I watch the ripples change their size
But never leave the stream
Of warm impermanence
And so the days float through my eyes
But still the days seem the same
And these children that you spit on
As they try to change their worlds
Are immune to your consultations
They're quite aware of what they're goin' through

Wednesday, June 14, 2017

Linkee-poo read the news today, oh boy

"But health care has shifted toward value-based care that focuses on outcomes and avoiding preventable hospital readmissions. Now, "you are accountable for patients beyond the four walls of the hospital, and you have to think creatively about how to create stability for them," Lawton says… With that in mind, many health care systems are focusing on medical-legal partnerships that target patients who are high users of services." And medical-food panty services, medical-psychological services, medical-financial services, etc, as the medical field begins to refocus on the patient as a whole instead of the patient as signs and symptoms. And you can than Obamacare for that, because it's directly tied into Medicare reimbursements now (and will be tied into other insurance payments soon).

"One of the challenges that can arise in communicating science (and medical information) and other forms of scholarship to non-experts is the jargon involved… But the most dangerous kind of jargon isn't the kind we notice. It's the kind that slips by… A common example comes from the statistical use of the word 'significance.' When a result is statistically significant, it means that it has been evaluated with a statistical test and found to meet some predefined threshold." That's especially true in medical trials. Let's say you test 1000 people, in the control group 3 suffer from a disease a treatment is meant to prevent, however in the group getting the medicine only 2 people have the problem. That's a 33% effectiveness rating (reduce 3 to 2). However, it's less than 0.1% change in the overall population study. But, that 33% is "statistically significant" and could be the drug or treatment is approved. What is even worse is the "unspoken" part of jargon. Sure, you may know that if you have coronary blockage you can have a cath procedure to open the arteries up (a little). But do you know you're not standing up for most of the next day (so you don't blow out the femoral artery patch)? Or that you have to change your diet and life? Or that even though you feel fabulous, the clock has started running on the final countdown (I mean it always is, but this is like hitting the snooze button). Your countdown number may be different from the person laying next to you in the Cath Lab recovery room, but that doesn't mean it hasn't started.

"Ever heard of the freshman 15? Nowadays, some people who are unhappy with the current political environment are complaining of the 'Trump 10.'"

"Trump is making America more hostile and mentally ill: New England Journal of Medicine study." (Grokked from Kathryn Cramer)

"Protesters who gathered on Saturday to denounce Islamic law were met across the country with equally sized or larger counter-protests… Organizers called the 'March Against Sharia' rallies to protest what they say is the threat to U.S. society posed by the set of traditional Muslim practices, which they say includes oppression of women, honor killings, homophobic violence, female genital mutilation and other abuses." Again for the people in the back rows, these things are cultural, not religious, memes. And except for "female genital mutilation", there are no US laws against the others (you may try to add "honor killings" in there, but domestic abuse is still rampant in the US and each day women's partners kill them here in our own country for the exact same reasons families in other countries commit "honor killings" - we just have a slightly better record of winning prosecutions, but only slightly better). My guess is the people protesting "Sharia" law probably are quite fine with the (erroneous) concept of US laws being Biblically based.

So the president and many conservatives talk about getting the economy to 3% (or bigger) growth. Basically, this is an acid trip dream at this point. Here is a Planet Money podcast on what is needed to get there. One way to get it, immigration. As in, lots and lots of immigration (hopefully this will spark jobs, innovation and entrepreneurialship). More people leads to more industry, leads to increased economic growth. Probably not going to happen. Another way is to up the age of retirement (again, keeps more workers in the workforce). I hate to break it to the economists, but we're already doing this. Currently retirement age is ~65. To get "full" Social Security requires you to work to 70. Well, for my generation, it'll take until 72 to get "full" retirement and that means the general retirement age will move to ~67 (note, there are still many people who retire at the end of their 50s, I have no idea - okay, yes I do - how they do it). Life expectancy in the US is dropping. I doubt that'll go over well. Also, move the bar for me again, and thems fightin' words. Because I've been working since I was 12. I'm tired. I will cut you over this. We could have two Dot Com booms. Or we could see productivity increases (note, since about 2003 productivity hasn't increased all that much). There is another way not discussed in the podcast. That way is increase taxes and create a jobs program using government money to create a infrastructure revitalization program about twice as large as what the president has announced (that he hopes will be mostly funded privately). So you're choices are pipe-dream or politically untenable. Again I'll note I remember in the 80s when President Reagan basically stated that 2% is the best we can hope for.

"So it went on Monday in the Cabinet Room of the White House, as Mr. Trump transformed a routine meeting of senior members of his government into a mood-boosting, ego-stroking display of support for himself and his agenda. While the president never explicitly asked to be praised, Mr. Pence set the worshipful tone, and Mr. Trump made it clear he liked what he heard." Nothing unusual here. I wonder who will eventually have to play Cordelia.

"It may well be that the Russians didn't affect the actual numbers last November but, as Bloomberg points out, that was not for lack of trying." The best hacks are the ones you can't detect.

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