Genetically modified food was declared too safe to label years ago. Greenpeace has been fighting to have Monsanto’s original data released. Their RoundUp resistant crops (“RoundUp Ready” in adspeak) and Bt corn are a large majority of GM crops worldwide. Monsanto lost some legal cases, the data finally became available, and have now been reanalyzed. (Via Slashdot)

The bottom line? You don’t have to stop eating, but it is time to get really, really, really mad.

(Background info for those who’d like it: Monsanto produces RoundUp, a glyphosate-based herbicide. That interferes with plant growth via a pathway not present in animals, although some of the significant molecules in the pathway are also vital in animals. Monsanto also produces the patented crop seeds that resist the herbicide. Then farmers can use more RoundUp to get rid of the increasingly resistant weeds without also killing their crop. In some places, resistant weeds make it unprofitable to grow anything except the patented seeds. RoundUp is widely used on corn and soybeans. Bt corn enables the plant itself to produce a substance toxic to many insect larvae by an insect-specific pathway that doesn’t affect mammals.)

Way back in another lifetime (the 1990s feel like ancient history for some reason) there was widespread concern about the rapid proliferation of GM food. Frankenfoods they were called. In the tabloid concept, these mutant monsters would infect us with extra heads or glowing green tumors. Those concerns were easy to laugh at, and they were. It was gently pointed out that humans are not plants. Dissidents, including me, have said for a while that there are real concerns, but the money was all on the other side. Oddly enough for such an open and shut case, Monsanto was adamant that nobody could see the data that proved how safe it all was.

Now that data is out there. The most charitable view is that they were so convinced of the safety they didn’t feel the need to make sure of it. The uncharitable view is that they cherrypicked the facts to reach the foregone conclusion. I’ll let the article speak for itself. (Numbers in square brackets refer to their references, which are linked in the original article.)

The three animal feeding studies were conducted in two different laboratories and at two different dates; at Monsanto (Missouri, USA) for NK 603 and MON 810 (June 7, 2000) and at Covance Laboratories Inc. (Virginia, USA) for MON 863 (March 14, 2001) on behalf of Monsanto. … Only 10 rats were measured per group for blood and urine parameters and served as the basis for the major statistical analyses conducted. … We note that these unrelated, different non-GM maize types [in the control groups] were not shown to be substantially equivalent to the GMOs. The quantity of some sugars, ions, salts, and pesticide residues, do in fact differ from line to line, for example in the non-GM reference groups. [I.e. the controls did not provide a stable reference point, but varied in ways that could affect the results. --Ed.] This not only introduced unnecessary sources of variability but also increased considerably the number of rats fed a normal non-GM diet (320) compared to the GM-fed groups (80) per transformation event, which considerably unbalances the experimental design. …

The most fundamental point to bear in mind from the outset is that a sample size of 10 for biochemical parameters measured two times in 90 days is largely insufficient to ensure an acceptable degree of power to the statistical analysis performed and presented by Monsanto. … This is exemplified when Monsanto performed one-way analysis of variance (ANOVA) calculations at 5% with a sample size of 10 animals for 10 groups. In this case the probability of not detecting a medium size effect [3] (0.5 SD for a t test for instance) is about 70% (power of the test 30%). However, the fact is that within 90 days, a chronic toxicity has a maximum chance of giving rise to a medium rather than large size effects. [I. e. chronic effects would be expected in the long term, but the design looked for acute effects in the short term. --Ed.] …

In summary, the tendency for physiological disturbance is characteristic of almost all rats of all GM-fed treatment groups, and physio-pathological profiles differ according to dose or sex. …

If a “sign of toxicity” may only provoke a reaction, pathology or a poisoning, a so-called “toxic effect” is without doubt deleterious on a short or a long term. Clearly, the statistically significant effects observed here for all three GM maize varieties investigated are signs of toxicity rather than proofs of toxicity [because there isn't enough data for proof]. …

The first observation that we were able to make was that there is a good general concordance between our data and the results of Monsanto as presented in their original confidential reports, in particular on the proportion of statistically significant observations. However, the methodology we employed revealed different effects, which completely changed the interpretation of the experimental results. For instance, the sex differences are fully taken into account in our study, which contrasts with the first published comments of these data [18, 26, 27]. …

We have previously demonstrated that glyphosate-based herbicides such as Roundup are highly toxic at very low concentrations to human embryonic kidney cells [36], inducing a decrease in viability, noticeably via inhibition of mitochondrial succinate dehydrogenase. …

Patho-physiological profiles are unique for each GM crop/food, underlining the necessity for a case-by-case evaluation of their safety, as is largely admitted and agreed by regulators. It is not possible to make comments concerning any general, similar subchronic toxic effect for all GM foods. However, in the three GM maize varieties that formed the basis of this investigation, new side effects linked to the consumption of these cereals were revealed, which were sex- and often dose-dependent. Effects were mostly concentrated in kidney and liver function, the two major diet detoxification organs, but in detail differed with each GM type. … This [hepatorenal toxicity] can be due to the new pesticides (herbicide or insecticide) present specifically in each type of GM maize, although unintended metabolic effects due to the mutagenic properties of the GM transformation process cannot be excluded [42]. … In conclusion, our data presented here strongly recommend that additional long-term (up to 2 years) animal feeding studies be performed in at least three species, preferably also multi-generational, to provide true scientifically valid data on the acute and chronic toxic effects of GM crops, feed and foods. Our analysis highlights that the kidneys and liver as particularly important on which to focus such research as there was a clear negative impact on the function of these organs in rats consuming GM maize varieties for just 90 days.

The good news is that since males are affected more than females, something may be done about this. The bad news is that the known effects so far don’t include ED, so maybe nothing will be done.

Seriously, though, this is an unbelievable mess. You don’t have to stop eating because these are all chronic effects, and it’s not likely to make a big difference if one consumes GMOs for a few more years until we know for sure whether there’s a problem or not. But that’s all the “good” news there is. Regulators in the US bamboozled us and then the rest of the world into not so much as labelling for genetic modification. Now it’s everywhere, and crops are dependent on it. If further research shows chronic toxicity and the RoundUp resistant and Bt products have to be pulled, crop failures will make prices shoot skyward. In the rich countries, that’s an annoyance. In the poor countries, that can mean famine. We are, in short, screwed. For Monsanto’s chance to make a few billion, we’re going to be paying hundreds of billions. (I just saw that line somewhere else before ….)

For me, there are several morals to this story, in addition to cleaning up the mess we already have. It shows what we have to do to prevent this crap in the future:

–Always insist on clear labelling.

–Always insist on full publication of all backup data before regulatory approval.

–And, I think, have penalties, such as jail time, for regulators who rubberstamp studies with such bad methodology. When somebody with one year of statistics can see a problem instantly (“A sample size of ten?”), the regulators have zero excuse.

GM food, frankenfoods, Monsanto, Vendomois, IJBS

Honestly, I know enough biology to know that it can’t be. It just can’t. And yet how else to explain the sudden ignorance of a guy as sharp as Bob Somerby? He’s talking about Keith Olbermann and Rachel Maddow beating up on Stupak for tribalistic, Village reasons.
Somerby finds that inappropriate.

For ourselves, we think pro-choice groups have every right to bail on the bill if they decide it ends up affecting choice in unacceptable ways. But then, we also think that anti-abortion groups have the right to make the same sort of decision. That is, to jump ahead just a bit: We assume that different people, acting in good faith, may judge the morality of a measure in different ways.

Leaving Olbermann and Maddow aside, this is the first time I’ve seen Somerby completely miss a question of right and wrong.

What if the amendment read, “Hair straightening is unnatural and immoral. No medical costs associated with complications can be paid for using any Federal tax dollars.” Would he be as tolerant of that viewpoint? Male circumcision is an unnecessary procedure whose only health benefit comes from compensating for poor hygiene (or, in the case of AIDS, from the unnaturally thickened skin of the glans). Would he be as quick to understand people with moral objections to the deformation of men? (Note to the humor-challenged: I’m paralleling anti-abortion attitudes, not actually arguing for a specific kind of anatomy.) If I felt it was immoral and harmful to everyone to overpopulate the planet, and attached an amendment saying that no Federal money should ever be spent on pregnancy, childbirth, or infants after the second child, would he sagely say my morality could become law if I had the votes?

I could have all the morals I want about these things. As soon as I tried to make anyone else live according to them, I would be wrong.

Stupak and Pitts deserve disgrace for trying to take away our rights. It has nothing to do with morals, Stupak’s, mine, or the man in the moon’s. Rights. The right to control our own medical procedures. The right to control our bodies. Rights. Get it?

So, no, “different people, acting in good faith” may not judge a law about rights in different ways. Not even when it’s a law about women’s medical rights.

What is so hard to understand about this? Even with the handicap of a Y chromosome?

Stupak, rights, human rights, politics

The Stupak amendment, the greatest rollback of rights for women in decades is now in that thing the House has been calling a “Health Care” bill. (Links from Reclusive Leftist, The Confluence, WiredLeft.)

But women are just, as always, the expendable canaries in the coal mine. Their rights are toast, which means so are everyone else’s.

I’m going to shout that: WOMEN’S RIGHTS ARE TOAST WHICH MEANS SO ARE EVERYONE ELSE’S.

Rights are for all. When only some people have them, they’re just privileges. And privileges can be taken away.

Think through the consequences of what equal rights for all really means, and you wind up with a system that doesn’t look much like what we have now. There’s lots more about it here, but this is the bit (paraphrased) that concerns us right now:

The right to control one’s own person is fundamental. Even the right not to be murdered is secondary, since killing is allowed in self-defence.

Abortion muddies the argument only because some people believe the fetus is a person with legal rights greater than those of the mother since it can require her life support. There is nothing to stop women from believing this and living accordingly because there is a right to control one’s own body. Depending on beliefs, an individual’s dilemma about abortion may be very complex.

But fair social policies are simple. Either everyone can live according to their beliefs, or nobody can. And personhood is necessarily a belief, a social or religious category. It’s not possible for it to be a matter of objective fact. Biology can only determine who belongs in the species Homo sapiens, but no cellular marker lights up when someone is due to get legal rights.

I’ll repeat: personhood is necessarily a matter of belief, whether that’s based on religion or social consensus.

Therefore those who oppose abortion because they believe the fetus is a person with special status have to hope they are never successful in legislating how others handle their pregnancies. If they are, it means that exceptions could be made to the right to control one’s own person.

Once that principle is admitted, then there is nothing to stop a majority with different beliefs from legislating forced abortions.

Over-population is, after all, the source of the environmental problems killing the planet.

There is nothing to stop an aging population from requisitioning a kidney from healthy people walking around with a spare.

There is nothing to stop doctors from performing medical experiments on you for the public good.

There is nothing to stop the majority from deciding all those old folks are too expensive to live.

Really. Nothing. Once you take away the right to control your own body.

Extreme? Sure. So why is it okay when applied to women?

Stupak, abortion, Health Care Reform Act, HRCA

There’s some amazement floating around (e.g. Digby, TPM) about this:

President Barack Obama is actively discouraging Senate Democrats in their effort to include a public insurance option with a state opt-out clause as part of health care reform. In its place, say multiple Democratic sources, Obama has indicated a preference for an alternative policy, favored by the insurance industry, which would see a public plan “triggered” into effect in the future by a failure of the industry to meet certain benchmarks.

I’m baffled that anyone is surprised. He told us loud and clear that helping the insurance companies was his priority. When he was an Illinois’ State Senator working on that state’s attempt at expanding coverage, this was the contribution he was proud of:

“We radically changed [the health care bill] in response to concerns that were raised by the insurance industry.” (Obama, 2004/05/19, report from Sep. 23, 2007)

When someone tells you who they are, listen.

health, reform, Obama, insurance

Blogland is abuzz over the latest fashion statement from the anonymous — always anonymous! — powers-that-be. This from Greenwald, but also for instance, Reclusive Leftist and Electric Blues:

John Harwood: “…one adviser told me today those bloggers need to take off their pajamas, get dressed and realize that governing a closely divided country is complicated and difficult.”

[and elsewhere in the post:]
… people in the basement working in their underwear who write blogs ….

Well, I, for instance, fit the Administration’s requirements. I don’t work in the basement (because I don’t have one, but, hey, it’s results that count). I don’t work in my underwear. (That would be unpleasantly cool where I live.) Nor do I sleep in pyjamas, so I have to get dressed in the morning.

And yet nobody has offered me a Cabinet position yet. Why is that?

I know it has nothing to do with the content of my character or the logic of my thoughts. Who has time for that nonsense? Certainly not an Administration that thinks having the Presidency and filibuster-proof majorities in Congress indicates a “closely divided country.”

bloggers, pajamas, politics

History shows that . . .

[CO2] Levels similar to those now commonly regarded as adequate to tackle climate change were associated with sea levels 25-40m (80-130 ft) higher than today.

That’s meters. That’s enough to drown a 10-story building. That’s enough to make several billion people move to higher ground or die. Or both. It won’t be pleasant for the people they move in on either.

And that is not conjecture or a probability statement or an extrapolation.

The new research was able to look back to the Miocene period, which began a little over 20 million years ago.

At the start of the period, carbon dioxide concentrations in the atmosphere stood at about 400 parts per million (ppm) before beginning to decline about 14 million years ago – a trend that eventually led to formation of the Antarctic icecap and perennial sea ice cover in the Arctic.

The high concentrations were probably sustained by prolonged volcanic activity in what is now the Columbia River basin of North America, where rock formations called flood basalts relate a history of molten rock flowing routinely onto the planet’s surface.

In the intervening millennia, CO2 concentrations have been much lower; in the last few million years they cycled between 180ppm and 280ppm in rhythm with the sequence of ice ages and warmer interglacial periods.

Now, humanity’s emissions of greenhouse gases are pushing towards the 400ppm range [c. 380ppm now], which will very likely be reached within a decade.

“What we have shown is that in the last period when CO2 levels were sustained at levels close to where they are today, there was no icecap on Antarctica and sea levels were 25-40m higher,” said research leader Aradhna Tripati from the University of California at Los Angeles (UCLA).

“At CO2 levels that are sustained at or near modern day values, you don’t need to have a major change in CO2 levels to get major changes in ice sheets,” she told BBC News.

The elevated CO2 and sea levels were associated with temperatures about 3-6C (5-11F) higher than today.

So, there you have it. The last time greenhouse gases were this high, there wasn’t a 2% chance of melting ice sheets. There was a 100% chance.

Does that mean it will happen again? We’ll probably see. Because the answer to, “Do you want to risk the whole planet to find out?” appears to be “Yes.”

global warming, Aradhna Tripati

I just had a thought. Compare these two things:

When anyone named Clinton talks about a right wing conspiracy, they’re nuts.

But when Bush the Second talked about how we had to fight Them over there if we didn’t want to fight Them over here, he knew what he was talking about because he had access to secret information.

?

Just because you’re not paranoid, doesn’t mean they’re not after you.

I’ve been thinking about the failures of government recently (1, 2), and it turns out (h/t dakinikat) I’m in good company. Sachs points out that “Not only are Americans deeply divided on what to do about [everything], but government is also failing to execute settled policies effectively. Management systems linking government, business and civil society need urgent repair.”

He goes on to list examples. Failure to prevent 9/11, to prevent the human toll post-Katrina, to prevent or stop corruption in Iraq, in the US’ own military, the financial crisis, the dilapidated “health” care system, and the literally dilapidated infrastructure.

However, despite a clear view of the scope and details of the problem, he doesn’t make the obvious connections about its source. He identifies the factors as insufficiently regulated privatization, collapse of planning functions, underfunding, and the inability of separate agencies to fit their priorities into intelligent overall planning. These factors are all real and they’re all huge problems, but they don’t spring into being on their own.

The technical experts who electrified the rural US, ramped up a vast industrial juggernaut to help win the Second World War, built the interstate road system, got to the Moon, and invented Medicare did not belong to some strange species whose methods are inconceivable to us. They were, by and large (we’re talking about whole populations, so by and large is what matters) the same people as the ones now incapable of running a hamster in a cage without a kickback scheme to pay for its kibble.

So what is different?

Democracy is one large experiment in accountability, but nobody actually likes being accountable. Over time the people who can will try to get out from under it. Time has gone by, and accountability has been eroded to the point where scamming The System is not a sign of disgrace but of smarts. The legal penalties may be the same or even worse, but the real preventive force, the social penalties have evaporated. There is functionally no accountability. Now the only requirement is not to get caught.

Since, by and large, people do just what is required of them and not much more, the result is that scamming the system is now the norm, not the exception, and everything is falling apart accordingly.

The problem is that the powerful are less and less answerable to anyone. The problems Sachs lists in government, industry, finance, the military, everywhere, can be traced back to an escape from oversight and retribution. Incumbents who do a dreadful job are reelected. Bankers who crash the economy get bonuses. Generals who lie about troop requirements are promoted. News organizations that broadcast nonsense retain advertisers.

Sachs’ solutions to the problems are that changes are needed “not only to policy but also to basic public management systems.”

I don’t think so. People haven’t somehow lost the ability to manage or to plan. We have the same brains and hearts as fifty years ago. The problem is the lack of accountability. You can work on management and planning till you’re blue in the face, but if you have no hold over the people implementing the ideas, you can never make them do their jobs.

The solution is to take away power from the those who’ve grabbed too much of it. We don’t need a reorg. Or not just a reorg. We need to return to accountability. And not in some braindead, No Child Left Untested, cheap, easy, and ineffective way. Politicians who don’t represent their constituents need to lose elections. The media has to fulfill its role in creating that crucial component of democracy: an informed electorate. Corporations need to be responsible for their actions.

What’s more, none of that has to be pie in the sky. Ways of starting down that path aren’t hard to see. For instance:

• Complete and exclusive public financing of political campaigns.
• An overhaul of redistricting so that it’s on the basis of topography and population, and ceases to be a way for politicians to select their voters, instead of the other way around.
• Significant non-profit, taxpayer-supported news.
• A return to something like the Fairness Doctrine. It was far from perfect, but it was a damn sight better than an echo chamber of nonsense drowning out all other voices.
• Ending the legal fiction of corporate personhood. Only flesh-and-blood people can be put in jail, and real people who sign off on a corporation’s decisions must be held responsible for them.

These are all legal matters. They don’t require any change in human nature or better behavior on anyone’s part. They require nothing more than a change in the laws.

I can hear you saying, “Yeah. Right. Good luck with that.”

And I can also tell you why you’re saying it. Because these things really would alter the balance of power, unlike an improved planning commission. You know and I know that powerful people will fight to the death against all of them because they’re no stupider than we are. They know that those seemingly small boring laws are the foundation of their might.

So, yes, getting any of those simple things actually done may well be impossible. But that doesn’t change the truth of where the real solution lies. If you’re trying to solve a problem, there’s no point looking for a solution in the wrong place. You will never find it there, no matter how much easier it might look. An understanding of the real solution has one advantage. It makes it simpler to see which courses of action are a waste of time.

I no longer remember to which kind blog I owe the enormous boon of finding Dr. Grumpy. At least once a day, sometimes oftener, his comments on life, neurology, and everything are laugh out loud funny. Today he’s on about insurance companies (go read the whole thing, it’s impossible to do it justice) and he manages to make even that funny. He needs to start a blog on death and taxes.

Doctor Grumpy in the House: Annie’s Song

If you don’t want bureaucrats between you and your doctor- TOO BAD. They’ve been there for years. THE ONLY PEOPLE WHO DON’T HAVE THIS PROBLEM ARE PAYING CASH FOR EVERYTHING! …

So what happens to you the way it works NOW, with your non-government insurance?

You come to me for some neurological issue, which requires further work-up. So I order, say, an MRI and MRA of your head.

Annie gets the order, and calls Bozo Insurance, Inc. (BII) to schedule it. BII refuses, saying they want more information. So they fax us a 5 page “pre-auth” form, which Annie spends 20 minutes filling out and faxes back. Then they say the form wasn’t enough, and they also want copies of your office notes, so we send those, too (yup, when you joined BII you agreed that they can read your medical records).

[A] few days go by. BII will claim they never got our fax. Or that we filled the form out wrong. Or that they don’t cover Capricorns when the moon is in Pisces. And we don’t know this until Annie calls back after a few days, because they’re hoping we forgot about it.

Eventually they’ll deny the whole thing, on the grounds that you don’t meet criteria for an MRI and MRA. …

[T]hey tell me I can appeal this via “peer-to-peer” review. Which means I need to personally call their “physician reviewer” to argue with them as to why I want the study.

So, during my insanely busy day at the office I have to call them. I’m promptly put on hold for 10 minutes, before finally reaching the reviewer. This person is a doctor- but NOT necessarily in my specialty. [And so it goes. Dr. Grumpy is an artist, so the story has an ending, but in the real world there is none. It just goes on and on.] …

So how did I get on this tangent? Because yesterday I was walking by Annie’s office, and heard her losing it over the speaker phone. And, as always, she was totally awesome.

Annie: “I’m calling because you people denied an MRI on a stroke patient?”

Pinhead: “Before we discuss this, I have to inform you that this is a recorded line.”

Annie: “Oh, good, hopefully someone will actually be listening to me then. Thus far it hasn’t happened.”

Pinhead: “Let me look up the tracking number… Okay. I have to inform you that we are unable to approve this study. Your doctor will need to make a peer-to-peer call.”

Annie: “Oh, now THAT’s a surprise.”

Pinhead: “What do you mean?”

Annie: “Is this line really being recorded?”

Pinhead: “Yes. It’s to improve customer satisfaction.”

Annie: “Oh, goody, because I’m sure not satisfied, and neither is the doctor, or the patient. Your company, and whoever is listening, never approves anything. In fact I can say that 100% of the time you require peer-to-peer review.”

Pinhead: “We do this to save our customers money on unnecessary testing.”

It goes downhill from there, but at least you’re laughing all the way. That’s also not like real life.

Dr. Grumpy, single payer, health, reform

This is a graph from pollster.com of Obama’s favorable vs unfavorable rating going back to Jan 2008. Anyone who’s read what I’ve written about him (1, 2, 3, 4, 5, 6, 7, 8, 9) knows I think he’s an empty suit. An empty, bigoted suit, pressed by the corporations who own him.

I’ve been wondering what’ll happen when people wake up to the depth of the con. Now I know. Nothing will happen. Waking up isn’t part of the plan. If they have to stop dreaming, they’ll just start hallucinating.

Look at those two converging lines.

That loss of rosy faith is not based on the fact that he’s broken every campaign promise he’s made, starting with not ending the war, the torture, the surveillance, the imperial Presidency, going on with not even trying to deliver on health care for all, and continuing through an endless list.

The pollsters say the loss comes from him being a Muslim Kenyan Socialist Nazi gun-hating terrorist-loving radical leftie.

Christ on a bike in a pancake hat.

A man who spent decades going to the most politically connected church in Chicago is not a Muslim. (Original article taken down from Chicago Tribune, May 2008)

A man who’s never since childhood spoken with an aunt, dearly beloved as per his book, an aunt who turns out to be barely scraping by in a Boston housing project, such a man knows less about the Kenyan concept of family than I do, to say nothing of actually having anything Kenyan about him.

A man who throws about a trillion taxpayer dollars (a trillion for God’s sake) at Wall Street without even trying to stop it from being used to pay obscene bonuses is not a socialist. (There was a feeble attempt after it hit the news, but the attempt was so weak, it died in the Senate without a word from him.)

A man whose idea of withdrawing from Iraq is to escalate in Afghanistan doesn’t hate guns.

A man whose concept of breakthrough thinking is begging Republicans to approve of his every word is so far from being a radical I’d call him a milquetoast.

But none of this is why people are losing that warm fuzzy feeling about him. It’s not even that they’re put off, at last, by the way he’s conveniently oblivious to vile misogyny, his own and his followers’. Or his arrogant disregard of gays. Or the cynical use of racism to squelch a few more voices.

It’s that he’s a socialist radical dictator freak.

And judging by the skid marks, these people brake for hallucinations.

Obama, Socialist, notasocialist, !Socialist

Being forced to die against my will would be terrifying. And I, personally, wouldn’t care whether the death panels making that decision were staffed by private bean counters from an insurance company — our current situation — or government bean counters from the Liberal Nazi Socialist Death Squad Agency — as imagined by the more crass or hallucinatory right wingers.

Being forced to live against my will is terrifying. Strapped into a chair so I can sit in front of a TV set. Or with a tube down my throat while my brain screams somewhere. Or . . . anyway, I can’t even stand to think about it. And I, personally, don’t care whether the people condemning me are on a private hospital “ethics” panel or represent the power of the State.

I’m not sure why any of this is hard for anyone to grasp. It’s not about death. It’s about who decides.

My right to control my life and death: essential. Somebody else controlling my life and death: hell on earth.

Unfortunately, I can only say that in bald and boring words. Terry Pratchett recently weighed in on this. Nothing further remains to be said.

Let me make this very clear: I do not believe there is any such thing as a ‘duty to die’; we should treasure great age as the tangible presence of the past, and honour it as such. …

But neither do I believe in a duty to suffer the worst ravages of terminal illness. …

Life is easy and cheap to make. But the things we add to it, such as pride, self-respect and human dignity, are worthy of preservation, too, and these can be lost in a fetish for life at any cost.

I believe that if the burden gets too great, those who wish to should be allowed to be shown the door. …

[earlier]
[M]y father’s problem was pain, and pain can be controlled right until the end.

But I do not know how you control a sense of loss and the slow slipping of the mind away from the living body – the kind that old-timer’s disease causes.

I know my father was the sort of man who didn’t make a fuss, and perhaps I would not, either, if pain were the only issue for me. But it isn’t.

I am enjoying my life to the full, and hope to continue for quite some time. But I also intend, before the endgame looms, to die sitting in a chair in my own garden with a glass of brandy in my hand and Thomas Tallis on the iPod – the latter because Thomas’s music could lift even an atheist a little bit closer to Heaven – and perhaps a second brandy if there is time.

Oh, and since this is England I had better add: ‘If wet, in the library.’

euthanasia, death panels, right-to-die, Terry Pratchett

Not only have I told you so, repeatedly, but so did everybody else who’s capable of coming up with four when adding two plus two, going right back to Amory Lovins and the DFHs.

US’ best source of carbon-free energy is efficiency. Not just the US of course. The laws of physics are the same all over the planet.

The McKinsey report [pdf] arrived at [its] figures by performing a fairly simple economic analysis: what measures, if rolled out on a large scale starting in the near future, would have a positive return on investment by 2020. Those are fairly conservative conditions, since many efficiency projects require a substantial up-front investment that’s only paid back gradually; time horizons longer than a decade aren’t uncommon when it comes to payback. Nevertheless, the numbers were staggering. $520 billion worth of investments would produce a total of $1.2 trillion in savings by 2020. Presumably, the numbers would look even better later into the century.

At 2020, we’d be avoiding using that 9.1 quadrillion BTUs. That would be enough to knock 23 percent off the expected demand, dropping it below the current national usage. It’s worth pointing out that there’s a bit of a multiplier effect of efficiency efforts, as well—by not producing the energy in the first place, all the losses that occur during generation and transport never come into play. The net result would be over a gigaton of greenhouse gas emissions avoided as well.

As far as the National Academies is concerned, the McKinsey report might just as well have been a chapter in its own publication. “The deployment of existing energy-efficiency technologies,” it has concluded, “is the nearest-term and lowest-cost option for moderating our nation’s demand for energy, especially over the next decade.” [emphasis added]

So could we now get with the program and stop chasing more pollution with less power? Crap like “clean coal” and nukes. And, environmentally less appalling but socially more so: food-sourced biofuels. Here’s yet one more repeat of what’s wrong with them.

“Clean” coal produces all the same destruction and pollution — and energy costs! — during mining as dirty coal. And another not-so-minor data point: the industrial-scale process to do it has not been invented yet (pdf, eg p. 31).

Nuclear energy: Produces pollution, environmental destruction, and uses energy during mining. Uranium is a finite resource. A finite resource. It will . . . wait for it . . . run out. (Am I frustrated that some people don’t get this yet? Yes, I’m frustrated.) It will run out in about a century if used to produce most of our energy. It takes time to build plants. One plant would have to be built every six weeks, starting yesterday, going on until the uranium runs out, to produce most of our energy. Nuclear energy creates radioactive waste. We have no viable method of dealing with current waste, forget the amount of waste that would be generated by a bigger nuclear program. Decommissioning costs are huge and underfunded. Companies are mothballing old plants to delay the day of reckoning when people are presented with the price tag. All that money spent on nuclear energy to get a fraction of the power needed cannot be spent on real solutions.

Biofuel produced from corn and other food sources: Destruction of habitat to grow monocultures of energy crops (a problem with any biofuel not generated from waste). Increased food prices in a world where around one billion people are living on around one dollar a day. That leads to even worse mass starvation than we already have. That leads to even more mass migration, social dislocation, riots, and wars. Just in case I’m not being clear, this is Not Good.

Now that we have yet more studies all saying the same thing, how about we all get on the same page and DO THE OBVIOUS!

energy, efficiency, NAS, McKinsey

The facts of the cost control debate are crystal clear: Countries with universal, accessible health care (note that I didn’t say “health insurance”) have per capita costs that are about half those of the US. ( e.g. Klein, Krugman, Somerby also has links to original data.) Should I repeat that? Our system of health care for people who pay costs twice as much as health care for everybody.

It’s that simple. The data are out there. So why are they invisible? Why doesn’t Obama point that out in his many TV appearances? He talks about cost control, but makes it seem it’s so complicated we need a 1000-page bill for it and over four years to implement. Why isn’t the simple fact a small enough sound bite for the chattering classes?

I think we’re up against more than interests vested in obfuscation. All the vested interests in the world aren’t enough to explain why people are so willing to believe it when the facts are so blazingly simple.

I think we’re up against a fundamental sense, a lizard brain thing, that says you can’t possibly get something unless someone else loses it. Win-win is counterintuitive. Lose-lose is even more counterintuitive. If my money is not being spent on those no-goods, then I must have more left at the end, right? And when that falls flat, when the whole damn economy is suffering because we refuse to have universal health care, then the problem is, obviously!, that too much money is still somehow being spent on no-goods.

The facts are eclipsed by the inability to understand them.

That has a practical application. It means that in this health reform debate we’re having nationally, the point to hammer home is not only that compassion and cost control go together, as Krugman has pointed out. The corollary is even more important. Lack of compassion does not lead to savings. Lack of compassion leads to trillions in wasted money.

The ads we should be running should show fiscal “conservatives” clutching a single dollar bill while setting fire to a sea of burning hundreds.

health care, reform, cost control, zero sum

The statistics don’t tell us anything we didn’t already know. The stealing of the Iran’s June 12 election has been obvious from the start. But that’s the nature of statistics; it’s real value is telling you that you what don’t know, it’s eliminating false positives. Walter Mebane of the University of Michigan in Ann Arbor has done the work to show that this disgraceful event really is a fact. I saw his article (pdf) when it first came out in mid-June, but seeing it again in Science News jogged me to talk about it. From SN:

“[Iranian election data] suggests that the actual outcome should have been pretty close,” says Mebane…. The official results showed Ahmadinejad getting almost twice as many votes as his closest rival.

Mebane cautions that the anomalous statistics could imaginably have an innocent explanation, that limited data is available, and that he is not himself an expert on Iranian politics. Nevertheless, he concludes that “because the evidence is so strikingly suspicious, the credibility of the election is in question until it can be demonstrated that there are benign explanations for these patterns.”

[A couple of paragraphs follow discussing the distribution of numbers in real data, known as Benford's Law.]

When Mebane studied polling station-level data from Iran, he found that the numbers on the ballots for Ahmadinejad and two of the minor candidates didn’t conform to Benford’s Law well at all.

In any fair election, a certain percentage of votes are illegible or otherwise problematic and have to be discarded. When people commit fraud by adding extra votes, they often forget to add invalid ones. Suspiciously, Mebane found that in towns with few invalid votes, Ahmadinejad’s ballot numbers were further off from Benford’s Law — and furthermore, that Ahmadinejad got a greater percentage of the votes.

“The natural interpretation is that they had some ballot boxes and they added a whole bunch of votes for Ahmadinejad,” Mebane says.

Mebane also received data from the 2005 Iran election that aggregated the votes of entire towns…. If Ahmadinejad fared poorly in a particular town in 2005, you wouldn’t expect him to do especially well there in 2009 either. …

The best relationship the model found produced 81 outliers out of 320 towns in the analysis, a strikingly high percentage. Another 91 fit the model, but poorly. In the majority of these 172 towns, Ahmadinejad did better than the model would have predicted.

“This is not necessarily diagnostic of fraud,” Mebane says. “It could just be that the model is really terrible.” But since the first analysis gives evidence of fraud, the cities the model flags as problematic are the sensible ones to scrutinize.

For me, the new bit of data in all that is just how bad they were at faking it. That gives watchdog groups a big opportunity if they can somehow get at the raw data before it’s destroyed.

I only regret that we in the US, with our long string of elections-as-theater, don’t have the Iranian opposition’s fire, and that we do have much more polished cheaters.

Update, Jul 24, 2009. I see today that there was another excellent article on the BBC on this topic, providing yet more examples of voting anomalies.

Iran, election, fraud

I live in California, and you may have heard that we’re having a bit of an argle-bargle about a budget in this state.

The history, for those who’d like it: Back in the 1970s, enough Californians felt their taxes were too high to limit property taxes by law. The limit is low, (1.5%, I thought, but wikipedia says 1%) and — this is the biggest deal — the assessed value of the property can’t increase more than 2% a year until it’s sold. The new assessed value is then based on that sale price. You’ve probably heard about property values in California. A house worth $60,000 in 1978 is worth $600,000 now, but it’s taxed at around $100,000. There’s something to be said for this in the case of retirees on fixed incomes, for instance. However, they forgot to limit it to people of limited means. It applies equally to movie stars. And to commercial real estate which can stay in the same hands forever, even when it’s sold, through the magic of shell corporations. That turns out to be a loophole big enough for the whole state to fall through.

Proposition 13, as it’s known, also said that any tax increase had to pass with a two-thirds supermajority. We have two, count ‘em, two, Republicans more than a one third minority. So that voting bloc, in its infinite intransigence, can stop any budget from passing. The situation is not helped by a Gropinator who vetoes legislation just to show off, as far as I can tell.

(Update: I should mention that the up-to-the-minute blog for all things political in California is calitics.com.)

On to the gnarly present. As Krugman wrote, California may once again be ahead of the curve in showing what happens when a bunch of Republicans decide to play politics with the future. This is not, at this point a faults-on-both-sides situation. This is a bunch of Republicans playing politics with the future. They have made the (apparently accurate) judgment that repeating NO NEW TAXES on an infinite loop will keep getting them re-elected till hell takes over.
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Medicine and the so-called free market are incompatible in important ways. An outstanding article in the recent New Yorker by Atul Gawande makes that point from yet another new angle. (newyorker.com has a nasty habit of putting archives behind a paywall, so I don’t know how long the link will be useful.) In all the talk of consumers, insurance, and governments, we’ve kind of lost sight of the doctors. Which is odd, considering that they’re the only ones who actually know what’s going on. Let’s begin somewhere near the beginning.

The issue of cost control in medicine is much in everyone’s mind. Krugman and Ezra Klein have been out in the forefront of the fact brigade. It’s supposed to be the central feature and purpose of health care reform. There are several approaches that boil down to a choice between free markets and regulated oversight. I’ll take the two in turn.

The free market, like anything with “free” in the name, has an appealing ring of being able to make one’s own decisions without interference. It doesn’t work in medicine. At all. I wrote a post a while back about how Profits Cost Us Cures, but it goes way beyond the pharmaceutical industry and touches every aspect of medicine.

Let’s face it, most medical expenses are in a class by themselves. People don’t go to the doctor like they go to buy a car. They don’t say, “Doc, insured patients pay $357 for this type of X-ray. If you’re gonna charge $973, I’m going to Doc B.” They don’t know enough to know a good deal from a bad one, or whether they need the deal at all. Nor should they have to. We’re paying doctors for their knowledge, so there’s something very bass-ackwards in the demand that we acquire the same knowledge before theirs is any use to us.

Even more important, nobody goes to the doctor because they no longer liked their old X-rays and wanted new ones. We’re at the doctor’s when we’re in pain, trying not to think about what it could be, and desperate to get the whole thing over with. At any price. That is also the exact opposite of a situation conducive to calm and careful comparison shopping.

The whole notion that somehow patients can control the costs of medicine is such an obvious crock that if it’s being propounded by anyone smart enough to have a public platform, they must have ulterior motives. As far as I’m concerned, those motives are obvious. Putting the powerless chickens to guard the henhouse is evidence of making sure that the fox meets no obstacles.

So we can forget all the classic consumer choice blather about controlling medical costs. On the evidence, we can also forget about the insurance companies doing it. Their concept is to cut care and grow salaries, an approach that has notably failed at controlling anything. The government? Judging by the Europeans and Canadians, they can do a better job than insurance companies, but at the price of inflexibility that simply can’t keep up with medical reseaarch. For someone fighting a recently curable but not yet insurable disease, that’s intolerable. There has to be a better way.

I think Atul Gawande has shown us in which direction it lies. As he notes:

Health-care costs ultimately arise from the accumulation of individual decisions doctors make about which services and treatments to write an order for. The most expensive piece of medical equipment, as the saying goes, is a doctor’s pen. And, as a rule, hospital executives don’t own the pen caps. Doctors do.

He goes on to question why there’s so much variation in the cost of care across US counties. The most expensive is over twice as much as the cheapest.

First of all, it’s got nothing to do with cheeseburgers. Gawande compares two communities, among others, McAllen and El Paso in Texas. Same demographics, same per capita cheeseburger snaffle rate, totally different costs.

The idea that it might have to do with quality of care is laid to rest as soon as he points out that one of the cheapest counties contains the Mayo Clinic.

And that also brings him to the most interesting observation. The Mayo Clinic achieves its lowest cost, bestest care by:

• Money coming in is pooled across the whole hospital and everybody is paid a salary.
• Patient care is explicitly the first priority, and people are promoted on that basis.
• They “meet regularly on small peer-review committees to go over their patient charts together. They focussed on rooting out problems like poor prevention practices, unnecessary back operations, and unusual hospital-complication rates. Problems went down. Quality went up.”
• They have a “regional information network—a community-wide electronic-record system that shared office notes, test results, and hospital data for patients across the area. Again, problems went down. Quality went up.”

In short, the doctors get money, plenty of it, but they’re not going to get a whole lot more by each opening their own redundant MRI facility and steering patients toward it. That entrepreneurial, profit-oriented process is what’s gone wild in McAllen, aka The Expensive County.

The Mayo Clinic process is more of a one-for-all-and-all-for-one, dare I say it . . . socialist process than a purely market-driven one. It’s also open source, so to speak. Information is pooled, not hoarded.

And, it liberates doctors’ professional instincts to do their best for their patients. The same doctors who actually know what that is and how to achieve it with the least pain and anguish and expense.

An important point here is that changing only the payment method, eg single payer versus multiple payers without changing the incentive structure for doctors will not solve our problems. For me, that was a new insight. But I find it very valuable because it tells us what to do with single-payer once we get it.

Don’t laugh. I want you all to close your eyes and hum along with me . . . “Another world is possible.”

I wish.