There! Are! Four! Lights!

It seems CIA torture is back in the news again.

This is a point I’m pretty sure I’ve made before, but I still don’t get why the administration and CIA decided to turn torture into a matter for public debate, by publicly coming out and saying they were torturing, and defending torturing, and whatnot. I’m pretty sure the longstanding CIA policy was just to torture people but not talk about it or admit it. I was fine with that, everyone was fine with that. Was it not working or something?

The only thing I can think of is that this was a calculated move to signal to our enemies that yes, indeed we tortured people. Whereas previously some of them might have harbored some doubts or something.

I presume that the recent controversies and threats of prosecution mean that we’ll revert to the policy of just torturing people (when we need to) in secret, and not admitting it, like we’ve always done and like any civilized country does. So, no harm no foul I suppose. I just hope the controversy wraps itself up sooner rather than later; if I have to read a lecture by one more lefty commentator who has convinced himself that “torture doesn’t work” – a “fact” that most people under the age of 40 have learned primarily by watching the episode of Star Trek: The Next Generation where Jean-Luc Picard is captured by that Cardassian a-hole who strips him naked and shines four lights at him but tries to get him to say there are five lights – but he doesn’t because everyone in the future knew that “torture doesn’t work” – I think I’m gonna puke.

Morality = Theocracy Unless It Doesn’t
August 31, 2009, 12:35 am
Filed under: Uncategorized

Everyone remembers the dark, theocratic Bush Years when the right-wingers decided it was okay to use government to impose their morality on the rest of us. I thought this was supposed to be a free country. But we had no freedoms under Bush, what with him imposing his morality on all of us. (Don’t you remember? When we had no freedoms? Man that sucked). Theocracy came to America. Just like the Taliban.

On an unrelated note, NewsReal has some fascinating excerpts from an interview between Bills Maher And Moyers:

Maher: And he never really effectively has yet anyway, made it a moral issue.

Moyers: He started just recently, a few days ago. He talked about health care as a moral issue. But it is a moral issue! It’s not an economic issue.

Yes, it’s about time President Obama “made it a moral issue”. (Gotta love that “not an economic issue” – this is what someone says when they know they’d lose the argument on economic grounds…)

Anyway, I sure hope you get the message: Morality imposed through government policy? Really really bad and fascistic. Except when lefties happen to agree with the policy. In that case imposed morality is great and something to be proud of, indeed it’s apparently the best argument lefties can think of.

August 26, 2009, 1:58 am
Filed under: Uncategorized | Tags: , , , , ,

Health care “reform” advocates are fond of claims that such-and-such number of people don’t have “access to” health care.

Effective phrase, and sure seems to support their case. But what does it even mean? What is “access”? It’s a pretty slippery notion to anyone who actually takes the time to, well, think about what it might signify.

At one extreme end of the spectrum, one might say that “access” must be free and unfettered to be true “access”. If you have to fork over money for entry somewhere, you don’t have access to it. If you had access to it, you’d be able to go there, and do the thing, without someone forcing you to fork over money. By this reading of “access”, it almost necessarily entails “free”. So if people “not having access” to health care is a valid complaint, and this is what “access” means (free), the complaint is essentially a demand for health care to be free. For everyone, I assume. (After all if it’s free for you what’s the argument that I should pay anything? There isn’t one.) In other words it’s an argument for fully socialized health care.

The other possible meaning, of course, is that “access” doesn’t quite mean “free”, it just means “affordable” – there may be some cost, but it isn’t a cost that exceeds one’s ability to pay. This definition of “access” is superficially appealing (according to it one might say I have access to a Toyota, but not to a Lamborghini, which sounds right). The problem is that by this definition, there will always be some subset of humans who “don’t have access” to any good or service you could name. There’s no such thing as a good or service that (a) isn’t free but (b) every single human can afford. Whatever price X you can name, there will always be some humans who can’t afford to pay X – and thus, “don’t have access”. So if this is what the complaint about “access” means, it’s not a valid complaint.

In summary: if the complaint has merit, it’s a veiled demand for socialized health care. If it’s not a demand for socialized health care, it’s a complaint without merit.

There is another dimension to the ambiguity surrounding “access” though and that is simply the fact that “health care” is not an unambiguously-defined service. What exactly is “health care”? To some people “health care” means “set my bone when it’s broke”. To other people “health care” means “I feel a twinge in my elbow so I made an appointment with my doctor”. There is often no simple, easily-defined concept of The Health Care Stuff Someone Needs. Instead there’s a fuzzy continuum of possible Health Care Treatments that may (or may not) work on someone’s ailments. When trying to ensure that everyone has “access” to “health care”, how high exactly must one climb this spectrum before “no access” becomes “access”?

Let me illustrate with an example. Cancer is often treated with external-beam radiation (XRT), and has been for some 50 years now. But within radiation therapy of cancer there is a specialized technique, a special form of XRT, called Intensity-Modulated Radiation Therapy (IMRT). IMRT was invented in its current form in the 1990s, more or less. It requires special software to optimize one’s treatment, and the radiation machine (linear accelerator) needs to be equipped with the right add-on gear and whatnot to be able to deliver it.

The difference between XRT and IMRT is sort of like the difference between attacking your cancer with a shotgun and attacking it with a sniper rifle. That exaggerates things, but you get the point: IMRT is more focused, and hones the radiation more tightly right where you want it (cancer, not health tissue). As a result IMRT can be expected to lead to fewer side effects, and by the same argument, using IMRT one might expect to be able to zap cancer more with no higher risk.

I should add that last time I was keeping up with these things, the reimbursement (from Medicare, if it covered it, or insurance companies) for getting a course of XRT was measured in the low thousands, whereas for IMRT it was in the low tens of thousands. Those numbers are highly approximate and I may be remembering it wrong (and these numbers may have converged in recent years) but it was definitely the case that IMRT is some multiple more costly to deliver than XRT.

With that setup, let’s try to apply this example to the issue of whether someone has “access” to “health care”. Say someone is a cancer patient. They need treatment. Cancer treatment is “health care”, and obviously, that’s what they need. And we are very concerned with ensuring that this person has “access” to it (the “health care”).

But wait: what IS “health care” for this person? Ask the radiation oncologist and he says a standard treatment for this cancer would be XRT. Or, one could opt for IMRT.

Which treatment is “health care”? Are they both “health care”? Suppose this person (or his ins. co.) will pay for the $2000 XRT treatment but would have trouble affording the $20,000 IMRT treatment. So he ‘only’ gets XRT. Does he have “access to” “health care” or not? Maybe he does (because at least he got XRT). But wait, look at that dude over there, his ins. co. shelled out for the IMRT. That’s not fair! He’s getting “access to” that health care which other people are not! But keep in mind, IMRT didn’t even exist prior to the 1990s. There was no such thing as IMRT. When exactly does it join the ranks of Treatments That Must Be Applied To Everyone Or We Have An “Access” Problem?

And it doesn’t end there, either. Because hold everything. IMRT, you say? That’s sooooo 1998. The new thing is Stereotactic Radiosurgery.

Wait! The new thing is Tomotherapy.

Wait! The new thing is proton therapy.


If we don’t subsidize proton therapy for every single human in the U.S. who has vaguely proton-therapy-treatable cancer, isn’t that an issue of “access”?

Surely you can see the slippery-slope here. It’s not at all well-defined to anyone who knows even a little (as I do – a little) about how these things work. There’s no simple cookie-cutter treatment you can slap the label “health care” on. The answer is obviously they’re all “health care”. It’s just that some treatments are Toyotas while others are Lamborghinis. Which one are the health care “reform” advocates insisting we must buy for everyone? Where do they draw that line (if they’re even aware of it)?

But if they were aware of these issues, they wouldn’t oversimplify things or speak in terms such as “access” in the first place. In other words, they wouldn’t sound as ignorantly propagandistic as they do. So in a sense, my questions here are moot. They answer themselves.

Three Greats

I tend to like most movies I see nowadays (with the help of internet recommendation software, Netflix, etc. – I probably won’t even start to watch a movie I’m not likely to like).  But it’s still pretty rare to see a movie that blows me away.  Well here are three recent movies that blew me away.

1.  Sorcerer, which I had only really known from modern pop movie-history as the quintessential “1970s movie that was buried by Star Wars ushering in a new era of blockbuster”, but finally made it to the top of my Netflix queue after what must have been a long and hard struggle through mud and over rickety bridges.

Brutal, depressing movie.  But great and deserves to be remembered for more than opening the same time as Star Wars.  It’s almost a story of redemption of man through hard work and knowhow, kind of the male equivalent of The Devil Wears Prada., okay, not quite.

2.   A Little Romance.  Not even sure how I came across this gem but damn I’m glad I did.  The first movie of (13-year-old) Diane Lane, and one of the last with Laurence Olivier.  Probably the best teen romance that I have ever seen.  And it’s so sweet and innocent as well.  A pure pleasure of a movie.

3. Inglourious Basterds, which I just saw today in a theater seemingly packed with senior citizens.  Unbelievable, mindbending experience.  Tarantino’s Star Wars, in my view (which is just a gut vibe I’m getting, not something I can fully explain).  I know this movie will be analyzed to death in the years to come, but it’s almost better to just let the whole thing sink into you, unanalyzed, undissected, as a whole and pure specimen of a kind of movie I have never ever seen before or even imagined in my life.  I’ve probably already thought about it too much in fact.   Here is what I wrote about it to Pastorius (who often has to bear the burden of hearing the first-draft of my reaction to this sort of thing).  I can’t wait to see it again.

It will probably be a very long time before I see three movies in succession that blow me away like this.  (Well, I do have high hopes for Hellboy II: The Golden Army…)  ;-)

Tomato, Tomahto
August 24, 2009, 12:08 am
Filed under: Uncategorized

There are some things my brain just refuses to assimilate permanently, and one is the iconography of the Rotten Tomatoes website.  Next to each review, you see, they place one of two symbols

1. A red tomato

2. A green thingy

One means the review was positive, and the other means it was negative.

I can never remember which was which!  (Without thinking about it for a ridiculously long time)

See, okay, I guess the concept is that if the review is good, the tomato is “fresh”, thus red.  If the review is bad, the green thingy is supposed to make us think of a rotten tomato.

But I always second-guess all that and think:  wait a minute.  Tomatoes are what angry audiences throw at things/people they dislike.  If a performer is bad he’s liable to get a bunch of bright red tomatoes thrown at his face.  Splat!  Hence, red tomato = bad.
Meanwhile, the green thingy?  Looks like a bundle of leaves.  Leaves like on a tomato plant.  Like someone just planted a nice fresh baby tomato plant.  How nice.  Nice and green and fresh.  Green = good, therefore.

All of which is backwards of course, and I do always realize that.  But I have to think about it.  Either this is because there’s just something wrong with my brain, or the Rotten Tomatoes symbols aren’t as effective as they could be.  Stars are effective (more means better).  You could imagine using a plus or a minus, a thumbs-up or a thumbs-down, a smiley face or an unhappy face, a guy applauding in his seat or snoring in his seat (SF Chronicle).  But this whole thing with the red and the green just isn’t working for me.

Okay, there’s probably something wrong with my brain.

Just Pay Me With Money. I’ll Buy My Own Stuff With It, Thanks.
August 23, 2009, 7:18 pm
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One of the things I keep coming back to in the health care debate is how stupid and antiquated it is that the government encourages companies to pay their employees partially in Health Plan rather than in Money.

As a general rule, can’t I please just have the Money instead?  Why is the government deciding for me what I want to spend my own Money on?  If you pay me Health Plan, I’ve got some Health Plan, which is fine, but which I may or may not want or use.  But if you give me the Money, I can buy whatever I want with it, which may or may not be Health Plan.  Why is it so difficult for so many people to understand that the latter is better than the former?

As a holdover from the Soviet Union, I imagine, my mother-in-law gets some free Circus tickets through her job every year.  This was probably some commissar’s idea of how to keep employees happy.  “Let’s allocate them some Circus tickets.”  (I suppose this may have solved some sort of unemployment issue on the Circus side of the equation as well.)  So every year, like clockwork, she gets Circus tickets.   Still.  Sometimes I guess they go.  Sometimes she gives them away.  Sometimes they probably go unused.  Now, there’s nothing wrong with the Circus per se.  It’s pretty cool in fact.  Especially in Russia.  But what if the Circus wasn’t your first choice?  What if you’d wanted to do something else instead?  Do you have Money, that you can use for any number of goods and services?  Sorry.  Bzzt.  You’ve got Circus tickets.  Which are only good for – you guessed it – going to the Circus.

I’m having trouble getting the words out because it’s so frustratingly obvious to me that THIS IS NOT THE DIRECTION WE WANT TO MOVE IN.  Less Soviet, not more, damn it!

Yet everywhere I look are people who are saying in effect “give me more circus tickets.  Give EVERYONE circus tickets.  That sounds like a good idea”.  So circus fans, they campaign for and get their circus tickets.  Health Plan fans, campaign for and get Health Plans.  We’re all stuck with the result, and everyone is campaigning for getting less and less Money and more and more Other, Particular Stuff in exchange.  Stuff that’s decided on by other people.

When you get Money, you don’t have to go with the decision of those other people.  You get to choose.  This is better.  Period.

Whatever busybody scheme or proposal or tax break you’ve got in that clever head of yours for having people paid with Other Stuff rather than Money, just shove it.  Please.  Is it really so objectionable to just let me have my fucking salary paid to me in Money so that I can decide for my own fucking self what I want to do with it?

In fact, I think I want to go to the Circus.

The Unmeasured Dimension of Health Care
August 23, 2009, 3:59 pm
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There is a touchy dimension to the health care debate, which is simply that not all people use health care equally, or in equal amounts.  Not simply because they “can’t” or can’t afford it – although that’s obviously true, that’s not what I’m talking about here.  I’m talking about the cultural tendency to use health care more… or less.   There is a gender dimension to this (women use health care more than men) and, more touchily, there is probably a cultural dimension as well (some cultures probably use health care more than others – I do not care to speculate).

I’m not sure I ever see anyone point this out.  Maybe it’s too subtle.  Or maybe it’s just too touchy, or not polite enough for mixed conversation.  But since all proposals for health care reform are in effect proposals to tax us more and pay/pool our health care costs via  a more government-involved method, I figured someone should point out that in effect this would necessarily result in transfer payments.  Obviously it’s no secret that there will be (yet more) transfer payments from the young/healthy to the old/sick.  But it would also mean, in effect, transfer payments from one gender (men) to another (women).  And – though this would be more difficult to measure – transfer payments, probably, from some cultures to other cultures.  Some social classes to other social classes (and not necessarily the ones you think).  And some races to other races (not necessarily the ones you think).

Imagine, for example, a 45-year-old woman within whose social group, social class, and culture (whatever those are) – and also due to her personality – it’s perfectly normal to visit her doctor like every six weeks.  To be on all sorts of various drugs (not for life-threatening reasons, but for aches and pains and sadnesses of various sorts).  And to make an appointment with her doctor when she gets the flu or sprains her ankle (instead of just toughing it out, like – oh, to name just a random example – I do).  And each time she does this she has a co-pay.  So this woman already pays $X/year not because she “needs” to but because according to her culture and personality, it’s the norm, and thus she feels like she needs to consume health care to a degree that other people – such as myself – would not (even if I had the exact same ailments!)

Is it any surprise that this woman favors “health care reform”, i.e. higher government taxes and more wealth-spreading in order to defray and uniformize health care – and thereby, lower the co-pays she’s already paying (because she feels like she needs to)?

At the margin, this woman is saying “this is stuff I already spend money on.  Sure would be nice if the government would step in, garnish other peoples’ salaries more, and offset this ongoing cost of mine, so I can keep it up”.

By the same token, however, imagine being someone on the other end of that equation?  Someone who doesn’t call his doctor for every ache and pain.  Someone who doesn’t have a lifestyle built around doctor appointments (heck, hasn’t even seen a doctor in years).  Someone who would be very interested in catastrophic-only insurance but doesn’t see a need for the “payment-plan” sort of insurance we have, and would gladly embrace a system where regular doctor visits and the like were just an out-of-pocket thing.

To such a person (i.e me), “health care reform” is just a disguised way of saying “gimme”.  Gimme more of your money.  The result will be to codify into law the health-care consumption patterns and lifestyle of the first sort of person (her) at the expense of the second sort of person (me).

This is a cultural battle as well.

Just worth pointing out.  Carry on.


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