Monday, February 15, 2010

Great minds

A few days ago, I said I wanted climate change scientists to provide the world with:

Raw temperatures for all land measurements for as long as we have them broken out into individual measurement stations. ... The next column in the spreadsheet should contain the adjusted temperatures. The next column in the spreadsheet should explain how the adjustment was calculated.

Prompted by a Times (UK) article headlined, “World may not be warming, say scientists”, TigerHawk is calling for the climate science community to:

hit the reset button on the whole project. Post all the raw data, then post all the adjustments with the explanations therefore. Do it in bloggy form, allowing for comment fields. Post the software used in the models, and use change control (which requires ex ante justification for any change), just as one would require for any mission-critical software. Use open-source programmers, when appropriate, who might well produce better code for a given routine. Harness the distributed power of the web, act in the open, and see what the data look like and the models predict then. Do all of that, and many more people will believe the result.

The additional step of posting and improving the model software is valuable but before we even start considering what the models predict for the future, we need to know for sure what the data are telling us about the past and the present. Thus I believe posting the data is the first step and should be done immediately rather than making it part of a package deal with the software - which could take forever to get up.

This seems even more urgent given the recent surprising interview with Professor Phil Jones. According to the Daily Mail (Via Watts Up With That), Professor Jones:

agreed that there had been two periods which experienced similar warming, from 1910 to 1940 and from 1975 to 1998, but said these could be explained by natural phenomena whereas more recent warming could not. [snip]

admitted that in the last 15 years there had been no ‘statistically significant’ warming, although he argued this was a blip rather than the long-term trend. [snip]

said that the debate over whether the world could have been even warmer than now during the medieval period, when there is evidence of high temperatures in northern countries, was far from settled.

If the report of the interview is accurate, this all seems like kind of a big deal and even more reason to make the data available.

On a completely unrelated topic, Megan McArdle has given sort of a throw-away endorsement of the idea of government-provided catastrophic health insurance:

The problem with both sets of plans [Republican and Democrat] is that the [Republican] voucher cap would never withstand the assault from angry and frightened seniors, while the [Democratic] provider caps and treatment disallowals would never withstand the pressure of various other interest groups. That's why I want to turn the Federal government into an income-based catastrophic insurer, for expenses that exceed 15-20% of AGI. I don't think there's much hope of controlling cancer treatments or heart surgery. But I think we could eliminate a hell of a lot of unnecessary day to day expenses--the ER visits of convenience and CYA tests for diseases there's no indication the patient has. But the only way we'll do that is by making the consumer responsible for those costs. Short of that, we're just rearranging the deck chairs on the Titanic.

I don’t remember her writing about this before although it’s possible I just missed it or she wrote about it before I began reading her regularly. If I could figure out a way to search just the text of her posts and not the comments, I’d try looking for earlier posts by her on the topic. Unfortunately, a Google search turns up 252 hits; I checked out the first few and all the references to catastrophic insurance are the comments. It would be interesting to see if she’s fleshed out her thoughts, taken a look at the costs, and so on.


Lynne said...

My gut feeling has always been that government can only do one of two things:
1. Cover life's day-to-day annoyances, like sprained tendons and sinus infections


2. Cover life's crises, like cancer, Orphan Diseases, and the like.

I just don't think it can do both. Remove #1 or #2, and let Joe Q. Public save for the other.

Mark Sorrentino said...


Government doesn't need to cover either. If folks were allowed to by insurance coverage that handled your number 2 and folks were forced to pay for your number 1 they would be much more affordable.

Anonymous said...

I agree with Mark: the government shouldn't do #1 in any case, and probably couldn't pull it off without destroying both the healthcare system and the American economy. It CAN do #2, and might be able to pull it off without undue destruction to either the healthcare system or the economy. And if the government did neither #1 nor #2, the costs for both would decrease.


Paul Brinkley said...

If government covered day-to-day annoyances, it would remove the incentive for providers of this service to improve. If they make an effort to save money, they won't get a bonus payment from the government; if they improve quality, they won't receive additional funding. Rather, they'll work about as hard as the government requires them to, and the government is not an expert in providing care, so it won't know how to judge. This won't be out of laziness; it's merely a rational reaction to the economic pressures on them.

If government covered crises, the same thing would occur, for providers of critical care.

That said, thanks for posting. There's clearly some underlying assumption to your proposal; I wonder what your thinking is.

Elise said...

Well, as I've posted, I lean toward the government covering catastrophes although I'm still thinking that through *and* still thinking through exactly how it would work.

To see why I'm leaning this way, take a look at my Five Health Insurance Issues category.

To me there's a difference between catastrophic illness and crisis/critical care conditions. A crisis happens quickly, needs attention quickly, and is over quickly. You're hit by a bus, rushed to the ER, and patched up. You live or die. (Yes, over-simplified because there's rehab and so on but work with me here.) There is never going to be any market incentive to make this cheaper; the only goal is to save lives. The government can force it to be cheaper if it's paying but that will cost lives.

A catastrophic illness is often slow-moving and of long duration. Cancer, for example, does sometimes kill people quickly but it's more and more likely to become an ongoing, multi-year condition. If we define catastrophic coverage as more than, say, 15% of income then that means the patient has to chip in 15% every single year. This means continued patient (consumer) involvement which means continued market pressure on prices.

Fleshing out these thoughts is part of my process of thinking through whether and exactly how government-provided catastrophic health insurance could work.