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A Woman’s Right to Safe Healthcare Outcomes

Married male with children, who was asked to write on three different subjects concerning women’s healthcare by the ConsumerSafety.Org . Although I have worked in the healthcare product industry, I am not a doctor.

All three of the healthcare issues I discuss scream for solutions as to what has been done, what should have been done, and how they impact women. I have no doubt if these problems impacted men as much as they do women, a Congress made up mostly of men would have addressed each issue far sooner.

 

Clinical Trials

Fact: Women make up over half of the U.S. population.

As reported by the GAO, women have been underrepresented in NIH supported clinical research which lead to unidentified differences in treatment results between men and women when incurring a disease. There have been instances of women experiencing different and also adverse effects to medications and treatments than what was experienced by men in NIH Clinical trials. It is thought the NIH’s Inclusion Policy established requirements governing women’s inclusion in its clinical research may have led to this issue.

Some study examples:

The Baltimore Longitudinal Study of Aging started in 1958 did not include women until 1978 in its study even though women lived 6 years longer than men. 1000 men were initially in the study and no women. Another study, the Physicians Health Study concluded in 1989, the taking of low-dose aspirin might lower your risk for heart disease. It included 22,000 men and zero women. A study investigating the possible interactions between the libido-boosting drug Flibanserin (also known as “female Viagra”) and alcohol used a study group of 25 participants which included twenty-three men. It raises the question, why and how would we ever know the impact of drugs on women if only men are used in trials?

Why the Under Representation?

The driving factor for the lack of women in tests is not necessarily driven by bias as much as a lack of knowledge of the biological differences determining how disease symptoms may present in each gender. A broad-based assumption was made of the test findings of men. The results could also apply to women? The testing of men is simpler as men are not subject to the hormonal fluctuations of women. As sound(?) as this reasoning may be in minimizing the number of trials, this appears to be more of a financial decision.

Reports of birth defects from the use of Thalidomide during the 1950s and 60s lead to FDA guidelines excluding potential child bearing women from participation in Phase 1 and 2 clinical studies until reproductive toxicity studies were conducted and evidence of effectiveness and safety was available. The FDA guide lines were misinterpreted and applied to all clinical study phases even though it was not intended to exclude women.

Dangers of Under Representation

Assumptions from an 11 year NIH study on moral development in children using only boys concluded little girls are morally inferior to little boys. Females are simply different and arrive at conclusions different than men and just as moral. Eight of 10 approved drugs were pulled from the market due to health risks for women which were not risky for men. More women than men used four of the drugs and for 4 other drugs women and men used them equally. The differences in men and women between the two sets revealed itself in the later set of 4 with women experiencing serious side effects more often than men. Hence, emphasizing the need to have women equally represented in clinical studies. “Excluding women makes a difference: If women had been included before 1978, the link between osteoporosis-calcium-estrogen and progesterone would have been discovered in time to help their mothers”.

Resolution

In 1993 the Health Revitalization Act was passed which incorporated the use of women and minorities in NIH clinical studies. In 2000, Congress asked the GAO to assess the progress of the NIH. While progress was made to include women and minorities in trials, the GAO recommended the NIH to improve reporting format. Later years the GAO again assessed the NIH recommending the NIH improve the consistency of reporting by sex so as to allow researchers to “identify potentially important sex differences that may ultimately affect patient care.”

Globally the representation in 43% women and 57% men in clinical trial representation. In the US, the representation has improved to 49% women and 51% men. There is still work to be done. Most recently, the 21st Century Cure Act was passed with one of its intents being to move new drugs to market faster through testing in the public sector. “Without detailed clinical trials and studies, there is effectively no way to determine the extent of potential side effects and other issues the current detailed trials and studies provide.” Numbers predicting probability versus clinical trial experience, we will have to see how this plays out.

 

Essure

In November 2016, the FDA issued a “boxed warning” for the permanent female sterilization device Essure device after reports of it causing perforation, abdominal pain, and serious complications. A “boxed warning” is a type of warning appearing on the package insert for certain prescription drugs or devices. The Food and Drug Administration specifies the warning be formatted with a box or border around the text and is done when there is reasonable evidence of a serious hazard when used. It is the strongest warning the FDA requires.

Essure is a permanent female sterilization device consisting of metal coils which eventually embed into a woman’s fallopian tubes creating scar tissue blocking sperm access to a woman’s eggs. It is reversible only through surgery. In February 2016, the FDA designated Essure to have a “boxed warning” which is meant to alert doctors as to hazards of the device.

In February 2018, a group of women calling themselves the E-Sisters met with former FDA Commissioner Scott Gottlieb. The E-sisters believe Essure has caused themselves and tens of thousands of others health problems, from bleeding, bloating, and pelvic pain to more obscure symptoms such as rashes, tooth loss, joint pain and fatigue associated with an allergic or autoimmune reaction. They brought with them a photo album of other E-Sisters who had suffered because of Essure and also Madris Tomes, a former FDA analyst. Ms. Tomes’s software company tracks adverse medical events reported to the FDA and had logged 26,000 events caused by Essure.

Asking whether a ban might be possible, Commissioner Gottlieb confirmed anything is possible. On March 7, 2018, Gottlieb confirmed Essure would remain on the market. In its history, the FDA has only banned two products.

The original manufacturer Conceptus put Essure through a Level III approval process and presented its data to a FDA advisory committee “touting its near-perfect effectiveness in preventing pregnancy and its high levels of satisfaction among women.” Later studies challenged the initial studies and effectiveness. A Yale study challenged the rigor of the Level III process. a JAMA study reported 5% of all women using these devices required follow up surgery, and a third study claimed women using Essure were 10 times more likely to require surgery.

After November 2017, the U.S. was the only country in the world where Essure was still available after new owners Bayer removed Essure from every other market for “commercial reasons” and not because of safety. Bayer announced in July 2018, it would also remove the device from the US market after December 31st, 2018 due to declining sales.

 

Maternal Mortality

Healthcare for women Maternal mortality is an important indicator of a nation’s overall quality of healthcare.

Even though maternal mortality worldwide dropped 44% between 1990 and 2015 830 women ; die every day from causes related to pregnancy and while giving birth of which much is preventable. 99% of all those maternal deaths occur in developing countries. WHO has launched an initiative to meet the needs of women in developing countries by addressing access to and the quality of reproductive, maternal, and newborn healthcare services. Everyone would agree the effort is necessary in developing countries.

One would think the maternal rate of death in a highly developed nation such as the US would be lower when compared to other and similar nations. Why not? With the advent of the PPACA, many preventative healthcare measures were put in place for women and Medicaid was expanded in many states. US citizens spend far more for healthcare and have greater or similar access to healthcare. And yet every year in the U.S, 700 to 900 women die from pregnancy, or birth-related causes, and an approximate 65,000 almost die due to complications. Contrary to what healthcare should be, the US ranks low in providing maternal healthcare in the developed world.

Even with the PPACA, expanded Medicaid in place; and when compared to their Canadian sisters, American women are three times more likely to die from the start of a pregnancy up till one year after the birth of a child (defined by the Centers for Disease Control). The death rate for American women is 26.4 deaths per 100,000 as opposed to 7.3 deaths per 100,000 in Canada (Chart). The ratio worsens when compared to Scandinavia countries as American women are six times as likely to die as Scandinavian women.

There are two stories, one for economically secure women and another for minority, native American, rural, and lower income women. The statistics worsens for women of color with their being more likely to die in pregnancy or childbirth and are nearly four times more likely to die from pregnancy-related causes than white women. In high-risk pregnancies, African-American women are 5.6 times more likely to die than white women. Amongst women diagnosed with pregnancy-induced hypertension (eclampsia and pre-eclampsia), African-American and Latina women were 9.9 and 7.9 times in danger of dying than white women with the same complications. Native American and Alaskan Native women experience similar discriminatory care. Half of all U.S. births are covered by Medicaid and covers women up to two months past delivery leaving a substantial gap after child birth when other issues can arise.

Barbara Levy, vice president for health policy/advocacy at the American Congress of Obstetricians and Gynecologists; “We worry a lot about vulnerable little babies and we don’t pay enough attention to those things catastrophic for women.”

The emphasis has been on safe baby care and safe birthing which lead to a significant decline in baby mortality. As reported in a Propublica, NPR report, the difference in “maternal mortality numbers contrast sharply with the impressive progress in saving babies’ lives.” Maternal death rates while giving birth and up to one year later has increased by an approximate 10 deaths per 100,000 since 2000 till 2015 or greater than the 9.2 deaths per 100,000 in the U.K, (Chart).

The problems occur before, during, and after delivery.

Mary D’Alton, chair of ob/gyn at Columbia University Medical Center and author of papers on disparities in care for mothers and infants. “The training was quite variable across the U.S., there were some fellows that could finish their maternal-fetal medicine training without ever being in a labor and delivery unit. When I had my own child I realized, ‘Oh my goodness. That was completely insufficient information.'”

And doctors fail to heed the warning signs women are alerting them too.

Elizabeth Howell, professor of obstetrics and gynecology at the Icahn School of Medicine, Mount Sinai Hospital; “The way that we’ve been trained, we do not give women enough information for them to manage their health postpartum. The focus had always been on babies and not on mothers.”

With 39 weeks of a good pregnancy, the expectant mother went to the hospital to induce labor. Inducing typically ends up with a cesarean delivery. 23 hours later, the mother delivered normally a healthy baby girl with the only occurrence being sharp pains in the kidney area alleviated with more epidural. In 20 hours, a healthy mother before the birth of her daughter died.

The pain came back 90 minutes after the birth. Upon her doctor husband questioning the ob/gyn, he was told it was acid reflux, and a common reaction after birthing. The pain increased, her blood pressure spiked at 169/108, and her husband asked the OB whether this could be preeclampsia.

Her blood pressure upon admission was 147/99, she experienced similar readings during labor, and for one period of 8 hours no readings were made. All eyes were on the health of the baby, not on the mother, and what could be coming to pass. For a woman with normal blood pressure such as this young mother, a blood pressure reading of 140/90 would be indicative of preeclampsia.

Her husband reached out to another doctor, he anxiously relayed the symptoms, and she quickly diagnosed what the young mother was suffering from . . . a disorder called HELLP syndrome or Hemolysis, (a breakdown of red blood cells); Elevated Liver enzymes; and Low Platelet count. A disorder if not treated quickly leads to death.

This is only a brief recital of the tragedy which befell Lauren Bloomstein and her husband Larry. With additional delays in finding a surgeon, Lauren began to experience bleeding in her brain which would lead to paralysis. She knew she was dying before her husband’s eyes. A neurosurgeon was called in to relieve the pressure and stop the bleeding. Since her platelets were low he could not operate, the hospital did not have an adequate supply, and by the time additional supply arrived it was too late. She was brain dead and was allowed to pass on after her daughter was placed next to her one last time.

The warning signs of life-endangering problems were there and were missed (pain in the kidney area) or ignored (abnormal high blood pressure for Lauren), excuses for pain (reflux) were made, and pain killers administered to dull the pain and other symptoms (blood pressure) not explored while she deteriorated in front of her husband who suspected preeclampsia. The missing part of this was the protocol to diagnose early on and prevent Lauren from slipping into late stages of preeclampsia. This is not an isolated incidence as the deaths of women giving birth keep increasing as evidenced in the attached chart.

This is but one story as told by NPR and Propublica. There are many more stories of tragedy which go untold.

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The Extreme Limits of Human Dishonesty and Stupidity

This is a follow up on my post on joy and sorrow. I feel great joy at having found the ultimate abyss of idiocy, but I fear Monday, October 30, 2017 Mysterious Ways

The competition for worst possible argument was provoked by the fact that former White House counsel Don McGahn told Mueller’s team that (sadly) current President Donald Trump twice told him to get Mueller fired and then told him to deny that “fake news” when it was reported.

Rudolf Giuliani attempted to surpass his previous accomplishments in dishonesty and idiocy by quibbling about an immaterial difference in wording

“I would ask, which of the three versions is McGahn standing by?” Giuliani told CNN’s Jake Tapper in response to McGahn’s lawyer’s statement, before listing several versions of the story.

[skip]

For example, while The New York Times used the word “fire” in its January 2018 report on the initial conversations between Trump and McGahn, McGahn himself did not use that word in interviews with Mueller’s team. Yet, Giuliani implied to Tapper that McGahn had used the word, citing the page number of Mueller’s report on which the New York Times article is described and saying: “The first version that he says is, ‘The President told me to fire him because he’s upset about conflicts of interest, and I told him I’d resign.’”

But there’s no such quote credited to McGahn in the redacted Mueller report.

It is impressive idiocy to base one’s case on the inconsistency between saying “Mueller has conflicts and can’t be the Special Counsel.” and “‘The President told me to fire him because he’s upset about conflicts of interest,” but it is truly outstanding idiocy to notice the difference in wording between McGahn’s testimony and a New York Times paraphrase of a leak.

One might expect that Giuliani’s denouncing someone for an immaterial difference between the words Giuliani put in his mouth and the words which actually came out of it would stand as the nadir of dishonest idiocy forever, or at least one day.

I put the following words in Kellyanne Conway’s mouth “hold my beer”.

She argued that we can tell that McGahn committed perjury for no compelling reason because

Don McGahn is an honorable attorney who stayed on the job 18 months after this alleged incident took place, and that if he were being asked to obstruct justice or violate the Constitution, or commit a crime, help to commit a crime by the President of the United States, he wouldn’t have stayed,”

Yes she said we know he is a felon who broke the law for no good reason, because we know he is honorable.

I really can’t even imagine dishonest idiocy which could top that, so I guess I will have to wait at least a day for Trump to outdo his minions.

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That One Sentence

That One Sentence

On March 25, Matt Taibbi wrote in Rolling Stone:

On Sunday, Attorney General William Barr sent a letter to Congress, summarizing the findings of Special Counsel Robert Mueller’s Russia investigation. The most telling section, quoted directly from Mueller’s report, read:

[T]he investigation did not establish that members of the Trump Campaign conspired or coordinated with the Russian government in its election interference activities.

That one sentence should end a roughly 33-month national ordeal (the first Russiagate stories date back to July 2016) in which the public was encouraged, both by officials and the press, to believe Donald Trump was a compromised foreign agent.

“That one sentence” unexpurgated:

Although the investigation established that the Russian government perceived it would benefit from a Trump presidency and worked to secure that outcome and that the Campaign expected it would benefit electorally from information stolen and released through the Russian efforts, the investigation did not establish that members of the Trump Campaign conspired or coordinated with the Russian government in its election interference activities.

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What Is The “Collusion Delusion”?

What Is The “Collusion Delusion”?

The Trump crowd has long claimed that there was “no collusion, ” repeatedly in many venues.  Somehow the MSM picked up on this screed, and so it is out there that indeed that the Mueller Report  declared that there was “no collusion,” a phrase that somehow Trump himself long put out there for his followers long before the Mueller Report came out.

But, in fact up front in the Mueller Report they made it clear that they were not  investigating “collusion.” They only briefly discussed the term, but the bottom line was that there exists no legal definition of this term. The final point in the report was that “collusion” is not even a “term of art” in the  legal system  Therefore, they simply ignored thereafter in the inquiry.

Bottom line is that there is massive evidence for collusion, that legally undefined form of half-baked cooperation that never got the level of coordination and conspiracy.  They were massively colluding, but never ccould get it together to engage in an organized mutually benefiicial operation to influence the election.  They were too incompetent to put  it together, although they made great efforts to do so, The obvious example was the meeting in Trump Tower in June 2016. The Russsians wanted certain Putin-related cronies exempted from the Magnitsy law, while the Trump people wanted more dirt on HRC than the Russians were willing to give then, although soon after they delivered the goods.

Barkley Rosser

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Childrens’ Day And The UN Convention On The Rights Of Children

Childrens’ Day And The UN Convention On The Rights Of Children

Associated with the UN Convention on the Rights of Children is a Universal Childrens’ Day.  It is November 20, the date that in 1959 the UN adopted the first version of the Convention, which had 10 articles.  It is celebrated in many nations, but not in the US.

A competitor is International Childrens’ Day, also called the International Day for the Protection of Children.  This is June 1 and was declared in Moscow in 1950.  It is also widely celebrated, mostly in former or current socialist or communist nations, and is a big deal in Russia in particular even now, a national holiday.  It is also not celebrated in the US.

Curiously there is an official Childrens’ Day in the US, although almost nobody pays attention to it.  It is  the second Sunday in June, a week before Fathers’ Day, which way dominates it, although Mothers’ Day way dominates both of them.  Ironically, given its current obscurity, the US one was the first one established, back in 1857 for that date by a Universalist minister, Rev. Douglas Leonard in Chelsea, Massachusetts.

At least 90 nations have an official Childrens’ Day, with a variety of dates for this.

The matter of the US starting Childrens’ Day but then coming to ignore it has a parallel with International Womens’ Day, founded in 1909 in Brooklyn by socialist Clara Zetkin. It is widely celebrated around the world, and a big deal in many nations, including Russia.  But it is only barely recognized, mostly by feminists, in the US now.

Mothers’ Day was founded by pacifist and Methodist, Anna Jarvis, in Grafton, West Virginia, in 1908 on its current date.  The US Fathers’ Day was started the same year nearby in Fairmont, West Virginia. Jarvis would later come to be unhappy with the crass commercialization of Mothers’ Day.

There is a much older Fathers’ Day celebrated by Roman Catholics since the Middle Ages.  It is on St. Joseph’s Day, March 19.

Anyway, I think there may be a link between the ignoring of Childrens’ Day in the US, even thought it was started here compared with how it is treated in many other nations, and the bizarre refusal of the US alone among UN nations not to ratify its Convention on the Rights of Children.

Barkley Rosser

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Devos’s Magic Show

What would it take to save a scab industry from leaving the market place? The sorcerous of Grand Rapids Betsy DeVos has the answer.

Betsy DeVos’s Department of Education reversed the Obama-era crackdown on vocational and career schools thereby allowing new and inexperienced entrants into the field and alleviating pressure on old participants to have meaningful programs leading to “gainful employment in a recognized position” for which they were trained. Making the words “gainful employment in a recognized position” disappear is what made prior scammers nervous when the government would take action and refunded the fees paid and loans alleviated.

Redundancy alert . . . precisely, the Western Michigan sorceress of charter schools removed the one regulation for “non-profit” and for-profit schools offering programs leading to careers and which allowed the Department of Education to crack down on fraudulent educational programs or programs which did not result in those meaningful words “gainful employment in a recognized occupation.” Ms. DeVos made this one requirement disappear because she did not want to “target schools simply by their tax status” such as “for-profit.” Her assumption was in error as the regulation covered “all” schools whether for-profit or nonprofit and was looking at the offered programs. Our current president even had to ante up when his real estate school did not produce results in gainful employment in a recognized occupation.”

Upon knowing this exclusion by DeVos, I would think even Joe Biden might change his message to Millennials telling them to “tough it out” and he may begin to have some empathy for them after campaigning for Republican Congressional Representative Fred Upton in Betsy’s backyard of Grand Rapids. But then he has been in the pocket of MBNA and Delaware Incorporated banks forever and has made it impossible to discharge student loans through bankruptcy. Maybe???

Now if these six words “gainful employment in a recognized occupation” magically disappeared (psst and they did), what would it take for a career education program to lose its eligibility for federal student aid under DeVos? . . . a for-profit institution could not lose its financial lifeline or federal student aid no matter how poorly it performed its mission as spelled out in a statute to prepare students for “gainful employment in a recognized occupation” resulting from that education as stipulated previously.

One hundred percent of students could be dropped from their career program with all of them deeply in debt, or perhaps no single graduate landing a job in their field of training, and still . . . still the federal government would keep the pipeline of guaranteed federal student loans and Pell Grants flowing in to the school.

With DeVos’s reversal, the NYT surmised: “Executives in the for-profit education industry would be sleeping better, secure in the knowledge that even the worst schools and programs were no longer at risk of “magically” being thrown off the taxpayer-backed gravy train, no matter how epically they failed and robbed their students.” This AB author took liberty and added words to make his point.

Under Obama, “the Job Training industry was on its heels. Under DeVos, they had been given a magical new life, a second chance by the department,” said Eileen Connor, the director of litigation at Harvard Law School’s Project on Predatory Student Lending.

Ms. DeVos, who invested in companies with ties to for-profit colleges before taking office, has made it an agency priority to unfetter schools offering training in professional jobs and trades by eliminating restrictions on them and also nonprofits. She also allowed a growing number of for-profit schools to magically evade those loosened rules by converting to nonprofits.

That is what the Los Angeles Pentecostal megachurch’s affiliate Dream Center wanted to do in 2017 when it asked to buy the remains of Education Management Corporation . . . change it from for-profit to nonprofit and use the profits to fund its other programs. One year after taking over a chain of for-profit schools, dozens of Dream Center schools are near bankruptcy and others have been sold with a hope they can survive.

Collectively Argosy University, South University and the Art Institutes have ~26,000 students in programs resulting in associate degrees in dental hygiene and doctoral programs in law and psychology. Fourteen campuses of mostly Art Institute schools have a new owner after an arranged transfer involving private equity. Another 40 or so others are now under the control of a court-appointed receiver who has accused school officials of trying to keep the doors open by taking millions of dollars earmarked for students to pay operating expenses.

Federal funding for Argosy ceased from the Department of Education when the court-appointed receiver discovered school officials had taken about $13 million owed to students at 22 campuses and used it for payroll expenses, etc. Lauren Jackson seeking a doctorate at Argosy’s Illinois School of Professional Psychology in Chicago did not receive the $10,000 she was due in January. She was paying expenses for herself and her 6-year-old daughter with borrowed money and GoFundMe donations.

26,000 students being defrauded by schools offering programs meant to teach them a skill leading to “gainful employment in a recognized occupation” is only a start to which DeVos has failed to account for in the Department of Education. DeVos does profit by this failure due to her own dabbling in areas feeding off of these failures. There is money to be made in preying on defrauded students, so many of them, and larger than the baby boomer generation. The most tragic consequence of conservatives’ abandonment of federal accountability of career programs is just that and the devastating personal toll it will take on hundreds of thousands of hopelessly indebted students” for whom there is no relief.

Millions in Student Loan Cash Disappears, Tejas Sachdeva, “Tasks”

Inside the Financial Holdings of Billionaire Betsy DeVos

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UN Convention on the Rights of the Child

UN Convention on the Rights of the Child

After Peter Dorman’s latest post this seems appropriate to follow up.  Very recently I was at a talk where somebody spoke on the United Nations Convention on the Rights of the Child.  A theme of the talk was how few Americans know about this UN Convention while most reasonably well informed people in virtually the entire rest of the world know about it.  A first version of it was passed  by the UN in 1959.  A second round was in 1989.  I do not know what the US’s position was on the first round, but on the second round, while the US signed it in 1995, it was never ratified by the Senate and never has been.  Right wing Christian types claimed it took away rights of parents over their children, although any reasonable examination of it shows that is nonsense.  Up until 2015, Sudan and Somalia also were with the US in not ratifying it, but then both of them did so, leaving the US to be the only nation on earth (or at least in the UN) not ratifying it.

Unsurprisingly there may be more reasons now why the current Senate will not raritify it as it looks like US behavior on our southern border is in open violation of parts of the Convention.  It has 42 articles, and the fact that so many nations have accepted it is a sign of how really uncontroversial it should be.  There is no reasonable reason to oppose any of the 42 articles.  Anyway, I shall simply note a few that are now especially unfortunate now given recent US conduct. (these are the simpler versions for children):

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Misleading Congress Appears to Be a Tactic of Barr

This tidbit was reported in an October 13, 1989 Los Angeles Times. In a June 21 (1989) legal opinion requested by Atty. Gen. Dick Thornburgh, Assistant Atty. Gen. William P. Barr reversed a ruling dating back to the Carter Administration denying the FBI authority to take unilateral action overseas in what was then referred to as the President’s snatch authority. The earlier Carter ruling had also warned federal agents could face kidnaping charges abroad if they used such tactics.

The ruling was made with regard to bringing Panama’s Noriega to trial for drug- trafficking. Assistant Atty. Gen. William P. Barr refused to discuss the broad new grant of power, the legal grounds used to justify it, or even to acknowledge its existence even though the earlier ruling in 1980 was made public.

When Congress asked to see the full legal opinion; Barr refused and said he would provide an account that “summarizes the principal conclusions.”

Yale law school professor Harold Koh wrote that Barr’s position was “particularly egregious.”

Congress had no appetite for Barr’s stance and issued a subpoena to acquire the full OLC opinion out of the Justice Department.

Koh posits:

“Barr’s continuing refusal to release the 1989 opinion left outsiders with no way to tell whether it rested on factual assumptions that did not apply to the earlier situation, which part of the earlier opinion had not been overruled, or whether the overruling opinion contained nuances, subtleties, or exceptions that Barr’s summary in testimony simply omitted.”

In 1991, Congress obtained a copy of Barr’s 1989 opinion which was later published by the Clinton Administration. What Barr did not disclose and which can be reviewed in Just Security’s Ryan Goodman’s “Barr’s Playbook: He Misled Congress When Omitting Parts of Justice Dep’t Memo in 1989” was:

• The 1989 opinion asserted that the President could violate the United Nations Charter because such actions are “fundamentally political questions.”
• The Presumption of acts of Congress comply with international law.
• A failure to report to Congress the opinion discussed international law on abduction in foreign countries.

While not the principal conclusions of the opinion and whether wrong or right, Barr “represented to Congress in his written and oral testimony that the OLC opinion did not address these legal issues, even though it did.”

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The Limits of Human Joy and Sorrow

In this post I will use revealed preference and assume people are rational. Sorry. I’m an economist and I can’t entirely resist.

I will argue that our joy and suffering is bounded, that we can’t be infinitely happy or infinitely miserable.

The first argument is standard, the second is something Peter Mollgaard thought of the instant I explained the first.

Both discussions are typically limited (as economists tend to be) to selfish swinish agents who care only about consumption. This has nothing to do with the argument.

The proof that we are not rational utility maximizers with utility unbounded above follows. It is called the St Petersburg paradox.

If we were capable of unbounded joy, for any positive epsilon no matter how small there is a lottery which we would rationally play which gave us horrible pain with probability 1-epsilon and good outcomes with probabilities adding up to epsilon. The trick is an infinite series of good outcomes. goodoutcome(i) for i a natural number. goodoutcome(i) occurs with probability epsilon/2 and gives us happiness 2/epsilon. Goodoutcome occurs with probability 2^(-i)epsilon and gives us happiness 2^(i)/epsilon

So expected happiness if we take the bet is (1-epsilon)(a very large negative number) + the sum from one to infinity of 1. That is infinite expected happiness.

We don’t make such bets. What if epsilon = 1/google that is 10^(-100) ? 10^100 is the original meaning of the word “google”. The company chose the word for that number exactly as the Apple corporation chose the name of a fruit.
what if epsilon = 1/(google plex)= 10^(-google) = 10^(-10^100). or one over a google plex plex and so on.

Similarly, we are not rational utility maximizers capable of infinite misery. For any X>0 no matter how huge and any epsilon >0 no matter how tiny, we would accept happiness of -X with certainty rather than + X with probability 1-epsilon and a series of increasingly horrible outcomes
getting -2/epsilon with probability epsilon/2 and -2^i/epsilon with probability 2^(-i) so if we didn’t take -X with certainty our expected welfare is minus infinity.

Again epsilon can be so low that if something happened with probability epsilon every millisecond, the chance that it has happened since the big bang is 1/(google plex). I guess I should call the second paradox the Mollgaard paradox, but I want to call it the Leningrad paradox, because Leningrad is St Petersburg and because the limits of human misery were well explored by the Stalinist purge of Leningrad followed soon after by the Nazi (and Finnish) seige of Leningrad. We are talking about two of the most massive losses of human life ever (and much slow death by borderline fatal malnutrition become fatal after long suffering). But it would be worth a 1/google plex risk of that happening again even if there were a series of risks of it happening once, twice, four times etc.

This has been another explanation of why the concept of infinity is pernicious following in the tradition of Zeno’s paradox but never reaching the end of the list of errors due to the concept of infinity (which list is infinite). Borges tried to catalogue them (he does that sort of thing) in “Avatars of the Tortoise.”

There is a concept which corrupts and upsets all others. I refer not to Evil, whose limited realm is that of ethics; I refer to the infinite.

Oh my look at the second google hit for [avatars of the tortoise]

I think it is also not needed. But I am confident with probability epsilon (not a type not 1-epsilon) that every counterintuitive result in mathematics has something to do with infinity and could not be explained if instead of natural numbers we started with the cyclical group with N elements (no matter how big N is) and then went on to define rational and real numbers as we do.

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Is Stephen Moore a Gold Bug?

Is Stephen Moore a Gold Bug?

A lot of the criticisms of putting the twin village idiots known as Herman Cain and Stephen Moore on the FED assert that they are gold bugs. Kate Riga watched CNN when Erin Burnett interviewed Stephen Moore on this allegation:

Stephen Moore tries to flip-flop on the gold standard — but Erin Burnett is prepared and armed with a montage of his past statements

Watch and enjoy! Now Moore did say he would prefer targeting an index of commodity prices, which led me to FRED and its Global Price Index of All Commodities. Moore has not be all that specific how his commodity price target would work but let’s speculate his index would be a lot like this one. Suppose the FED targeted commodity prices to be where they were in 2005 since this index is based where it would equal 100 in 2005. Just imagine how a Moore monetary policy would have worked say during the booming 1990’s. Commodity prices were low so his policy prescription would have been massively expansionary during a booming economy. For much of the period from 2007 to 2014, we would have had a contractionary monetary policy even as U.S. aggregate demand was often incredibly weak. In other words, his commodity price based monetary policy would be about as destabilizing as was monetary policy under the gold standard.

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