Relevant and even prescient commentary on news, politics and the economy.

Female Doctors

This has been widely reported over the past few days:

 

Doctors from Harvard have an intriguing suggestion for saving 32,000 lives each year: Make sure all senior citizens who wind up in the hospital are treated by female doctors.

After examining the medical records of Medicare patients from across the country, the Harvard researchers calculated that 10.82% of those treated by physicians who were women died within 30 days of being admitted to the hospital. Among patients treated by male physicians, the 30-day mortality rate was 11.49%, according to a study published this week in JAMA Internal Medicine.

That gender gap persisted even after the researchers accounted for factors like the age, gender and income of patients, how sick those patients were when they first checked into the hospital, the resources of the hospitals and the experience of the doctors. In that analysis, the Harvard team found that 11.07% of patients treated by women died within 30 days of being hospitalized, compared with 11.49% of patients treated by men.

I haven’t had time to check out the original study, but I can’t see any particular reason why the effect being reported wouldn’t be true.

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Crime and Punishment – A Thought Experiment

Imagine two neighborhoods in the same city subject to the same laws. Assume the crime rate is the same. Then you would expect arrest and prosecution rates to be the same.

Now, assume two other neighborhoods, also in the same city and subject to the same laws. Call them A and B. Assume the arrest and prosecution rate is X times higher in A than in B. Assume that has been the case for a long time.

Given this scenario, under what conditions do you expect crime in Neighborhood A to exceed crime in Neighborhood B? Under what conditions would you expect the reverse to be true?

Note. A good answer is generalizable.

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Michigan Lame Duck Legislature

The Republican controlled House and Senate has been largely busy passing bills in the few days left in 2016. This particular one caught my eye.

Michigan had put in place a new Unemployment System (Michigan Data Automated System or MiDAS) to help in detecting unemployment fraud. With the passage of Senate Bill 1008 by the Republican led House, $10 million is transferred from the Unemployment Contingent Fund to the General Fund to be done with in the General Fund as determined by the Republican held Legislature.

Just a little history; MiDAS was put in place (2013) by Governor Rick Snyder of Flint, Michigan fame to automate the system away from the manual process. The system sends out a series of questions, which the Unemployment Applicant has to answer picking from listed answers. There is no room for explanation. The claimants chosen answers from the list of answers are then loaded into the MiDAS data base and notification is sent to the former employer who then confirms the answers the claimant has listed in the system. If there is any discrepancy, MiDAS assumes the claimant has committed a potential fraud.

Another questionnaire is then sent to the claimant, which is also limited to listed responses. If you do not respond in 10 days, it is assumed a fraud has been committed as determined by MiDAS. A notice is “supposedly” sent out and the claimant has 30 days to answer. If no notice is sent out and the claimant does not answer, MiDAS assumes fraud and the issue goes to collections where just about anything can take place to collect the unemployment funds already given to the claimant. There is little or no human interaction throughout the process and little can be done to explain circumstance during the process.

The Michigan Unemployment Insurance Agency, partly at the request of the federal government and partly on its own, reviewed 22,427 cases in which a computer determined a claimant had committed civil fraud between October 2013 and October 2015 and found that 20,965 of those cases did not involve fraud. Unemployment Insurance Agency spokesman Dave Murray said on Wednesday. That’s an error rate of more than 93%.”

The $10 million will be transferred from the Unemployment Contingent Fund which had already grown by 400% after the MiDAS caused spike in fraud cases of which nearly all of them unfounded. Senate Bill 1008 is balancing the state budget on the backs of innocent citizens wrongfully accused of false unemployment claims.

Governor Rick Snyder spent $47 million of taxpayer funds to install MiDAS which has been shown to be correct in determining fraud < 7% of the time. Rather than give the funds to those who were unjustly denied Unemployment Compensation by MiDAS, the Republican led Michigan legislature and Republican governor Rick Snyder are keeping much of it in the Unemployment Contingent (used to train workers and for rainy days) and will also transfer $10 million of it to the General Fund to help balance the budget. This is the same as using the additional Medicaid funding received from the expansion to balance the budget rather than set it aside for later years which would have kept Michigan from having to add to Medicaid funding till 2027. It too was used to balance the budget. By doing so in both cases, the Republicans do not have to raise taxes on the rich in income.

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How What We Eat Has Changed

From Pew:

The American Diet - From Pew

Americans eat more chicken and less beef than they used to. They drink less milk – especially whole milk – and eat less ice cream, but they consume way more cheese. Their diets include less sugar than in prior decades but a lot more corn-derived sweeteners. And while the average American eats the equivalent of 1.2 gallons of yogurt a year, he or she also consumes 36 pounds of cooking oils – more than three times as much as in the early 1970s.

Americans’ eating habits, in short, are all over the place, at least according to our analysis of U.S. Department of Agriculture (USDA) data.

The post goes on:

Broadly speaking, we eat a lot more than we used to: The average American consumed 2,481 calories a day in 2010, about 23% more than in 1970. That’s more than most adults need to maintain their current weight, according to the Mayo Clinic’s calorie calculator. (A 40-year-old man of average height and weight who’s moderately active, for instance, needs 2,400 calories; a 40-year-old woman with corresponding characteristics needs 1,850 calories.)

Nearly half of those calories come from just two food groups: flours and grains (581 calories, or 23.4%) and fats and oils (575, or 23.2%), up from a combined 37.3% in 1970. Meats, dairy and sweeteners provide smaller shares of our daily caloric intake than they did four decades ago; then again, so do fruits and vegetables (7.9% in 2010 versus 9.2% in 1970).

I guess its not just me. Or you.

On the other hand, I don’t like chicken, so this is more you than me:

Several interesting shifts are happening within food groups. For the past decade, for instance, chicken has topped beef as the most-consumed meat. In 2014, Americans ate an average of 47.9 pounds of chicken a year (2.1 ounces a day), versus 39.4 pounds (1.7 ounces a day) of beef. While average chicken consumption has more than doubled since 1970, beef has fallen by more than a third.

How healthy any of this is another story. (Warning: link to Youtube.)

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“One neat trick to stop Social Security ‘Reform'”

Republicans constantly try to bring Social Security into ongoing debates about ‘Balanced Budgets’. But they face a fundamental problem with their math. For a variety of reasons, some quite reasonable and others nakedly political (seniors vote) nearly every ‘Reform’ proposal out there promises to hold 55 and older harmless. Meaning you can’t have any more than miniscule effects on Cost projections until today’s 54’s and younger start retiring. Except for a handful of early retirees that event happens 11+ years in the future, which is to say outside the 10 year Budget Scoring window.

You can’t have a fix to a problem scored over 10 years with a solution starting Year 11. Sure the ‘Reformers’ will blather about “Infinite Future Horizons”. But any proposal that spares current seniors from cuts will score close to zero by CBO and JCT. You just have to count years on your fingers.

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Discussing Differences: A Letter to My Son (a few years from today)

The letter below summarizes my thoughts on a touchy subject. I have put them in the form they are in because I don’t think my son is old to have that discussion in its entirety right now.

To My Dear Son,

One of your mother’s hobbies is investigating her ancestry. She spends a lot of time on various websites, tracking down distant cousins and having email conversations with strangers about whether they might possibly related. She also took a genetic test to give her more information about her ancestry and convinced me to do the same.

I didn’t pay enough attention, but my recollection is that taking into account your mother’s background and my own, your blood, so to speak, is primarily Ashkenazi, Irish and Iberian. In our culture you learn a lot about the Ashkenazi and the Irish, but not so much about Iberia, so let me share some of its key history with you. Perhaps more important than anything else was the conquest by the Moors and the long campaign to drive them out. In 711 AD, these Arab-African invaders crossed the straights of Gibraltar. It took two decades for the Moorish expansion in Western Europe to be halted. A Frankish army under Charles Martel defeated the Moors at the Battle of Tours, but that didn’t help your ancestors; the invaders would enslave and subjugate Iberia for almost 800 years.

Over 8 centuries, a lot happens. There were times when the Moors could be described as benevolent overlords. At other times, the Moors were vicious, crushing their subjects underfoot with little remorse. But the desire for freedom remained through all of that, and eventually, there was the Reconquista. In 1492, the Portuguese and Spanish people finally managed to take back their countries.

A natural reaction might be anger or even hatred toward Arabs and Africans for perpetrating such an outrage on your ancestors. You might even think restitution is in order. That might be a natural reaction, but it is a bad one for a number of reasons:

1. These events happened a long time ago, and they didn’t happen to you. Sure, there is path dependence, and perhaps your circumstances would be very different had the Moors been less cruel, but that is conjecture and wishful thinking. What you deserve, morally, for the suffering of your ancestors is nothing. Absolutely nothing. For the same reason, I might add, you don’t owe anyone else for what happened to their ancestors either.

2. The people who invaded Spain and Portugal and oppressed your forebears are long since dead. Their descendants who were expelled to Africa in the decade or two beginning in 1492 bear no guilt. How could they?

3. 800 years is a long time. Time enough for the invaders and the invaded to mix and match a little bit. The Moors bred with the locals, sometimes by force and sometimes with consent. As a result, there may even be a touch of Moor, however diluted, in your gene pool. It doesn’t show up in the tests your Mom took, but that may well be due to imprecision of the current commercially available technology.

4. In the same way, some Africans today have Iberian genes. Perhaps more than you do, in fact.

5. The sad fact is, we are all, with the possible (but extremely unlikely) exception of the San, descended from oppressors and invaders. And we know one thing with certainty: your ancestors gave better than they got. This is self-evident from the fact that you are here and an uncountable number of bloodlines were wiped out.

As a result, the wise thing to do is to treat everyone with the same respect, at least until they prove they don’t deserve it. But not everyone has wisdom. Sleights perpetrated against their forebears motivate a lot of people. Making matters worse, one person’s oppression is another person’s heroism. For instance, Osama bin Laden, whom you will one day study in a history class, talked frequently about reclaiming Al-Andaluz (i.e., the Iberian Peninsula). To him, the Moors were conquering heroes spreading the One True Faith, and their expulsion was an injustice that must be avenged.

So while you should treat everyone the same at first, try to develop the ability to tell if a person feels the same way. Be very, very wary of those who carry around the past like a crutch or a club. Some of them are dangerous. Most will accomplish nothing, and the reasons for it will generally lie close to home. But people don’t easily accept mediocrity, especially when it is self-induced. People like that will blame you for their failure. These people don’t respect themselves, and they certainly don’t deserve respect from you.

Love,

Dad

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Topical Comments and Open Threads

It appears many of the “Topical Posts”are being used to discuss anything and everything. It is important to keep to the main topic of the post. It also shows courtesy to the poster by being topical and not hijacking the post for other topics.

AB does have “Open Thread Posts where just about any Topic can be discussed. Please use them for this purpose.

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