Why? Because I am NOT an anti-science zealous denier.
Here’s what I want those who also think they are steeped in sciency-goodness to do:
(1) Explain the known health risks of drinking sugary beverages. This includes how much we know (and we know, I’ve read the “science”) about how much soda contributes to BMI, this includes showing us how much a huge tax (e.g. 100%) on soda would reduce BMI, this includes how much eliminating soda entirely changes BMI and other behavior and of course this includes showing all of us just how much these all translate into disease incidence later in life and the costs of those diseases. This is all necessary of we are being sciency-good.
(2) Explain then, where soda risks rank in the larger panoply of risks. I want to see risks it puts on you becoming obese as well as disease risk and mortality risk, and how soda feeds into those. For example, I’d like to see how car accidents rate, how suicides rate, how gun accidents rate, how pneumonia rates, and so on, and where exactly soda falls. We are being sciency-good, so of course this is necessary.
(3) Explain then, what the common risks we regularly face are – from walking across the street, to smoking marijuana, to drinking beer, to tanning at the beach, to eating ice cream, to playing baseball, to going skiing, and I want to see where soda drinking falls.
(4) Then, I want to see a scientific explanation for why things that are more risky are not banned or limited and why things that are even more safe sometimes are banned.
(5) I want to ban anything and everything that is more risky and more costly to the medical sector and more likely to cause disease than drinking soda.
All in the name of sciency-goodness.
When most people think of “corporations” I am pretty sure they have in mind places like Exxon and Disney and Merck and the like. At the same time, when most people think of corporations they get somewhat of an icky feeling – either because of the bureaucratic corporate nonsense that they imagine when sitting in a cube, or mostly because of the idea that corporations are somehow evil or run the world. That view is especially popular on campus. Indeed, my newly entering freshmen seem to uniformly believe, as a matter of faith, that corporations rule the country and are evil.
But stop for a moment and think about this.
Most corporations that these folks would name for you, absent the horrible likes of Charlie and David K., are publicly traded. This means that every single American has an equal chance of being an owner of a corporation. Indeed, many Americans own pieces of lots and lots of corporations and are not much aware of it. You are, by ANY way you define it, a capitalist. Most anti-capitalists are in fact capitalists. And you only need a few bucks, a bank account and web access to become one. In these corporations, the shareholders all have equal say (mostly) in voting for boards of directors and thereby directing corporate policy. It is truly democracy in action (oh, you say, but some people have more shares than others – this does not prevent groups of you, say, in the form of socially conscious mutual funds, from buying enough shares) – and if folks wish to say corporations are running the country and are influencing the country and “we need to take our country back” from the corporations and return it to the people, what, exactly could this mean?
Take the country back FROM ourselves and give it TO ourselves? It can mean no other.
And even in the case where you think “the people” DON”T have a “democratic influence” on the corporations they own, you’d be wrong to suggest that it’s still not “the People” that run the show. Even the most greedy capitalistic privately held corporation is at the mercy of consumers. Consumers small and large, with all kinds of preferences, drive the bus – the corporations are merely figuring out how to get you where you want to go. Soda companies are rich because “the people” love fizzy caffeine drinks. Apple is rich because “the people” love snazzy electronic devices. Walmart is rich because “YOU, the people” want inexpensive necessities. And so on. So even if you want to “take back America” from the corporations, I can’t really understand that this can mean anything other than, “take back America from the people and give it to the people.”
Astute readers of course know this, and will also understand that when you hear something like, “give it to the people” you should really insert “give it to SOME people whom we happen to like better than ALL or SOME other people.” But that’s not polite to utter publicly. Have a nice weekend, I’ll be seeing the stars on Wright Peak, then over to Algonquin, Iroquois, a long drop down to Lake Colden then up and over Colden. And if any energy is left after that, hopefully a run up Mt. Jo to get a picture of the entire span of that jaunt.
I think that when people approach you, particularly unsolicited, and ask questions AND demand answers, that is as close to bullying as you can get without actually bullying. Is it? Once you are put in an awkward position of dealing with a question that you’d prefer not to speak about, no matter how you respond (unless you are a lot more clever than I am) your response is indicative of something that perhaps you didn’t want to reveal.
Now, personally, I used to just say, “deal with it” when I am put in that situation, but I find myself increasingly in this position. In fact, what is most awkward is that I can’t actually go farther than this point before someone will be offended, or misinterpret what I want to say, and so on. Lest I am not clear, there are some times when folks simply do not wish to engage, do not want to share their opinion, do not want to be part of the conversation. And just as people find it unseemly when folks are uninvited and interject themselves into a situation, it seems no different to be dragged into it.
But I am finding myself in that position more and more these days – in a position to either have to lie (which really doesn’t feel all that gratifying or is really not that polite), or be made to say something that I don’t want to say.
Does this happen often to you? Or am I such a raging jerk to people that I can’t help but put myself in a position to be put into that position more than most people?
No new ground broken here, but I just read a news story about the rise of people who refuse to have vaccines administered to their children. Strangely, the families that appear to be most likely to refuse vaccines are the most educated among us, and not like you might suspect, the least educated. The vaccine issue is packed with the same problems that plague economic and environmental questions elsewhere. We have a group of people who seem to disregard the overwhelming evidence that vaccines are safe. But we also have this same group of people who wish to make choices for themselves regarding what to do with their own children. However, muddying these waters is the fact, yes fact, that THEIR decision to not vaccinate their children does indeed increase the risks of disease and the associated costs of those diseases, to everyone else.
So, what we have is a pretty interesting uptick in the prevalence of whooping cough, mumps and other stuff you may have never heard of because we eradicated the stuff decades ago. I am not going to analyze or moralize, but merely ask what is different about whooping cough than climate change? I think people on all sides of the climate change question, interestingly, can pick an angle to this story that suits their bias. On the “climate change won’t kill us” side of things, you can easily point out that all of the vaccine scare stories that were conjured up by the media and a few fringe people who post wildly on the internet, were of course ridiculous. There is simply no credible evidence that vaccines are causing cancers, autism or any of the horrible things that people claim. And indeed, this is indeed the way the Acid Rain story, the Superfund stories, the “bees and butterflies will disappear” stories, the “we’re running out of resources” stories have proceeded in the past. On the other hand, I am sure that people who sincerely believe that climate change is going to kill us will point to the “overwhelming scientific consensus” on vaccines being “denied” by some fringe wackos.
Given my biases of course, I think the “denier” angle here is most interesting. The same people who are “denying” vaccines’ effectiveness and harmlessness (relative) are from the highly educated group that argues from authority about the “science” of global warming. So it’s fun to see things line up this way. And from a macro-enviro-health perspective, from the numbers I see being tossed around at the number of diseases spreading because of the refusal of vaccines and the number of related deaths, we are talking about a health problem larger than any health problems caused by a warming planet, despite what you hear in the news.
What is even more interesting is that we see these health problems escalate despite us knowing very clearly how to handle them, and being able to handle them for pennies, not trillions of dollars.
Yet we can’t get vaccine policy right. We can’t get people to cooperate on this hugely important public health initiative that is far more important than anything global warming will bring. Where are the marches on NYC on this? And what stuff are you smoking if you think anything serious can be done about CO2. If, and when, CO2 stuff ends up happening, it is going to be despite us, not because of us. And I would want to begin making an argument that were in not, now, for two and a half decades of climate change worries and policies attempting to do something about it, we’d be further along toward decarbonizing than we are today. But that’s for another day.
Heading out into the woods again, hope the bears don’t eat me. I mean that quite literally.
Sep 23rd, 2014 by wintercow20
Sep 22nd, 2014 by wintercow20
In my inbox this morning is this working paper:
Should Hospitals Keep Their Patients Longer? The Role of
Inpatient and Outpatient Care in Reducing Readmissions
by Ann P. Bartel, Carri W. Chan, Song-Hee (Hailey) Kim - #20499 (HC HE PE)
Twenty percent of Medicare patients are readmitted to the hospital within 30 days of discharge, resulting in substantial costs to the U.S. government. As part of the 2010 Affordable Care Act, the Hospital Readmissions Reduction Program financially penalizes
hospitals with higher than expected readmissions. Utilizing data on the over 6.6 million Medicare patients treated between 2008 and 2011, we estimate the reductions in readmission and mortality rates of an inpatient intervention (keeping patients in the hospital for an extra day) versus providing outpatient interventions. We find that for heart failure patients, the inpatient and outpatient interventions have practically identical impact on reducing readmissions. For heart attack and pneumonia patients, keeping patients for one more day can potentially save 5 to 6 times as many lives over outpatient programs. Moreover, we find that even if the outpatient programs were cost-free, incurring the additional costs of an extra day may be a more cost-effective option to save lives. While some outpatient programs can be very effective at reducing hospital readmissions, we find that inpatient interventions can be just as, if not more, effective.
Now, I don’t know them, but most economists I am familiar with attend seminars, teach classes, etc. from the comforts of their own office or at some hotel. But when I see findings like, “if heart patients stayed in the hospital for one more day as compared to sending them home, outcomes would improve,” I get weak hearted. First this is bad economics. Unless these are dynamic general equilibrium models, there is no way to figure out if in fact these partial equilibrium results hold. Why? Have we asked what happens to the other patients when patients who were released are staying in the hospital one more day? Now, you might say, “they come back anyway, so this doesn’t matter,” but it does. When a patient is released, they are in less immediate danger than those coming out of surgery and other emergency situations. So keeping these folks for an extra day, even if medically necessary for them, may not be medically optimal “for all.” Second, and my family would have very good reason to appreciate this, is that it’s not just as simple as “keeping patients for another day” on various hospital flaws. We all talk about medicine as if there are an endless stream of doctors, mid-level providers,, nurses, care coordinators, cleaning staff, etc. But there are not. And a little birdie tells me that our recovery units and other critical care units are already swamped with patients, very likely understaffed by professionals at all levels, and generally pretty intense places to be. It’s not like there are lots of empty beds and equipment sitting there readily available for patients – there is a reason patients are sent home, the hospitals need the space. There are lots of important details I am not permitted to share, but needless to say (I hope) if but rest assured there are a host of other bad incentives running around our hospitals, and these researchers are now ignoring any and all of those things when concluding, “just keep folks in the hospital for another day” and wholly disregarding whether surgeries are necessary, whether the extra people can be cared for reasonably well, and more.
This problem is not simply the province of this paper, but a good number of new ones I come across.
Like many parents, last week I was able to attend the opening meetings at our childrens’ school which included a brief “ra ra” assembly with the Principal and then we go to the classrooms to meet the teachers and listen to their shpiel on how they will educate our kids and how lucky they are to have our kids and so on. I didn’t register much of it – after the first bit of ra ra on how our school fares on standardized tests (I don’t care) and more ra ra on the new goodies bought in each classroom like smart boards (I don’t care), we finally got to something I DO care very much about. The Class Rules. Here is why I send my kids where they go now:
3rd Grade Class Rules
- Treat others as you would wish to be treated
- Respect others
- Be responsible for yourself
- Be kind
- Be honest
- Be fair
In any event, I think it is in 3rd grade that the actual indoctrination of children begins. In their “social studies” unit they are learning all about communities this year, I’ll share tidbits with you as it comes in. And the science done by third graders is a mix of life science and earth science – but with very little actual physical science (a shortcoming of all science education in my view is that this is not done early or often or deeply enough) and a nice big chunky section on climate. I don’t remember having climate taught to me in third grade. Or fourth. Or really much, ever. For fun, I am going to ask my child to write a paper for her science project comparing all of the deaths worldwide due to easily preventable causes like infectious diseases caused by poverty as compared to all of the deaths due to climate, and we will be generous and assume any death caused in anything remotely weather related can be attributed entire to the burning of fossil fuels.
Finally, our school does not do normal grading like when I was in school. I distinctly remember getting letter grades (A, B, C, D, and F) as early as first grade. Now, even in third grade, we get “Beyond Mastery” or “Mastery” or “Developing Mastery” or “Not Meeting Standards.”
At least I admit it.
So I’ve heard people with a professed Keynesian bent argue that we should end the idea of “tax cuts for the rich.” Fine, I suppose. But I’ve even heard this uttered during recessions, including the time from 2007 right up through today. I am not making this up so far, am I? OK, isn’t a primary objective of Keynesian economics that we should conduct countercyclical economic policy to cool down expansions and get the wheels turning again during recessions? So, while Keynesians might prefer additional government borrowing and spending for a variety of reasons (go check the empirical literature on this question by the way, you’ll be fascinated), tax cuts would also serve as stimulus when times are bad and tax increases as ways to cool things down during boom times.
Given this general idea, how is it plausible that Keynesians argue against “Tax Cuts for the Rich?” I can’t see it. It is argued that we should instead direct tax cuts to the poor. I can see why of course – you can argue that they have a greater propensity to consume newly granted income than the rich. But on economic grounds that’s shaky to begin with – do rich people EAT their tax cuts? If they stick it in the bank, then instead of consumers spending it, it ends up being spent by folks in need of excess loanable funds … in other words it just ends up as I instead of C in the fancy macro equations.
So, while it might reasonably be argued that tax cuts nicely targeted at the poor would be better there is not really a leg to stand on to oppose tax cuts to anyone in times of recession. Or is the primary objective actually NOT to fight recessions, but rather to use recessions to enact policies you otherwise couldn’t get accomplished.
Two final points that I think I’ve made long ago here.
(1) The fact that I’ve never heard a Keynesian vociferously argue, or write a heated OpEd, arguing that “now the economy is ON FIRE!” And it’s high time we slashed the government budget deficit to cool things down a bit, tells me of course they we’re arguing from an identity, not a principled theory.
(2) People smarter than me have correctly pointed out that there is no such actual economic theory called “trickle down economics.” I’ve never seen it in any economics book that was used to teach me, nor did I even see the term “supply side economics” used. It’s a straw man term invoked politically, not by actual real, living, breathing economics people. Nonetheless, it is used as a term of ridicule even to this day. But suppose we accept the ridicule, and accept it proudly. Then what dear reader, exactly, is Keynesian economic stimulus? Give some tax cuts to people or have the government spend a lot of money and they spending will “trickle down” to everyone else. This is particularly the case of stimulus spending, when it is most certainly not targeted well at lower income people.