Archive for September, 2009

Dwindling options

By Daniel Holz | September 9, 2009 5:09 pm

There’s one thing that all Americans, be they liberal or conservative, Democrat or Republican, rational or loony, seem to agree on. Our current medical system is broken, and needs to be fixed. You can listen to personal experience. You can look at pretty graphics. You can read expert discussion. Health care in the US is in need of Change.

Listening to the current health care debate is unbelievably depressing. It isn’t really a debate about healthcare at all. Instead, it has devolved into a debate about all the conservative boogeymen: big government, high taxes, Obama personally telling your doctor what to do. The “debate” is fundamentally unmoored from the actual proposals being set forth. This is one of the most important public discussions this nation has had in recent memory. The results will directly impact each and every American. And yet, the entire debate is completely incoherent and misleading.

The possibility of a “single-payer” healthcare program has fallen off the table. I’m not sure exactly how or when this option became untenable, but it shows how quickly the efforts of pharmaceutical and insurance companies can reframe a discussion. After all, there are billions upon billions of dollars at stake, which is precisely why it is such a profound issue for our long-term fiscal health. It is not at all surprising that these companies are spending millions to defeat meaningful reform. The essential goal of this reform, after all, is to reduce the amount of money our nation spends on health care (while improving overall care). Which is not at all in the interest of these companies. What is astounding is that they are actually succeeding in derailing the discussion into lunacy.

Now it looks as if a “public option” will fall victim as well, and be eliminated from consideration. An (incredibly vocal) minority has become convinced that the public option will destroy capitalism, and that Obama is the second coming of Hitler. Really. These people live in an alternate Universe. Here is a two-minute summary of the public option by Robert Reich:

As Paul Krugman says, “the argument against the public option boils down to the fact that it’s bad because it is, horrors, a government program.” In addition, “the argument against it is sheer nonsense. It is nothing but the insurance lobby.”

In a few minutes Obama will give a much-anticipated speech on healthcare. We can only hope he is able to change the nature of the discourse. We are at a critical juncture. The whole nation is focused on fixing healthcare. The diagnosis is clear. The patient is in crisis. Prospects for recovery are increasingly slim. Heroic action is needed.

Update: Text of the speech can be read here. Obama made a range of proposals, including a public option. He tells us: “Well the time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care.” I hope he can.

As if on queue, a Republican from South Carolina interrupted Obama in the middle of his speech, yelling “You lie!”. The irony, of course, is that at that very moment Obama was busy decrying the absurd claims being widely promulgated by those who aren’t interested in civil dialogue, but aim to “kill reform at any cost”. It gives a good sense of the current state of affairs: that a Congressman would actually interrupt the President, and accuse him of lying, to his face, on national TV. And, needless to say, the Congressman was absolutely, unequivocally wrong. And, “surprise”, he receives lots of money from healthcare industry lobbyists, and is basically a nutcase.

CATEGORIZED UNDER: Health, Politics

It's baaaaaaaack!

By Julianne Dalcanton | September 9, 2009 10:54 am

Remember a few months back, when we were all excited about the Space Shuttle taking a crew of astronauts to fix and upgrade the Hubble Space Telescope (HST)? At the time, it looked like the repairs worked well (as in, nothing obvious went wrong, electronics woke up and said “hi”, etc). However, until the instruments actually take data, one never knows.

Well, now we know.

Omega Centauri

The new and refurbished instruments officially kick astronomical butt.

Even better, I’ve been hearing rumors of killer numbers, at least for the imaging cameras — throughputs that are 15% better than measured from the ground, electronic read noises that are lower than before the instruments broke a few years back. I have no numbers on the spectrographs, but the press release photos show some nice looking spectra, which is a zillion percent improvement on the pre-repair state of the telescope, for which the only spectroscopic capabilities were grisms (which only the most studly of spectroscopists dare to use). Phil will probably have more, given his history with one of the refurbished spectrographs.

(For the near-infrared channel of the new imager WFC3, I can personally verify awesomeness. We got some imaging during the last month, and had to sign non-disclosure agreements that we would keep our mouths shut, which was nearly impossible because the data quality was insane.)

Anyways, everyone involved in making this happen should be very proud!

CATEGORIZED UNDER: Science, Space

Our Health Care Problems Are More Vivid When Presented in Colorful Graphical Video Form

By Sean Carroll | September 7, 2009 10:05 am

Talking about health care provides a great opportunity to link to this video by Peter Aldhous, Jim Giles and MacGregor Campbell — the last of whom was once Tom Levenson’s advisee. (Also via Bioephemera, who at least was kind enough to embed the video.)

The video, also at New Scientist, takes data from studies by Dartmouth and the OECD, and uses Gapminder to make the graphs come alive. It helps explain one of the paradoxes behind health care in the U.S.: we spend more than most other developed countries, and we get less for it. The explanation — you’ll be unsurprised to hear — lies in our screwy incentive system. By making health care a matter of profit for various sets of people — doctors, hospitals, insurance companies, pharmaceutical companies — we push into the background the incentive that we’d really like the system to have, namely keeping people healthy. Changing those incentives doesn’t mean that Barack Obama decides what treatment you get from your doctor; it just means that we can focus human ingenuity on the task of making people healthier, rather than just making other people wealthier.

CATEGORIZED UNDER: Health

What I Did on My Summer Vacation – Part 1

By John Conway | September 5, 2009 11:00 am

For most academics, summer is the time to devote full time to research and, perhaps, a vacation. Not for me, this year…I have been in the front lines of health care, and so the national focus on the health care insurance reform issue has been particularly poignant. Here is my report.

The health problem at the core is not my own, it’s my father’s. For some time, more than a year, he had had increasing trouble walking. I was convinced it was degeneration of his knees; at 77, after a physically demanding career as a locomotive mechanic in Chicago, that seemed to be the best explanation for his increasing difficulty.

In February we visited him in his house in Chicago and, unlike the previous visit in January, he came out to eat lunch. We had tremendous difficulty getting him down the stairs, to the car, into the restaurant, and back into his house. He took one stair at a time, very slowly, and we carried him up the last one. Clearly it would not be much more time until something had to happen. He had spent most of the winter inside; kind neighbors helped by buying him food at the store.

About a week later I got a call from him, on the cordless phone I had installed for him in the fall. He was on his way to the hospital, having fallen in the house. He had been unable to get up for hours, and finally the paramedics got the front door open and got him out of there. Being nearly 2000 miles away in California, with no family there in Chicago to help him, I was quite worried. He checked into the ER of a hospital near his house, and was admitted.

Over the next few weeks my dad received a full suite of tests to determine the underlying cause of his inability to walk, and got some physical therapy. The eventual diagnosis was scary: ALS, amyotrophic lateral sclerosis, or Lou Gehrig’s disease. ALS is the degeneartion of the voluntary motor neuron system. Any muscle that you can voluntarily control is affected. There is no known cause for ALS, and no known cure. The time from diagnosis to death, which is usually due to inability to breathe, is typically 3-5 years. There is no test for ALS; all you can do is rule out other conditions and it wasn’t joint degeneration, spinal cord damage, a toxin, brain tumor, or any of the numerous other things they checked. He was discharged to a skilled nursing facility for rehabilitation and physical therapy.

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CATEGORIZED UNDER: Health

Mistaking Beauty for Truth

By Sean Carroll | September 4, 2009 10:53 am

Everyone’s talking about this Paul Krugman essay on where economics, as a discipline, went wrong. Partly, “going wrong” means the failure to appreciate the risks in our financial system, and the corresponding failure to predict the crash we’re currently trying to deal with. But from an insider’s perspective, something else has happened: an uneasy consensus between two different approaches to economics has been shattered. One, which Krugman labels the “saltwater” approach, is associated (in the U.S.) with some variety of post-Keynesian analysis, generally identified with some willingness to have the government intervene in the economy over and above the Fed’s control of the money supply. The other, the “freshwater” approach favored by the Chicago School and other inland economists, is more purely free-market and non-interventionist. (Truth in advertising: I am not an economist.) These camps could more or less get along when everything was going fine, but have dramatically different reactions to a crisis. To the extent that you find freshwater economists claiming that unemployment is currently high, not because there aren’t many jobs, but because there are too many incentives for people not to work.

One of the reasons it’s a great essay is that it’s a wonderful example of popularizing science. You can debate all you like about whether economics counts as a science, but there’s little doubt that Krugman does an amazing job at explaining esoteric ideas in non-technical language, and is so smooth about it that you hardly realize difficult ideas are even being discussed. I wish I could write like that.

One part of the essay worth commenting on, or at least musing about, is the punchline. Krugman thinks that a major factor leading to the failures of economics to understand the mess we’re currently in was the temptation to think that beautiful models must be right.

As I see it, the economics profession went astray because economists, as a group, mistook beauty, clad in impressive-looking mathematics, for truth. Until the Great Depression, most economists clung to a vision of capitalism as a perfect or nearly perfect system. That vision wasn’t sustainable in the face of mass unemployment, but as memories of the Depression faded, economists fell back in love with the old, idealized vision of an economy in which rational individuals interact in perfect markets, this time gussied up with fancy equations. The renewed romance with the idealized market was, to be sure, partly a response to shifting political winds, partly a response to financial incentives. But while sabbaticals at the Hoover Institution and job opportunities on Wall Street are nothing to sneeze at, the central cause of the profession’s failure was the desire for an all-encompassing, intellectually elegant approach that also gave economists a chance to show off their mathematical prowess.

Without knowing much of anything about the relevant issues, I nevertheless suspect that this moral might be a bit too pat. Sure, people can fall in love with beautiful theories, to the extent that they overestimate their relationship to reality. But it seems likely to me that the correct way of understanding all this, once it’s properly understood, will look pretty beautiful as well. General relativity is widely held up as an example of a beautiful theory — and it is, when understood in its own language. But if you put the prediction of GR in the Solar System into the language of pre-existing Newtonian physics (which you could certainly do), it would look ugly and ad hoc. Likewise, Newton’s theory itself is quite elegant, when phrased in the language of potentials on a fixed spacetime background; but if you express the theory in terms of differential geometry (which you could certainly do), it looks like a mess. Sometimes the beauty/ugly distinction between theoretical conceptions is more a matter of how well we understand them, and less about their intrinsic qualities.

So my counter-hypothesis would be that it wasn’t beauty that was the problem, it was complacency. If you have a model that is beautiful and works well enough, you’re tempted to take pride in it rather than pushing it to extremes and looking for problems. I suspect that there is a very beautiful theory of economics out there waiting to be developed, one that understands perfectly well that individuals aren’t rational and markets aren’t perfect. One that has even more impressive-looking equations than the current favored models! Beauty isn’t always a cop-out.

CATEGORIZED UNDER: Science and Society

Our Neighborhood

By Sean Carroll | September 2, 2009 4:40 pm

A very cool picture of our Solar Neighborhood. See this and a bunch more at The Neighborhood.

nabesphere2008.jpg

The collection isn’t complete; it focuses on relatively bright stars and those associated with known exoplanets. A slightly more realistic representation would have a lot more small, dim, red stars. Still, I like it.

CATEGORIZED UNDER: Space

A Tip for Students Interested in Law School

By Sean Carroll | September 1, 2009 2:07 pm

A new study looks at the average LSAT scores of students with different undergraduate majors, sometimes grouping related fields together to gather a statistically significant sample. (Via.) And the best scores were attained by students studying: Read More

CATEGORIZED UNDER: Academia
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