Thursday, December 31, 2009

Anthropogenic Global Warming

I will call people who believe in anthropogenic global warming (AGW), warmists, those who are less certain, denialists. I hope it insults both sides equally.

My BS degree is in earth science. I work for an oil company. I believe in the scientific method. I believe that government has a legitimate role to play in society. I am not a Neanderthal.

I have biases. Some may think that because I work for an oil company, I desperately want to see the warmists fail. Look, I'm too close to retirement for anything that happens now to have an effect on my personal earnings or career, so I don't think that comes into play. And by the way, I live on this planet. If humans are doing something to damage the planet, I want it to stop. I want us to take action to fix and reverse the harm. I may be retiring within fifteen years, but I hope to live a lot longer than that, and I want my kids to inherit a good place.

I have read a lot about the science, politics, and economics of the CO2/global warming issue and am not convinced that spending trillions of dollars to reduce human CO2 output will be money well spent. The science is unconvincing, the economics are dubious, and the political hysteria is ridiculous.

Tom Friedman and Paul Krugman (both of whom I generally respect) wrote broad-brush, ad hominem, idiotic columns about my ilk, and think I'm angry and/or ignorant. They think this because they think that anyone who is not on the AGW bandwagon is misinformed, ignorant, or simply opposed to progressive causes based on ideology.

Stewart Brand considers there to be four categories of opinions on the subject of AGW: Catastrophists (actually Calamatists from the link), Warners, Skeptics, and Denialists. Here's how I think of them. Catastrophists and Denialists see the worlds as black and white.  Catastrophists believe that Global Warming is happening and it's going to be really bad. Denialists tend to the opposite corner. Warners on balance believe that the evidence overall supports that human carbon dioxide emissions are the major cause of warming, and that overall it is likely to have bad effects. Warners tend to favor the precautionary principle. If there is a chance, no matter how small, of total catastrophe, we should protect from it. Finally, skeptics tend to believe that the case that human carbon dioxide emissions are a major cause of warming (if any) is far from proven, and that even if it warms, the damage is highly unlikely to be catastrophic.

Has The Earth Warmed?
From the data I have seen, I do not have high certainty that the earth has warmed substantially over the last 100 or so years. On balance, I think it has, but I can't say how much.
Why: pro: the earth hit a climate low about 150 years ago, temperatures may have been rising since then. Why not: However, there are inconsistencies in the data, and the graphs that are shown to the general public contain corrections, which in some cases are greater than the anomaly that they are showing. As an example, there are temperature time-series that uncorrected show an actual decline in temperature of 0.2 deg C. Then adjustments are applied and they show an increase of 0.6 deg C. This is a swing of 0.8 and converts the trend from negative to positive. There may be good reason to apply corrections, but when corrections are as large as the anomaly, you have to wonder.

Temperature stations have been documented as being of poor quality. The error in the temperature stations exceeds the amount of warming being hypothesized by the climate scientists.

There are inconsistencies between temperature station measurements and proxies. In fact, this is the source of the "hide the decline" issue in the recent climategate controversy. The proxy (tree ring thickness and density) indicated cooling (the decline), while thermometers showed warming. This kind of inconsistency casts a shadow of doubt on using he proxies as a reliable proxy for temperature.

While we're on ClimateGate...
Warmists are minimizing the ClimateGate scandal, denialists are jumping for joy. Again, I don't know what the answer is on many of the issues, and whether "tricks" is about obscuring data. What I do know is that a small group of influential people in the warmist community used their influence to stifle dissenting voices, deliberately withheld data from people with different opinions from theirs, and destroyed correspondence.

This may or may not be illegal, but I know it is unethical and scientifically indefensible. Science is about inquiry and honest debate. Opening data sets and models to scrutiny can only improve the outcome. If they are right about their science and statistics, they have nothing to fear. If they are wrong, they need to be corrected before significant commitments are made based on the faulty analysis.

By declaring the science to be settled and refusing to engage with the opposition, the warmists are showing either hubris or fear. Either way, my trust in their thought processes and work plummets. A much stronger video view is provided here by Lord Christopher Monckton.

This just smells rotten. It would just by a minor blip in scientific lore if the stakes involved weren't so high. But they are.

ClimateGate 2 - Hide the Decline
The graph shows the issue of the infamous "hide the decline comments from ClimateGate. Here is a thorough analysis of the issue by Steve McIntyre. In essence, when the lead researchers noted that the tree ring data (red line) diverged from the "consensus view" of warming, they truncated the data series (green line), then effectively hid it by plotting it with other time series (spaghetti bowl effect).

This link takes you to a website that has a tremendous 30 year timeline of AGW and the players involved in ClimateGate. It's worth a look.

Consensus View
What is the consensus view anyway? Here's what I think is the consensus. Carbon Dioxide in the atmosphere has a net warming effect on the climate of the earth without considering any of the feedback mechanisms. An increase of CO2 will cause additional warming of the atmosphere, all else being equal. The IPCC document sets forth a scenario in which there is a gradual warming over the next century of between 1.1  and 6 deg C and sea level rising between 18 cm (7 in) and 1.6 meters), depending on the selected scenario.

The warmists proclaim that there is no further argument, the debate is over, there is consensus on the science. The mere existence of denialists and skeptics puts the lie to this statement. I have seen warmists make the claim that denialists are the equivalent of flat-earthers. This is wrong in a number of ways. First, insulting people and trying to discredit them by name calling is a defense of the fearful. Second, direct observation and measurement of the earth has has completely disproven any idea that the earth is flat. There is no interpretation involved. It is fact. It is direct observation. Climate change is much more subtle than that. The changes in temperature tend to be small, and very gradual, occurring over generations. That by itself implies techniques beyond simple observation. But once you get past simple observation clearly pointing the way, you go into the interpretational realm. For example, most temperature stations have adjustments on them, but adjusting the data adds a layer of interpretation and uncertainty to the data.

Scientific Method
Scientific research cannot prove that CO2 causes warming. The way it works (or should) is that a researcher puts forth a hypothesis and then tries to disprove it through tests and observations. The AGW null hypothesis seems to be something like "increase in CO2 in the atmosphere has not been the major causal factor of warming since 1950." Through 1999, if you believe the temperature readings, planetary outcomes have been inconsistent with the null hypothesis. However, in the 10 years since, the planet has actually been cooling or flat temperature., which is consistent with the null.

It does not mean that the AGW hypothesis is disproved entirely, just that there may be some other factor that the scientists are not accounting for. It proves that something besides CO2 has a significant impact on global temperature. So it weakens the hypothesis.

Precautionary Principle
The precautionary principle is the idea that if there is any chance of catastrophic outcomes, we should insure against it. In the case of AGW, the argument goes something like, "The climate models show that there is a  reasonable chance of planetary ecological destruction caused by warming, which is caused by CO2. Even though there is a possibility that this will not come to pass, we should make great efforts to reduce CO2."

It sounds reasonable, but it comes down to your Choice of Catastrophes. There is also a chance that an asteroid will slam into the earth and obliterate all life forms larger than a mouse. Shouldn't we be doing something about that? Dick Cheney's 1% doctrine as documented here by Tom Friedman is also a form of the precautionary principle. There are infinite possible catastrophes, and a wide range of responses. How certain do we have to be of the catastrophe, and how much should we spend to avert it are really the issues. I have not seen real evidence that any of the proposed actions to cut carbon would act to avert the catastrophic scenario.

The following has been attributed to Mike Hulme, Director of Tyndall Climate Research Centre.
"...to reduce emissions requires more evidence than that humans are altering climate. We need to know something about the potential risks associated with future climate change, whether these risks can be minimised through adaptive action and then have some socially negotiated basis for deciding about the necessity and extent of desirable emissions reductions. On none of these issues do we have a good basis to work from. The precautionary principle, if chosen, would imply start reducing emissions now – but I am not convinced a blind application of the precautionary principle in this case is the most appropriate instrument."

No Harm If We're Wrong and Cut Carbon Emissions
In a recent New York Times opinion piece, Thomas Friedman asserted that even if we're wrong, by reducing our carbon footprint the world will be a better place. I agree with that, but only under certain conditions.

Think about this happy scenario. You win $10,000 in the lottery. So you take the money and hide it under your mattress. Your friends tell you, "But you should put it in the bank. You only earn a taxable 1% on it, but you're better off with that $70 after tax per year than without it." So far, so good.

But you also have $10,000 in credit card debt at 20% non tax-deductible interest. so you would be even much better off paying off your credit card debt than putting the money in the bank. This alternative use of money is a really important concept in economics and can't be ignored. It is your opportunity cost.

In the case of AGW, are the expenditures required to cut CO2 emissions the best place to spend the money and political energy? According to the Copenhagen Consensus studies, there are much better returns available. So like the man who wins the lottery, we would be better off by doing something than doing nothing. However, the real options are doing something about CO2 or doing something better.

What About Clear and Present Dangers? Is that the "simple" path?
I have heard it argued that focusing on the current problems, e.g. malaria, potable water, etc. is an easier path than to focus on global warming, with the implication that AGW is harder, but better.

I'll turn that around and ask how many people we are willing to kill in order to protect us from some computer-modelled, unproven, hypothetical threat from CO2? Focus on CO2 may be a more difficult path, but the measure of better is highly subjective.

Cause and Effect
One of the denialist arguments is that CO2 actually follows warming, rather than the opposite. This is supported by data from ice cores. The warmists agree that, in fact, the CO2 levels lagged warming in the past. Their argument though is that sometime early in the 20th century that relationship changed. CO2 became the driving force, rather than an effect. I don't know enough about climate science to have a strong point of view on the likelihood of this kind of change in the relationship of these two variables.

However, it sets off my BS meter. I am sure this kind of thing happens in physical systems, and maybe even this one. But it just seems too facile. It seems like someone is distorting their model to fit their preconceived notions. Perhaps I could be convinced if I saw some data, but I'm not there.

Catastrophe Alert
The urgency and the worst case scenarios in the warmist message are troubling to me as well. You have ministers of the Seychelles "meeting" in scuba gear underwater to dramatize their situation. High ranking officials stating that if we don't do something now, we're doomed.  People holding up the millions living in Bangladesh as people who will be flooded out of their homes.

I say we need to get a grip. There are three kinds of people putting out this rhetoric: those who simply believe all the scare stories and haven't really thought it through, people with an agenda, and people who have really given it a lot of thought but whose explanations have not yet reached me.

To the best of my knowledge, nobody is really forecasting a fast, catastrophic sea-level rise. Sure, if the sea level were to rise 2 meters over the next century, many people would have to adapt. But it's not like they would drown in their sleep one night as the sea engulfed their homes.

If sea level increases appreciably, low lying poor areas will, over time, become uninhabitable swamps and wetlands, and the people will move to higher ground. Low lying rich areas, where people have something they want to and can protect will build levees and install pumps to prevent encroachment. People and institutions will adapt to the gradually changing circumstances.

On top of that, they have been saying for years that if we don't act now (pick your consequence). So far, we haven't seen those consequences. Each time they say that the sky is falling (and then it doesn't), they erode their credibility.

But there's another aspect to the false urgency. If we spend large amounts of money to abate CO2, that leaves less money for actual wealth generation. This means that if the earth warms anyway, e.g. if the warming is from other causes, such as changes in the sun's energy, we would be left with fewer resources to then deal with adapting. Focusing on CO2 as the means of preventing global warming carries risk with it. Following through with the Kyoto standards would have delayed earth's full warming by six years 100 years from now (from 2100 to 2106). The cost would be large, and let's face it, it doesn't prevent anything. More consideration should be given to adapting.

The Great Reframe: Global Warming vs Climate Change
One of the disturbing trends is for the warmists to jump on the idea of well it might not be warming much, but CO2 is changing the climate patterns. It's causing drought and storms in unusual places. I won't argue about whether climate is changing. It does all the time and has throughout the history of the world.

Those changes come from natural and external forces, sometimes from man as well. The Sahara desert used to be fertile cropland. The top of Mt. Everest is a marine limestone. What was once the Garden of Eden is now a desert.

When climate changes, people adapt. Sometimes they fight nature for a time, sometimes they simply move on. It is the story of mankind. However, the link between CO2 and climate change is even weaker than the link with warming. Are humans changing the ecology of the planet? Yes. But we are doing it through more direct effects than CO2 which leads to warming and/or climate change. Deforestation, overfishing, and toxic pollutants are much more direct and proximal things we are doing to the planet.

Today's Temperature in Context
This is an amazing contextual display of temperature over the years.

It puts our situation into an interesting perspective. You should come away from that page with a renewed understanding of just how much natural variation there is in the system.

Higher Level Context
I believe in science and the scientific method. But when people start demonizing those who do not agree with or who question the science, we are not doing science anymore. It's sales, politics, and personal motives coming into the scene. Yet it is being sold as science.

If the warmists turn out to be wrong, science gets a black eye. The very basis for looking at the world in evidence-based rational terms is undermined by the hyperbole. So in declaring the science as certain and settled, they are positioning science to be the fall guy in this. The scientists behind this are being used as dupes by people with an agenda. Someone like Al Gore, can and will fall back on "I was just doing what the scientists said." I have a real problem with this.

At the same time, there are problems and issues that science and policy can help with. Overfishing the planet's oceans, mercury in water, malaria, potable water, current flooding in low-lying areas, brutal human rights abuses in Africa. These are all things in the here and now, that call for solutions. How many people will die this year from malaria? How many will be tortured, raped or disfigured in Africa? Will there be enough food to feed people high quality nutrients?

Worrying about something that "might" happen gradually over the next 100 years ignores the here and now. Casting AGW in the light of "certain" science may reduce the ability of science to identify and solve other problems.

What About Al Gore
I think Mr. Gore is a sincere well-meaning individual. I think he truly believes that he is doing the right thing. I am also quite concerned that he is so locked into his position on AGW, that no amount of evidence contrary to his position could possibly move him due to his cognitive dissonance (see Mistakes Were Made (But Not by Me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts).

He has long been a proponent of the AGW hypothesis. He has written two books about the environment and won a Nobel Prize for his efforts. I really don't follow him closely, but I am disturbed by some of his behaviors. In 2009, he went before a congressional committee inquiring about global warming. I don't know the purpose of the inquiry. The representative from Tennessee, asked him about his interest in Kleiner Perkins, a San Francisco Bay Area venture capital firm with interests in carbon technologies. He tried to sidestep the fact that he, in fact, has an economic interest in the furthering of the AGW hypothesis.

Again, I think he is well-meaning, and I think he has good motives. However, denying that he may have a bias is not a realistic position. At the start of his quest his bias was small. He now has a vested interest in the policy decisions that stem from the AGW hypothesis. He really should bow out of the politics at this point.

He also refused to debate Bjorn Lomborg. Lomborg has written several books including "The Skeptical Environmentalist" and "Cool It." He is also leader of the Copenhagen Consensus, which has tried to look at some of the alternatives to fixing global warming (more about that later). Lomborg's position is that he accepts the official view of the science of global warming. He takes the IPCC reports as a given. The question then is what to do about it.

Lomborg challenged Mr. Gore to a debate. From the Wall Street Journal.
“Mr. Gore stuck to his prepared script about the urgency of taking action to curb global greenhouse-gas emissions, down to well-worn phrases he trots out at conferences across the country: America is at “a political tipping point” on climate change, and even if Washington has failed to address the energy challenge in the last 35 years, “political will is a renewable resource.”
“But he was challenged by Mr. Lomborg, the Danish skeptical environmentalist who thinks the world would be better off spending more money on health and education issues than curbing carbon emissions.
“I don’t mean to corner you, or maybe I do mean to corner you, but would you be willing to have a debate with me on that point?” asked the polo-shirt wearing Dane.
“I want to be polite to you,” Mr. Gore responded. But, no. “The scientific community has gone through this chapter and verse. We have long since passed the time when we should pretend this is a ‘on the one hand, on the other hand’ issue,” he said. “It’s not a matter of theory or conjecture, for goodness sake,” he added."

Lomborg has no interest in debating the science. His interest is in policy. Gore knows this, yet he refused to debate him because the "science is settled." He sidestepped the real issue, which is about our response to global warming. Mr. Gore is wrong; our response is not settled science. In fact, it's not science at all.

Good Bye and Thanks for All The Models
Bjorn Lomborg. The warmists seem hate this guy. He is charismatic and smart and has an intelligent, rational approach to understanding the best response to global warming. So why do they despise him so?

I think there are a few reasons. First, he agrees with them. He doesn't dispute the science. He says in essence, "Thank you for your excellent work scientists. You have given us a superb basis for making decisions. Now go back to your computer models and let the policy professionals determine the best response." They must hate being minimized like that.

But this is how it really should be. The climate scientists are very deep specialists. They know about heat transfer, currents, cloud formation, thermometer technology--not economic stability, legislative reform, and national and international governance.

So is Lomborg right in his policy recommendations? No, probably not. What he is right about though is an approach to considering our response. Like the lottery winner, we may have better things to do with our efforts. That is the discussion that needs to happen and will not as long as those in the driver's seat (for now the warmists) refuse to debate and engage with the denialists.

Krugman vs. Lomborg debate.

Forget The Science Arguments, How About a Solution?
So I really don't know the answer to this whole global warming or climate change thing. The thing is I don't need to. If these negotiators can come up with a way to make any taxation or caps contingent on actual global warming, it averts the whole argument about what might happen in the future. Simply set the tax very low now, then set up a system such that if the climate heats up, taxes are increased somehow in proportion to the change in temperature. It averts this whole discussion about who is right and simply lets time and actual climate outcomes determine the degree of economic burden that will be imposed. Such a format was suggested in John Tierney's column in the New York Times and discussed further on his blog. This approach will not please the hardest core catastrophists who believe that we are at a tipping point for runaway heating, but may be a path to an ultimate agreement that all sides can live with.

The Causal Chain for CO2 Abatement to Work

A view of the causal chain that must work for CO2 abatement efforts to have a positive effect.

from Monckton: Climate Sensitivity Reconsidered (AGW viability)
  • "Even if temperature had risen above natural variability, the recent solar Grand Maximum may have been chiefly responsible.
  • "Even if the sun were not chiefly to blame for the past half-century’s warming, the IPCC has not demonstrated that, since CO2 occupies only one-ten-thousandth part more of the atmosphere that it did in 1750, it has contributed more than a small fraction of the warming.
  • "Even if carbon dioxide were chiefly responsible for the warming that ceased in 1998 and may not resume until 2015, the distinctive, projected fingerprint of anthropogenic “greenhouse-gas” warming is entirely absent from the observed record.
  • "Even if the fingerprint were present, computer models are long proven to be inherently incapable of providing projections of the future state of the climate that are sound enough for policymaking.
  • "Even if per impossible the models could ever become reliable, the present paper demonstrates that it is not at all likely that the world will warm as much as the IPCC imagines.
  • "Even if the world were to warm that much, the overwhelming majority of the scientific, peer-reviewed literature does not predict that catastrophe would ensue.
  • "Even if catastrophe might ensue, even the most drastic proposals to mitigate future climate change by reducing emissions of carbon dioxide would make very little difference to the climate.
  • "Even if mitigation were likely to be effective, it would do more harm than good: already millions face starvation as the dash for biofuels takes agricultural land out of essential food production: a warning that taking precautions, “just in case”, can do untold harm unless there is a sound, scientific basis for them.
  • "Finally, even if mitigation might do more good than harm, adaptation as (and if) necessary would be far more cost-effective and less likely to be harmful.
"In short, we must get the science right, or we shall get the policy wrong..."

The probability that CO2 abatement is an effective response is vanishingly small.

Summary
I believe that human emitted CO2 has had some effect on temperature and climate. It will continue to do so. I believe that the predictive models are not accurate--there are simply too many variables and unknowns. I believe that nobody has an accurate assessment of the net impact of increased CO2. The hype and catastrophism of some of the warmists, including leading politicians is troubling. The ClimateGate writings reveal bad science, poor ethics, and probable data fudging in action.

Always remember the law of scientific equilibrium:
If it is settled, it is not science.
If it is science, it is not settled.

Further Reading
http://wattsupwiththat.com/2009/12/10/climategate-reaches-the-british-house-of-lords/
http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=409454&c=2
A powerful blog from a person who was a believer with lots of explanations and diagrams.



Sunday, September 13, 2009

Obama Health Care Plan Summarized

Obama Health Care Plan Summarized by Andrew Tobias

If You Have Health Insurance,
the President’s Plan:

  • Prevents insurance companies from dropping you when you get sick.
  • Caps out-of-pocket expenses so you don’t go broke when you do get sick.
  • Eliminates charges for preventive care like mammograms, flu shots and diabetes tests.
  • Eliminates the “donut-hole” gap in coverage for prescription drugs.

If You Don’t Have Insurance,
the President's Plan:

  • Makes it available even if you have a pre-existing condition.
  • Creates a new insurance marketplace – the Exchange – so you can compare plans and buy insurance at “group rates.”
  • Helps low-income citizens pay for it.
  • Offers new, low-cost coverage through a national “high risk” pool to protect people with preexisting conditions from financial ruin until the new Exchange is created.

For All Americans,
the President’s Plan:

  • Won’t add a dime to the deficit and is paid for upfront.
  • Requires additional cuts if savings are not realized.
  • Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality.
  • Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system.
  • Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine.
  • Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform.

Tuesday, August 18, 2009

Health Care Visually

Here is a visual version of the health care reform as a flowchart.

Good finally some clarity on at least the mechanics of the darn thing.

Click on the chart to go to the original post.

Thursday, August 13, 2009

Insurance - Health and Other

There is an unspoken undercurrent in the health care debate and it really bothers me.

"If someone is poor or simply unhealthy due to misfortune they should die."

That is the core of the arguments against health care reform in the US. Oh sure, the arguments look like anti-communism or anti-socialism, but at their base this is that argument.

I don't want to argue about whether that value is "right." It's really a case of individual choice and what each person thinks is right. I do think however that that is where the discussion should be--about real values.

The entire purpose of insurance is to "spread risk." People take on a certain, small expense in order to avoid an uncertain, but potentially much greater expense. In the health care system in the United States, if you happen to work for a large company that has a fair amount of clout, you get health care. It may not be cheap, and it may not cover everything, but you will be protected from the big stuff. They won't drop you or deny you coverage.

If you chose the wrong parents, or simply were unlucky in life, you may not be able to get coverage, and even if you do, you may be dropped on a technicality. Yes you do have legal recourse maybe, but it doesn't do you much good if you are already dead.

I don't want to pain insurance companies as "bad guys." They are simply agents trying to maximize profits. They are doing the right thing for their owners the shareholders, but...

Is that where we want to be? Do we say to someone that they can die simply because of an accident of their birth. In all likelihood, many of the people would get some coverage in any case. Hospitals do take on some charity cases. Government does cover some people who are not otherwise covered. So we do pay for this. The real questions are, "what are our values as a nation?" and "how do we best represent those values at the lowest cost?"

So here are some of the questions you have to consider:
1. People who leave their jobs, voluntarily or not, run the risk of not being able to get medical coverage due to pre-existing conditions. Some of these people will die because of that. Is this what we want? What if it were your mother or sister?

2. Your insurance company has the power to simply refuse to pay for your medical treatment. Sure they must have "grounds" to refuse, but we have all heard stories of really shaky grounds. If you have been paying for insurance, should insurance companies have a right to refuse payment for treatment or to discontinue your insurance during the course of treatment. The "conservative" argument is that you have the right to challenge that in court, or that companies that engage in that behavior will lose business. People have died and will continue to die because of that treatment. Is that where we want to be? What if it were your father or brother?

3. Many of these people end up getting care anyway. Paid for by hospitals, reduced fees from doctors, government agencies. Hospital and doctor fees get adjusted upwards, taxes increase. you didn't think that 2 aspirin in he hospital really cost $120 did you? We all pay in some way through increased fees. We are currently simply in denial about this aspect.

4. Insurance companies exist to take in more money than they pay out. They have shareholders to please. A significant portion of their money pays for marketing, administration, and dividends. Would it be acceptable to say, increase administration costs, and at the same time remove the marketing and dividend cost? More of the money we pay would go directly to coverage.

5. Do you think the free market is really working here with the health insurance companies, or have they been able to erect high barriers to competition? In a perfect world, the competition would drive companies to lower fees, reduce administrative costs, and be customer-centric in its payouts. We are far from that perfect world. Health isnurance either needs to be brought into a more competitive realm with better protections for sick people, heavily regulated in cases where competion cannot be established, or eliminated by going to a single-payer option.

6. I have seen a number something like 46 million people are not covered today. One argument is that many of those people choose not to be covered. Who are those people? Healthy young people who have never been sick. What happens as they age and do get sick, or get in that car accident? Is it ok for ambulance companies and hospitals to just turn them away? What if someone has insurance, but cannot in that moment be identified? Is it ok to take the tough luck approach on them? I hope that when the crunch comes it's not any of my kids.

7. There is a fundamental conflict of interest with insurance companies between providing health care and making money. I believe that most people in the health care industry have a conscience and are reasonable. "Most" is not enough. Is it ok that rewards for people in the health insurance industry are misaligned with your goal in purchasing health insurance.

Remember. The tragedies are individual and personal. Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone.

If you are lucky enough so far to have picked the right parents or career or company, good for you. but remember, luck changes. Your spouse, parents, and children may not be so lucky. Is that the world you want to leave?

Learn about what health care reform really means. Do not trust the talking heads on CNN or Fox. Think about the tragedies in the context of what could be or could have been. Have some humility. Put the tragedies in the context of "There but for the grace of god..."

Read about the insurance industry. Andrew Tobias wrote an excellent book about insurance.
Invisible Bankers: Everything the Insurance Industry Never Wanted You To Know

Whereever your personal values lie, bring the discussion to the meaning and implications of your position. Big sweeping generalizations about the American way do not capture the personal nature of this issue.


Addendum
Nicolas Kristof editorial about "Health Care That Works"
David Brooks editorial "Let's Get Fundamental"
Sad story about a 32 year old who could not get health care

Saturday, July 11, 2009

Skidmarks Disease in the Town of Allopath

Correlation is not causation

Monday, June 15, 2009

The Battle of the Diets: Is Anyone Winning (At Losing?)

Really interesting video about a Stanford study comparing Atkins to other diets. People in the study did their best to follow the diet.

January 17, 2008 presentation by Christopher Gardner for the Stanford School of Medicine Medcast lecture series.

Atkins wins, not just on weight loss, but a series of other measures as well.

Also, insulin resistant people do better on low-carb diets. Lots of people in the US are insulin resistant...

He still uses the paradigm that stomach fullness is the driver of hunger. I think he's off on that. I think it can cause near-term changes, but your body's cells need fuel.

Saturday, April 11, 2009

Settlers of Catan

Settlers of Catan is the hot new boardgame. I read about it in Wired magazine (here) and it's time to buy.