Monday, July 30, 2012

Runaway Determinism

A common thing heard nowadays is that something was "a failure in leadership."  Such lamentations are often accompanied by "needing to take responsibility" or "needing to take ownership."  While I too don't like it when bad things happen, I take a rather dismal view to those wanting to attribute responsibility everywhere, everywhere except with the actual perpetrator.  Add to that a zero toleration policy for everyone else's actions but your own and you end up with less actual accountability.  Accountability is a necessary thing, but people should only be accountable for things they have control.  Even then, a liberal birth should be granted so that defensible actions are not treated as incompetence.

A lot of this has seemed to have come from a die-hard determinism.  Determinists tend not to think that there are unknowns.  They just believe there are things you didn't have the will to figure out.  They take it as gospel that if one tiny detail were changed in the past, an outcome today would have been totally prevented.  Perhaps I wasn't as exposed to the same science fiction as these folks growing up, but that is the exact opposite of my own experience.  My experience has been that exceptional events are indeed exceptional.  My experience has been that quickness to presume has not led to insight but rather to rash judgement.  Perhaps I have simply acquired a more refined empathetic spirit, but I have great difficulty holding people to my level of judgement, let alone to a level impossible for even me to achieve.  At the same time, I don't have near the trouble condemning people engaged in actual wrongful behavior as others seem to do.

Monday, July 23, 2012


Rarely do I recycle comments I leave elsewhere.  This comment however pretty much sums things up:
PSU [Penn State University] got what they paid for. Heaven forbid one of these reports ever just say people did what they thought was best with the information they had. Instead we have to pretend that PSU could have prevented child abuse, a rather absurd idea in practice as opposed to the mere ideal of wanting to prevent it. These reports [a reference to the Freeh Report] are necessary though, because they signal we have overcome our past sins, a baptism if you will. Perhaps PSU can even put up signs signaling that they are a pedophilia free zone so as to really emphasize how far they have come. It is all nonsense, but that is social panic for you.
Now the university has chosen to remove the statute erected in Paterno's honor. It unfortunately perpetuates this belief Joe Paterno was instrumental in Sandusky's sexual abuse of boys.  Paterno of course admitted a desire to have done more had he known more, as would all of us.  That isn't enough for the people posing for holy pictures.

With Paterno, everything is evidence of his complicity.  If Paterno talks to school officials and follows up with them, it is evidence that he is trying to cover up the matter.  If Paterno leaves other officials to do their work after reporting his conversation, it is evidence of his callous disregard for the victims.  One of the cases end up in the local prosecutor's lap and he declines prosecution, yet Paterno gets to be the one who clearly didn't exercise his power - whatever that power was off the field - prudently.  His choices for whatever reason are the lynch pin in this whole saga.

One of the more disturbing things about the present generation in power is their callousness to truth and principle.  It is a generation that cares solely about outcome and only the immediate outcome at that.  Their actions will invariably result in more sexual abuse cases being covered up.  The first reason is that the person they know is always the exception to their outcome based philosophy, e.g. the welfare queen is always someone a person doesn't know.  Therefore they will be hesitant to see the perpetrator face the full wrath for what they will invariably consider a misunderstanding or mistake.  The second reason is that people of action have a tendency to get into trouble whereas people who keep their mouth shut don't.  McQueary's life would be a thousand times better today if he hadn't confessed to seeing what he saw in that locker room.  This case has reinforced that.

Friday, July 20, 2012

On Guns Briefly

Before this massive shooting, I had basically resolved myself to the position that we should examine disarming the police.  Specifically, I thought a large caliber rifle for the squad car, even a high capacity one, should be sufficient.  By removing hand guns, my belief was that police officers would be less reluctant to place themselves in situations where one would be necessary.  This is turn would make the police less confrontational.  Time would solve more issues..

With the shooting in Colorado, the debate about guns has begun again.  I tend to be ambivalent on the topic.  I think supporters of gun control tend to be correct that guns are antisocial, and I think they are correct in their constitutional interpretation that guns are a corporate rather than individual right, despite claims by the Supreme Court otherwise.  I also think opponents of gun control tend to be correct that gun control laws have their most pronounced affect on the law abiding.  However, I'm coming around to the belief that prior efforts toward gun control were sabotaged.  I'm coming around to the belief that success can be had if it is willed.

Wednesday, July 11, 2012


The power of politics is in the power of organization.  Politics in America is fairly weak right now due to the combination of democracy and cheap information.  The first problem is simply that there aren't a whole lot of minority interests not being addressed.  People tend to organize when it is necessary, and if they are generally happy or believe that their concerns are merely idiosyncratic, they aren't going to feel the need to do so.  Cheap information has allowed political leaders to become very attuned to their chosen constituencies.  Rare is the politician who makes a large unforced error in policy nowadays.

Oddly enough the cheap information age has brought with it a decline in the quality of information from policy organs.  Sister Walsh, spokeswoman for the USCCB, sounds and acts like a right wing shill when she mindlessly repeats talking points of dubious veracity.  Admittedly the only people who follow USCCB statements are people who have already made up their minds on policy questions.  There is no persuasion taking place.  I could cynically describe it as a paint by numbers thing to appeal to six figure and above donors.  The paint by numbers thing is simply having the ability to show the USCCB worked on the donor's pet issue.  To go on a tangent, that reminds me that it is increasingly apparent that a lot of these umbrella organizations are not for the benefit of their members but are little more than vehicles for connecting professionals to large donors.  Is there really any doubt that the USCCB's pro-life office is controlled by donors?

Monday, July 9, 2012

Health Care

While my experience in health care has become dated, I will hazard some opinions on myths and solutions to health care in the United States.

1)  The US needs more clinics.  Yes and but mostly no.  While it is true that one shouldn't have to go to a grocery store to get a loaf bread, the cheapest avenue for providing bread will be through grocery stores.  What small dispenseries like gas stations do is allow for people of greater means to purchase either a higher valued substitute good or a better experience.  While in the case of bread, there are places outside of grocery stores where you can get cheap bread, convenience stores aren't the place to organize the wide distribution of cheap food.  So MRI systems at the clinic level likely aren't saving a whole lot of money system wide.  They are however a convenience and are likely utilitized for more marginal cases.

As for the yes part of the answer, there is gross underutilization in the poor community with a dearth of clinics.  Rather than fee for service, the better model seems to be salaried professionals at the clinician level.

2)  Hospitals are expensive.  They are, but that seems to be an outcome of prior choices.  A lot of clinician work and hospice care used to be done at hospitals.  Taking out the bottom has made the top more expensive.  (The $100 aspirins are a billing choice, much like the old $60 dealer oil change.)  The other change is the proliferation of 6-figure administrators.  Despite television advertisements protesting otherwise, it doesn't seem that the 'hospital' adds much to the health care experience, so one should question the value of all the 6-figure administrators.  (Particualarly galling is the demand for volunteers at hospitals among this excess.)  Then there are the doctors themselves who enjoy large incomes and a disproportionate number of professional protections, albeit protections not as rich in other countries.  Those countries demand doctors receive less pay for those protections.  If this money were adding value, it would be another issue.  There is little evidence for this.  The quality of care in this country seems to be actually divergent.  The cause of this seems to be the relatively weaker oversight of doctors.  Doctors are most accountable to the insurance industry, and the protection for them there is to simply paint by numbers.  Hospitals often fear the doctors more than the doctors fear the hospitals.

3)  Insurance as a huge problem is a myth.  It is only a funding mechanism.  Asking it to control costs is something it is not equipped to do.  They are too distant from cost centers and lack ability to induce providers to find efficiencies.  While I don't think insurance as presently constituted is the best funding model for health care, it is too broad of a brush to claim that wiping it out would significantly lower costs.