Reminder

Just a reminder. When it comes to interfering with other countries’ elections, the United States is the heavyweight champ. Here’s a claim, published at Politico EU that the U. S. is interfering with Hungary’s elections:

BUDAPEST — The Hungarian government on Thursday accused the U.S. State Department of interfering in the country’s election campaign.

The Hungarian Foreign Ministry summoned the top American diplomat in Budapest, chargé d’affaires David Kostelancik, after the U.S. State Department’s Bureau of Democracy, Human Rights and Labor (DRL) announced on November 7 that it would provide up to $700,000 “for projects that increase citizens’ access to objective information about domestic and global issues in Hungary.”

“DRL’s goal is to support media outlets operating outside the capital in Hungary to produce fact-based reporting and increase their audience and economic sustainability,” the State Department wrote on its website.

One man’s “fact-based reporting” is another man’s picking candidates who favor the point of view that you’re advocating.

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The Reader’s Digest Version

Let me summarize Jeffrey Snider’s most recent offering for you: economics has been mathematicalized not made into a science. The basis of science of observation and the measure of a science is how closely its predictions hew to actual phenomena.

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Stopped Clocks and All That Rot

It had to happen eventually. John Tamny has written a piece that I agree with completely, in this case on the globalization of the economy.

I wish he’d taken it one step farther and I wish that economists and, even more, politicians understood what has happened. The effects of economic policy do not stop at the water’s edge. We can stimulate the global economy but that doesn’t necessarily mean we’ll be stimulating the U. S. economy.

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A Few of My Favorite Things

There’s an article at Democracy that conjoins a number of my favorite topics: the limits of the tax code in producing social welfare, “shared capitalism”, value-added taxes, and Section 162(m) of the Internal Revenue Code. I doubt that any single law has done more harm to the United States other than, perhaps, the Federal-Aid Highway Act of 1956.

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Quorum Call

In reaction to the allegations of sexual misconduct levied against Minnesota Sen. Al Franken that led the news yesterday, the editors of the Washington Post write:

Senate Majority Leader Mitch McConnell (R-Ky.) and Minority Leader Charles E. Schumer (D-N.Y.) have both called for an investigation into Mr. Franken’s conduct, to which the senator pledges his cooperation. We’re glad to see members of Mr. Franken’s own party voice their support for a fair probe by the Senate Ethics Committee. Mr. McConnell’s commitment to supporting committee investigations into “all credible allegations of sexual harassment or assault” also must hold firm for members of his own party — not only Republican Senate candidate Roy Moore, into whom Mr. McConnell has promised an ethics probe if Mr. Moore triumphs in an Alabama special election. Ms. Comstock’s and Ms. Speier’s stories show that abuse of power on Capitol Hill is a problem that crosses party lines.

As the committee looks into Mr. Franken’s behavior, it will have to consider what comes next. What level of misconduct merits a lawmaker’s departure from Congress? Should the legislature have a zero-tolerance policy, or can gradations of offense be recognized? If a member’s wrongdoing took place entirely before his time on the Hill, should that affect continued service? Members of the House of Representatives should be asking these same questions.

There’s also a story out there that the Congress paid millions in hush money to victims of harassment over the last few years. If true that not only increases the scope of any investigation but it raises additional questions of misuse of funds and abuse of power.

Far be it from me to defend Sen. Franken or, indeed, any member of Congress but I’m curious as to what standard the Congress would apply to these cases? The situation is a minefield. Too lenient a standard and they’ve essentially giving a pass not just to Roy Moore but to future harassers and abusers. Too strict a standard and it will apply to a very large proportion of Congressmen. IMO any reasonable standard applied evenhandedly will make it difficult to convene a quorum. Not that that’s a bad thing.

Keep in mind Sam Clemens’s wisecrack: “the United States has no native criminal class excepting, of course, the Congress.”

Update

Scanning down the page a little and there’s an op-ed opposing Franken’s being forced to resign on the grounds that such demand would not be applied evenhandedly.

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Welcome to Dreamland

The editors of the New York Times sum up their assessment of the military coup in Zimbabwe which has resulted in Robert Mugabe, the dictatorial leader there, being placed under house arrest:

But the dawn of a post-Mugabe era, no matter how cloudy, could be an opportunity for the African Union, the Southern African Development Community and Zimbabwe’s powerful and more prosperous neighbor, South Africa, to press for real democracy, even helping Zimbabwe’s economy recover from years of mismanagement.

In my opinion they’re dreaming. The gravest need for Zimbabwe as in Venezuela is not for more democracy but for the rule of law, independent courts, and the protection of civil rights, particularly minority rights. Those are the foundation stones for liberal democratic government, the sine qua non and that’s as true in the United States as in Zimbabwe.

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Why Technology Is In Health Care’s Future

Ezekiel Emanuel (brother of Chicago’s mayor, Rahm) has a Wall Street Journal op-ed, “The Hype of Virtual Medicine” in which he takes a not unexpectedly critical eye to all of the various computer-based technology being marketed to people in the name of making them healthier:

Will “virtual medicine” transform the American health-care system? Will the latest computer-based technologies—apps, wearables, remote monitors and other high-tech devices—make Americans healthier? That’s the promise made by tech gurus, who see a future in which doctors and patients alike track health problems in real time, monitor changing conditions and ensure both healthy habits and compliance with drug and therapy regimens.

If it all sounds too good to be true, that’s because it is. Computer-enabled technology will indeed change the practice of medicine, but it will augment traditional care, not catalyze the medical revolution prophesied by Silicon Valley. Machine learning will replace radiologists and pathologists, interpreting billions of digital X-rays, CT and MRI scans and identifying abnormalities in pathology slides more reliably than humans. Remote observation of patients will be used in tele-intensive care units. And monitoring technologies will make it easier to treat patients at home, facilitating more out-of-hospital care.

But none of this will have much of an effect on the big and unsolved challenge for American medicine: how to change the behavior of patients. According to the Centers for Disease Control and Prevention, fully 86% of all health care spending in the U.S. is for patients with chronic illness—emphysema, arthritis and the like. How are we to make real inroads against these problems? Patients must do far more to monitor their diseases, take their medications consistently and engage with their primary-care physicians and nurses. In the longer term, we need to lower the number of Americans who suffer from these diseases by getting them to change their habits and eat healthier diets, exercise more and avoid smoking.

There is no reason to think that virtual medicine will succeed in inducing most patients to cooperate more with their own care, no matter how ingenious the latest gizmos. Many studies that have tried some high-tech intervention to improve patients’ health have failed.

Whether Dr. Emanuel likes it or not, the use of technology in health care will increase and it will increase beyond the American practice of medicine’s ability to control for three reasons. First, for the developing world there is no other choice. The developed world is importing physicians from the developing world as fast as they can be trained even as there’s a dire shortage of physicians in the developing world. If many of the world’s people are to receive any sort of care at all, it will be through “virtual” medicine or telemedicine and many of those people will think that some care is better than none at all. It apparently has escaped Dr. Emanuel’s notice that 95% of the people in the world do not live in the United States.

Second, medical technology companies will insist on it. They won’t be willing to cede a market of five billion people to Chinese and Indian medical technology companies.

But third and importantly while it might be true that technology will not change patients’ behavior it makes physicians’ behavior a lot less important. We can’t afford the present high rate of misdiagnosis, estimated by some to be between 10% and 20%. Based on my own experience it’s much, much higher since that estimate probably doesn’t consider the cases in which a correct diagnosis was eventually arrived at rather than all of the misdiagnoses that preceded them. Furthermore, iatrogenic morbidity and mortality is one of the leading causes of death in the United States. Blaming the patients is only telling half of the story.

In my view the battle that American physicians should be fighting is the fight to ensure that the direction of medical technology is towards helping patients rather than just reaping profits. A delaying action against technology is a mug’s game.

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Cancel the Revolution

I don’t believe that the editors of the Wall Street Journal understand Cook County at all. After cataloging the tax increases that state and local governments here have put into place and noting the successful opposition to the sweetened soft drinks tax, they remark:

Here’s hoping that the spirit of ‘17 prevails when Illinois voters go to the polls next year. For the moment, the Tribune is documenting more uncharacteristic blue-state behavior. One might have expected the death of the soda tax to inspire local pols to consider new ways to soak the middle class as well as the hated top 1%—and this should never be ruled out in Chicago. But the Trib says that Cook County Board President Toni Preckwinkle is now pursuing a different approach…

That approach is belt-tightening. But there’s a problem. Cook County’s single biggest expense item is public employee pensions, those are commitments that is beyond the county’s power to escape, and no amount of belt-tightening will pay for it.

The greater factor they’re missing is that for Cook County Democratic politicians in general and Chicago politicians in particular increased taxes are what’s called a “valence issue”. They don’t disagree on their necessity or desirability. They just compete with each on how high they’re going to raise them.

Cook County Republicans? They don’t even field candidates for many offices. You can’t win an election in which you don’t run. And there is no mass exodus from the Democratic Party going on here. People will oppose individual issues as they have the soft drinks tax. But they won’t oppose the party more generally.

Here’s the one-line summary: every candidate who wins in next year’s elections here will be running on a platform of higher taxes.

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My Mom’s Birthday, 2017

Today is my mom’s birthday. That’s her in the picture above, a lifetime and more ago. My lifetime anyway.

I think I’ve mentioned before that among my many mental quirks is that when I picture someone mentally it’s always as they were when I first met them. Well, that’s very much what my mom looked like when I first met her and that’s very much as I always imagine her. It’s how I imagined her even towards the end when she was an old lady, barely able to walk.

I can still see her when I look at my siblings.

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