At MedicalExpress there’s a report on an interesting study:

The team randomly sampled 195 exchanges from AskDocs where a verified physician responded to a public question. The team provided the original question to ChatGPT and asked it to author a response. A panel of three licensed health care professionals assessed each question and the corresponding responses and were blinded to whether the response originated from a physician or ChatGPT. They compared responses based on information quality and empathy, noting which one they preferred.

The panel of health care professional evaluators preferred ChatGPT responses to physician responses 79% of the time.

“ChatGPT messages responded with nuanced and accurate information that often addressed more aspects of the patient’s questions than physician responses,” said Jessica Kelley, a nurse practitioner with San Diego firm Human Longevity and study co-author.

Additionally, ChatGPT responses were rated significantly higher in quality than physician responses: good or very good quality responses were 3.6 times higher for ChatGPT than physicians (physicians 22.1% versus ChatGPT 78.5%). The responses were also more empathic: empathetic or very empathetic responses were 9.8 times higher for ChatGPT than for physicians (physicians 4.6% versus ChatGPT 45.1%).

“I never imagined saying this,” added Dr. Aaron Goodman, an associate clinical professor at UC San Diego School of Medicine and study co-author, “but ChatGPT is a prescription I’d like to give to my inbox. The tool will transform the way I support my patients.”

which confirms something I’ve been saying for some time.

My prediction is not that computer programs will replace flesh and blood physicians but that they’re going to make human physicians more productive. Such programs will also affect what skills are emphasized in the selection and training of physicians. We need physicians who are more human rather than more machine-like. Machines will beat human physicians at being machine-like every time. The challenge is for them not to be more human as well.

I struggled with writing this post a good deal of yesterday, ultimately discarding what I had done, reaching the conclusion that it would take a lot more than a blog post to express what needed to be said.

Let me give a quick summary. Reducing the amount of stuff we’re producing along with consolidation in the defense sectors is leaving us vulnerable. Imagine the situation where some commodity critical to defense is only produced by a single supplier in a single facility and an accident takes that facility offline. That’s exactly what happened when an accident in a blackpowder facility in Louisiana shut down production there. We haven’t produced the material which is still used in bullets, etc. for more than two years. We’ve been burning through stockpiles and relying on imports from Germany, Poland, etc.

The problem is that measures to mitigate the risks of accidents or deliberate sabotage are unappealing, too. Stockpiles large enough are expensive. Intellectual property may be involved. The DoD is tough to do business with. Preventing consolidation outright is impractical.

I’ve made my view clear many times. I think we need to be producing a lot more of what we consume. It’s hard to make that happen but that’s what we need to do.

I guess the story most worthy of comment today is the debt ceiling. The House has passed a bill raising that debt ceiling that also reduces spending to 2022 levels and caps spending growth at 1% per year, repealing some renewable energy tax incentives and stiffening work requirements for antipoverty programs. The bill isn’t expected to pass the Senate.

As you might expect there are differences of opinion about the bill. By and large Democrats want a “no strings attached” increase of the debt limit. The editors of the Washington Post largely concur:

In an ideal world, House Republicans would do their duty and lift the debt limit without exacting a ransom. This is about paying the money that Congress — in a largely bipartisan fashion — already committed to spend. This is also about reassuring a fragile world that the U.S. government can still do something as basic as pay its bills. A potential debt-limit catastrophe is lining up to hit just as the U.S. economy flatlines. The latest report on gross domestic product on Thursday showed a slowing economy in which businesses have already cut back sharply on spending in the face of high uncertainty. On top of that, China and Russia are making a push to get other nations to sign on to alternatives to the U.S. dollar. A U.S. default would enhance their cause.

It’s true that President Biden and Congress need to discuss spending. The nation is on a fiscally unsustainable course. Social Security and Medicare costs are rapidly escalating, along with interest expenses as the debt grows. But holding the debt limit hostage to impose blunt spending cuts would only backfire. A default — or even a near-default — would lead to higher borrowing costs. That’s exactly what happened in the 2011 debt-limit standoff.

It would be best if Republicans agreed to raise the debt limit and Mr. Biden and Congress launched a separate, parallel process to negotiate how to stabilize the budget. Mr. McCarthy likes to tout that his bill would save nearly $5 trillion over the next decade. But here’s the catch: House Republicans do not specify where $3 trillion of those cuts in discretionary spending would come from. It’s far easier to talk about general budget cuts than to spell out how much less funding they want for roads, schools and the military.

Mr. Biden’s insistence that House Republicans pass a clean debt-limit increase without any strings attached is the morally and economically correct course of action. But reality has to sink in. It would be wise for Mr. Biden to start talking seriously with Mr. McCarthy. Budget talks can remain on a separate path, but they need to commence.

while the editors of the Wall Street Journal are more sympathetic with the House Republicans:

Mr. Biden doesn’t seem to have figured out that the House vote changes the balance of negotiating power. Senate Majority Leader Chuck Schumer needs at least nine GOP votes to pass any debt limit increase, and that means he needs help from GOP leader Mitch McConnell. With the House vote in his back pocket, Mr. McConnell isn’t going to provide those votes for free, even if he had the power to do so on his own.

What part of divided government and bicameral legislature doesn’t the President understand? Perhaps he’s still under the illusion that he can refuse to negotiate and cause Republicans to panic as the debt deadline looms. No doubt the press corps will try to give him cover.

But Wall Street will grow increasingly anxious, and even some Democrats have noticed that Nancy Pelosi is now a backbencher. “While I do not agree with everything proposed,” Sen. Joe Manchin said of the House plan, “it remains the only bill moving through Congress that would prevent default and that cannot be ignored.”

Mr. Biden’s refusal even to meet is weird given his long record as a politician willing to talk to the opposition. In 2012 as Vice President, he negotiated a deal to avoid the “fiscal cliff,” after President Obama’s haughty approach stalled. Mr. Biden reminisces occasionally about his younger years in the Senate, sparring with segregationists like Mississippi Democrat James Eastland. “We’d debate like hell on the floor of the Senate,” Mr. Biden said last year, “and go and have lunch together.”

Yet Mr. Biden won’t meet with Mr. McCarthy to hash out a debt deal? Ms. Jean-Pierre said Thursday that Mr. McCarthy’s plan is “an extreme MAGA wish list,” and Republicans are “saying to the Senate, they’re saying to the President, that we have to go with this agenda in its full form.”

No, they’re simply saying that the House has passed a bill to lift the debt limit, and Mr. McCarthy would like to negotiate a final deal with Mr. Biden that can get through both chambers and signed into law. If Mr. Biden won’t work with Republicans in the House and Senate on a compromise, then he’ll be responsible for the financial calamity he’s been warning about.

I think we need to take a lot of what the editors are saying with a substantial helping of salt. The Congress that committed to the spending (“This is about paying the money that Congress — in a largely bipartisan fashion — already committed to spend”) was a different Congress and Congresses’ ability to bind future Congresses is limited.

I also found the WaPo editors’ “in a perfect world” trope amusing. My version of perfection is obviously different from theirs. My version would include provisions like requiring the Congress to raise revenue when they increased spending beyond some percentage, e.g. the rate at which aggregate supply is growing.

However, the base purpose of the Congress is legislating negotiated deals. That’s what should happen here, too. I don’t know whether the House’s demands are a “MAGA wish list” or not. I’m open to suggestions one way or the other on that although I suspect that’s how the White House would characterize anything that passed a House with a Republican majority.

Like the editors of the Washington Post I think the White House should be open to negotiations with the Congress. If it takes “holding the debt ceiling hostage” to accomplish that, so be it.

Today closing arguments in the trial of the “ComEd Four” began. The “ComEd Four” are four ComEd executives presently on trial for conspiring to bribe former and long-time Illinois House Speaker Michael Madigan to get favorable treatment for the utility from the state. Steve Daniels opens his report at Crain’s Chicago Business:

Liars on the witness stand attempting to run away from their roles in a criminal conspiracy. Or, four defendants who are “collateral damage” in a prosecutorial obsession to put Mike Madigan in jail.

Closing arguments in the “ComEd Four” trial Monday presented starkly different interpretations of six weeks’ worth of evidence from nearly 50 witnesses, dozens of wiretapped recordings and hundreds of emails that jurors will begin to sift through, likely late Tuesday.

What follows is a lengthy exposition of the closing arguments of the defense and prosecution.

I have no idea of what the jury’s verdict or the outcome of the trial will be. I wish I were able to find some good and unbiased commentary but I have found that extremely difficult.

I have speculated that, if they are found guilty, we may see the largest civil suit in the history of the United States.

Now the case has gone to the jury.

Let’s consider some potential outcomes (or lack thereof) in Ukraine:

1. Ukraine wins outright between now and November 5, 2024 (ED)
2. Ukraine loses outright between now and ED
3. The war continues to drag on past ED

Here are my questions:

1. Which is best politically for Joe Biden?
2. Which is worst politically for Joe Biden?
3. Which is best for the United States?

I don’t think there’s any question that Ukraine winning outright sooner rather than later is better for Ukraine while Ukraine losing outright sooner rather than later is best for Russia.

Would many people doubt that Ukraine winning outright before ED would be the best political outcome for Joe Biden?

Would Ukraine losing outright before ED be better or worse for Joe Biden politically than the war continuing to drag on?

I think that what’s in the best interest of the United States depends on what you think those interests are. If you think the U. S. interest in the war in Ukraine is degrading Russia, wouldn’t the war continuing to drag on be most in the U. S. interest?

In his announcement that he was running for re-election, President Biden said he was running “for the soul of America”:

President Joe Biden made it official Tuesday morning: The 80-year incumbent is running for reelection, setting up what could be a rematch of the ugly and tumultuous 2020 campaign against Republican Donald Trump.

In a three-minute video posted to his social media accounts, Biden asked Americans to help him “finish the job” and cast the race as a referendum on freedom and democracy itself.

“When I ran for president four years ago, I said we are in a battle for the soul of America. And we still are,” Biden says in the video, which was posted four years to the day after he announced he would run for president in 2019. “That’s why I’m running for reelection.”

Opening with scenes of the Jan. 6 insurrection at the Capitol and segueing quickly to scenes of abortion rights protesters, Biden warned against the rights that would be rolled back if Republicans were to take charge.

“Around the country, MAGA extremists are lining up to take on those bedrock freedoms, dictating what health care decisions women can make, banning books and telling people who they can love – all while making it more difficult for you to vote,” Biden warned in the ad.

as quoted in a piece at Newsweek by Susan Milligan. I have no idea what that means. 20 years ago I thought I might have been able to tell you. Not only that but that to the degree that America’s values had changed over the last 80 years, the change had been for the better.

Now not only do I not know what is meant by “the soul of America”, more Americans than ever before think our values are deteriorating as noted by Gallup:

and here’s what they found as the relative priorities:

That’s from June of last year. We’ll need to wait until June for an update.

Does what President Biden said align with that or not?

The singer, actor, and activist Harry Belafonte has died. From his obituary in Variety by Chris Morris:

Singer, actor, producer and activist Harry Belafonte, who spawned a calypso craze in the U.S. with his music and blazed new trails for African American performers, died Tuesday of congestive heart failure at his Manhattan home. He was 96.

An award-winning Broadway performer and a versatile recording and concert star of the ’50s, the lithe, handsome Belafonte became one of the first Black leading men in Hollywood. He later branched into production work on theatrical films and telepics.

As his career stretched into the new millennium, his commitment to social causes never took a back seat to his professional work.

I think that Mr. Belafonte has been somewhat overshadowed, unfairly I think, by Sidney Poitier, his precise contemporary. Not only did he have hit records while Sidney Poitier was still playing supporting roles, he began playing leading men in movies before Mr. Poitier. To the best of my knowledge he was the first black actor to have a white love interest (in The World, the Flesh, and the Devil) almost ten years before Guess Who’s Coming to Dinner. None of that is to take anything away from Mr. Poitier—I just think a revival of interest in Harry Belafonte is long overdue.

The only observation I will make about President Biden’s announcement that he is running for re-election in 2024 is that today is April 25, 2023. November 5, 2024 is a long way away, particularly when you’re 80 years old.

It reminds me a bit of when my mom had a new furnace installed (she was in her 80s). When the installer asked if she wanted a lifetime warranty or the standard 5 year warranty she laughed.

My quote of the day is from the Roman historian Tacitus: Corruptissima re publica plurimae leges. The more numerous the laws, the more corrupt the government.