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Tuesday, March 1, 2011

Playing the Odds, or The Art of Being NICE



Need access to a family-practice physician, and want to move to tiny Norwood, Ontario? Don’t expect to see a family physician unless you feel lucky, because Norwood has instituted a lottery to pick who will get to see the town’s only doctor. Winners are chosen each month by the town counsel, which provides off-the-book incentives to the only physician willing to stay and take on 4 new patients a month. Losers lose out. Welcome to Canadian health care in an otherwise lovely small town. Government market distortions forced the town to apply this peculiar form of rationing, and demonstrates how socialized medicine does not reward winners as much as it chooses losers.
The United Kingdom’s program for early detection of cancer is like playing Russian roulette with your doctor; 3 out of 4 “win”, and are diagnosed correctly, but 25% of people with cancer are sent home with a pain pill. Those who accept their first diagnoses become unhappy statistics of a lower cure rate. If you play the U.K. lottery system of health care, your chance of dying from breast cancer is 88% higher in the U.K. than the U.S.. Not surprising, when the doctors miss it 25% of the time.
The creators of the National Institute for Health and Clinical Excellence have always seen this as a marketing problem, hence the syrupy acronym NICE to describe a tough system that routinely denies care. Nobody flies to the U.K. for their wonderful dentistry, clean hospitals, and 27% death rate from cancer out of all deaths, but if you’re stuck living there you don’t have a choice, so they may as well sell you on a slick concept.
According to marketing professionals, contests with high odds of winning are counter productive because too many customers feel like losers; nobody likes to scratch off 100 tickets with “Sorry! Try Again!” written on them. The trick is to find the sweet spot where people perceive their chances are good enough to take the trouble to scratch, and not feel too disappointed when they lose. If you have a 1 out of 4 chance of getting a small prize like a free cola or 15% off your next purchase, you actually look forward to the game ticket, but if it’s your health at stake, the “Sorry! Try Again!” card can really make you mad, especially when you’re forced to play over and over. Most patients prefer the 99.9% win rate in health care, but up till now, patients were probably not aware of the small print usually found at the bottom of the game piece which states how much time you can expect to lose playing the game without reward.
This all brings to mind, “The Lottery” by Shirley Jackson; a short story about a small town that chooses a single loser each year in order to sacrifice him/her to ensure a good crops. The chances of dying in this lottery is one in 300, and, oddly enough, it’s death by stoning. Sort of a Shariah style death panel.
Except for the kindly acronyms, what's the difference between various capricious lottery systems that end up killing people for lack of care, and holding a yearly contest to decide who to stone to death?




February 17, 2011

Thoughts from CPAC:

The astonishing Ayann Hirsi Ali was selling signed copies of her books to support her cause, the AHA Foundation, which aims to protect the rights of western women against the onslaught of militant Islamism. Serene and ethereal, all rustling, coughing and whispered conversation ceased abruptly whenever Ali spoke.

Panels on pop culture and the war on conservative values-I was amazed at how many wanna-be conservative filmmakers kept asking about conservative opportunities in the film industry-as if you could go to Hollywood and join the “Conservative Movie Guild” to get your heavy handed conservative films made. The panelists seemed to have a hard time convincing some folks of the value of just being a good storyteller. Once you have a reputation, you can make films that reflect conservatism.

Andrew Brietbart. Hero of the revolution in thinking about the left. My husband says the difference between Ann Coulter and Andrew Brietbart is that Ann has very funny, clever lines. Andrew, who is also very smart, is just plain funny. His rambling narrative, perfectly timed for laughs, describes his method for turning the left’s tools on itself. He encourages everyone to buy a camera, and ask questions. (Note to Andrew: I saw you like, 5 times in the lobby, but I was not stalking you)

Libertarian presence. Of course Ron Paul won; a huge proportion of the straw poll was libertarian. Mostly a bunch of fired up young men, libertarian audiences at Ron and Rand Paul speeches were by far the most raucous, screaming “End the Fed!” over and over. In addition I found libertarians are totally convinced of their political ascendancy. Christopher Malagisi has a excellent article on this.

Mark Steyn’s non-presence. Sigh. Basically all the women, and most of the men at CPAC would have loved to have heard him speak. No one knows why he hasn’t been there in a while, (Is it because of Marriott’s ban of SteynOnline?) but most agreed he would have been a bang-up keynoter. Two women in particular said that they were "extremely saddened" by his absence. Maybe next year?

GoProud. A non-issue for me, especially since Ann Coulter claims to have gotten them to drop the gay marriage issue from their plank. To me, nothing could be more stupid than to throw away a coalition that’s with us on 90% of the issues. Conservatives need groups that have splintered away from the left.

Overall, a great conference with terrific speeches, spiced up with a pinch of controversy to keep things interesting. Some of my friends didn’t attend because of a perception that CPAC is drifting away from it’s conservative roots. I saw it as an opportunity to sharpen skills in something more than an echo chamber. Check it all out online.

Update: Smart funnyguy, and MC, Steven Crowder posed with me for a photograph; he is absolutely drop-dead gorgeous, and my teenage daughter nearly died of jealousy.

Update #2: Giddy with joy, I've just noticed that Mark Steyn has posted my tweet on his "Reader of the Day" feature.
Thank you, Mark!




February 1, 2011

Snowpocalypse
It’s been a long time since Lansing*, Michigan has had a really big snowstorm. Most local folks under the age of 25 have never experienced an authentic blizzard; the kind that drops more than a foot of snow and blows drifts that bury automobiles, mailboxes, and even buildings. Tonight we may be visited by a “beast” of a storm that is roaring across the Midwest, has dumped 21” in Tulsa, and is sucking up moisture over the big lake before clobbering us.

Predictions for mid Michigan range from 10” to 18” over the next 24 hours, with lots and lots of drifting. For those of us growing up in the sixties, it marks a return to winter’s business as usual, and the thought of how I forgot to get the primer button fixed on the snow blower is foremost on my mind. Fortunately, I planned waaaay ahead, and am now in possession of two hulking teenage boys who understand the connection between helping Mom, and using the new PS3.

These guys grew up during a mini Global Warming Period, with mild winters and falling lake levels, long summers, and Al Gore. I’ve been regaling them with stories from the great blizzard of 1967, when the snow paralyzed everything, and we had a week long vacation from school. A full two feet feet fell, and remains the record. However, today’s newspaper states the snowfall during the 1967 blast was 15.4”. That number appears to have been picked from an early report during the blizzard. It’s curious that current researchers chose an understatement of the snow depth. I do wonder why. http://www.lansingstatejournal.com/article/20110201/LANSING01/302010012
From the internet version of the Lansing State Journal:
Record snowfalls in Lansing
15.4 inches, Jan. 26, 1967

• 15.1 inches, Jan. 26, 1978

• 14.5 inches, Dec. 11, 2000

• 13.9 inches, March 17, 1973

• 12.6 inches, Jan. 22, 2005

• 10.3 inches, Jan. 13, 1979

• 10.2 inches, April 1, 1970

• 9.9 inches, April 2, 1975

• 8.9 inches, Dec. 11, 1970

• 8.8 inches, Jan. 13, 1976

Not to be dramatic, but didn't this kind of data massaging bring on Climategate?

Since weather forecasters are predicting as much as 18”, it seems as if the reporter hopes we achieve a new record tonight. Of course, news sells papers, but this kind of news also sells bad ideas, and I’ve lost count of how many references I’ve heard today of Global Climate Change, and how this “massive storm” is directly related to it.

My husband, who continues to surprise me, announced that he had kept the newspaper clippings from the snowstorm of 1967, and triumphantly retrieved them tonight. I was aware of his collection of the moon landing, and the assassination of JFK, but now I actually appreciate his peculiar obsession.


Pictured at right, a street scene shows cars nearly buried in snow.



















Note the headline of the Apollo disaster. A few days later, another stated that because of that horrible fire, NASA's moon shot program was endangered.






Pictured below is one of many collapsed roofs.






Of course, in 1967 we weren't yet worried about Global Warming, because it didn't yet exist. The backwards notion of the day was that the world was doomed to repeat a long overdue ice-age; with increasingly vicious snow storms, shorter summers, and much colder weather, which culminated in the winter of 1976-77. In the whole month of January 1977, the thermometer never once topped 0 degrees Fahrenheit.

Now, we know better; the current colder temperatures, heavier snowfall, and general change in the weather from day to day is caused by Global Warming, or rather the more fashionable term, Global Climate Change. Indeed, no matter what happens in the swirling dark tonight, the same people who accuse Rush Limbaugh. Glenn Beck and Sarah Palin of scare-mongering, will hurry to press in the morning with the latest bleak predictions of doom.


*My original essay omitted the word Lansing, which is where I grew up. Several folks wrote angry letters claiming I knew nothing about the State of Michigan, since it's common for lake effect snow to be measured in feet; the Upper Peninsula basically gets completely buried every year, and digs tunnels to get around. All I can say is, I'm sorry. The story is about Lansing, the flat, industrialized capital city whose lucky residents hardly ever experience really bad weather, but nonetheless is home to a dense population of pampered liberals who panic at the vicissitudes of daily living.

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