I found this article in Scientific American, a sort of status report on the War on Cancer, interesting:

Cancer has spawned a huge industrial complex involving government agencies, pharmaceutical and biomedical firms, hospitals and clinics, universities, professional societies, nonprofit foundations and media. The costs of cancer care have surged 40 percent in the last decade, from $125 billion in 2010 to $175 billion in 2020 (projected).

Research funding has also surged. The budget of the National Cancer Institute, a federal agency founded in 1937, now totals over $6 billion/year. That is a fraction of the total spent on research by nonprofit foundations ($6 billion a year, according to 2019 study), private firms and other government agencies. Total research spending since Richard Nixon declared a “war on cancer” in 1971 exceeds a quarter trillion dollars, according to a 2016 estimate.

Cancer-industry boosters claim that investments in research, testing and treatment have led to “incredible progress” and millions of “cancer deaths averted,” as the homepage of the American Cancer Society, a nonprofit that receives money from biomedical firms, puts it. A 2016 study found that cancer experts and the media often describe new treatments with terms such as “breakthrough,” “game changer,” “miracle,” “cure,” “home run,” “revolutionary,” “transformative,” “life saver,” “groundbreaking” and “marvel.”

There are more than 1,200 accredited cancer centers in the U.S. They spent $173 million on television and magazine ads directed at the public in 2014, according to a 2018 study, and 43 of the 48 top spenders “deceptively promot[ed] atypical patient experiences through the use of powerful testimonials.” A 2014 study concluded that cancer centers “frequently promote cancer therapy with emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, costs, or insurance availability.”

Cancer has spawned a huge industrial complex involving government agencies, pharmaceutical and biomedical firms, hospitals and clinics, universities, professional societies, nonprofit foundations and media. The costs of cancer care have surged 40 percent in the last decade, from $125 billion in 2010 to $175 billion in 2020 (projected).

Research funding has also surged. The budget of the National Cancer Institute, a federal agency founded in 1937, now totals over $6 billion/year. That is a fraction of the total spent on research by nonprofit foundations ($6 billion a year, according to 2019 study), private firms and other government agencies. Total research spending since Richard Nixon declared a “war on cancer” in 1971 exceeds a quarter trillion dollars, according to a 2016 estimate.

Cancer-industry boosters claim that investments in research, testing and treatment have led to “incredible progress” and millions of “cancer deaths averted,” as the homepage of the American Cancer Society, a nonprofit that receives money from biomedical firms, puts it. A 2016 study found that cancer experts and the media often describe new treatments with terms such as “breakthrough,” “game changer,” “miracle,” “cure,” “home run,” “revolutionary,” “transformative,” “life saver,” “groundbreaking” and “marvel.”

There are more than 1,200 accredited cancer centers in the U.S. They spent $173 million on television and magazine ads directed at the public in 2014, according to a 2018 study, and 43 of the 48 top spenders “deceptively promot[ed] atypical patient experiences through the use of powerful testimonials.” A 2014 study concluded that cancer centers “frequently promote cancer therapy with emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, costs, or insurance availability.”

Cancer has spawned a huge industrial complex involving government agencies, pharmaceutical and biomedical firms, hospitals and clinics, universities, professional societies, nonprofit foundations and media. The costs of cancer care have surged 40 percent in the last decade, from $125 billion in 2010 to $175 billion in 2020 (projected).

Research funding has also surged. The budget of the National Cancer Institute, a federal agency founded in 1937, now totals over $6 billion/year. That is a fraction of the total spent on research by nonprofit foundations ($6 billion a year, according to 2019 study), private firms and other government agencies. Total research spending since Richard Nixon declared a “war on cancer” in 1971 exceeds a quarter trillion dollars, according to a 2016 estimate.

Cancer-industry boosters claim that investments in research, testing and treatment have led to “incredible progress” and millions of “cancer deaths averted,” as the homepage of the American Cancer Society, a nonprofit that receives money from biomedical firms, puts it. A 2016 study found that cancer experts and the media often describe new treatments with terms such as “breakthrough,” “game changer,” “miracle,” “cure,” “home run,” “revolutionary,” “transformative,” “life saver,” “groundbreaking” and “marvel.”

What’s the reality behind the hype? “No one is winning the war on cancer,” Azra Raza, an oncologist at Columbia, asserts in her 2019 book The First Cell: And the Costs of Pursuing Cancer to the Last. Claims of progress are “mostly hype, the same rhetoric from the same self-important voices for the past half century.” Trials have yielded improved treatments for childhood cancers and specific cancers of the blood, bone-marrow and lymph systems, Raza notes. But these successes, which involve uncommon cancers, are exceptions among a “litany of failures.”

The article continues with a discussion of mortality rates. IMO a fair report would say that the results are mixed. Some effective treatments have been developed for some cancers. The progress on other cancers is negligible.

I guess what you think of the results of the “war on cancer” depends on your own experiences. If you, your child, your spouse, or your parent are alive today because of it, you probably think it was worth every penny. The answer is likely the same if you’re a medical professional.

As a pathologist buddy of mine puts it, everybody dies of something. The older you get, the more likely it is to be cancer. I think there should be more consideration of what constitutes a good death rather than in simply prolonging life. There are hard deaths and easy deaths and cancer can be a very hard death. Maybe that’s just me.

I wasn’t really sure what the purpose of the piece was. There are all sorts of possibilities including battlespace preparation for a prospective national debate over “Medicare for All”.

Okay, it’s time for a quiz. Which of the following do you believe will happen?

1. Sanders will go into the Democratic Convention with a majority of delegates, become the nominee, and go on to win the presidency.
2. Sanders will go into the Democratic Convention with a plurality of delegates, become the nominee, and go on to win the presidency.
3. Sanders will go into the Democratic Convention with a plurality of delegates, become the nominee, and lose the election to Trump.
4. Sanders will go into the Democratic Convention with a plurality of delegates, some other individual will become the nominee, and whoever that is will go on to win the election.
5. Sanders will go into the Democratic Convention with a plurality of delegates, some other individual will become the nominee, and whoever that is will go on to lose the election.
6. Sanders will drop dead before the Democratic Convention.
7. Sanders will drop dead after the Democratic Convention but before the general election.
8. Other

I think the greatest likelihood is C but E, F, and G are all distinct possibilities.

NPR’s Domenico Montanaro draws six conclusions from the Nevada caucuses which Vermont Sen. Bernie Sanders won handily:

1. Sanders expands his base

   Here’s a telling quote:

   “In Nevada,” Sanders said, “we have just put together a multigenerational, multiracial coalition that is not only going to win in Nevada, it’s going to sweep this country.”

2. Biden lives to fight another day

   The South Carolina primary is make or break for Biden. He remains the candidate most likely to secure a majority of black voters and black voters remain the most important constituency for the Democratic Party. Under the circumstances you might wonder why there aren’t more black Representatives and Senators. Me, too.

3. The moderates gambled—and are losing—on opposing Medicare for All

   Here’s another telling quote:

   Former South Bend, Ind., Mayor Pete Buttigieg, who finished third in Nevada, said something Saturday that moderates should take note of.

   It came immediately after accusing Sanders of believing in “an inflexible ideological revolution that leaves out most Democrats, not to mention most Americans.”

   That’s materially what Rahm Emanuel has been saying, too. To date unions, another important Democratic constituency, have opposed Medicare for All. Will that change? As I see it the Medicare for All plan that can pass won’t work and the one that can work won’t pass.

4. Expect a forceful Warren at Tuesday’s debate
5. Republicans were thrilled with the result — and lack of (fast) results
6. Caucuses may very well be doomed

   I think that’s right. I’m surprised they’ve lasted this long.

At this point the mathematics of the primaries looks like this. Delegates are awarded proportionally, based on the percentage of votes a candidate receives. Sanders can anticipate receiving from 25% of 40%, depending on how many votes Elizabeth Warren siphons away from him, and, due to the very concentrated schedule of primaries, she’s likely to remain in the race until Super Tuesday (March 3) at which point 60% of the delegates will have been awarded. Sanders may even win a majority of delegates in some primaries outright but, the longer that Warren, Buttigieg, Steyer, Klobuchar, and Bloomberg remain in the race the less likely it is that he’ll come into the convention with a majority of delegates.

I was nonplussed by the claim by Carter Malkasian at Foreign Affairs that our adventure in Afghanistan was a “good war” or that we might have succeeded there:

The United States failed in Afghanistan largely because of intractable grievances, Pakistan’s meddling, and an intense Afghan commitment to resisting occupiers, and it stayed largely because of unrelenting terrorist threats and their effect on U.S. electoral politics. There were few chances to prevail and few chances to get out.

In this situation, a better outcome demanded an especially well-managed strategy. Perhaps the most important lesson is the value of forethought: considering a variety of outcomes rather than focusing on the preferred one. U.S. presidents and generals repeatedly saw their plans fall short when what they expected to happen did not: for Bush, when the Taliban turned out not to be defeated; for McChrystal and Petraeus, when the surge proved unsustainable; for Obama, when the terrorist threat returned; for Trump, when the political costs of leaving proved steeper than he had assumed. If U.S. leaders had thought more about the different ways that things could play out, the United States and Afghanistan might have experienced a less costly, less violent war, or even found peace.

That is arrant nonsense from top to bottom. It was never a “good war”. There are justified wars. There are unavoidable wars. There are necessary wars. There are wars of choice. There are tactical wars. There shouldn’t be but there are. No war is good. War means killing and suffering and pain and destruction.

In the instance of Afghanistan a punitive action against Al Qaeda, the Taliban, and Afghanistan was completely justified and, sadly, was politically and psychologically necessary. It went wrong almost from the beginning when we elected to remove the Taliban government and replace it with one more to our liking. Once that had been done the die was cast.

All of the impediments to a “better outcome” were true and known to be true by anyone who actually knew anything about Afghanistan before the first American soldier set foot in Afghanistan. Talking about “hindsight” or “in retrospect” is foolishness. Better to talk about fecklessness and heedlessness.

I’m going to try to summarize what we know about the coronavirus outbreak that began in Wuhan, Hubei Province, China and is now spreading to other countries in the region and around the world. Most of the information is drawn from this article from the Associated Press.

By now there have been at least 78,000 cases of the disease, mostly in China, and more than 2,300 deaths, also mostly in China.

Outside of China there are substantial outbreaks in Japan and South Korea, with lesser outbreaks in Singapore, the United States, Thailand, Taiwan, and Australia. Recently, there has been a rash of cases in Italy.

Some people are blithely making projections of the disease’s trajectory, based on insufficient information. At this point all we can say confidently is that there have been a large number of cases and a large number of deaths in China and the contagion is spreading beyond China’s borders. We don’t honestly know whether the number of new cases and fatalities is increasing, decreasing, or staying the same.

The CDC’s guidelines for controlling the spread of the disease are here. They’re pretty boilerplate for respiratory infections. The facemasks you see pictures of people using, particularly in China, probably don’t do much, at least as they appear to be being used. I wonder if they’re helping psychologically or hurting due to moral hazard.

There have been reports of people contracting the disease again after recovering from it. I’m not sure how one could ever make confident projects of the contagion’s trajectory if there’s a substantial likelihood of reinfection.

I’m hearing a lot of complaints from people who clearly don’t understand the concept of risk.

I’ve mentioned it before there’s a wisecrack of my former business partner’s I think of as “the reverse Voltaire”: I agree with what you say but I will condemn to the death your right to say it. That’s what I thought when I read former Chicago Mayor Rahm Emanuel’s op-ed in the Wall Street Journal this morning.

There were quite a few things with which I agreed in the op-ed but I was gobsmacked by it because Rahm Emanuel is such a terrible messenger for those points for reasons I’ll go into later in this post. For example, I agree with this and I think a lot of Americans do:

In the quarter-century since Newt Gingrich became speaker of the House, Washington has become increasingly dysfunctional. Whatever your theory for why that’s happened, Donald Trump’s surprise election in 2016 was born largely of presenting himself as a change agent for those angry at Washington. Now Democrats are faced with a fundamental choice: Should we promise to return Washington to the pre-Trump “normal,” or should we instead take back the mantle of change?

That’s something I think that Democrats need to face. Without the perception that Washington was working fine for the rich but not for ordinary people and that, indeed, the Washington elite openly despises ordinary people, would there be a Trump?

Or this:

State and local government today get things done, while Washington so frequently falls short.

That’s a reality that those who want to concentrate everything in DC just don’t understand. Health care programs (mostly Medicare and Medicaid), Social Security, Defense, veteran’s benefits, and interest on the debt account for 80% of federal spending. Toss in farm subsidies, federal spending on education, and building new highways (but not maintaining existing ones) and you reach 90% of federal spending. Practically all of your, my, and everybody else’s quotidian encounters with government are with state and local government. State and local governments run the schools and most of the courts, maintain the roads, produce and enforce most regulations, fight fires, respond to emergencies, provide for the safety of the buildings around you, and provide almost all of the law enforcement. The notion of the federal government absorbing those responsibilities is not only absurd on its face but would be horrifically inefficient.

Now he gets to the meat of his argument:

Sen. Bernie Sanders is an anomaly. As someone who’s running for the Democratic nomination without even being a Democrat, he presents himself as an outsider. But as Mr. Biden has pointed out, Mr. Sanders has been making the same argument about profit-seeking corporations and greedy executives for decades. It’s pretty hard to maintain a legitimate claim on the “change agent” persona when your most memorable line in the campaign is “I wrote the damn bill!” Perhaps it’s no surprise that his support in New Hampshire fell from more than 60% in 2016 to less than 26% this year. Radical as his solutions may be, he is offering voters a bridge to the past.

Mayor Emanuel is right that there is a contest going on for the soul of the Democratic Party. As Peggy Noonan pointed out in her column today, it can be summarized in just two short sentences:

Mike Bloomberg: You can stomach me.

Bernie Sanders : You can stomach socialism.

I honestly don’t see how today’s Democratic Party can frame itself as the “agent of change” and the agent of the civil bureaucracy and financiers as Mayor Emanuel apparently wants to do. And that brings me around to why he’s such a flawed messenger.

First, he’s the consummate inside. He wasn’t just mayor of Chicago. He was an advisor to President Bill Clinton, his primary spokesman for a while (during the impeachment), a Congressman, the party insider who crafted the House majority from which President Barack Obama benefited early in his first term, and Obama’s first chief-of-staff. What does he know about outsiders?

And he was a terrible mayor. During his tenure the homicide rate soared to levels unseen in decades (maybe ever), Chicago’s bond rating went to junk status, he gave teachers a 30% raise that the city couldn’t afford which will saddle Chicagoans with increased pension payouts for decades to come, and he championed amenities for well-heeled downtown professionals while closing Southside schools.

If you’re going to position the party as being an institution that delivers, you’ve got to do a better job than that.

David Brooks’s latest New York Times column centers around myth-building and I agree with a lot of it. He points out that Bernie Sanders is succeeding in building his campaign around a myth that his supporters find compelling:

Successful presidential candidates are mythmakers. They don’t just tell a story. They tell a story that helps people make meaning out of the current moment; that divides people into heroes and villains; that names a central challenge and explains why they are the perfect person to meet it.

In 2016 Donald Trump told a successful myth: The coastal elites are greedy, stupid people who have mismanaged the country, undermined our values and changed the face of our society. This was not an original myth; it’s been around since at least the populist revolts of the 1890s. But it’s a powerful us vs. them worldview, which resonates with a lot of people.

Trump’s followers don’t merely believe that myth. They inhabit it. It shapes how they see the world, how they put people into this category or that category. Trump can get his facts wrong as long as he gets his myth right. He can commit a million scandals, but his followers don’t see them as long as they stay embedded within that myth.

Bernie Sanders is also telling a successful myth: The corporate and Wall Street elites are rapacious monsters who hoard the nation’s wealth and oppress working families. This is not an original myth, either. It’s been around since the class-conflict agitators of 1848. It is also a very compelling us vs. them worldview that resonates with a lot of people.

Not only are the other Democratic candidates for president failing to build their own myths to compete with Sen. Sanders’s, they actually buying into his myth. That is especially true of Elizabeth Warren:

My takeaway from Wednesday’s hellaciously entertaining Democratic debate is that Sanders is the only candidate telling a successful myth. Bloomberg, Joe Biden, Pete Buttigieg, Amy Klobuchar all make good arguments, but they haven’t organized their worldview into a simple compelling myth. You may look at them, but you don’t see the world through their eyes.

Elizabeth Warren inhabits a myth without expressing it clearly. It just happens to be Sanders’s myth. I thought her performance Wednesday evening was tactically brilliant and strategically catastrophic. Her attack on Bloomberg was totally through the Bernie lens. Her attacks on Buttigieg and Klobuchar were also through the Bernie lens. (Through that lens a bigger spending proposal is always better than a less big spending proposal.)

Warren was a devastatingly effective surrogate for Sanders, but she reinforced his worldview rather than establishing one of her own.

That’s why my assessment of her debate performance was that she’s jockeying for the VP slot. She was acting a Sanders’s surrogate.

Mr. Brooks then builds a little myth of his own:

Over the past five years Sanders and his fellow progressives have induced large parts of the Democratic Party to see through the Bernie lens. You can tell because every candidate on that stage has the categories and mental equipment to carve up a billionaire like Bloomberg. None have the categories or mental equipment to take down a socialist like Sanders.

Sanders goes untouched in these debates because the other candidates don’t have a mythic platform from which to launch an attack. Saying his plans cost too much is a pathetic response to a successful myth.

It’s the myth of inexorable rise. Unfortunately for Mr. Brooks, that doesn’t actually stand up to scrutiny. Sen. Sanders has just about the same support as he did four years ago. It’s just that the other candidates are divvying Hillary Clinton’s base of support amongst themselves, unable to attract Sanders’s supporters. Oh, Elizabeth Warren has attracted some with much the same vision, presumably on identity grounds, but does anyone really doubt that Warren’s supporters will find Sanders a suitable alternative?

Mr. Brooks concludes by proposing a myth of his own:

Everywhere I go I see systems that are struggling — school systems, housing systems, family structures, neighborhoods trying to bridge diversity. These problems aren’t caused by some group of intentionally evil people. They exist because living through a time of economic, technological, demographic and cultural transition is hard. Creating social trust across diversity is hard.

Everywhere I go I see a process that is the opposite of group vs. group war. It is gathering. It is people becoming extra active on the local level to repair the systems in their lives. I see a great yearning for solidarity, an eagerness to come together and make practical change.

These gathering efforts are hampered by rippers at the national level who stoke rage and fear and tell friend/enemy stories. These efforts are hampered by men like Sanders and Trump who have never worked within a party or subordinated themselves to a team — men who are one trick ponies. All they do is stand on a podium and bellow.

In the gathering myth, the heroes have traits Trump and Sanders lack: open-mindedness, flexibility, listening skills, team-building skills and basic human warmth. In this saga, leaders are measured by their ability to expand relationships, not wall them off.

The gathering myth is an alternative myth — one that has the advantage of being true.

I agree that the “gathering myth” is closer to the truth and it more closely reflects the reality I see around me. But it’s not a rallying cry.

However, I would urge Mr. Brooks to consider that the notion of a vanguard elite pushing events in a direction beneficial to themselves but to few others and certainly not to the country as a whole is precisely the myth that Trump’s supporters hold. He apparently holds it, too.

Today seems like a good time to consider the results of some public opinion polls. I’m going to try to make this a dry recitation of facts with as few opinions as possible.

1. President Trump’s presidential approval rating is the highest of his presidency.

According to Gallup’s most recent findings that approval rating is 49%. That’s higher than President Obama’s was at this point in his presidency, outside the margin of error, and about the same as President Bush’s was at that point.

2. If the election were held today and we elected presidents at large, he would be likely to win against any of the Democrats presently seeking their party’s nomination.

According to the latest Economist/YouGov survey present opinion suggests, by margins of greater than 19 points, that Trump is likely to win:

3. The econometric models of presidential election outcomes support Trump’s re-election.

Ray Fair’s model and the three different econometric models from Moody’s all forecast that Trump will be re-elected. If people vote their pocketbooks, as they have during the post-war period, Trump will be re-elected.

4. The betting markets favor Trump’s re-election.

5. The election will not be held today and we do not elect presidents at large.

The election is still more than eight months away, God help us. And the Electoral College still elects the president. The statistics I would really like to see are the opinions of people in the states that Trump carried in 2016. Said another way the Democratic candidate whoever he or she might be could carry every state that Hillary Clinton did in 2016 by larger margins than Hillary Clinton secured and still lose the election if unable to switch any states from Trump to themselves.

The editors of the Wall Street Journal renew their pitch for mass immigration:

Democrats and many Republicans complain that U.S. corporations are raking in huge profits as blue-collar jobs disappear. The reality is the opposite, a new Conference Board business survey reports. Corporate profits have been declining as employers increase wages to hire scarce blue-collar workers, but hold the champagne.

Eighty-five percent of blue-collar businesses report recruiting difficulties versus 64% of white-collar employers. One reason is the working-age population without a college degree is shrinking as baby boomers retire and more young people enroll in college. Labor participation among 16- to 24-year-olds has fallen 10 percentage points in two decades.

and

Nonetheless, 90% of blue-collar businesses report operating with unfilled positions, and 29% say this has made them reduce output or turn down business. Rising wages together with sluggish productivity growth are crimping corporate profits. Between the fourth quarter of 2014 and the second quarter of 2019, profits for nonfinancial corporations declined 17% and 46% for manufacturers.

Frankly, having been in the situation of seeing how job notices can be crafted to avoid applications, I’m a bit skeptical of their statistics. I wish they had explained why the jobs are “unfilled”. Are there too few applicants, too few applicants deemed qualified, or do the qualified applicants want more than they’re willing to offer? The answers matter.

One way of avoiding applications is to advertise job in Peoria from your Sitka branch. Not enough people who might be interested will see it. Another way is to tailor the notice so that no one or practically no one can fill it. The classic example of that was the ad from 1983 for an IBM PC programming expert with five years of experience. Nobody satisfied those requirements in 1983. Nowadays for a comparable case you’d have 50 resumes on your desk from Tata of people all claiming to have the requisite experience. You’d have no way to validate the claims so and they’re willing to work for a lot less than the workers you already have so why the heck not?

Additionally, 30 years of industrial policy focused on college educations have convinced people that there’s something distasteful or dishonorable about blue collar jobs. Too many young people today are looking for jobs as communications directors or marketing analysts that pay $120,000 a year for entry level workers.