiers returning with combat stress.” Earlier that year, the head of psychiatry had “sent out an ‘SOS’ memo desperately seeking more clinical help. … Individual therapy with a trained clinician, a key element in recovery from PTSD, is infrequent, and targeted group therapy is offered only twice a week.”

But surely these are problems that money can solve. So did the $2.7 billion dollars that Congress poured into the Pentagon’s maw in the three years following thePost’s series do anything to change the way that the DOD and VA address treatment and research for “the signature wounds of the wars in Afghanistan and Iraq”—psychological health (PH) and traumatic brain injury (TBI) treatment? That’s hard to say, because the GAO’s January 2012 report found “that DOD programs supporting P.H. and TBI treatment and research are poorly coordinated, and the department has failed to provide reliable and comprehensive data on how more than $2.7 billion in funds for such programs have been used in recent years.” In other words, there’s no way of knowing what, if anything, went into patient care.

There is, by the way, no good reason why the DOD or VA should have been caught flat-footed by the waves of veterans that flooded their facilities in 2006, more than a third of whom reported symptoms of stress or other mental disorders as they returned from the wars in Iraq and Afghanistan. At least two of its own top people—the chief of psychiatry at Walter Reed and the Executive Director of the VA’s National Center for Post-Traumatic Stress Disorder—had published pieces in a 2004 edition of the New England Journal of Medicine predicting the crisis. . .

Continue reading.

Written by LeisureGuy

20 May 2013 at 8:38 am

Faulty thinking on Social Security

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The Washington Post really doesn’t like the Social Security program for some reason, and they constantly run opinion pieces on how the program should be cut. Dean Baker points out the (abysmal) quality of reasoning displayed in one such column:

How Much Money Do You Need to Get an Op-ed in the Washington Post?

That’s what readers of Jim Roumell’s column on wealth-testing Social Security must be asking. The column, “the rich can save Social Security by giving up their checks,” gets almost all its facts wrong, and suffers from huge problems of logic.

The basic idea is that we have some very rich people who don’t need Social Security, therefore there shouldn’t get it. Of course these people did pay for their Social Security. While Roumell is certainly right that the very rich don’t need the money, they generally wouldn’t need the interest on the government bonds they own. We could also deny them the interest on these bonds, that would make as much sense as Roumell’s proposal on Social Security, but let’s not get bogged down in such moral considerations.

Roumell sees large savings if we deny Social Security to the rich:

“According to the Wall Street Journal, the top 1 percent of the United States’ 115 million households have a net worth of $6.8 million or greater. The top 5 percent have a net worth of $1.9 million or greater. If just the top 1 percent of wealthiest households gave up their Social Security income, assuming two-thirds of these households are of retirement age and will receive benefits averaging $30,000 a year, more than $200 billion would be saved in the first 10 years. That would contribute greatly to resolving the projected funding gap. If Social Security is gradually phased out for the wealthiest 5 percent of households, beginning with just a 10 percent benefit reduction, the savings climbs to nearly $500 billion over 10 years.”

Let’s see, two-thirds of the top 1.0 percent are over age 65? Where exactly did Roumell get this one? Has the Washington Post heard of fact checking?

If we eliminate Social Security for the wealthiest 5 percent, then we would be eliminating benefits for household with incomes of around $80,000 in their retirement. That’s a new definition of “rich.” It was $400,000 a year when we talked about small increases in tax rates.

But the best part of the story is trying to envision what Roumell’s wealth test even would look like. People tend to accumulate wealth during their working lifetime and spend it down as they approach retirement. How do we monitor people’s wealth? Do we do annual assessments of the value of their stock portfolios, their home and vacation properties, personal items like expensive paintings and jewelry? Then if they cross the magic $1.9 million threshold at any point in their lives we put a permanent hold on their Social Security benefits?

The long and short is that Roumell’s proposal is completely unworkable as anyone who has given it a moment’s thought would recognize. But hey, he wants to go after Social Security and he has a lot of money, why not give him a column in the Washington Post?

Written by LeisureGuy

20 May 2013 at 8:28 am

Wonderful shave

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SOTD 20 May 2013

A perfectly wonderful shave this morning: from two-day stubble to BBS.

I used my Omega 40033 boar brush, letting it sit soaking wet while I showered. I see I turned the tub so you can’t see which shaving cream I used: it’s Saigon, by AlsShaving.com:

The lovely top notes that introduce Saigon are impossible to ignore, a juicy citrus carried on some soft tropical grass. Next to emerge are a spice and bitter notes reminiscent of green galbanum, which seem at first to align. A dark, earthy accord and a very potent note assert themselves to turn Saigon abruptly from herbal oriental to a deep woody-green scent.

The lather is abundant, slick, thick, and protective, and three easy passes of my Merkur vintage slant holding an Astra Superior Platinum blade resulted in a BBS result.

A nice splash of Saint Charles Shave’s Bulgarian Rose with Lemon aftershave, and here I am.

How To Grow A Moustache has posted an interview with me.

Written by LeisureGuy

20 May 2013 at 8:18 am

Posted in Shaving

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