Krugman Weighs In vs Medical Industry War On Knowledge

by: Paul Rosenberg

Wed Feb 11, 2009 at 00:33


Remember this chart?

It's from diaries such as "Medicare Myths--Don't Blame The Boomers" and "The Wall Street Agenda vs. Medicare, Medicaid And Social Security" and the point it seeks to make is that Medicare's problems don't come from too many people in the program, since other countries have significantly more people 65 or older.  Rather, the high costs come from an underlying wasteful and inefficient health care system.

Now Paul Krugman has something to say related to that, which should really get you steamed.  It seems that the industries running up those costs don't want us to know whether they're doing any good.  Knowledge leads to socialism, don'tcha know!  (Actually, that's sorta true, but....)
Paul Rosenberg :: Krugman Weighs In vs Medical Industry War On Knowledge
Krugman:

This is really unbelievable:

    The drug and medical-device industries are mobilizing to gut a provision in the stimulus bill that would spend $1.1 billion on research comparing medical treatments, portraying it as the first step to government rationing.

Because freedom is all about laying out vast sums on medical treatments without knowing whether they're actually doing any good.

Remember this the next time someone talks about "entitlement reform" (which will probably happen in the next three seconds or so.) Health care costs are the main reason long-term fiscal projections look so scary - and here we have corporate interest trying to prevent us, not from trying to spend our health dollar more wisely, but from even trying to find out what we get for the health care dollar.

This is truly vile.

Truly vile? Sure.

Par for the course? Absolutely!

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Krugman Weighs In vs Medical Industry War On Knowledge | 99 comments
Have you noticed ... (4.00 / 7)
Krugman ... Gore .. some of those people have gone from neo-liberal .. to more full-fledged DFH in the past few years .... interesting to watch the progression ... that is for sure
Similar to my own progression (4.00 / 6)
I think it says more about the times then the people, but who knows.
[ Parent ]
What Is Neo-Liberal? (0.00 / 0)
Seriously.  I see this term thrown about all the time and I have no idea what it means.  I know neo-cons are the morons who basically believe in an American imperialist foreign policy and led us into the folly of Iraq.
[ Parent ]
Right wingers already pushing back.. (4.00 / 1)
http://americandaily.com/index...

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!
I know someone who's an executive in the health insurance biz (4.00 / 4)
and has worked on the whole gamut of insurance products from group to individual to Medicare to HMO, and he once told me that one of the most promising developments in the field is the establishment and application of efficacy metrics standards, to determine what drugs and procedures work, which providers are most effective, etc.

Of course, from the point of view of private insurers, this often  means figuring out ways of providing minimally acceptable (if that)medical care for minimal cost, to generate maximal profit. But as a general proposition, this is a way of keeping costs down while providing high quality health care. If drug X is 95% as effective as drug Y, yet costs 25% as much, it seems like a no-brainer to use it 95% of the time, with procedures in place for determining the 5% of the time when it's better to go with the more expensive drug. And so on.

I'm surprised that this is still considered to be "new", at least in this field. Hasn't the science of metrics been around for decades?

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

Science? (4.00 / 1)
Hasn't the science of metrics been around for decades?

Science?

Good one, kovie!


"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
Then what would you call it? (0.00 / 0)
A bagel?

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
Irony (4.00 / 3)
I would call it irony. It's what makes Paul a DFH. That, and his training as a mathematician. Sometimes I think it wouldn't be that hard to make our country a better place. All we'd have to do, really, is make use of the tools our better-intentioned forebears left in the cupboard for us.
[ Parent ]
Which doesn't answer my question (0.00 / 0)
Which was meant seriously, baked good reference notwithstanding. What is metrics, then, when used to systematically track performance? If it's not a science, then what is it, formally? A field? An art? A craft? A discipline? The fact that it's not necessarily always practiced properly is besides the point. Neither is medicine, but that doesn't make it not a field.

I used the word "science" generically, to mean field, which I thought was self-evident.

And I'm not sure what the rest of your comment has to do with my original comment.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
Oh, Kovie! (0.00 / 0)
For the record, I don't deny that metrics is a science. Neither, I think, does Paul. If he's guilty of anything, it's making a joke in the presence of earnestness.

For what it's worth, I appreciate the inside information from both you and Michael Harold. No offense intended to either of you.

[ Parent ]
It is a science and it has been around for twenty years (4.00 / 3)
Kovie's right. It is an applied science. I worked in health care IT for five years and gained intimate exposure to HMO, insurance, medical records and clinical (Lab, Radiology, Nursing, Microbiology, Surgery, etc.) software and business practices. It is a science and it has been used for the most part to identify diagnoses with the highest paid DRG (diagnostic resource group) and to "meter" patient care in an effort to generate the highest revenue and cash flow as a function of the patient's ability (i.e., insurance) to pay. This "value chain" of patient care encompasses every point at which the patient touches the health care industry - from the doctor's clinic to the hospital and its "outsourced" service providers to the pharmacy system.

These types of metrics are used (and have been used for the past twenty years) by major healthcare institutions and organizations throughout the U.S. to maximize revenue and minimize costs.

A fun fact to know and tell your friends: Every single time and materials charge from a Band-Aid to having a coke delivered to your room to a heart transplant is contained in a single file called a charge master. Every bill you receive from a hospital is derived from the aggregation of hundreds and thousands of individual charges contained in this file into large groups of charges into the final bill. As a general rule you don't actually receive a lot of the stuff you are billed for. It just "comes with" the DRG.    

[ Parent ]
You Miss My Intent (0.00 / 0)
The Bush cartel using science?

Puh-leeze!

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
And you missed my intent (0.00 / 0)
Which was that in the right hands, it could be used to do good. Where did I suggest or imply that Bush or his ilk were using it for that?

This subthread is so Lemon-Lyman.com...

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
I Just Took It To Be Obvious (0.00 / 0)
So obvious, indeed, that there was nothing to say but use it as the occasion for some good old-fashioned Bush/Cheney snark.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
But it's not obvious (0.00 / 0)
except to clubby insiders. And even then it's not obvious, or even true, because your citing Bush as proof of why it's not a science is like citing Bush as proof of why there's no such thing as a legal or financial system. The corruption of a process doesn't mean that the process itself is inherently discredited or incapable of being done right.

You're basically laughing at your own jokes here, Paul. Ok, with a couple of fans, I'll grant.

But have a virtual bagel on me, with a big shmear.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
Too bad that the health care and insurance industries (0.00 / 0)
are only good at being efficient when it comes to maximizing profits and minimizing costs, and not at maximizing patient value and overall health. Which I thought was my original point before this subthread devolved into a self-congratulatory DFH snarkfest.

Incidentally, I've also worked in health insurance IT, but in other aspects of it (product development and management, and network management), where, in my experience at least, the use of technology is seriously behind the times and showing little sign of improving soon (my meager attempts at doing so notwithstanding).

But these are cost, not profit centers, which figures. So long as there's no financial or legal incentive to focus on best practices as they pertain to maximizing patient health care value, it won't happen. But the tools for doing so have been around for years, sitting around unused, like a lifeboat on a sinking ship, off-limits to steerage class.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
Is this the same measure in the Stimulus bill that Krugman is referncing (4.00 / 1)
and Drudge and Rush are going after based on a piece by the infamous Betsy McCaughey?

http://digbysblog.blogspot.com...

The name "Betsy McCaughey" may not be totally familiar to you, but it may interest you to know that perhaps nobody is more responsible for the fact that America is the only industrialized nation on Earth without a universal health care system than her. The latest distortion, that because of the health IT provisions in the stimulus - backed by every side of the ideological spectrum from Barack Obama to Newt Gingrich - a National Coordinator of Health Information Technology will

...monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and "guide" your doctor's decisions.




"Incrementalism isn't a different path to the same place, it could be a different path to a different place"
Stoller
[ Parent ]
Yup! (0.00 / 0)
One and the same.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
We Need A Govt Body Like (0.00 / 0)
the Institute of Medicine or the National Institutes of Health to do clinical trials on new procedures and technologies to see what is effective and what isn't.  If the clinical trials show the procedure or technology to be effective, it should be covered by Medicare, Medicaid and private insurers.  If the science shows it to be ineffective, it shouldn't be covered.  

You will get pushback from medical device manufacturers, pharma companies and certain specialty hospitals who make a lot of money on unproven technologies or procedures.  However, this would be a really good way to eliminate waste and improve quality all in one swoop.

Medicare actually has a good process for determining this which could be used as a model for the rest of the health care field.

[ Parent ]
Not without significantly more funding (4.00 / 1)
The NIH is already stretched to the point where only about 10% of the proposals get funded, and that is AFTER one has eliminated the truly bad proposals which don't even get scored.

The real value of the US medical research system, as exemplified by the NIH, is in our resources (especially human resources), infrastructure, and scope for basic medical research. That is, the kind of studies that will drive the clinical trials of the future.  This is a very real strength (one of the few that this nation has left, actually) that attracts the best and brightest from around the world to come here to do their research.  Its also my chosen field and I've been doing it for close to 20 years.

While I see and understand the value and importance of the idea you express, I see no value in shunting even more of the NIH budget away from its core mission; basic medical research.

This is not off-topic.

"It sounds wrong...
     ...but its right."

[ Parent ]
Obviously You Would Need to Fund It (4.00 / 1)
I wasn't thinking you would take money out of existing programs.  The Institute of Medicine might be better suited to the job but the point I was trying to make is a respected health entity should be doing scientific research to determine the efficacy of procedures and technology.
[ Parent ]
I hear you (4.00 / 1)
I disagree with nothing you have posted.

I felt I had to speak up, though, to provide a bit of detail to the discussion from one that is actively involved in medical research and has been fighting this fight for quite some time.

Part of the reason that the NIH is in such dire financial straits is that they have been taking on more and more of the clinical trials, which are very expensive.  Basic research is losing out.

Intellectually and ideologically, I'm supportive of a government institution doing this work, rather than the pharmaceutical companies.  However, when it comes to the question of funds, its a bit backwards. In essence, big pharma gets to have their trials funded by public money, then pocket the profit from the products that get to the market. We are subsidizing the drug makers, and this point is rarely brought up during political debates on these issues.

Its critical on this site because some of these ideas actually filter through to the politicians and activists.


"It sounds wrong...
     ...but its right."

[ Parent ]
Glad We Agree (0.00 / 0)
I work in health care too but I didn't realize NIH was in such dire straights.  That is really bad that basic science research is losing out.  Is this the partially the result of the Bush Admins anti-science bias?
[ Parent ]
Actually (4.00 / 1)
Given the way you phrase the question, I have to say "no".  Bush was not particularly hard on the NIH, they suffered budgetting problems due to the fact that alot of cash was blown in Iraq, just like many federal agencies.

Certainly, particular areas of research were more negatively affected, such as embryonic stem cell work, but over all it's hard to say that the NIH was specifically targeted by Bush/Cheney. At the same time, it was not a priority, either.

Its the costs that are hurting the research labs. I don't want to turn this into a tutorial on NIH funding, but those grants pay for health insurance and retirement plans, too. Moreover, the nature of basic research has also changed very significantly over the last 5-10 years. The cutting-edge, high-value, efforts require very expensive equipment with very high up-keep costs, too. The small boosts we've seen in the NIH budgets are simply not keeping up.

True, some new money has been pushed into research directed at issues relating to "bioterrorism" and stuff like that, much of it through the DOD and DOE. But, these are often approached with a kind of "zero sum" mentality, where additons to the DOD or DOE research budgets are seen as satisfying the needs of the research community, so NIH has a harder time making their case for their own budget increases.  

I worry that the newer ideas of "green technology" will end up in the same situation. That is, the politicians that have success getting new money for resaerch aimed at developing new fuel sources and such, will be less inclined to push for medical research dollars because they have already taken care of the scientific community.

"It sounds wrong...
     ...but its right."

[ Parent ]
You are both aware, I assume (0.00 / 0)
that this stimulus bill had an extra $10B inserted into it, effectively but not technically as an earmark, in order to win over Arlen Specter, in whose state the NIH is HQed and who's running for reelection in '10 (but who's also a multiple cancer survivor, so perhaps it wasn't a totally political move). Is this going to help much, or is it a drop in the bucket?

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
Yes, I'm aware of this (0.00 / 0)
Its still an open question as to how that money will be distributed. But, maybe that discussion would be a bit too "inside baseball". It will be stimulative, but "one time" money cannot solve systemic, on-going problems.


"It sounds wrong...
     ...but its right."
[ Parent ]
Inside baseball is part of what blogs like this are all about (0.00 / 0)
So discuss away! :-)

And I agree that this needs to be part of an ongoing funding increase, well beyond just the NIH, that will hopefully be done in an upcoming bill.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
And Here I Thought It Was Inside Croquet! (0.00 / 0)
So that's what I was doing wrong!

Swinging vertically, instead of horizontally!

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
Inside ontolgy (0.00 / 0)
or the Essence of Existing within the Current Paradigm of what is Believed to Comprise Reality.

I have sudden hankering for toasted cheese balls. Why is that relevant?

"It sounds wrong...
     ...but its right."

[ Parent ]
The Society for the Protection of the Reproductive Rights of Cheeses (0.00 / 0)
has it's eye on you.
[ Parent ]
Have you been hanging out with Michael Phelps again? (0.00 / 0)


"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
He's too sloppy for my tastes (0.00 / 0)
But he does seem kind.

"It sounds wrong...
     ...but its right."
[ Parent ]
Like most everything else, its about power (0.00 / 0)
and control.

The NIH, like any granting agency, has a multitude of existing mechanisms by which they distribute funds. I'm not just talking about programs by which they accept new grant proposals for consideration. They send money to Universities and other research labs on a continuing basis. Just like you and I pay our utility bills, rent, or a mortgage.

When budget cuts come along, or even unrealized budget increases (this is a rather prospective system), it is not uncommon for the grant agency to deal with the situation by applying an across-the-board reduction of "everyone's" yearly aliquot of cash. I put "everyone" in quotes because the scientific system, as meritocritous (sp?) as it is, is still subject to loop-holes, cronyism, and fraud; like most other human endeavors.

Thus, the cuts (sacrifice) are borne by "all". Now, to the stimulus funds.

Apparently, these are to be distributed by a new mechanism that will ultimately direct the funds to those few labs that can pass the rigors of peer review in a novel RFP; roughly 10-15% of the proposals selected for scoring. (Roughly, it is the top 60-70% of submitted proposals that are scored. The rest are triaged, and include those that are poorly prepared, e.g. over page limits, or incomplete.)

If the goal is "stimulus" defined as very immediate impact in the economy, a better (and more just) means would be an across-the-board increase in the next FY allocation, or Spaghetti Monster forbid, a supplemental allocation to every grant holder. This money that WILL be spent; we are ACHING to spend these funds. Most of my waking hours (and more than a few stolen moments) over the passed 8-9 years has been dedicated to trying to convince various committees to give me the money to spend.

Enter power and money, stage right. Why develop an entirely new mechanism for distributing these funds?

Partly, it may be infrastructure support. One of the casualties of the recent budget difficulties are the major research centers in the nation and the proposed funding mechanism may be a way to channel the one-time allocation to these centers. Or, it could be cronyism and politics. (not the "left" "right" politics necessarily, but "science politics"; what's hot, what's not). Being outside of the major academic institutes, I am suspicious.



"It sounds wrong...
     ...but its right."

[ Parent ]
So Arlen basically gets to direct the majority (0.00 / 0)
of these funds to either pet projects that he cares about, most likely in oncology for obvious reasons, or to ones that he hopes will win him votes in '10? Nice. It's still going to stimulate some parts of the economy, but in a less equitable and perhaps even immediate manner.

Nice.

No wonder I don't really care for sausages. I keep thinking of how they're made.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
I doubt the good Senator will direct the funds (0.00 / 0)
Its the higher ups at the Institutes within the NIH that will get to direct the funds, most likely. It'll be internal politics, not the DC variety.

Although the congress critters can put strings on some money, like not allowing it to be used for study of embryonic stem cells, or trying to target it toward specific issues, diabetes, brain injury, etc. Sometimes particular reps. or sens. will try to target funds for a program that has a big presence at a university, or other business in their district/state. If they want to be more specific in targeting the funds, then they do an earmark.  

"It sounds wrong...
     ...but its right."

[ Parent ]
HAHA. Looking at USA health care costs (0.00 / 0)
without looking at the cost of lawyers, medical malpractice insurance is ridiculous. That's why our health care costs are higher. How easy do  you think it is to sue your doctor here, compared to the UK?

Or what about most the medical research? Other countries piggyback our medical research.

Evidence Much? (4.00 / 4)
Or just straight rightwing talking points, no chaser?

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
For starters (0.00 / 1)
look at what happend in Florida when the lawyers went wild and sued every doctor who performed Ceseareans. America has the highest per capita number of lawyers in the world. How do you think ambulance chasers make their money?

  And as for medical research spending per capita, it's obvious America is #1.

Freedom works. If you want state control, that's unAmerican.

[ Parent ]
Thats only improving the quality of care (0.00 / 0)
Cesarians are overdone anyhow.

http://transgendermom.blogspot....
[ Parent ]
A free people (0.00 / 1)
can not exist without a free market.
[ Parent ]
Hayek sucks. (4.00 / 5)
Your free market failed.

Get used to it.  Your phony God of free markets failed.

Empiricism, not faith.

This depression is a judgment of the failure of your faith.  

[ Parent ]
What;s your alternative? (0.00 / 1)
Cuba? North Korea?

The FREE MARKET DID NOT FAIL. The Federal Reserve created the asset bubble by lowering interest rates to near 0 during the Tech Bubble. That created mal investments that led to the housing crash. Fannie Mae and Freddie Mac were quasi-government programs that pushed through home loans. That's not the free market.

There is no depression. Unemployment was 25 percent in 1932. It's 7.5 right now, on par with the 1990-1991 recession.

Stop the fear-mongering, Mr. Busheconomics.

[ Parent ]
Not Exactly, Troll (4.00 / 4)
The FREE MARKET DID NOT FAIL. The Federal Reserve created the asset bubble by lowering interest rates to near 0 during the Tech Bubble.

The Fed Funds Overnight monthly averages: 

01/1995  5.53    10/1996  5.24    07/1998  5.54    04/2000  6.02
02/1995  5.92    11/1996  5.31    08/1998  5.55    05/2000  6.27
03/1995  5.98    12/1996  5.29    09/1998  5.51    06/2000  6.53
04/1995  6.05    01/1997  5.25    10/1998  5.07    07/2000  6.54
05/1995  6.01    02/1997  5.19    11/1998  4.83    08/2000  6.50
06/1995  6.00    03/1997  5.39    12/1998  4.68    09/2000  6.52
07/1995  5.85    04/1997  5.51    01/1999  4.63    10/2000  6.51
08/1995  5.74    05/1997  5.50    02/1999  4.76    11/2000  6.51
09/1995  5.80    06/1997  5.56    03/1999  4.81    12/2000  6.40
10/1995  5.76    07/1997  5.52    04/1999  4.74    01/2001  5.98
11/1995  5.80    08/1997  5.54    05/1999  4.74    02/2001  5.49
12/1995  5.60    09/1997  5.54    06/1999  4.76    03/2001  5.31
01/1996  5.56    10/1997  5.50    07/1999  4.99    04/2001  4.80
02/1996  5.22    11/1997  5.52    08/1999  5.07    05/2001  4.21
03/1996  5.31    12/1997  5.50    09/1999  5.22    06/2001  3.97
04/1996  5.22    01/1998  5.56    10/1999  5.20    07/2001  3.77
05/1996  5.24    02/1998  5.51    11/1999  5.42    08/2001  3.65
06/1996  5.27    03/1998  5.49    12/1999  5.30    09/2001  3.07
07/1996  5.40    04/1998  5.45    01/2000  5.45    10/2001  2.49
08/1996  5.22    05/1998  5.49    02/2000  5.73    11/2001  2.09
09/1996  5.30    06/1998  5.56    03/2000  5.85    12/2001  1.82

NASDAQ peaked March 10, 2000.

Fish. Barrel. Yadda-yadda-yadda.

You are right in one respect: the free market didn't fail--because the free market doesn't exist.

And the doesn't exist--because the free market can't exist.

All markets have rules and regulations.  That's part of what makes them markets, as opposed to stickups.  Although the folks you're defending would definitely prefer stickups.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
"rules and regulations" - that's basic Adam Smith, 1776. (4.00 / 3)
Makes you wonder on what guys like freedomfunds base their understanding of the economy. The bible???
:D
[ Parent ]
Pamphlets, Mostly (4.00 / 3)
They base their understanding on crank pamphlets from the 1950s and 60s, on the level of "Communism, Hypnotism and the Beatles."

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
You're wrong (0.00 / 0)
The Beatles weren't around till the 60's. You're probably thinking of Elvis, the most hypnotic commie ever. Everyone knows that Don't Be Cruel was a veiled reference to Bill Buckley.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
From Boing Boing (0.00 / 0)

I appreciate all the readers who emailed me pointers to possible sources for David Noebel's rare Communism, Hypnotism And The Beatles pamphlet from 1965. Special thanks to BB pals Ken Sitz and Bill Geerhart of the magnificent site Conelrad, purveyors of the finest mid-20th century American weirdness, from Cold War films to atomic age LPs. Here's their page on David Noebel's classic spoken word LP The Marxis Minstrels: The Communist Subversion of American Folk Music. The audio samples are a laff riot. Link  


"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
I didn't doubt that such a book existed (0.00 / 0)
But sometimes you can be too literal, Paul.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
Sigh.... (4.00 / 2)
The Central Committee of Libertarian Lunacy has found OpenLeft. From now on it'll be all Austrian, all beggar thy neighbor and all Ron Paul all the time. I do hope that the management realizes that they have an infestation problem before we start finding nests in the pantry.
[ Parent ]
Done (4.00 / 3)
I consider banning at the first comment, as it was perfectly obvious from the start.

But, I wanted to see what would happen overnight.

Pretty low grade, I'm afraid.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
All of your trolls are belong to us! (0.00 / 0)
Or, is that you, Amity, and when do you expect to stop lying your ass off to sell that crappy Regnerian POS book? Ah, that felt so much better.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
Is "medical research" in the USA (4.00 / 2)
or anywhere else based on a "free market" system?


"It sounds wrong...
     ...but its right."
[ Parent ]
Good One, SpitBll! (4.00 / 3)
You're right up there with kovie!

"Science."

"Free market."

You guys kill me!

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
For the 11th time, Paul (0.00 / 0)
I was referring to how metrics was SUPPOSED to be used, not how it was abused or misused by Bushies and such. You more than anyone knew that right off.

But if you're having a bad day and the doctor ordered a heavy dose of snark, oookay. Just send me the bill. Oh, wait, you already have!

Photobucket

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
See? He's Singing "I Am The Walrus," Too (0.00 / 0)
I wrote some snark that didn't strike your fancy.  You should have just said, "T'ain't funny McGree."  And that would have been that.

But, no!  For some reason, you were having a bad day.

"I am he as you are he as you are me and we are all together"


"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
And like I responded (0.00 / 0)
Goo goo ga joob.

Works both ways, Jojo.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
Health care isn't a free market in economic sense! (4.00 / 1)
For a free market, you need total transparency, and market players acting under rational decisions.

Healthcare isn't transparent at all, even specialists are overwhlemed by the complexity, and healthcare decisions are highly emotional, with ratio trumped by fear and even panic. And the providers work hard to keep this this way, because more transparency and reasonable customers would bring the prices down.

Sry, but that healthcare is a free market is just a myth!

[ Parent ]
Another difference betwen healthcare and free market (4.00 / 2)
The dynamics of supply and demand don't apply in healthcare. For instance, as the demand for vaccines against infectious diseases such as malaria has increased in third world countries, the supply of these drugs has decreased because drug companies have no interest in manufacturing something that yields very little to no profits. Unlike a true free market, the demand for life-saving drugs has nowhere else to turn for a "competitive" supplier. So what are they supposed to do? Well, according to libertarian free market capitalists, they're just supposed to die.
[ Parent ]
And What Do You Know They Do! (4.00 / 2)
Thus proving that Hayek was right all along!

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
Ooooh, that was a very bad one,Paul! :D (0.00 / 0)
Very british, your humour today! lol
[ Parent ]
What Can I Say? (4.00 / 1)
I was raised on Flanders and Swan.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
That medical research brought you Viagra! Great. (4.00 / 1)
Really essential. What would we do without it?

No seriously, the pure height of medical research per capita is misleading. You have to look into it and check what part of that research really results in better life expectancy and better health for the citizen.

Viagra and his numerous competitors sure improve the qulaity of life for some people, but this mutiple research on the same problem is inefficient, and this isn't a health improving issue in the first place.

Not to speak of that such an international comparison doesn't make much sense. There are lots of nations without any pharmaceutical industry. They just imort these goods. Doesn't say anything about the health of their citizen.

[ Parent ]
It also brought you Gleevec (4.00 / 1)
and the most basic understanding of how a human body actually works to maintain itself and stimulate endogenous repair mechanisms.

The true value of medical research is not in producing new drug products, however. It is in providing a solid scientific understanding of how living systems work. Now, such is not generally considered to be a "product", in the sense of a car, or a computer, but it is very true that "knowledge is power".


"It sounds wrong...
     ...but its right."

[ Parent ]
Fact-based arguments, not emotion-based librulism (0.00 / 1)
In the U.S., malpractice insurance premiums increased rapidly in the 1970's and 1980's
and again in the early part of this decade. These recent hikes have led the American Medical
Association to declare a 'malpractice premium crisis' in 20 states, including Florida, Pennsylvania
and New York.2 Nationwide, malpractice insurance premiums increased 15 percent between
2000 and 2002.3 During the same time period, specialists in some areas experienced premium
increases of more than 100 percent.

http://www.law.uchicago.edu/fi...  

University of Chicago Law/

Let the lawyers do real work.  

[ Parent ]
nice research paper there (4.00 / 2)
did you get an A?

this is a good article on tort reform, someone else posted it a couple days ago:
http://www.commondreams.org/vi...

"Will outlawing our right to sue grossly negligent doctors for punitive damages stop the escalating costs of health care? The non-partisan Congressional Budget Office figures that medical malpractice lawsuits account for one half of one percent of health care costs.

Would insurance rates go down? According to the American Insurance Association, "The insurance industry never promised that tort reform would achieve specific premium savings." (March 13, 2002) and the American Tort Reform Association added, "We wouldn't tell you or anyone that the reason to pass tort reform would be to reduce rates." (July 19, 1999)."

[ Parent ]
You;re only looking at the cost (0.00 / 1)
of the lawsuit, not the INSURANCE! How'd you  score on your paper?
[ Parent ]
And there isn't a direct link between the two? (0.00 / 0)
Why would an insurance company legitimately charge proportionately more for a policy than is justified by an increase in risk-based and other costs?

Oh, wait, could it be an improperly regulated and overseen insurance company that might allow such companies to rip off doctors?

Where a market segment isn't doing well, I'll show you a government agency that's failing to do its job. Markets don't fail so much as the people in charge of regulating them fail.

Or have you ever attended a baseball game that went well without rules or umpires?

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
Furthermore, you (0.00 / 1)
quoted commondreams.org WTF? I sourced a t14 U Chicago top notch Law school. Don't think those bullshit partisan thinktanks whether it be Heritage or Brookings or Center for Budget Priorities or Cato are anything about biased hacks.
[ Parent ]
Good One, freedomfunds! (4.00 / 1)
U of Chicago not biased hacks!

You're as funny as kovie or SpitBall.

Too bad you're banned.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
Paul (0.00 / 0)
You're seriously getting tiresome. Whatever it is that's bothering you today, deal with it, instead of cheaply taking it out on others.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
Wah? (0.00 / 0)
No lo comprendre.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
The co-relation between insurance premiums (4.00 / 5)
and malpractice suits is zero.

What insurance premiums do co-relate with, and almost perfectly, is the stock market. Basically insurance companies gamble in the market and when they lose, raise premiums to recoup their losses. And we pay because we have no choice.

Any more rightwing talking points?

Montani semper liberi

[ Parent ]
You're the right winger (0.00 / 1)
Liberalism is about freedom , economic and social freedom. Take your statist agenda to the Republican headquarters.
[ Parent ]
Rabies Test Just Came Back Positive (4.00 / 1)
No surprise.

Though we first thought it might just have been an allergic response to facts.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
Careful with the semantics (0.00 / 0)
Define "medical research" before we go any further.

"It sounds wrong...
     ...but its right."
[ Parent ]
Malpractice (4.00 / 2)
By far the biggest waste in the medical industry is the insurance industry itself.  It takes 20% off the top (vs. 3% for Medicare) plus adds layers of work at the hospital and doctor level.

Medical malpractice costs are a flat fee that does not vary depending on the number of surgeries performed although it does vary by medical specialty and new physicians get a three year phase in of their premiums (1/3, 2/3, 3/3).  I've done work for doctors and one surgeon was paying over 20% of his income for malpractice insurance while another pays less than 1%.  The big difference was not the insurance rate but the income.  With the single exception of ob/gyn, the myth of malpractice as the single engine pushing up rates is just that, a myth.

One side effect of malpractice insurance is to weed out certain problem patients.  Patients who have had multiple unsuccessful surgeries are poor risks.  Patients who have had multiple unsuccessful surgeries and are lawyers are very poor risks.  Patients who complain to the hospital administration before they have seen a doctor and who are lawyers are to be avoided like the plague.  It is not rocket science and the usual talking points are misleading.  It is not even the usual 80/20 theory (80% of the problems come from 20% of the patients, employees, customers, etc.  This is or at least was taught in business school), more like 98/2.

Will I name names.  Of course not.  But this is real life stuff based on accounting and tax records.  

So you're saying that high risk patients don't deserve care? (4.00 / 1)
Your characterization is an absurd parody of what it is to be a high risk patient. Nice strawmen there.

How can you effectively weed out certain patients from the system? Sooner or later someone's got to take care of them; you can be the person that turns them away, but they gotta end up somewhere. Or should we just let those people die off because you deem them unworthy from a business perspective?

[ Parent ]
Not just high risk (4.00 / 1)
This is not a strawman.  This is the advice of the doctor's lawyers.  A straw man is a made up case.  These cases are quite real.

These particular doctors do a large number of high risk patients where the complications are medical.  They will do revisions, surgeries botched by a previous doctor that are fixed.  Most doctors will not do these operations. However, some people are crazy, very high maintenance, and darned likely to sue.

However, when patients have had the same problem fixed at least three or four times surgically, the chances for a successful surgery (at least this type) are virtually nil.  Most surgeries are not life and death.  What is at stake is functionality, quality of life, and pain.  A fourth surgery is unlikely to improve things much.  The reccomended course is pain management, not surgery.

I even did work for one doctor who donates two months each year to treat patients for free (through operations) in poor countries in Africa and Asia.  The surgeries are so dramatic that one of the Discovery channels spent a one hour show just showing several of them (I think the series was "Medical Incredible").  Even he would be reluctant to take on some of these patients and it is not a fear of medical risk.

[ Parent ]
Even if that was true, it only accounts for 20% of the costs, maximum. (4.00 / 1)
But the difference between healthcare costs in the US and aother nations with a better average life expectancy are much higher than that. How to explain this? Sorry, but imho the malpractice arguement isn't really convincing.
[ Parent ]
Actually, it accounts for even less than that! (4.00 / 1)
I'm sure that malpractice costs are higher in the US than elsewhere, but they are not 0 elsewhere. I know this because my brother and sister are both doctors in the NHS in Britain. There has apparently been a dramatic rise in litigation against the NHS and its doctors too, although I'm sure much less than in the US.

I googled for some actual numbers, but couldn't find any, and should go back to doing some work, sorry.

[ Parent ]
Here's how our medical industry works (4.00 / 2)
1. Patient gets sold a lousy insurance policy from Midwest National Life Insurance Company, which is laden with all sorts of legaleeze to hide the fact that the policy doesn't begin to cover the real costs of a hospital visit.
2. Patient experiences a medical emergency resulting in a significant hospital stay that rings up huge charges.
3. Hospital bills insurance company which in turn delivers minimal outlays based on its interpretation of the policy.
4. Patient receives a whopping big bill he has no way of paying.
5. Hospital negotiates a payment plan with Patient which results in a loss to the hospital but at least guarantees a revenue stream of cost recovery for the next 5-6 years.
6. Because the hospital is not in the collections business, the cost-recovery contract is outsourced to a collections agency.
7. Because collecting on hospital and other unpaid medical bills is a highly lucrative source of investment income, the collections agency sells the cost-recovery contract of the Patient to a hedgefund owned by The Blackstone Group who sells shares in the hedgefund on Wall Street for a tidy profit.
8. The Blackstone Group also happens to own -- Midwest National Life Insurance.
9. rinse and repeat.
"Knowledge leads to socialism" - They fear the liberal bias of the facts! (4.00 / 1)
Nothing really new in this stance. They know the facts are against them, so they try to suppress and/or distort them as much as they can. This is exactly why good guys like Krugman are so essential in breaking this conspiracy of silence and lies. And this should also make liberal critics of Michael Moore think twice. Every effort to show the true picture of health care in the US should be applauded, even if some pedantics think it is "sicko"!
Knowledge will lead to anarchy (0.00 / 0)
if we are lucky. Were every citizen well educated, thoughtful, wise, and empowered, what need would such a society have of a strong central government?


"It sounds wrong...
     ...but its right."
[ Parent ]
H,, lots of well educated, thoughtful, wise, and empowered people here... (4.00 / 1)
..and still we have problems reaching even a low level of consensus. Btw, not even Wikipedia works without some kind of government.

No, sry, no matter if yo call it anarchy or libertarianism, but imho you need a totally different kind of human to make it work. Living with some dozens clones of yourself on a remote Island may be a solution, but I wouldn't even bet on this.
:-/

[ Parent ]
I agree (4.00 / 1)
Humans are not ready for the responsibility of living in an anarchy and I doubt we will ever become ready.

My comment is essentially snark, but I truly wish humans could get to the point where it was not such.

Of course, if wishes were horses...and all that.

"It sounds wrong...
     ...but its right."

[ Parent ]
With Strong Healthy Cells, Who Needs A Body, Much Less A Brain? (0.00 / 0)
Nice logic, there.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
Respectfully (0.00 / 0)
you are outside of your field of expertise.

A brain, or a central nervous system,is not a requirement for the development of a functional and healthy body. Some worms have little in the way of a "brain", yet this has not prevented them from surviving.

The brain of highly differentiated metazoans (such as human beings) is more of an organizing principle than a requirement. Its one way to solve the question of survival.

In fact, there is a growing body of evidence that even bacteria and slime moulds have evolved the means to coordinate their activities, i.e. cooperate, without anything that even remotely resembles a brain. When you get a chance, look up "quorum sensing" or "chemotaxis" with the search engine of your choice.

Where is the "brain" that organizes an ant colony?  Its done with chemicals, rather than laws.

We are way off subject here and this sub-thread started from a snarky remark. I admit what I'm putting down sounds alot like science fiction or some drug-induced fantasy.  But it ain't.

"It sounds wrong...
     ...but its right."

[ Parent ]
Dude! (4.00 / 1)
I'm not a biologist, but I was a little boy.  Into worms, slime molds, all that weird stuff which segued rather effortlessly into speculative xenobiology. Even as a 5- or 6-year old, I knew that plants (much less worms) were made up of cells, just like animals.  So what's the what with the lecture?

I used to be a philosophical anarchist, too.  Until I finally realized that (a) most folks really don't want to think about politics 24/7, and would readily relate to big government as simply a convenient labor-saving device, (b) there was no way a social democratic social contract was going to survive at this point absent big government, and (c) I was just adding fuel to the libertarian's fire.

Bottom line: just as the cells are healthy because they're part of a healthy body, so, too, the individuals are healthy because they're part of a healthy state.

Except our state is not very healthy right now after 40+ years of intense rightwing hegemonic warfare.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
Sometimes, and I say this with love in my heart, (0.00 / 0)
it seems appropriate to "lecture" you.:)

The fact that you insist that your insights from when you were 5 or 6 years old that living things are all made of cells is pretty much equivalent to my 15+ years engaged in actual studies of living systems makes me want to continue the lecture. Basically, you proven my point that, when it comes to biology, you are outside of your area of expertise.

If you noticed my response to another poster on the same thread - my comment about anarchy was pretty much snark, or in more traditional language: a joke. I'm with you on the whole "philosophical anarchy" thing.

"It sounds wrong...
     ...but its right."

[ Parent ]
Overkill (0.00 / 0)
Of course I'm not saying that my knowledge as a 5-year old kid was equivalent to your adult expertise.  Quite the opposite.  I'm pointing out that even a 5-year old kid with sufficient curiosity and the right environment knew the point you were making originally.

Why someone as smart as you misreads things like this with some regularity continues to puzzle me.  It may just be one of those internet things chalked up to lack of paralinguistic cues so each of us only gets 95% of what the other is saying.

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
Perhaps it is not misreading (0.00 / 0)
might it be that you do not appreciate the depth of thought on my part?

I "read" you loud and clear. I accept (most of) your premises. This does not imply that these are beyond question.

My method is the madness of asking very basic and fundamental questions. This works very well in the research sciences although it is not well tolerated by non-thinkers and those in awe of their own wisdom.

Certainly, I am as guilty of all these "sins" as anyone else including yourself. But I have convinced myself that I am more uniquely aware of this than most others, which mutes my omnipotence (imagined or otherwise). More critically, I believe that I am aware that I'm fooling myself when i purport to be objective and "fact based". You, i fear, are not. At the same time, I sense that you might. So, I antagonize.

[note for followers of meta meta meat meta: that lower-case "i" is as intentional as "meat" in the "meta"]

I take projection as a matter of fact for humans, not some affliction that besets the "right wingers". If we could not project, we would have no bases for community, movement, or morality. Ditto quorum sensing.



"It sounds wrong...
     ...but its right."

[ Parent ]
What I Was Trying To Say Here (0.00 / 0)
Why someone as smart as you misreads things like this with some regularity continues to puzzle me.  It may just be one of those internet things chalked up to lack of paralinguistic cues so each of us only gets 95% of what the other is saying.

Is that you and I repeatedly misread each other.  And your response is yet another misreading. As has, indeed, been the case with this whole sub-thread.

Indeed, it has nothing at all to do with depth from my POV.  It comes from you misreading the cells/body/mind metaphor.

More critically, I believe that I am aware that I'm fooling myself when i purport to be objective and "fact based". You, i fear, are not. At the same time, I sense that you might. So, I antagonize.

I disagree, primarily because I don't see being objective and "fact based" as incompatible with having a POV.  Sure we can't be objective in a God's-eye sort of way, and so we will always fall short of that sort of ideal.  We are creature of embodied reason deluding ourselves with dreams of transcendence.  And yet, if we step back and see what we are doing, we can appreciate that it produces very useful results, if only we recognize that they are artifacts of our own creation.  But when we stop trying to be objective, then all that stops.

So, is that really a disagreement, as I said at the top of that paragraph?  Or is that just my way of saying substantially the same thing?  My sense is that (a)if we were to sit down in pub and talk it through for an hour or so, we'd probably agree that we're basically in agreement, but express ourselves in different ways, drawing on different arrays of experience and interpretive frameworks, but (b) if we discuss this online, we will either come to the opposite conclusion, or never reach a conclusion at all.

Finally,

I take projection as a matter of fact for humans, not some affliction that besets the "right wingers". If we could not project, we would have no bases for community, movement, or morality. Ditto quorum sensing.

You are confusing projection with projective identification.  Which is quite understandable, given that many professionals confuse the two as well.  And for some purposes it doesn't really seem to matter.  But the two really are different.  They derive from the work of different--in fact antagonistic--theorists, and have origins at different stages of development.

Projection is an ego defense mechanism.  It was Anna Freud, building on her fathers work, who provided the first systematic approach in The Ego and the Mechanisms of Defense.  That was 1936.  Melanie Klein did her first work on projective identification the following decade, it came from her work with children, and she located its origins in the pre-egoic stage of infancy.  Rather than being an ego defense, projective identification is one of the mechanisms out of which the ego is created in the first place.  It has been said that projection is projection onto the other, projective identification is projection into the other.  Projective identification is, for example, the foundation of the therapeutic relationship via transference and counter-transference.  But it's far more pervasive than that, and when you wrote:

If we could not project, we would have no bases for community, movement, or morality. Ditto quorum sensing.

you were absolutely right about projective identification, but not projection.

Projection, as a defense mechanism, actually is used much more by conservatives, largely because they tend to be less ego secure.  If you look at Wikipedia's "Categorization of Defence Mechanisms", most conservatives function most often at level two, which includes projection along with fantasy, acting out, passive aggression and idealization, among others.  In contrast, most liberals function most often at levels 3 or 4.  Level 4 includes such mechanisms as altruism, anticipation, humor, identification, introjection, sublimation, and suppression, which are far more prevalent among liberals.  It's Level 3 where one finds the most mechanisms seen among both liberals and conservatives, such as displacement, dissociation, isolation, intellectualization, reaction formation, repression and regression.

All this is based on statistical differences, not a hard and fast rule, of course.  But when you sum over large population, the results are entirely different sorts of typical political narratives.  On the right, you have Rush Limbaugh with his projection--and even "delusional projection", which is a Level 1 mechanism.  On the left you have AL Franken with his use of humor.  

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3

[ Parent ]
We're even on the lecture count (0.00 / 0)
It's the Blind Monk Effect .

         " O how they cling and wrangle, some who claim
         For preacher and monk the honored name!
         For, quarreling, each to his view they cling.
         Such folk see only one side of a thing."



"It sounds wrong...
     ...but its right."

[ Parent ]
Paul (0.00 / 0)
You're having a weird day. Surely even you see that. Whatever's up, chill.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
Not So Much (0.00 / 0)
I wrote some snark that didn't strike your fancy.  You should have just said, "T'ain't funny McGree."  And that would have been that.

But, no!  For some reason, you were having a bad day.

"I am he as you are he as you are me and we are all together"


"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3
[ Parent ]
You're repeating yourself (0.00 / 0)
Is this Paul, or has he been taken over by the Borg?

Onoez, do not snark, resistance is futile!

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
Prisoner's dilemma kind of refutes that (4.00 / 1)
Our ability and tendency to act out of fear, malice, avarice, weakness, self-interest, survival, pleasure-affinity and pain-avoidance, among many other factors, makes a strong (but not oppressive) central government essential. In the ideal world which you postulate, humans would no longer be human, they'd be robots, or effectively so. And even then, for perfectly rational reasons, they'd likely, at least a a while under a new order worked itself out, fight it out with each other disasterously. Government and order were invented to deal with the unintended bad consequences of our unique human attributes, and laws were invented to define and limit their role, nature and scope in order to limit their own potential for unintended bad consequences. There's a reason that lions and tigers and bears--oh my--don't have a constitution or DoJ. They don't have the kinds of qualities that would call for it.

And now I feel silly for having just written that.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
You're right (4.00 / 1)
That's why Gray and I (and Paul, too) agreed that humans may never be able to handle the responsibilities of anarchy.

Perhaps a more timely question is whether humans can handle the responsibility of living in a highly mechanized society that is ostensibly based on representative democracy, and whether we can manage not to kill off our species (and few others) with the poisons produced by the technologies that our amazing capacity for tool-making has produced.


"It sounds wrong...
     ...but its right."

[ Parent ]
Funny way in which we're "agreeing" with each other ;-) (0.00 / 0)
I'm wondering if we're not all a bit on edge these days as we see our worst fears (or something approaching them) about Obama come true, and it's manifesting itself in our online banter. I know that it's freaking me out even though I expected him to do some of these things. I Just didn't realize how bad it would be, so soon. I had the most idiotic flamefest with a bunch of Obamabot trolls and likely astroturfers on DKos over this earlier today. They seem to believe that this is as good as it gets and all part of the sausage business or jiu-jitsu or ginzu knives and anyone who complains is just getting in the way blah blah blah.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton
[ Parent ]
Krugman Weighs In vs Medical Industry War On Knowledge | 99 comments
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