Sunday, February 28, 2010

Courage

It is easy to be brave from a safe distance. - Aesop

Today on This Week, host Elizabeth Vargas and House Speaker Nancy Pelosi had the following exchange about passing health care reform:

VARGAS: ... What do you say to your members, when it does come to the House to vote on this, who are in real fear of losing their seats in November if they support you now?

PELOSI: Well first of all our members -- every one of them -- wants health care. I think everybody wants affordable health care for all Americans. They know that this will take courage. It took courage to pass Social Security. It took courage to pass Medicare. And many of the same forces that were at work decades ago are at work again against this bill.

But the American people need it, why are we here? We're not here just to self perpetuate our service in Congress. We're here to do the job for the American people. To get them results that gives them not only health security, but economic security, because the health issue is an economic issue for -- for America's families.


I think Pelosi has a good point. Ideally members of Congress should be about more than just getting themselves re-elected. The problem is that it’s very easy for Pelosi to say this: she has been in the House since 1987 and took 71.9% of the vote in the 2008 elections. So I wonder if she’d be willing to take the same stand if there was any chance she’d lose re-election this November, if it was her service in Congress that was in danger of not being perpetuated.

Here’s my proposal: Nancy Pelosi should tell her fellow House Democrats that if the House passes a health reform bill and the Democrats lose their majority in the House, she’ll resign. From the House.

Friday, February 26, 2010

Hi. I'm Lamar and I'll be your server today.

I only saw bits and pieces of the health care summit but it bothered me that President Obama was calling everyone by his or her first name. After all, no one was calling him “Barack”. Maybe this is the way things worked in earlier presidencies and I just missed it but it sounded weird to me.

Plan B

From JustOneMinute, quoting the Wall Street Journal (emphasis mine):

President Barack Obama will use a bipartisan summit Thursday to push for sweeping health-care legislation, but if that fails to generate enough support the White House has prepared the outlines of a more modest plan.

His leading alternate approach would provide health insurance to perhaps 15 million Americans, about half what the comprehensive bill would cover, according to two people familiar with the planning.


Half? I simply do not understand how we ended up in this position with a Democratic Congress and a Democratic President. Surely the priority for Democratic health care reform would be - should be - to make sure people who don’t have health insurance get health insurance. Sure they went off-track a little and instead of a ten-page bill that made sure people without health insurance could get health insurance, they ended up with a bill that has an additional 1,990 pages that do who knows what. Now they’ve realized they may not be able to pass their 2,000 page bill. So do they eliminate the 1,990 pages of dreck and keep the ten pages that actually get everyone health insurance? Of course not. They eliminate the coverage for half the uninsured and keep, well, I have no idea what they’re keeping.

I’m sorry to repeat myself but this just makes me nuts. If President Obama, Harry Reid, and Nancy Pelosi had any sense between the three of them then on January 21, 2009, they would have proposed a bill that made sure people without health insurance could buy it if they wanted to. Let everyone who wants to buy into the Federal Employees Health Benefits Plan or buy into Medicaid or buy whatever insurance they want and subsidize those who cannot afford to do so. That should have been their priority and it would have been politically feasible. Even all those people who are very happy with their existing health insurance worry about what would happen if they lost their jobs or their premiums skyrocketed. As for paying for it, they could have used some of the money that went into the stimulus bill. Heck, David Plouffe himself said that health care is a jobs creator.

Insuring the uninsured would have solved the most urgent of our health care problems and bought the country time to figure out how to lower health care costs. And since the Democrats would have successfully accomplished the task of protecting everyone’s health insurance they would have had political capital to help push through the rest of their health care reform.

Instead, Obama and the Democrats ceded not only the best political ground but also the best moral ground and committed themselves primarily to lowering health care costs. They acted as if extending coverage was a sort of dessert they'd promise not consider unless they managed the Brussel sprouts of cost control. That's a strange approach for Democrats and particularly Democrats in control of the Federal government.

Clive Crook believes that Obama’s closing statement at the health care summit:

did crystallise the key point of difference between the two sides. Democrats mainly want to expand coverage, and promise to contain costs in order to pay for it. Republicans have the opposite priorities: first contain costs, which they say would make insurance more affordable.


I don’t see it that clearly in the transcript but even if Crook is right, he goes on to acknowledge that:

Up to now [Obama] has emphasized cost control first, broader coverage second--because that is where most voters seem to be. Relatively little effort has been spent on making the case for wider coverage, and on persuading the country that this is worth paying for. Making the switch now comes a little late.


In other words, what could have been - should have been - a golden opportunity to accomplish what I always assumed was a key Democratic goal of insuring the uninsured has been frittered away. We’ve spent a year on a health care reform bill that probably won’t pass; we’ve spent a year with the uninsured staying uninsured; we’ve reduced the chance of any bill that covers the uninsured getting through Congress; we’ve done nothing to address health care costs; and while we were failing to accomplish all that we also weren’t paying much attention to stuff like improving the economy and getting people back to work. (Although if the health care reform process is any example, the economy and the unemployed might be better off if Congress and the Administration don’t try to help them.)

What the heck happened?

Monday, February 22, 2010

Why is that my problem?

In a good explanation of the health insurance premium rate review provision in President Obama’s proposed health care bill, Wonk Room says:

Since conservatives will surely claim that rate review is some kind of government take over of private industry or a burdensome new federal requirement for insurers, it’s important to note that states that have instituted rate review house profitable insurance companies and maintain competitive and vibrant markets.


Um, no. I hope that conservatives are intelligent enough to claim that rate review is best handled by States, especially since the Wonk Room post itself says (emphasis mine):

According to the New York Times the Health Insurance Rate Authority, “made up of health industry experts that would issue an annual report setting the parameters for reasonable rate increases based on conditions in the market.” What’s ‘reasonable’ will vary from state to state.


Although Wonk Room talks about the success some States have had in beating back health insurance premium rate hikes they considered unreasonable, it also claims that “state governments often lack the resources or political will to keep insurers in check.” Perhaps, but why is that my problem? My State of New Jersey regulates its health insurance companies within an inch of their lives and I’m sure some of my State tax dollars go to pay for that regulation. I don’t see why I should also pay for the Federal government to "take care" of States whose voters aren’t willing to do the job themselves. Or who even - heretical as it no doubt seems to Obama - don't think the job needs to be done at all.

(Via Legal Insurrection via Neo-neocon)

Catching up on comments

I’ve caught up on responding to comments that have come in while I was out of commission:

Yes

Great minds

This sounds familiar

And I deleted a comment on a very old post. I’m so proud: the Spambots have found me.

If I wasn’t such a coward I’d try installing the widget that shows recent comments. Maybe someday...

Rainbow's End

[I’m struck speechless by reading that President Obama’s “new” health care proposal apparently includes (via Neo-neocon) price controls on health insurance premiums. I haven’t looked at the White House posting myself yet and hope that it will turn out to be not really as described. Failing that, I hope voters will be smart enough to realize that this way lies disaster. For now, though, I need to write about something less fraught and figured that if Megan McArdle can write - however dangerously - about makeup, I can certainly write about candles.]

I’m a Yankee Candle junkie. So sue me. It’s a relatively harmless addiction: there’s a limit to how many candles I can burn so I don’t have to mortgage my house to feed my habit and it has the pleasant side-effect of making the house smell good even when it’s, shall we say, not looking its best.

The problem with my addiction is the usual: I’m dependent on my supplier. And Yankee Candle shows a distressing tendency to discontinue candles I really like. The most heart-breaking of these discontinuations is Rainbow’s End (tm). This is a lovely candle. It’s a watery almost aqua color described as having:

A fresh, clean and cool scent like the country air after a storm


To me it smells nice, definite, but not specific. That is, it doesn’t smell like anything. Not fruit or flower or food or wood or Christmas or autumn. When I found Rainbow’s End years ago, it was a revelation because so many of the Yankee Candle scents classified as “Fresh” (i.e., not found in nature) smelled like dryer fabric softener sheets. That’s changed now although YC still sells the scent Clean Cotton and as far as I’m concerned you get the same effect by draping a piece of Bounce over a lampshade. And since I hate the smell of dryer fabric softeners, finding a non-specific candle that didn’t make me think of laundromats was wonderful.

Rainbow’s End has been discontinued for years now. It’s been so long that the last time I was in a Yankee Candle store the two women who worked there had never even heard of it. I check from time to time but I’ve never seen it among the “temporarily revived” scents YC makes from time to time.

I have one lone Rainbow’s End votive candle left, stored away safely. I hate to burn it: it’s the last of its kind. And yet if a candle never burns, is it really a candle?

*****

If you’re interested in reading the Roy Edroso article that prompted McArdle’s “feminine” response, it’s here. I can’t decide if it’s incredibly stupid or incredibly funny. Probably stupid since this level of arrogance is too frightening to ever be truly funny. Althouse considers pity the appropriate response.

Friday, February 19, 2010

Lost in the ozone

I had shoulder surgery on Monday which was pretty minor and went very well. I got a nerve block for pain which meant my left hand was insubordinate for a couple of days (and still occasionally seems to harbor rebellious impulses). Further, the dregs of the general anesthetic and whatever the opposite of dregs is of the pain meds are resulting in spectacularly brilliant thoughts that I suspect wouldn’t seem nearly as brilliant to anyone who read them.

All of which is a long way of saying I have lots of stuff to say about lots of stuff - including the interesting comments that have come in over the last week - but probably won’t be saying it for at least a few more days.

Back to Xanadu.

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.

Sunday, February 14, 2010

Yes

I snarl about Reclusive Leftist quite often but today she’s hit one out of the park. She’s discussing feminism, Sarah Palin, liberalism, and polar bears. Go, read “The Unresolvable Paradox”.

Butchering the budget

During the campaign, John McCain proposed an across the board spending freeze on all Federal programs except the Department of Defense, veterans programs, and entitlements. Barack Obama responded that McCain’s proposal amount to "using a hatchet where you need a scalpel." Now President Obama is proposing a spending freeze. His Administration argues it is still a scalpel because the freezes will be targeted; some programs will increase will others will decrease, thus freezing the level of spending without freezing where the spending goes.

I don’t have any argument with the Obama Administration’s claims. They are quite correct that it is possible to have a targeted spending freeze in which you leave alone or increase funding for programs you believe are valuable while decreasing funding for programs you believe are not valuable. They clearly understand logic. They also clearly do not understand the politics behind the government’s inability to control spending.

I’m pretty sure the reason McCain proposed an across the board spending freeze was because he knew that once you get into the details of which programs are valuable and which programs are not, suddenly somehow every single penny being spent is absolutely crucial. It’s going to be very, very difficult for the Obama Administration to identify any programs that have no enthusiasts. At a bare minimum, it’s a pretty safe bet that someone’s salary is being paid by every Federal program and if the program is big enough so that cutting it will actually help our bottom line, then probably a lot of somebodies’ salaries are being paid by it.

Plus, I suspect that most Federal programs do benefit some group. It may be a group the Administration thinks doesn’t need support or a group the Administration thinks doesn’t deserve support but it’s awfully easy to make a heart-wrenching argument for the value of almost any Federal program in existence. Someone, somewhere is going to be hurt by any Federal spending decreases and once those who will be hurt are paraded in front of television cameras, there’s a good chance there will be a collective, “Aw, why are you picking on them?” from a lot of people. It’s easy to see that cutting funding for swine research will hurt those decent, hard-working Iowa farmers; it’s a lot harder to see that keeping funding for swine research means money out of everyone’s pocket, money we could all use to buy bacon.

President Obama had hoped to address the problem of government spending another way. He wanted Congress to pass a bill establishing a Bipartisan Task Force to consider tax increases and spending cuts. The recommendations of such a Task Force would then be presented to Congress for a simple up or down vote. The Senate declined; as far as I can tell, the House never considered it. Despite what I have occasionally read and heard from the Left, the Senate’s declination was bipartisan: 36 Democrats, 16 Republicans, and 1 Independent voted for the bill; 22 Democrats, 23 Republicans, and 1 Independent voted against the bill.

Even if the Task Force had come into being, I’m not sure how much good it would have done. The fights over which programs are too valuable to cut would simply have moved into the Task Force deliberations and, as far as I can tell, there would have been no requirement that the Task Force recommend any spending cuts or tax increases at all, much less substantial ones. It would have been far too easy for the Task Force members to either come up with extremely minor cosmetic recommendations or just throw up their hands, declare they couldn’t get anything done, and blame the other side.

What we need is something to concentrate everyone’s mind. Here’s what I propose. Let’s pass a bill that says we’re going to cut Federal spending by 10% each year until we’re spending 50% of what we’re spending now. We’ll hit about 53% in the seventh year. If we decrease spending by 5% the eighth year, we’ll hit just about 50%.

We’ll also adjust Federal tax revenues in lockstep but at a slightly lower rate: 9% per year. By the seventh year, the Federal government will be taking in not quite 57% of what it is taking in now. If we decrease taxes by 4.5% the eighth year, Federal tax revenues will be just about 54% of what they were when we started.

We’ll be taking in more than we’re spending which will let us start to pay down our debt. The money no longer being taken by the Federal government in taxes can certainly be taken in taxes by the States or by local governments if their residents want to continue to receive the same government services they used to get from the Federal government. Otherwise, it’s money in the pockets of individuals and corporations.

What spending and taxes will we cut? Well, that’s up to Congress to decide. If they want, they can cut the whole 10% of spending from a single program. They can decide to cut nothing from Defense and everything from Education - or vice versa. That’s up to them. However, if they don’t make those decisions then the cuts happen across the board. And I mean the whole board, including Defense, veterans’ benefits, Social Security, Medicare, agriculture subsidies, public health, everything. Nothing is shielded.

The same rules hold for tax cuts. Congress can give the entire tax cut to individuals with lower incomes or to corporations or to the middle class. However, if Congress cannot decide how to allocate the tax cuts then every person and every corporation gets a 10% reduction in their taxes - all their taxes including those for Social Security and Medicare. The taxes get calculated just that way too, no fiddling with tax rates. The first year we all calculate our taxes under the existing tables, then take 9% off whatever we owe the government. The second year, we do the same calculations and take 17% off what we owe the government. And so on.

It would be great to trim the Federal government’s fat with a scalpel. But if the surgeon doesn’t have the guts to operate, better a butcher with a hatchet than letting the country die from its own gluttony.

Saturday, February 13, 2010

What's wrong with Colorado?

Let’s consider the case of Peggy Robertson, a resident of the Great State of Colorado. Ms. Robertson had given birth by Caesarean section. Because having one child by Caesarean section means a woman is more likely to have later children by Caesarean section, many insurers consider that a pre-existing condition. This means that when a woman who has had a Caesarean section applies for an individual health insurance policy (group policies usually work differently), the insurer will either exclude coverage for a Caesarean for some number of years or cover Caesareans but charge the woman a higher premium.

In 2007 Ms Robertson had individual health insurance coverage but was shopping for a better rate. She applied to the Golden Rule insurance company and was denied coverage. She was “mystified”. She contacted the Colorado Division of Insurance which contacted Golden Rule asking for an explanation of the denial. Golden Rule then wrote Ms. Robertson to explain their decision:

The plan you applied for is an association group plan and is medically underwritten. As a general rule, our underwriting guidelines require that we issue coverage with a rider excluding benefits for caesarean section delivery for three years. However, the Colorado Division of Insurance no longer allows us to place that rider. Without the rider, we have decided that we cannot provide any coverage for the individual. Unfortunately, we cannot collect sufficient premium to offset the risk of paying for a repeat C-section delivery during the first three years of coverage.

In order to consider coverage without a rider, we require that certain requirements be met. One requirement is that some form of sterilization has occurred since the caesarean section delivery. Also, women age 40 and over, who had their last child two or more years prior to applying for coverage, will not require a rider. Unfortunately, since you had not met either of these requirements, it would have been necessary to place the C-section rider.


Some people on the Left reported this as “woman was told to ‘get sterilized’ if she wants insurance.” This is, of course, not at all what the letter said but it made a handy stick with which to beat insurance companies. (I’m pretty sure that if Golden Rule had sent Ms. Robertson a letter without that second paragraph about sterilization and Ms. Robertson had had her tubes tied after her Caesarean section, those same people on the Left would have reported this as “sterilized women denied insurance because of previous Caesarean.”) In fact, the letter was a straightforward, professional response to a request for information.

Golden Rule was asked by its regulating agency to respond to Ms. Robertson’s complaint about being denied coverage. It did so and it explained the circumstances under which Ms. Robertson’s Caesarean section would not have caused her to be denied. It’s no different from an insurer turning down someone who was injured working at a high-risk job; explaining that they had to do so because they aren’t allowed to exclude coverage for injuries from the high-risk job or charge a higher rate for coverage because of the high-risk job; and stating that they would not have denied coverage if the applicant had taken safer employment since the accident. I don’t understand why, more than forty years after the founding of NOW, we’re arguing that women deserve special treatment and apparently accepting the idea that merely mentioning the world “sterilization” to a woman of child-bearing years causes her unbearable mental anguish.

But why, you’re wondering patiently, did I call this post, “What’s wrong with Colorado”? Because the real source of Ms. Robertson’s denial is not Golden Rule; Golden Rule would have been happy to write her an individual health insurance policy. The real source is the Colorado Division of Insurance which has got to be in the running for stupidest insurance regulator in the country. The CDI forbad Colorado insurance companies to exclude Caesarean sections from coverage: if an insurance company takes on a new customer, the insurance company must cover Caesarean sections beginning immediately. However, it obviously never even occurred to the CDI that this would mean insurance companies would simply start refusing to take on women who had had Caesarean sections. Not only did such an outcome never even cross the minds of the rule-makers at the CDI, it apparently also never occurred to them to actually ask insurance companies, “What would happen if we forbad you to exclude Caesarean sections from coverage for new policyholders?” I’m pretty sure that anyone who worked for an insurance company would have foreseen quite clearly that their company would simply stop writing policies for such women.

But perhaps it’s perfectly understandable that the CDI would never have asked an insurance company what the outcome of their new policy would be. After all, insurance companies are all the spawn of Satan whose only goal is to be mean to people who need insurance. None of their decisions have any rational basis, they just randomly do whatever is the most hurtful thing they can think of. The guys in government are smart enough to see through their dastardly plans and thwart them without having to pay any attention to what those monsters at insurance companies say about anything.

Way to go, stalwart members of the CDI. I’m sure Peggy Robertson appreciates your efforts on her behalf.

Look, I’m not sure insurance companies have a role in health care/insurance going forward. Their business model does not seem workable to me in an era when we can help sick people a lot more than we once could by spending a lot, lot more money than we once did; when people increasingly think health care is a God-given right; and when any hint of profit is considered the mark of the devil. This country spends about $8,000 per year on health care. If we accounted for our spending honestly, that would mean an insurance premium of $32,000 per year for a family of four. Darn few families could afford that. So the only route for insurance companies is to either raise premiums so high no one can afford them or do their best to weed out people who are actually sick. Neither one is sustainable in the long run. None of that means insurance companies are evil. It just means they are reality-based. It’s easy to rail about what insurance companies should be doing when you don’t have to meet an insurance company payroll or have enough in the bank to pay an insurance company’s claims. Dollars and cents, however, are not amenable to uninformed rhetoric.

We can try to regulate away the practices we don’t like but as Ms. Robertson can testify, reality cannot be regulated away. Of course Colorado can now turn around and require insurance companies to write individual policies with no exclusion of coverage and no higher premiums for women who have had Caesareans. The result would be that premiums for everyone with health insurance would go up. That’s a nice outcome for Ms. Robertson - everyone else is subsidizing her chance of having another Caesarean - but it’s not so nice for the other policy holders.

And, of course, States can require insurers to write standard individual polices not just for women who have had Caesareans but for people with diabetes and heart trouble, with cancer and multiple sclerosis, with any and all diseases and conditions you can think of. My State of New Jersey has basically done that. Our health insurance is very expensive and we may well be in that downward death spiral where regulators force insurers to cover everyone no matter how sick; insurers have to raise rates; fewer people can readily afford the rates so healthy people drop their health insurance; the people left in the health insurance pool are sicker on average; rates go up again; and the whole thing repeats until the only people with health insurance are those who are unlucky enough to be really sick but lucky enough to be pretty rich.

On the other hand, we can go down the path of the health bills passed by the House and Senate which somehow let us convince ourselves that we can cover 10 or 20 or 30 million more people without spending one more cent. Or down the path of single-payer where we can convince ourselves that health care is free because it will be paid for by taxes - and 95% of us will assume that the taxes will be assessed only on the other 5%.

Or we can finally admit that we can’t have everything for nothing and decide what we’re willing to pay for and what we’re willing to give up. Perhaps David Brooks is right and President Obama can become the leader who forces us to face up to those choices - or at least to realize the choices actually exist and can’t be wished away by everyone’s perfectly understandable desire to get what they want and leave someone else with the bill. It would be a great service to the nation and require an unflinching look at the reality of health care costs.

And that’s the reason I object so strongly to demonizing insurance companies: it’s just a way of pretending there are no choices to be made when it comes to health care. As long as we tell ourselves that all our health care woes are the result of rapacious insurance companies, we allow ourselves to refuse to look full on at why insurance companies really do what they do. That means we allow ourselves to refuse to acknowledge that money only goes so far, everything we want has to be paid for by someone, and the more we want the more it’s going to cost.

*****

Afterword:

I was going to write about Peggy Robertson when I first read about it last October but never got around to it. I decided to revisit it after Movin’ Meat put up a post about another example of how stupidly Colorado is regulating its insurance companies. I’m really sorry the Colorado Division of Insurance is incapable of doing a competent job but I don’t think that’s a very good argument for passing a massive overhaul of the entire nation’s health care/insurance.

Thursday, February 11, 2010

Götterdämmersnow

We survived the snowpocalypse without so much as a flicker of the lights. Today it’s spectacularly beautiful out there: blue, blue skies and blinding sunshine. The snow is heavy and just wet enough so that it stuck where it was blown, coating even the vertical trunks of bare trees and the downward slope of deck railings like icing laid on by a sugar-addicted pastry chef.

It’s easy for me to admire it, of course. I don’t have to be anywhere until Monday, my husband is the snow shoveler (my job is to keep him supplied with hot tea during breaks), and I don’t have a dog. The only negative from my point of view is our poor bushes. The bigger ones are fine, fantastical and rather eerie. The smaller ones are not fine: they’re so weighed down by snow they look like those monumental statues of serfs ground beneath the heel of tyranny. For them this was definitely snowverkill.

Unpremeditated Global Warming

(This is a slightly cleaned up version of part of an email I sent to a friend. Since I wrote him there has been a dust-up about the China temperature stations which makes what I want even more important so I keep thinking I should take what I wrote to him, clean it up, insert the appropriate hyperlinks, and post it. That’s not happening anytime soon so I decided to just post my raw thoughts and spiff them up later if I have the time and inclination. Voila.)

Although I find the dumped East Anglia CRU emails discomforting, my real problem is with the Harry_Read_Me document and the code files. I did not slog through all of them and my Fortran days are far behind me but my heart bleeds for this poor programmer. At the same time, if his comments are accurate there is no way the data at East Anglia can possibly be the basis for anything. Never mind what the climate models are doing in predictive terms - the data are clearly being tortured to make them confess to the crimes of which their jailers suspect them.

I've never had any problem with adjusting raw temperature data. The usual example justifying it is the problem of the urban heat island: a temperature station near a growing metropolis will show higher temps just because there are more people, there is more concrete, there are more cars, buildings, etc. So of course any reputable scientist would attempt to control for that by adjusting temps downward as the urban sprawl sprawls. However, there are three problems with what I'm now reading about the raw temp adjustments.

First, a fair number of them appear to be adjusted up. I know there can be good reasons for this but I'm now very curious about how many temps were adjusted up and how many were adjusted down.

Second, I keep hearing that temp stations are disappearing from the world temp averages. I read more than a year ago that most of the interior of Canada was gone. Russia seems to fade in and out. In California, I read that the temp stations moved to the beach. I would very much like to see how much difference inclusion of the disappearing stations makes in the current numbers. (I'm giving the GWists the benefit of the doubt by assuming that if a temp station is no longer included in today's global temp calcs it is also excluded from the calcs on temps 50 years ago. If not, we should really just shoot them all and be done with it.)

Third, I always figured there was some formula for making adjustments to raw temperature. Population growth of x% means we adjust temps by y degrees. A temp station moved x meters higher means we adjust temps by y degrees. And so on. However, based on the info coming out of the data dump plus such distressing matters as the unseemly fight over the Darwin Airport adjustments, I now fear that there is no formula for adjustments but rather they are done based on the whim - or, if you prefer, gut level feeling - of the adjuster.

So here's what I'd like to see:

Raw temperatures for all land measurements for as long as we have them broken out into individual measurement stations. And by individual, I mean one station, no moves, no physical changes. If the station in Sydney started at the harbor, that's Sydney-1. When it gets a little sunscreen it becomes Sydney-2. When it moves 300 meters higher up, that's Sydney-3. And so on. The next column in the spreadsheet should contain the adjusted temperatures. The next column in the spreadsheet should explain how the adjustment was calculated. I would be overjoyed if that column always said, "Reference Rule #x for the algorithm".

My understanding is that atmospheric temp measurements are also adjusted so I'd like to see the same thing for those. And although I haven't paid much attention to them, if the ocean measurements (Argos?) are adjusted, I'd like to see the same thing for them. This should all be trivial to do and would go a long way toward reassuring people like me about what's going on inside those black boxes that claim the earth has gotten warmer. The greatest tragedy of the East Anglia data dump will be if the the most alarmist AAGWers turn out to be right and yet their own idiocy destroys their credibility.

Tuesday, February 9, 2010

Ugh!

The Corner has up a post with the text of a letter from House GOP Leader John Boehner and Whip Eric Cantor (R., Va.) responding to President Obama’s invitation to a bipartisan health-care summit. This letter is seriously ugly.

Let’s leave aside the fact that I think the letter is very poorly put together, with ideas jumbled together, logical flow choppy or non-existent, and paragraph breaks seemingly occurring based on word count rather than by key points. That may be a matter of style (theirs stinks) and personal opinion (I’m right). The real problem is that this is not the letter of a political party that wants to lead; this is the letter of a political party that wants to sit back and make political hay by taking potshots at those in power.

First, the stench of political point making arises from the pixels like noxious fumes from a, well, a fever swamp. The letter begins by pointing out that the GOP asked for a bipartisan discussions way back in May but would Obama listen? No, of course not, so now he’s getting his comeuppance. The snarky “assuming the President is sincere” (twice!) is just bush-league - and a mistake I doubt either the elder or the younger George Bush would make. The references to the “job-killing bills” is unnecessary and frankly stupid if the GOP really wants to get something done; it assumes facts not agreed on by both sides and is deliberately provocative. Then there’s the stuff that sounds like something a fifteen-year-old girl would scream at her mother before slamming the door to her bedroom. For example: “‘Bipartisanship’ is not writing proposals of your own behind closed doors, then unveiling them and demanding Republican support.” And, of course, there’s this laugher:

The President says Republicans are ‘sitting on the sidelines’ just days after holding up our health care alternative and reading from it word for word. The President has every right to use his bully pulpit as he sees fit, but this is the kind of credibility gap that has the American people so fed up with business as usual in Washington.


Right. As opposed to this letter which is concerned solely with policy and with getting something done for the American people.

Even worse than the political posturing, though, are the questions. A party that wants to lead doesn’t ask questions about what the President will do; a party that wants to lead sets its own agenda. There are 979 words in the body of the letter; 295 of those words are contained in questions: Will the President give up the idea of reconciliation; will he make legislative proposals available at least 72 hours before voting; will he include these guys and those guys and opponents and people from the States and these experts and those experts and special interest groups? The Republicans sound like an over-anxious mother grilling her kid about who’s going to be at Barack’s house. Worst of all is this question: will Republicans be permitted to invite health care experts to participate? Permitted? Now the GOP sounds like a nine-year-old asking if he can invite friends over for dinner.

Don’t ask. Tell. The President has invited the GOP to sit down and discuss health care reform. The GOP shouldn’t use its response to score political points - or, more accurately, try to score political points since I don’t think they’ll succeed with this approach. Nor should the GOP hand all the power over to the President by asking him what he’s going to do about this, that, and the other. Rather the GOP response should set out - clearly, calmly, and without nastiness - the conditions under which the GOP will agree to such a meeting. Somebody has to be the grown-ups here. How about if the GOP gives it a try?

Monday, February 8, 2010

Take what you want, says God - and pay for it

On February 4, at a Democratic National Committee fundraiser in Washington, President Obama referred to an Obama campaign supporter who died of breast cancer:

She didn’t have insurance. She couldn’t afford it, so she had put off having the kind of exams that she needed. And she had fought a tough battle for four years. All through the campaign she was fighting it, but finally she succumbed to it.


JustOneMinute has done yeoman work in pulling together the details of this woman’s illness and death beginning with a detail Obama omitted: her name was Melanie Shouse. JOM wrote further about Ms. Shouse when he outlined the inconsistencies in her timeline. Those don’t bother me: if you deal with a serious illness for years, what happened exactly when gets very blurry. JOM also clarifies her insurance situation and the details about her insurance provider or providers’ refusal to pay for Avastin. And today JOM sums up with:

It's a very sad story but the takeaway is more complicated than "she had no insurance".


Based on JOM’s information, here’s my understanding of the timeline of Ms. Shouse’s illness:

- Sometime in 2004 she went deeply into debt to open a store. As a result she could only afford an insurance policy with an extremely high deductible ($5,000) and significant co-payments (an additional $3,000 to $5,000 maximum per year).

The timeline gets a little murky but it appears that a year elapsed between when Ms. Shouse began to feel ill and found a lump in her breast and when she was diagnosed. Since it seems clear she was diagnosed in October of 2005, the timeline would presumably be:

- In the Fall of 2004, Ms. Shouse began to feel ill and found a lump in her breast. She chose to ignore her symptoms because she could not afford to have them checked.

- In October of 2005, Ms. Shouse was diagnosed with Stage 4 breast cancer

Now Ms. Shouse was seriously ill so she could not switch to a policy with a lower deductible and co-payment.* She was, however, eligible for the Missouri Medicaid program.** She was treated from October 2005 until September 2009, covered under Medicaid and eventually under Medicare. In September 2009 her “insurance provider” refused to pay for any further treatment with Avastin. The assumption among those who support Ms. Shouse’s stand on universal health care is that the “insurance provider” in question was her private insurance company, Wellpoint. However, apparently neither Missouri Medicaid nor the Federal Medicare program would pay for it either. It is not clear whether anyone was willing to pay for further conventional treatment like chemotherapy.

So to sum up: Ms. Shouse decided to expand her business and went deeply into debt to do so. As a result she could only afford catastrophic health care insurance and did not have the money to pay the deductibles and co-payments necessary before insurance kicked in. She thus decided to ignore a serious health problem until she became so sick she could no longer do so. Once she was diagnosed as being seriously ill, State and Federal insurance paid for her treatment for at least four years. Finally, no insurance provider - private, State, or Federal - would pay for additional treatment with a particular drug and she died.

The only part of this story that could possible have any bearing on the type of universal health insurance proposed in the House and Senate bills (hereinafter “Obamacare”) is the beginning of the story: because she chose to purchase catastrophic health insurance while not having the money to cover the resulting out of pocket obligation, she put off getting medical treatment for her illness in its early stages. As Ms. Shouse put it:

I had to take the ultimate risk with my health in order to chase the American Dream, like so many small business owners in America today.


This was Ms. Shouse’s choice. She knew she was gambling her health - her very life - in order to expand her business. She was not forced to make this choice; from all accounts she was a dynamic, intelligent woman who could have found a job with excellent health insurance or a job that paid enough for her to purchase her own excellent health insurance. Instead she chose - freely and willingly - to spend her money elsewhere.

Now, it may be that we as a country don’t want people to have to make that choice. Perhaps we prefer that everyone should be able to spend their money as they please without thinking for one minute about whether that means they can’t afford health insurance or health care. That’s certainly a decision we can make and - given my own disinclination to work for someone else - I can see the advantages.

However, I would point out that under Obamacare, the constraints on Ms. Shouse would not be any different. Obamacare is not going to give anyone health care for free. Rather Ms. Shouse would have been required to purchase health care. If Obamacare even allows a catastrophic plan, we have to assume that is the plan Ms. Shouse would have selected: her finances did not and would not have permitted her to do otherwise. If Obamacare allows only health insurance policies with lower deductibles and co-payments, then Ms. Shouse would have been forced to spend her money for such a policy and would not have been able to expand her business. Yes, Obamacare will subsidize those who cannot afford health insurance but I find it hard to believe that someone who could lay her hands on $30,000 would qualify for such a subsidy.

In other words, under Obamacare Ms. Shouse would have made the same choice she actually made: choosing to risk her life to expand her business. Or she would have been denied the chance to make that choice and would have good health insurance but no expanded business. Not even Obamacare could have afforded Ms. Shouse the opportunity to do what she wanted without paying for it one way or the other.

Ms. Shouse’s story is a very sad one and for Ms. Shouse herself, her family, friends, and loved ones I have nothing but the deepest sympathy. However, we cannot make policy based on heart-rending anecdotes - from either side. Instead we must make policy with a clear understanding of what we want - and what we're prepared to pay for it.

*****

* Yes, the evil pre-existing conditions exclusion. It doesn’t mean that insurance companies are the spawn of the Devil; it means that someone who is betting her life she won’t get seriously ill can’t shift that the cost to other policy-holders when she loses the toss.

** JOM asks, reasonably, why Ms. Shouse wasn’t eligible for Missouri Medicaid when she first found the breast lump. Based on this story from September 2009, I believe it’s because she only became eligible when she “became too ill to work.” Note that the references to Stage 4 cancer being a “jackpot” disease for eligibility apparently pertain to Medicare.

Sunday, February 7, 2010

Who dat?

Tonight nobody says it:

Colts 17
Saints 31

Congratulations!

Thursday, February 4, 2010

Horsefeathers

Reclusive Leftist is objecting to the Tebow Super Bowl ad from a more ideological and less slanderous point of view than the women’s organizations* I mentioned in my previous post. Although I will admit that I am not super happy about NFL cheerleaders, I don’t agree with RL’s take on this in general; “the patriarchy” is simply not a term I’m comfortable with.

However, what I find truly objectionable about RL’s post is its total disregard for facts. I gather that the Super Bowl is not a a big deal in far Left feminist circles and I don’t have a problem with that. It’s not a big deal with most of my female relatives either and I can assure you they are not far Left feminists. Nonetheless, I think if you’re going to write about a topic and especially if you’re going to draw sweeping conclusions about it, you should at least get your facts straight. Yet RL quotes approvingly the following from Jaclyn Friedman, writing for The Nation and NPR:

The ad becomes even more disturbing when we consider who it’s trying to reach. Assuming that Focus on the Family operates with the same mindset as most Super Bowl advertisers (and there’s really no evidence to suggest otherwise), it’s also safe to assume that men are one of the primary targets of this spot.


Um, no. As this article makes clear, ads targeted at women are nothing new during the Super Bowl:

So what does the increase in viewers translate to? For advertisers, the answer is more commercials geared toward a female audience.

A study by Venables Bell and Partners, an independent ad agency in San Francisco, found that, in general, women look forward more to the commercials than the game [snip]

Dove used the 2006 Super Bowl as a means to launch its highly successful "Dove Self Esteem Fund" with its "Little Girls" commercial, which discussed everyday insecurities of young girls and promoted a campaign to re-empower them. [snip]

last year Budweiser, Pedigree, Pepsi ( PEP - news - people ) and Cheetos also took a special interest in their female demographic with feel-good commercials. [snip]

... while men are more likely to discuss their favorite play after the game, women are more likely to discuss their favorite ads.

They are also more likely than men to purchase a product they see advertised during the game (and share it on Facebook with their friends), which hasn't been lost on the female-friendly advertisers planning commercials for this year's Super Bowl.


There is no reason to believe that the Tebow Super Bowl ad is targeted at men. (It took a second reading, but I did notice that Friedman covered herself by saying, “men are one of the primary targets of this spot.” I’m not always on top on the latest demographic information but based on my understanding of the makeup of our society, that would seem to leave women as the other primary target of the ad. (Sadly, my tolerance for idiocy is very low today.))

RL goes on to quote further from Friedman:

So now what we’ve got is an ad telling men that it’s wrong for women to abort their potential children, lest those children not get the chance to grow up to be famous quarterbacks who paint Scripture references into their eyeblack. In light of new research revealing that about a third of women who report partner violence also report that their partners try to pressure them into pregnancy and motherhood (as do 15 percent of women who had never reported relationship violence), this male-targeted argument is particularly chilling.


Um, no. Neither Friedman nor RL provide a link to the “new research” but given the date and the results, I assume the study being referenced is this one. First of all, based on the Abstract (I do not have access to the entire text), it is most emphatically not the case that “15 percent of women who had never reported relationship violence” report that “their partners try to pressure them into pregnancy and motherhood”. Rather 15 percent of all the women surveyed reported that.

Second, the number that leaps out at me is this: 53% of the young women “said they had experienced physical or sexual violence from an intimate partner.” I simply refuse to believe that these young women are a representative sample. There is no way more than half the women in this country are physically assaulted by their husbands, boyfriends, lovers, or significant others. Whatever is going on with these extremely unfortunate young women, their circumstances tell us nothing about “pregnancy coercion” or “birth control sabotage” in the population as a whole.

Let’s do some math. Of the 53% who experienced violence in their relationships, 35% reported “reproductive control”; that is, either “pregnancy coercion” or “birth control sabotage”. So of the 1,278 women in the study, 677 of them (53%) experienced violence. Of these, 237 (35%) reported reproductive control. If those 237 were the only women in the survey who reported reproductive control, then 18.4% of the total sample (237/1287) would have reported reproductive control. In fact, the abstract tells us that 19% of the entire sample reported experiencing pregnancy coercion and 15% reported birth control sabotage. It appears that the women who experienced violence in their relationships were, in fact, the only women who reported reproductive control. This numerical conclusion is born out by the final sentence of the “Results” section:

In analyses stratified by partner violence exposure, associations of reproductive control with unintended pregnancy persisted only among women with a history of partner violence.


In other words, only those women with violent partners became unintentionally pregnant as a result of “reproductive control”.** To me that means incidents of reproductive control fall well outside the norm of society. Normal men do not assault their romantic or sexual partners and women whose partners do not assault them do not become unintentionally pregnant as a result of their partners’ coercion and sabotage. To believe that watching a Super Bowl ad will somehow make a perfectly normal man decide to beat his woman to keep her pregnant (and probably barefoot) requires a leap of (bad) faith far beyond what anyone who actually knows a fair number of men would be willing to make.

Given RL’s concept of The Patriarchy, her disdain for the Super Bowl is understandable. I sympathize to some extent with her concerns about the extent to which football in general and the Super Bowl in particular represent women as sexual objects. However, to use a bogus representation of an interesting but not generalizable study to argue that presenting a mother glad she carried her child to term will cause men across this country to force their wives and girlfriends to become “baby machines” is way out of line.

And, finally, I would like to point out that - as far as I know - nobody actually knows what the ad looks like anyhow.

*****

* This is the same old naming problem. I don’t consider organizations like NARAL and NOW to be truly feminist organizations. Neither do I consider them to represent the views of all - or even most - women. So what do we call them? Sally Jenkins has some wonderful suggestions in her very highly recommended piece on the Tebow ad:

The National Organization for Women Who Only Think Like Us;
The National Organization of Fewer and Fewer Women All The Time;
and my favorite:
Dwindling Organizations of Ladies in Lockstep (DOLL)

** Apparently one of the questions asked of the young women was:

Has someone you were dating or going out with ever told you not to use any birth control?


If this is truly how the question was worded - with no qualifiers about “other than in the heat of the moment” - and replying “Yes” to it was considered proof of “pregnancy coercion” I believe the entire study should be taken with a very large grain of salt.