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Belmont Club

Monthly Archives: July 2009

And where does the power come from, to see the race to its end? From within. Jesus said, “Behold, the Kingdom of God is within you. If with all your hearts, you truly seek me, you shall ever surely find me.” If you commit yourself to the love of Christ, then that is how you run a straight race.

Chariots of Fire

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The endless ride

July 31st, 2009 - 12:47 pm

Two news items underline the fundamental problem of the administration. The first is a story from Bloomberg reporting that the Department of Commerce now believes that the first 12 months of the recession was twice as bad as previously estimated. The article says the real steepness from the period beginning in December, 2007 sheds light on why the Fed cut interest rates so drastically, and why unemployment had declined so precipitously. It also says that the recession of 2001 was not nearly so bad as was believed. In other words, GWB was handed a better economy than thought and Barack Obama drove away from the lot thinking a paint job would set things right when all along the chassis was cracked in half a dozen places. A lunch at the White House is related, in a narrative sense, to the new story of how bad things were — or are. The Politico says that CEOs invited to lunch at the White House were billed for the meals. It’s an act without much potential to reduce to Federal deficit, but one with considerable power to communicate. We’ve gone from expectantly waiting for “green shoots” to “brother, can you spare a dime?”

Taken together the two items collectively characterize the difficulty: what, beside more symbolism, can the Obama White House do to fix the troubled economy? Maybe there’s nothing more he can do. But if he’s out of “dos” maybe he can start on “don’ts”. If government is at least partly the cause of the current problems, then high on the list of solutions would be negative actions like “don’t the feed the bubble” which started the problem in the first place; and don’t manufacture a new bubble to take the place of the old one.

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The House of the Rising Sun

July 30th, 2009 - 3:47 am

Forbes and the Washington Post both describe the disastrous Massachusetts health care system — with which the Obama care models share similarities — and the post begins with a warning from the Commonwealth’s treasurer.

Some have asked, as national healthcare reform works its way through Congress, is there anything we can learn from the Massachusetts experiment? Yes, according to the state’s treasurer, interviewed today on CNBC: Whatever you do, don’t do what we did. In a blisteringly frank interview, treasurer Tim Cahill laid out some jaw-dropping stats, which eviscerated the plan and excited every conservative’s worst fears about government getting further into the health insurance business:

– The program has so far cost 30 percent more than anticipated.
– It already has a $9 billion shortfall projected over the next two years.
– Costs have risen 41 percent since the program’s inception, well outpacing the rise in healthcare costs nationwide, which stands at 18 percent.
– We thought this program would mean fewer people would go to hospitals, which is the highest cost any insurance plan has to pay. In fact, fewer people are not going to hospitals.
– A Harvard study shows 60 percent of state residents are unhappy with the plan. The most unhappy? Those whom it should be helping the most — those making $25,000 to $50,000 per year.
– To cut costs, the program is now having to kick out legal immigrants.

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The one and the many

July 30th, 2009 - 3:15 am

If you were in the business of detecting original data, which would you rather have? An array of 10,000 independently reporting, but cheap sensors sending a raw signal or one very expensive sensor that decides whether or not an event had occurred? Dan Rather argued that the White House should create a commission to find ways to save the struggling journalistic profession, according to the Aspen Daily News.

“I personally encourage the president to establish a White House commission on public media,” the legendary newsman said. … “A truly free and independent press is the red beating heart of democracy and freedom … This is not something just for journalists to be concerned about, and the loss of jobs and the loss of newspapers, and the diminution of the American press’ traditional role of being the watchdog on power. This is something every citizen should be concerned about.”

Speaking at the Aspen Institute, Dan Rather expressed his concerns about online blogging, which he believed could never replace the “craft” of journalism which was reeling under the triple whammies of “corporatization, politicization, and trivialization” and in “free fall”. “On the Internet, nobody wants censorship … just put anything out there with no accountability.”

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The constipation of power

July 29th, 2009 - 8:33 am

Mark Steyn describes the problem of understanding the gargantuan bills that come before Congress. In the NRO he says,

Thousand-page bills, unread and indeed unwritten at the time of passage, are the death of representative government. They also provide a clue as to why, in a country this large, national government should be minimal and constrained. Even if you doubled or trebled the size of the legislature, the Conyers conundrum would still hold: No individual can read these bills and understand what he’s voting on. That’s why the bulk of these responsibilities should be left to states and subsidiary jurisdictions, which can legislate on such matters at readable length and in comprehensible language. As for optimum bill size, the 1773 Tea Act, which provoked the Boston Tea Party, was 2,263 words. That sounds about right.

The information required to describe a system is proportional to the complexity of the undertaking. While the design for a rowboat can be set down on a single sheet of paper, describing the battleship New Jersey required a 175 tons of blueprints “equaling a single strip of paper 30 inches wide and 1,100 miles long”. The only way Mark Steyn’s vision of brevity can be attained is either for Congress to restrict its lawmaking to high level specifications or to construct systems incrementally. Any legislation which hopes to come in under 3,000 words must be either a framework document or an implementing rule within a given framework. But any attempt to comprehensively build a complex edifice — like health care — will almost by definition generate documents as voluminous as the battleship New Jersey blueprints.

So why can’t Congress work at a general level of specification and incrementally after that? After all, that is how many complex systems are designed.

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Shoot the hostage

July 28th, 2009 - 4:19 pm

Scott Carney of Wired asks a Somali pirate when they deem it advisable to ransom or kill sailors they capture off their coasts. Here are the highlights of the conversation.

  • No one will come to the rescue of a third-world ship with an Indian or African crew, so we release them immediately. But if the ship is from Western country or with valuable cargo like oil, weapons or then its like winning a lottery jackpot. …
  • Often we know about a ship’s cargo, owners and port of origin before we even board it. … The financiers are the most important since they organize and plan the big shot operations and are able to pay running cost[s]. Financiers always need to forge deals with traders, land cruiser owners, translators, business people to keep the supplies flowing during operations and manage the logistics. There is a long supply chain involved in every hijacking.
  • Hostages — especially Westerners — are our only assets, so we try our best to avoid killing them. It only comes to that if they refuse to contact the ship’s owners or agencies. Or if they attack us and we need to defend ourselves.

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Conversations

July 28th, 2009 - 6:54 am

Mulberry BushABC News describes the beer sitdown between Cambridge Police Sergeant James Crowley and Professor Henry Louis Gates to discuss differences between them as “Frothy Diplomacy”. Describing the froth is the easy part. Gates will have Red Stripe or Beck’s.” Crowley is drinking Blue Moon.  The “diplomacy” component is more problematic. The fundamental problem in diplomacy is “who’s talking to whom?” It traditionally connotes a dialogue between two nations.  The problem is, what are the two nations? Black and White? Town and Gown? Or elite and working class? Just as with the beers, there’s a wide selection on offer.

The coming White House meeting would be incomprehensible unless somehow each of the beer drinkers was emblematic of some point of view or there would be no point to the meeting. The saddest commentary on the state of public discourse is that it while would be completely inappropriate to even speculate on what those banners might be, its easy enough to take a guess: a cop’s pride, a black academic’s deeply rooted fears, the President’s interest in what he has already purportedly transcended. It’s a teaching moment in which the blackboard has been left blank, where the entire curriculum is typed between the lines, where everything often is.  The message is in the drama; the sound is off, but that’s OK. Everybody knows the lines.

“Today is the day to move forward,” City Manager Robert Healy said at a news conference. … The committee, led by “nationally recognized experts,” will not investigate the arrest of Gates, nor will it “make any judgments” on the officers involved, Healy said. The committee “will identify lessons to be taken from the circumstances surrounding the incident” and will advise the police department on how “those lessons can be applied” to its policies and practices.

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Without borders

July 27th, 2009 - 12:56 am

The Belmont Club has a fatal flaw. It is trapped in the dimension of ideas. Within its pages a dozen possibilities struggle to escape. Few will succeed. One of the weaknesses of the blog as a platform is the difficulty of going from ideas to persons, to making the jump from the abstract to the concrete. The post-and-comment format is a good way of starting a discussion; it is even useful for achieving a consensus. But post-and-comment lacks support for creating organizations. It can’t even arrange for a meeting between a few people. For example, L3 is trying to organize a small get together in the Houston area and sends this message:

I am [L3 is] organizing a little informal get together in Houston for any BCers who are interested in some social cheer. If you would like to participate, please sign up to follow this Twitter account:

http://twitter.com/BCinHouston

Time and location are TBD, but by signing up to follow this account, you will be notified of the details when they emerge.

But there’s no direct way in WordPress to sign up, see who else is going or query the organizer without going through the cumbersome rigamarole of post and comment.  It doesn’t help if your blog gets bigger. Ironically, the more heavily trafficked a site is, the more restrictive the blog format becomes for arranging any kind of concerted activity. Comment threads on this site are often fifty items or more in length and tracking a conversation interspersed among the many asides and discussions involves a lot of scrolling up and down.

To overcome this problem, developers have created “social networking” platforms, of which Facebook or Ning are some of the best known. Wikipedia describes social networking software as a service that “focuses on building online communities of people who share interests and/or activities, or who are interested in exploring the interests and activities of others. Most social network services are web based and provide a variety of ways for users to interact, such as e-mail and instant messaging services.”  The role that different Internet-based vehicles plays in modern life was illustrated by events in Burma, Iran and China. Arguably, the “Tea Party” movement depends critically on the Internet for its existence. But the Tea Party events themselves probably required a lot of telephone calls, email exchanges, SMS messages and Facebook Wall scribbles to arrange.

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Flatland

July 25th, 2009 - 5:03 pm

Nina Munk at Vanity Fair describes how Harvard spent itself into a hole by imagining that its burgeoning endowment would continue to rise forever. Banking on an ever-rising bubble, Munk lays out how the administrator’s multi-billion dollar plans to recreate Florence in Allston (across the river) became a reproachful, possibly unfunded hole in the ground staring back at its visionaries, who must now, horror of horrors, install coffee and candy machines where once there were leafy cafes, if they are to pull back from the yawning financial grave. Yet it is the inadequacy of the “realignment”, the inability to take the steps which might save Harvard if it comes at the cost of alienating sacred cows that is the most sobering. One is reminded of why history is so tragic. It is because nothing is so impossible to undertake as the obvious.

The fascination of the Vanity Fair article is that it can be read as a parable. If the Titanic was a model of the Edwardian Age, then Harry Widener’s academic descendants have found themselves on another sinking ship of sorts. The fate of Harvard’s endowment closely tracked the nation’s own financial bubble. Here, acted out in microcosm by the Charles were the very follies that were taking place on a national scale. Even the names in the drama were shared, Larry Summers being but one. But there is no sense, in Munk’s article, of being on the Carpathia the night after the iceberg was struck. There is no feeling of relief; instead there is the sense that by the effect of some hideous dimensional machine, the survivors of the microcosmic disaster have been promoted to a higher order world and are fated to repeat with the inevitability of a Greek tragedy their voyage toward yet another mountain of ice on another dark sea.


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Getting better

July 25th, 2009 - 4:37 pm

Bala Ambati, who is an MD, takes a sober and well reasoned look at the healthcare debate on his site, Daylight’s Mark. He breaks out who has health care coverage; why or why not; where the potential cost savings are; where the ripoffs may be located and finally lists out the measures which, in his opinion, can really make health care system better.

Now, how would I go about deciding what to cut and how to save money and “bend the future cost curve”? I would rate behaviors & services on a scale of evil (which for this discussion I define as greed:utility ratio). So things that I’d like to see happen that I think would curb costs without degrading current or future quality of care would be:

1. Significant tort reform…

2. Assigning the cost burden of unnecessary or likely futile services to patients or their families . Eliminating television and direct to consumer pharmaceutical marketing (which all started only in the late 1990s) (drug company marketing is now about $57.5 billion annually, according to a PLOS study by Gagnon & Lexchin in 2008, which nearly equals the $58.8 billion spent in R&D by the drug industry. This would help reduce costs by allowing physicians breathing room to recommend older yet equally effective medications to their patients.

3. Breaking the oligopolies of health insurance coverage present in many states & regions. … Government could do a great service by jumpstarting the infrastructure to create such a true free market but it should not take over such a market.

4. Encouraging charity care: Lawyers can treat pro bono work as a tax deduction; hospitals treat charitable services (which are often overcharged in the first place) as a tax write-off and get income tax exemption for being nonprofits. Physicians currently have no such benefit.

5. Cost Transparency: … Patients are charged wildly different amounts, and quite often indigent patients get stuck with full charges while Medicare or large insurance company patients get charged much less due to contractual arrangements. This process is just insane…
6. Encourage innovation: Increasing tax credits for R&D, establishing prizes for translating discovery for big problems, and extending patent protection for new molecular entities while limiting patent extension for me-too drugs maneuvers turning Prozac into Sarafem or Wellbutrin into Zyban, would promote advances in drug and device development and maintain America’s edge in science & technology.

Here’s his take on what is good and bad in the health care proposals.
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