March 7, 2011, 12:15 PM
Comparative Destructiveness
Jonathan Chait gets angry at the way Republicans, who claim to care about the deficit, propose saving money by cutting back on expenditures that are needed to control health costs. Indeed. But there’s a larger dynamic at work here than mere stupidity.
Let’s focus, in particular, on the ridicule some of the quoted Republicans heap on “comparative effectiveness research.”
Ask yourself, what do we have to do to control Medicare costs? We can save some money, maybe a lot, by reforming payment systems so that providers are paid for overall treatment rather than on a fee-for-service basis. But over the long term, the fundamental issue is going to be to decide what Medicare will and won’t pay for. We need, as Henry Aaron has often said, to learn how to say no.
Notice that this is very different from the issue on Social Security. You can propose simply cutting retirement benefits by 25 percent, and that’s doable. But you can’t decide to do only three-quarters of every operation and test that Medicare pays for (and no, you can’t demand that patients pay 1/4 of the cost without effectively denying care to many Americans.) So Medicare cuts are an inherently harder problem than SS cuts. In fact, I suspect that’s one reason, beyond the political motivations, why inside-the-Beltway types love to talk about Social Security, a trivial concern, while avoiding the vastly more important Medicare issue.
So how are you going to make decisions about what not to do? Um, you need good information about which medical interventions work, and how well they work: comparative effectiveness research. And no, that information isn’t already out there: doctors know surprisingly little about how effective procedures are relative to one another.
Why, then, are Republicans opposed to this kind of research? Some of it is sheer stupidity and/or anti-intellectualism — hey, those researchers are probably atheistic Democrats, you know.
via Comparative Destructiveness – NYTimes.com.
rePost:: ::Discover the real side of cities, if you’re brave, with GuidedByALocal
Would love to try both sides of this within the year.
If you’re the ‘adventurous traveler’ type, you probably want to get to know the ‘Real’ side of places you visit. A Netherlands-based team has created GuidedByALocal as the ideal place to find someone to show you just that.
Currently featuring 314 local guides in 202 cities in 68 countries, the site is designed to connect globetrotters with volunteer guides around the world.
via Discover the real side of cities, if you’re brave, with GuidedByALocal.
Lest We Forget :: Chiz Escudero's Stupid Proposal on Education Curriculum Reform for our Country
I can only cite myself as an example,magmula po nung natapos ako nung high
s c h o o l h i n d i k o p a n a g ami t a n g C a l c u l u s , h i n d i k o p a h o n a g ami t a n d
Trigonometry, hindi ko pa ho nagamit and Algebra, iyung Geometry, sa bilyar ko
lang nagamit. At iyong mga ibang itinuturo ay marapat sigurong ituro sa kolehiyo
kung nais maging inhinyero ng isang bata. Iyong mga ibang itinuturo, marapat
sigurong ibigay na lamang nating sa kanila sa kolehiyo o bilang elective
pagdating ng high school.
This would effectively give more time to our children to spend with their
families and perhaps and help them in whatever it is that they are doing to earn a
livelihood. If by any chance we are able to reduce the curriculum by half, we would
effectively double the number of classrooms in a day and overnight because we
can now use the classrooms twice over instead of simply being used once given the
overburdened curriculum that our children have. If only, Mr. Speaker, to propose
the following, I think we can reduce the curriculum to perhaps five or six subjects,
namely: Language, to include Filipino and English; Social Studies and History
both of the world and our country; Math and Science; Computer and Good Manners
and Right Conduct. And I believe that we could develop our children holistically
in such a manner.
This, however, is only a proposal. This is a suggestion for us to look into once
again and study it. And we have made known our proposal to the Secretary of
Education so that they could review this with a view of unburdening our students
at present
I had difficulty finding this. If the congress needs help with their website I’d gladly volunteer to make it more searchable and reliable. If I wasn’t persistent enough I wouldn’t have been able to get the source document.
PDF HERE :
If I only had the time I know If I read through these I’ll be able to find more gems of law makers being less than enlightening.
Best Read::rePost::Letters of Note: Be your own self. Love what YOU love.
Transcript
ray bradbury enterprises
[Redacted]
los angeles, california 90064
dear william stanhope:
most important decision i ever made came at age 9…i was collecting BUCK ROGERS comic strips, 1929, when my 5th grade classmates made fun of me. I tore up the strips. A week later, broke into tears. Why was I crying? I wondered. Who die? Me, was the answer. I have torn up the future. What to do about it? Start collecting BUCK ROGERS again. Fall in love with the Future! I did just that. And after that never listened to one damnfool idiot classmate who doubted me! What did I learn? To be myself and never let others, prejudiced, interfer with my life. Kids, do the same. Be your own self. Love what YOU love.
Best wishes,
(Signed, ‘RAY B.’)
Bradbury
10/28/91
via Letters of Note: Be your own self. Love what YOU love..
We kill the light of truth we have because
How energy alternatives can make us safer and healthier « Science in the Triangle
James Bartis, a senior policy researcher with the RAND Corp., a global policy think tank with an office in the Middle East emirate of Qatar, was one of the speakers at the conference. In testimony before the U.S. Senate Committee on Energy and Natural Resources two years ago, Bartis urged that there was “a compelling need to reduce greenhouse gas emissions” and a need for research on technologies that would allow us to use less oil, coal and natural gas, the three fossil fuels linked to almost 90 percent of the emissions.
At the NCSU conference, where he participated on a panel of alternative energy experts, Bartis was asked why lawmakers aren’t heeding his advice more. “There’s a lot of money to be had [with fossil fuels] and there’s a lot of inertia,” he responded.
About 83 percent of the U.S. economy runs on fossil fuels and Alan Hegburg, a senior fellow at the Center for Strategic and International Studies and the conference’s keynote speaker, didn’t expect much will change the next 10 years.
Coal is plentiful and cheap – no country has more coal reserves than the U.S. Crude oil is also still plentiful and cheap to extract – in the Middle East, which has more than half of the world’s oil reserves.
Fossil fuels pack a lot of energy. Their production is efficient. The delivery infrastructure is finetuned. And markets are well developed. In contrast, energy alternatives cost more and are less energy-dense. And functioning delivery systems to drive demand are rudimentary at best where they exist.
“Getting this train to change tracks will take a huge effort,” Hegburg said.
Then why try? Speakers at the conference offered as the main reason the hidden costs of fossil fuels.
Generating electricity from coal and burning oil for transportation is a dirty business. In 2005, pollution caused an estimated $120 billion in damages to human health, crops, timber yields, buildings and recreation nationwide, according to a report the National Research Council published 18 months ago.
Another study published a few weeks ago in the Annals of the New York Academy of Sciences estimated that extracting, transporting, processing and combusting coal caused $345 billion in damages to the health and the environment in 2005.
Factor in the hidden costs and electricity would be at least twice as expensive, according to the study. Do the same with oil and gasoline prices would be at least $1.50 per gallon higher, Bartis said.
Suddenly, wind and solar energy and investments to boost energy efficiency and conservation become competitive. Calls from research hubs for more funding to make cleaner energy alternatives cheaper and more efficient begin to make sense.
via How energy alternatives can make us safer and healthier « Science in the Triangle.
rePost:: Rough Type: Nicholas Carr's Blog: Distractions and decisions
“We’re fooled by immediacy and quantity and think it’s quality,” says Eric Kessler, a management expert at Pace University’s Lubin School of Business. “What starts driving decisions is the urgent rather than the important.”
The fact that we think less clearly when we’re distracted shouldn’t be a big surprise, but perhaps the hard evidence Begley reviews will give pause to those who labor under the misapprehension that, when it comes to information, more is always better.
via Rough Type: Nicholas Carr’s Blog: Distractions and decisions.
rePost :: :: 51 hours left to live : IAmA
51 hours left to live (self.IAmA)
submitted 17 hours ago by Lucidending
On Tuesday I’ll finally end my battle with cancer thanks to Oregon’s Death with dignity act. As part of my preparations I’ve ended my pain medication and am trying to regain what little dignity and clarity I can.
Who I was doesn’t matter. I’m in pain, I’m tired and I’m finally being granted a small shred of respect. Feel free to AMA if you’re so inclined.
6944 commentssharesavedhidereport
via 51 hours left to live : IAmA.
submitted 17 hours ago by Lucidending
some notable words:
rePost :: PeteSearch: The American Way of Dating
Hmm the weird thing is that we follow the american model when out heterogeneity as a nation maybe lends itself more towards the British model.
The British standard is “go to a party, down some drinks, make eye contact with a person you fancy, proceed to kissing and often much more, wake up the next morning to find that you have magically become one half of a couple”. It seems like the goal was to avoid any unambiguous declarations of interest, so that at any point either person can end the process without the other losing face.
This isn’t how it usually works in the US, at least in the mainstream. The formality and rituals surrounding courtship feel like something out of a Noh play. The very idea of actually asking a near-stranger for a date, explicitly and with no particular preamble, in the full knowledge that you may be turned down, seems nothing short of revolutionary compared to the system I grew up with.
via PeteSearch: The American Way of Dating.
Elink Video :: [ Baz Luhrman ] – Wear Sunscreen
Elink Video :: Wear a Condom (song)
Got this from chuckie:
Lucidending [S] 674 points 17 hours ago[-]
rebel_rouser 4 points 16 hours ago[-]
Lucidending [S] 146 points 16 hours ago[-]