Politics stuff

This is your GOP government in action:

Keep an eye on the TED spread to see how bad things will get. It is basically a quick snapshot of the liquidity crisis. It shot up to 2.01 within a few hours yesterday from near 1.0. That's a bad sign.


A few points:

• The collapse on Wall Street can be laid squarely at the feet of people like Phil Gramm, who inserted deregulation language covertly into finance bills:

  If McCain wants to hold someone accountable for the failure in transparency and accountability that led to the current calamity, he should turn to his good friend and adviser, Phil Gramm.
  
  As Mother Jones reported in June, eight years ago, Gramm, then a Republican senator chairing the Senate banking committee, slipped a 262-page bill into a gargantuan, must-pass spending measure. Gramm's legislation, written with the help of financial industry lobbyists, essentially removed newfangled financial products called swaps from any regulation. Credit default swaps are basically insurance policies that cover the losses on investments, and they have been at the heart of the subprime meltdown because they have enabled large financial institutions to turn risky loans into risky securities that could be packaged and sold to other institutions.
  
  Lehman's collapse threatens the financial markets because of swaps.

  Don't forget McCain's role in the Keating 5 scandal was basically to deregulate the market, which ended up costing taxpayers about $165 B total in the S&L scandals. And don't forget how people like McCain cheered as bankers took chainsaws to the regulation laws that King W and congressional Republicans did away with. Their libertarian philosophy tells them, "all regulation bad," but reality tells a different story, doesn't it?
  


• The DNC has a great "Count the Lies" site up documenting McCain's mendacity. As others have noted, he's basically trying to reinvent himself, going from "honorable man who happens to be a politician" to "sleazy dishonorable politician who will fulfill W's 3rd term"...


• Even David Brooks thinks Palin is not the woman for the job:

  Sarah Palin has many virtues. If you wanted someone to destroy a corrupt establishment, she’d be your woman. But the constructive act of governance is another matter. She has not been engaged in national issues, does not have a repertoire of historic patterns and, like President Bush, she seems to compensate for her lack of experience with brashness and excessive decisiveness.
  
  The idea that “the people” will take on and destroy “the establishment” is a utopian fantasy that corrupted the left before it corrupted the right. Surely the response to the current crisis of authority is not to throw away standards of experience and prudence, but to select leaders who have those qualities but not the smug condescension that has so marked the reaction to the Palin nomination in the first place.

  Preach it brother.


• Bob Herbert's column on McCain's disastrous health care "plan" is worth reading in its entirety. Here's a snippet:

  Talk about a shock to the system. Has anyone bothered to notice the radical changes that John McCain and Sarah Palin are planning for the nation’s health insurance system?
  
  These are changes that will set in motion nothing less than the dismantling of the employer-based coverage that protects most American families.
  
  A study coming out Tuesday from scholars at Columbia, Harvard, Purdue and Michigan projects that 20 million Americans who have employment-based health insurance would lose it under the McCain plan.
  
  There is nothing secret about Senator McCain’s far-reaching proposals, but they haven’t gotten much attention because the chatter in this campaign has mostly been about nonsense — lipstick, celebrities and “Drill, baby, drill!”
  
  For starters, the McCain health plan would treat employer-paid health benefits as income that employees would have to pay taxes on.
  
  “It means your employer is going to have to make an estimate on how much the employer is paying for health insurance on your behalf, and you are going to have to pay taxes on that money,” said Sherry Glied, an economist who chairs the Department of Health Policy and Management at Columbia University’s Mailman School of Public Health.
  
  Ms. Glied is one of the four scholars who have just completed an independent joint study of the plan. Their findings are being published on the Web site of the policy journal, Health Affairs.
  
  According to the study: “The McCain plan will force millions of Americans into the weakest segment of the private insurance system — the nongroup market — where cost-sharing is high, covered services are limited and people will lose access to benefits they have now.”
  
  The net effect of the plan, the study said, “almost certainly will be to increase family costs for medical care.”
  
  Under the McCain plan (now the McCain-Palin plan) employees who continue to receive employer-paid health benefits would look at their pay stubs each week or each month and find that additional money had been withheld to cover the taxes on the value of their benefits.
  
  While there might be less money in the paycheck, that would not be anything to worry about, according to Senator McCain. That’s because the government would be offering all taxpayers a refundable tax credit — $2,500 for a single worker and $5,000 per family — to be used “to help pay for your health care.”
  
  You may think this is a good move or a bad one — but it’s a monumental change in the way health coverage would be provided to scores of millions of Americans. Why not more attention?
  
  The whole idea of the McCain plan is to get families out of employer-paid health coverage and into the health insurance marketplace, where naked competition is supposed to take care of all ills. (We’re seeing in the Bear Stearns, Fannie Mae, Freddie Mac, Lehman Brothers and Merrill Lynch fiascos just how well the unfettered marketplace has been working.)
  
  Taxing employer-paid health benefits is the first step in this transition, the equivalent of injecting poison into the system. It’s the beginning of the end.
  
  When younger, healthier workers start seeing additional taxes taken out of their paychecks, some (perhaps many) will opt out of the employer-based plans — either to buy cheaper insurance on their own or to go without coverage.
  
  That will leave employers with a pool of older, less healthy workers to cover. That coverage will necessarily be more expensive, which will encourage more and more employers to give up on the idea of providing coverage at all.
  
  The upshot is that many more Americans — millions more — will find themselves on their own in the bewildering and often treacherous health insurance marketplace. As Senator McCain has said: “I believe the key to real reform is to restore control over our health care system to the patients themselves.”
  
  Yet another radical element of McCain’s plan is his proposal to undermine state health insurance regulations by allowing consumers to buy insurance from sellers anywhere in the country. So a requirement in one state that insurers cover, for example, vaccinations, or annual physicals, or breast examinations, would essentially be meaningless...

  How's this even a close race? Do people care about the issues? Sadly, I'm starting to conclude, "No."

Praying for Jamey didn't work out so well

When I first moved to Columbia, I saw lots of bumper stickers that said, "I'm praying for Jamey."

I finally found out what they're about: a guy who got pancreatic cancer. Well, he died this January (9 months ago). I have a feeling a lot of people will take those stickers off without even reflecting on their effect...that is, their lack thereof.

In one of my posts at Debunking Christianity, I looked at the question of whether or not there really is any scientific evidence that "prayer works" or a correlation between faith and health. Unsurprisingly, I found none.

The core methodology of such studies is flawed for three reasons:

1) Some studies examine how frequent churchgoing relates to health. The problem with this methodology is that the same correlation would appear between frequent football game attendance as well; anyone healthy enough to frequently attend anything that they enjoy will do so, and the more unhealthy you get, the less you will be able to attend...and so church attendance is not special.

2) Another big problem with studies designed to measure the "prayer effect" is that the people are often receiving medical care while being studied, and it is impossible to say that the prayer had an effect compared to their treatment. If you could study only patients who have exactly the same disease at exactly the same stage and receive exactly the same treatments, then you could truly control these other variables. However, it is basically impossible to control the other variables that will affect the prognosis.

3) The final problem is that it is impossible to separate people into "prayed for" and "not prayed for" groups by virtue of the fact that you'd have to ask each person and their extended families and their entire churches not to pray...and do you think that is going to work? If someone has a serious condition and is religious, they're going to stop praying for a few weeks or months? No. And so many of the people in the "not prayed for" group whose situation turns bad are lumped in as "evidence" that those who don't receive prayer are worse off...even though the people themselves as well as their families and church members were praying for them, especially if the health condition is serious, like cancer or heart disease.

And those are just the core methodology problems. In other studies, the ones cited as "evidence prayer works", the sample sizes are very small (n<20), and therefore the probability values are unimpressive: p>0.05. Whether or not you agree that the standard for statistical significance should be p<0.05, when p values approach 0.2, you have very little statistical evidence to back up a claim of a significant impact from whatever variable you're studying. But people conveniently ignore this when touting these meager studies.

In the only double blind, multi-year, multi-thousand-patient study ever conducted on the effect of prayer on health, God failed the test. Big time. Every empirical study has shown the same thing -- that nothing fails like prayer. Don't believe me? Find one documented amputee whose limb grew back from prayer. One. Ever.

Some studies purporting to support the idea that prayer works have been literally written by criminals and frauds.

Dr. Richard Sloan (M.D., not Ph.D.) has done a lot of work in examining these sorts of issues and wrote a book recently summarizing the facts -- there is no valid study supporting the idea that prayer changes anything (valid in the sense that they used a competent methodology and a large sample size and got a good p value).

On the logical side of things:

Does prayer move God to act? If yes, then God is callous/cruel, and God is not totally sovereign. If no, then God will act regardless of whether you pray or not.

If the desired goal does not happen after you pray, would you admit that God wanted things to turn out the way that they did, or do you believe that God wanted things to turn out differently? If God wanted things to turn out the way that they did, then your prayers don't matter, because God is sovereign. If God wanted things to turn out differently, then your God is weak or stupid or both.

See, God gets the credit when the desired goal occurs, but none of the blame when it doesn't.

So both from the logical and evidential sides, you really have an uphill climb in trying to show that praying for someone even makes sense.

Religulous, randomness

I am quite anxious to see Bill Maher's "Religulous", coming out 10/3/08, according to Wikipedia. Here's the trailer via YouTube:

Lionsgate has registered a domain, disbliefnet.com, and God is it a funny spoof of beliefnet.com.

Speaking of funny spoofs of religion, and in the vein of "Every sperm is sacred", my second favorite Monty Python clip, The Onion has a hilarious article on Hothouse Effects:

On a complete tangent, the John McCain official flip-flop list that I mentioned before now has a new URL and a new graphic. It's great!

On another complete tangent, our health care system's failure is documented. Again.

GOP on Health care: damned commies!

Amazingly, Fed chief Bernake's recent talk before Congress had nothing to do with interest rates or inflation, but instead...health care. Bernake said that access to care for the 47M Americans without it must be a top priority for our country, as well as improving the quality of care and cutting costs. Health care is definitely a bread-and-butter issue for voters this November. As such, there's no better way to sum up the GOP's proposals and responses to Barack's health care plan than this: "Socialism!"

I hope they keep it up. These standard-bearers on the right show you exactly the sort of intellectual rigor and human decency that now characterizes the conservative platform and response to Democratic (not Democrat) policy proposals and arguments. Obama is doing better than that: going to one hour from my hometown, in the heart of Appalachia, to deliver a substantive health care platform speech. The local paper covered the event with a news article and a solid editorial.

Let's look at some statistics in order to get a sense of "what's wrong with healthcare in America":

The Kaiser Family Foundation has a wonderful online tool showing the "fast facts" in slide show format concerning US healthcare. Looking at the number of uninsured in America, totaling 16% of the total population, or 47 M, I found an interesting statistic: 71% of uninsured have a full-time worker in the family and 11% have a part-time worker in the family, meaning that unemployment status can only be blamed in 18% of uninsured cases.

KFF also shows the decline in companies (large and small) offering health care to their workers: from 62% in 1999 to 59% in 2007. If that doesn't sound like much, remember that this is all US companies, so we're talking about literally millions of people losing coverage.

Krugman pointed to new stats on the huge uptick in underinsurance (having inadequate care) among the middle class from a report by the Commonwealth Fund:

The number of underinsured U.S. adults—that is, people who have health coverage that does not adequately protect them from high medical expenses—has risen dramatically, a Commonwealth Fund study finds. As of 2007, there were an estimated 25 million underinsured adults in the United States, up 60 percent from 2003.

Much of this growth comes from the ranks of the middle class. While low-income people remain vulnerable, middle-income families have been hit hardest. For adults with incomes above 200 percent of the federal poverty level (about $40,000 per year for a family), the underinsured rates nearly tripled since 2003.

These results and others are published in How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007, (Health Affairs Web Exclusive, June 10, 2008), by The Commonwealth Fund's Cathy Schoen, Sara R. Collins, Jennifer L. Kriss, and Michelle M. Doty.

So this isn't just a question of lower-class income, nor of uninsurance. Underinsurance has to be in the mix as well.

There are four basic models of health care reform: (1) incremental change to existing structures, (2) building on employer-based insurance, (3) consumer-based insurance, (4) single payer.

McCain's plan falls under the third model -- consumer-based insurance, and the Grand Old Party has proposed its favorite panacea to the health care crisis: tax cuts. Unfortunately for those who think this is a solution, reality here has a liberal bias: Robert Laszewski, president of Health Policy and Strategy Associates, LLC (HPSA), analyzes McCain's plan in detail and shows how it comes up far short.

1. People with pre-existing conditions are screwed.
2. A $2500 individual/$5000 family tax credit falls far short of the average $12000 cost of a health care plan.
3. He completely lacks any proposal for "cost containment" and quality improvement
4. Trade associations that's he's proposed would circumvent underwriting laws
5. The young would pay much less and the old much more -- age rating

Robert Kuttner shows in Everything for sale: the virtues and limits of markets that this free market proposal would be undermined by the following false premises:

First, it assumes that competing health plans will take a high road of offering better service, rather than a low road of risk selections and secret financial incentives to participating doctors.
Second, it assumes consumers will have a free choice among competing plans.
Third, it assumes that good plans will drive out the bad ones, rather than vice versa.
Fourth, it assumes that plans will not acquire a degree of monopoly power. And it presumes that consumers will be adequately informed about competing plans.

In short, this summarizes the weakness of McCain's plan.

The Democratic proposals from Barack and Clinton (and Edwards) are a hybrid of (1) and (2), which focus on making affordable insurance available to those without employer-based insurance. The plans do differ on the issue of mandates, an issue where I clearly side with Obama. Barack's plan would prevent the problems associated with McCain's plan in age rating and medical underwriting and pre-existing conditions clauses. In addition, Barack's plan offers a subsidy for low-income families to get insurance coverage that actually makes it affordable for them.

Harold Pollack responds to Krugman about Barack and mandates. His points about the study summarized:

So we're back where we started: two plans, both with guaranteed availability of insurance regardless of health status, both with subsidies. One has a mandate with (as yet undefined) enforcement mechanisms. The other has no mandate but (as yet undefined) financial disincentives for free-riding. Until the two plans are better specified, there is no basis on which to estimate how many people will wind up not buying insurance under either plan, and therefore no basis for any firm estimate of costs to the taxpayer.

This is hardly justification for the holy war the Clinton campaign is waging on Obama on the mandate issue.

David Brooks follows up on the same issue (Clinton's mandates and dealings with health care):

Moreover, the debate Clinton is having with Barack Obama echoes the debate she had with Cooper 15 years ago. The issue, once again, is over whether to use government to coerce people into getting coverage. The Clintonites argue that without coercion, there will be free-riders on the system.

They’ve got a point. But there are serious health care economists on both sides of the issue. And in the heat of battle, Clinton has turned the debate between universal coverage and universal access into a sort of philosophical holy grail, with a party of righteousness and a party of error. She’s imposed Manichaean categories on a technical issue, just as she did a decade and half ago. And she’s done it even though she hasn’t answered legitimate questions about how she would enforce her universal coverage mandate.

Cooper, who, not surprisingly, supports Barack Obama, believes that Clinton hasn’t changed. “Hillary’s approach is so absolutist, draconian and intolerant, it means a replay of 1993.”

Barack Obama has always been against a mandate requiring people to sign up for health care, much to the chagrin of Krugman et al., and last month's American Prospect shows why, by examining a state-level model for the national proposals by Democrats -- Massachusetts:

What's happened since then? While those beneath the poverty level signed up for free insurance in even greater numbers than anticipated, very few people who were required to pay for their own insurance signed up. Even those eligible for partial subsidies were slow to enroll. The deadline to purchase insurance had to be extended, and 60,000 uninsured people were exempted from the mandate because -- yes, that's right -- they couldn't afford it (so much for universality).

And what about enforcement of the mandate? The state has had to push back enforcement, but plans next year to hit individuals with a fine, although they've relaxed the standards required of employers...it's obviously a flawed system. What is the solution? I'd say single payer, model (4) and the model employed by numerous countries around the world.

Agreeing with me would a lot of experts, think tanks and coalitions of health care providers.

If you're more interested in learning about single-payer, check out those links.

In the meanwhile, we have to address a lot of misinformation and elect a lot of progressive politicians.

Check out current and detailed information on politics and health care at Kaiser

"Author of a Controversial Paper on the Medical Benefits of Prayer Is Accused of Plagiarizing"

And I'm not surprised in the least. How else could you find evidence for a phenomenon that doesn't exist (the healing power of prayer), except to fabricate it?

Author of a Controversial Paper on the Medical Benefits of Prayer Is Accused of Plagiarizing

By ELYSE ASHBURN

A controversial study that claimed to demonstrate the efficacy of prayer in medicine has suffered yet another blow to its credibility, as one of its authors now stands accused of plagiarism in another published paper.

Doctors were flummoxed in 2001, when Columbia University researchers published a study in The Journal of Reproductive Medicine that found that strangers' prayers could double the chances that a woman would get pregnant using in-vitro fertilization. In the years that followed, however, the lead author removed his name from the paper, saying that he had not contributed to the study, and a second author went to jail on unrelated fraud charges.

Meanwhile, many scientists and doctors have written to the journal criticizing the study, and at least one doctor has published papers debunking its findings.

Now the third author of the controversial paper, Kwang Y. Cha, has been accused of plagiarizing a paper published in the journal Fertility and Sterility in December 2005. Alan DeCherney, editor of Fertility and Sterility and director of the reproductive biology and medicine branch at the National Institute of Child Health and Human Development, said on Monday that it was clear to him that Dr. Cha, who has since left Columbia, plagiarized the work of a South Korean doctoral student for a paper he published on detecting women who are at risk of premature menopause.

Jeong Hwan Kim, then a student at Korea University, in Seoul, had published the same paper in a South Korean journal in January 2004, according to Sunday's Los Angeles Times. Mr. Kim brought the matter to the attention of Fertility and Sterility in the spring of 2006, Dr. DeCherney said. In an interview on Monday, he said he had spent the intervening time confirming the accusations.

Dr. DeCherney said he would recommend that the journal's oversight committee publish a statement saying that the paper was plagiarized and bar Dr. Cha, who appeared as the lead author on the paper, and the five other listed authors from publishing in the journal for three years. The publication committee of the American Society of Reproductive Medicine, which oversees the journal, is expected to decide on the issue in April.

Dr. Cha, a businessman whose company owns fertility clinics in Los Angeles and Seoul, could not be reached for comment on Monday. He also did not return calls from the Los Angeles Times, according to that newspaper's report.

Dr. DeCherney said that he had compiled a list of other papers Dr. Cha has published in Fertility and Sterility, and that he would review the list if other complaints arose. As for the validity of the 2001 paper on the efficacy of prayer, Dr. DeCherney said his journal had declined to publish the findings in the first place.

"It's baloney," he said. "That's not in question."

Editors at The Journal of Reproductive Medicine, which is affiliated with several organizations including the Martin L. Stone Obstetrical and Gynecological Society of the New York Medical College, did not return calls for comment on Monday. Lawrence D. Devoe, the journal's editor in chief, said in 2004 that the journal was further scrutinizing the paper (The Chronicle, December 2, 2004).

But Bruce L. Flamm, a researcher who has worked for years to debunk the 2001 paper, said the plagiarism accusations against Dr. Cha should leave the Journal of Reproductive Medicine with no choice but to retract it.

"I'm convinced that paper is fraudulent," said Dr. Flamm, a clinical professor of obstetrics and gynecology at the University of California at Irvine. "And over the years, everything that has happened has confirmed that opinion, not moved me away from it."

There simply is no magical correlation between faith and health. Sorry, folks, but facts are facts.
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