“The insurance companies simply do not offer those plans that are being cancelled. And there’s no way they can reformulate them in the 30 days available. And anyway, killing off those plans was the whole point of the design change. They wanted to destroy “insurance” as a concept in health care and to move to something much more like pre-paid health care. Thus plans that had high deductibles (ie, catastrophic plans, aka insurance instead of assurance) had to be banned. This isn’t a mistake, an error, a flaw in the plan, it was one of the very points of it all.”
- Tim Worstall, commenting on calls by former US president Bill Clinton for efforts to be made to prevent insurance firms scrapping medical cover in the US, and hence save the face of the current Obama administration. When a politician as crooked as Clinton is seen trying to come to the rescue, you are, in non-technical terms, up shit creek sans paddling device. (Actually, given how things are going, Clinton’s era was a veritable golden age, although let’s not forget that his own “Hillarycare” reforms were shot down by the-then Congress.)
In my previous posting here I asked: What if there is a real collective disaster? Well, from what I’ve been reading, in the US of A now, they’ve got one. Not a day now goes by when I don’t thank the universe that I won’t have to navigate my way through Obamacare, or anything like it, any time soon.
I particularly liked this comment on it, from Peggy Noonan:
I bet America hopes the websites never work so they never have to enroll.
SQotD has already been taken, but had it not been …
I also liked the comment from a few days back (sorry don’t recall where) to the effect that the most secure thing about Obamacare is that not even the hackers are able to get into it long enough to steal anything.
A few years back, whenever one of us Brits here had a moan about the state of things in Britain, American commenters would chime in with invitations to us to give up on dear old doomed, doomed Britain, and come and live in the land of the free. There’s been less of that sort of commenting lately.
“Never in human history has the general health of most ordinary people been better than it is now. But paradoxically, there can scarcely ever have been a time when health care has been a more difficult political problem for the governments of advanced countries than it is now. These two apparently contradictory facts are not unconnected. It is precisely because of the stupendous advances in the treatment of disease that the role of government has become so contentious. With the scope for life-prolonging medical intervention now virtually limitless – and thus spending on it being potentially limitless as well – there are moral and practical questions about its availability and distribution which every democratic society has to address.”
- Janet Daley.
As she explains, the lessons that ought to come out of the UK’s nationalised, socialist model of healthcare ought to give pause anywhere to reformers trying to impose a similar system. Which naturally leads her to look at the disaster of the Affordable Care Act. (US economics blogger and long-distance athlete Charles Steele has smart observations on this.) And the Marginal Revolution blog has an interesting perspective on the IT disaster of the ACA.
Tangentially, a rather fine novel, called Nobel Vision, was published a few years ago in which the lurch towards socialist-style healthcare was part of the plot. (The Ayn Rand influence is pretty clear on the author, it seems.)
Circumcision ruling: European bureaucrats are effectively banning Jewish boys, argues Brendan O’Neill, quoting the Jerusalem Post and unintentionally supported in his argument by the creepy quote from the Council of Europe in which it calls for “debate” and in the same breath announces what the result of said debate is to be. And this was put forward by a German rapporteur. I am not usually one for endless digs at modern Germans for evil done before most of them were born, but, Frau Rupperecht, do you have any idea of what that must look like to some of the Jerusalem Post’s older readers?
And yet – irreversible modification of a child’s body without the child’s consent. Gulp.
And yet again – parents irreversibly modify their children’s bodies by surgery all the time.
We have discussed this several times before, acrimoniously. Any new thoughts? Any constructive reformulations of old thoughts?
I have a question for medically knowledgeable readers. I gather that a far higher proportion – 79% in 2002 – of men in the US are circumcised than in the UK, yet the number uncircumcised is also huge. There must therefore be scope for large scale comparisons of outcomes. Have these been done? Does male circumcision make much difference?
It’s Friday, so let us talk about “paleo”. No, I am not talking about right-wing conservatives like Pat Buchanan, I mean stuff to do with a current trend in diet and lifestyle. The diet known as “modern paleo” seems to be taking off in the US and elsewhere. It is a diet that shuns grains, legumes, refined sugars and processed foods, and goes for things such as grass-fed beef, fish, vegetables – as a prime source of carbs – fruits and so on. The idea is that until a few thousands years ago, we “noble savages” were happily hunting animals, running about and getting fit, eating berries, sleeping when we needed to or wanted, and that things all went tits-up when we started harvesting crops. I guess the ultimate symbol of evil is a combine harvester.
Here is a typical take from one of the movement’s Big Cheeses (or should I say, Paleoistas?), Mark Sissons:
Right around 10,000 years ago, when former hunter-gatherers began growing grain seeds in neat, organized rows, something happened. Population exploded, because we now had a steady source of calories. Villages and cities sprang up, because we no longer had to follow our food. We could simply grow it where we lived. Those sound like pretty good things, at first. More food and shelter sounds good, right? Well, something else happened, too. Those early farmers were shorter than the hunter-gatherers they replaced. They didn’t live as long, and they had smaller brains. They got a lot more infectious diseass and more cavities. In short, they were not as healthy as the hunter-gatherers. Same genes, same homo sapiens, different environment, worse health.
Right. So let’s follow this through: Man lived a longer, healthier, happier and probably better-looking life up until relatively recently, and for some dumb reason, decided to get fat, ill and stupid. This transition, otherwise known as agriculture, is not really explained in this account. It is one of the oddities of some Darwinians, or those who like to use Darwin’s doctrines of evolutionary development in support of their ideas, as paleoistas do, that they don’t stop to ask that if a course of action – like farming – is so bad for us, how come those who practiced it did not die off and the supposedly fitter, older forms of behaviour take over again? And yet as Sissons has to concede, although agriculture may have its downsides, it enabled the human population to explode in numbers, and when, what is called the Agricultural Revolution happened (new ways of growing crops, use of fertilisers, etc), it also created the economic surplus to enable the Industrial Revolution, with all its marvels. Is Sissons claiming that we’d be better off in some sort of primeval state? I doubt it, of course.
Look, I can see that there is a lot of common sense behind some of these modern dietary ideas and yes, I have personally adjusted my lifestyle a bit, such as cutting down on grains and bread and so on. But there is something about the almost religious fervor behind this “paleo” stuff that bothers me. The fact is that without what we call modern agriculture, the vast majority of the today’s population would not be alive. And that is a rather big plus for agriculture. Sure, there is obesity and associated issues to deal with, many of which have complex causes. But I am damn glad we did have agriculture. It is precisely the wealth that such developments made possible that enable people today to worry about this stuff, and even make whole careers and businesses out of it.
(Full disclosure, I am a Suffolk farmer’s son, and probably the only person on this blog who has driven a combine harvester for its intended purpose.)
The Daily Mail has published eerie pictures of the abandoned medical facility in North Brother Island, to which Typhoid Mary was exiled by the New York public health authorities.
She meant no harm, certainly had not committed the sort of crimes that usually result in a life sentence, yet she caused several deaths. What should have been done with her?
Mary Mallon ended up causing more deaths by her stubborn refusal to believe that she was a carrier, and her breach of her undertaking to cease working as a cook. What should be done with someone who through no fault of their own carries a dangerous disease and unlike Mallon tries their best to act responsibly – but who nonetheless still causes deaths by their mere proximity to other people? We are horrified at the medieval leper’s bell and the leper colony but our sense of superiority rests on the fact that we now can treat leprosy. New plagues might arise that we cannot treat…
…yet we can be certain the plague of tyrannical abuse of power in the name of health will always be with us.
In response to a rather gushing article by Sally Gardner, a dyslexic novelist, entitled “Dyslexia is not a disability – it’s a gift”, one Alftser responded that if he or she had been given that gift “I’d find the receipt and get a refund.”
I laughed at that. However stripped of all the self-dramatisation (a pardonable sin in a novelist) and the wishful bagging of Einstein, Steve Jobs, and any public figure who ever misspelled a word as fellow dyslexics, Ms Gardner’s story is quite impressive: she is a winner of the Carnegie Medal who did not learn to read until she was 14. In a sense one cannot quarrel with her assessment that her own dyslexia has been a gift – and not just because she has been successful but because one cannot quarrel with anyone’s experience of their own lives. Well, one can quarrel with it. I’ve known people who could quarrel with the speaking clock. But you know what I mean.
Sadly, for most dyslexic people dyslexia is a pain in the part of the anatomy that I will exercise sufficient self control to not make a joke of misspelling, because dyslexics have heard all the jokes before. Most children with dyslexia are not going to have their inner genius unleashed even when presented with positive role models because they do not have an inner genius. Humanity is like that: mostly supplied with the inner genius slot vacant. Dyslexia may indeed, as Ms Gardner suggests, promote the skill of navigating the world by other means than arranging the written word, but in most cases this skill is simply not as useful as the one it substitutes for. That’s tough, but not insurmountable. Surmount it.
For a minority of dyslexics and quite a few pretenders, the diagnosis is a means to get free laptops, extra time and marks in exams, and a ready made victim identity.
Free stuff takes a very strong spirit to refuse. The extra marks are OK, so long as you do not end up deceiving others or yourself. But DO NOT TAKE THE VICTIM IDENTITY. It is poison.
ADDED LATER: G K Chesterton once said, “The dipsomaniac and the abstainer are not only both mistaken, but they both make the same mistake. They both regard wine as a drug and not as a drink.” I think that those who, like Sally Gardner, regard themselves (without irony) as being special because of their dyslexia (“Dyslexia is not a disability – it’s a gift. It means that I, and many other dyslexic thinkers can portray the world through images because we think in images. I can build worlds, freeze the frame, walk around and touch. I can read people’s faces, drawings, buildings, landscapes and all things in the visual world more quickly than many of my non-dyslexic friends. I paint with words; they are my colours.”) and those who embrace victimhood are making the same mistake. They both regard dyslexia as an identity and not as a condition.
It seems that another pandemic panic may be about to strike. (Thank you Instapundit, who seems a bit panic-stricken himself.)
It so happens that I have recently acquired and have been reading Matt Ridley’s excellent book, The Rational Optimist, which Johnathan Pearce has often blogged about here, in this posting, for example. (Here is a piece by Ridley, defending his book against Monbiot.)
And it further so happens that The Rational Optimist contains a very interesting passage (pp. 308-310), which I already had in mind to flag up here, even before this latest news of another flu outbreak, about the spread of infectious diseases, which explains why any pandemic panic that now materialises is likely once again to be greatly exaggerated:
In the 2000s influenza, too, proved to be a paper tiger. H5N1 strains of the virus (‘bird flu’) jumped into human beings via free-range ducks on Chinese farms and, in 2005, the United Nations predicted five million to 150 million deaths from bird flu. Yet, contrary to what you have read, when H5N1 did infect human beings it proved neither especially virulent nor especially contagious. It has so far killed fewer than 300 people worldwide. As one commentator concluded: ‘Hysteria over an avian flu pandemic has been very good for the Chicken Little media, authors, ambitious health officials, drug companies … But even as many of the panic-mongers have begun to lie low, the vestiges of hysteria remain – as do the misallocations of billions of dollars from more serious health problems. Too bad no one ever holds the doomsayers accountable for the damage they’ve done.’
I suspect this is too strong, and that flu may yet mount a serious epidemic in some form. But the H1N1 swine flu epidemic of 2009 that began in Mexico also followed the usual path of new flu strains, towards low virulence – about one death for every 1,000-10,000 infected people. This is no surprise. As the evolutionary biologist Paul Ewald has long argued, viruses undergo natural selection as well as mutation once established in a new species of host and casually transmitted viruses like flu replicate more successfully if they cause mild disease, so that the host keeps moving about and meeting new people. A victim lying in a darkened room alone is not as much use to the virus as somebody who feels just well enough to struggle into work coughing. The modern way of life, with lots of travel but also rather more personal space, tends to encourage mild, casual-contact viruses that need their victims to be healthy enough to meet fresh targets fleetingly. It is no accident that modern people suffer from more than 200 kinds of cold, the supreme viral exploiters of the modern world.
If this is so, why then did H1N1 flu kill perhaps fifty million people in 1918? Ewald and others think the explanation lies in the trenches of the First World War. So many wounded soldiers, in such crowded conditions, provided a habitat ideally suited to more virulent behaviour by the virus: people could pass on the virus while dying. Today you are far more likely to get the flu from a person who is well enough to go to work than one who is ill enough to stay at home.
Of course the pessimists could be right, in this or that particular instance. And of course we here are very pessimistic about the future course of the world’s current financial crisis. That is surely going to get far worse before it gets much better. I recall reporting here on a debate on that subject, where the other side was taking it for granted that the crisis that had just happened was now over and done with, and the only question concerned how best to “manage the recovery”. We here regard the people who talked like that, then, as the
Chicken Little Panglossian tendency.
And Matt Ridley himself is careful to include doubts about future flu outbreaks maybe not all being so un-apocalypctic. “Flu may yet mount a serious epidemic in some form.”
Nevertheless, interesting. And it will be interesting to see how this latest flu flare-up plays out.
Last week I attended a book launch (picture of author J. P. Floru here), and after the formal proceedings had been concluded, I meandered into a conversation involving the ASI’s Sam Bowman, about something called “Soylent”. Until then, Soylent to me only meant that Charlton Heston movie about food made of people. Sam and his pals were talking about something rather different, but the subject changed to something else and that night I learned very little out what this twenty first century version of Soylent is, beyond the fact that Sam Bowman was excited about it. Later, however, Sam sent me an email about it that got me chasing the story a bit.
Soylent is food, sort of, but not made of people. Basically, what the Soylent guy, whose name is Rob Rhinehart, says he did was … well, let him explain it, in the piece he wrote a month into the experiment that he performed on himself:
I hypothesized that the body doesn’t need food itself, merely the chemicals and elements it contains. So, I resolved to embark on an experiment. What if I consumed only the raw ingredients the body uses for energy? Would I be healthier or do we need all the other stuff that’s in traditional food? If it does work, what would it feel like to have a perfectly balanced diet? I just want to be in good health and spend as little time and money on food as possible.
I haven’t eaten a bite of food in 30 days, and it’s changed my life.
So how did this make him feel?
I feel like the six million dollar man.
If Rob Rhinehart, or anybody else who thinks as Rob Rhinehart is now thinking, ever got a job in government that involved him or her telling other people what to consume, then I would join what I hope would be a loud chorus of hatred and derision. But given that Rhinehart is experimenting on (a) himself, and now also on (b) other consenting Californians, I am a tentatively enthusiastic admirer of what he says he is doing, only tentative because my enthusiasm is subject to all the obvious caveats and hesitations about it all later turning out to be fraudulent nonsense.
But assuming all this to be for real, a particular point that Rhinehart makes is that the human body is resilient, in the sense that it can survive without quite a few “essential nutrients”, which would thus seem to be not quite as essential as that word implies. Even if the Soylent that Rhinehart has so far arrived at misses out on some supposedly essential nutrients, it didn’t kill him, despite worries that others expressed:
Perhaps this does not constitute the ideal diet, but I am quite confident that it is healthier than any easy diet, and easier than any healthy diet. I’m touched so many people are concerned about my intake of possible unknown essential nutrients. No one seemed to worry about me when I lived on burritos and ramen and actually was deficient of many known essential nutrients. The body is pretty robust. If you can survive on what most Americans or Somalians eat, you can surely survive on Soylent. I’m no longer just surviving, though. I’m thriving.
It sounds like a really interesting operation, both from the scientific point of view and as a potential money spinner. Nutrition that is as cheap as truly nutritional nutrition is capable of being, and as unheavy and unvoluminous as nutrition can be, has obvious applications, both in reducing the money spent by poor people feeding themselves healthily, and reducing the payloads consumed in the process of feeding such people as astronauts or submariners. Obviously, to start with, it will only be rich Californians giving this stuff a go, but everything has to start somewhere.
This whole story, and in particular that word “Soylent”, still has me and I am sure many others thinking: internet hoax. When I started reading Rhinehart’s stuff, I did a quick check to see if we had yet reached April 1st. But if all this is a hoax, quite a few people seem to have fallen for it, at any rate as far as I have, by writing about it.
But, if it is not an internet hoax, this would appear to be a classic case of suck-it-and-see (in this case literally that) technology-stroke-science, of just the sort I was writing about in this earlier posting here about where science (and art) come from. It really is very striking how very much, in this enterprise, the advance of science and the potential making of a mega-mountain of money would appear – touch wood – to be advancing hand in hand. At the very least, Rob Rhinehart is going to learn about why food, as opposed merely to Soylent, is, after all, necessary for human flourishing. But, if it isn’t, and if Soylent 4.2 (or whatever) will actually suffice … Rhinehart could be on his way to making a hell of a lot more than six million dollars.
Another nice titbit of news about all this is that Rhinehart would appear, judging from his use of the word “regulation” in the second sentence of this, to be some kind of free marketeer, libertarian type, although maybe I am reading too much into one word there.
I think Rhinehart ought to change that name though. His “Soylent” is not made of people, only for them. Nor does it contain any Soya.
Details. Another way of saying all of the above is: if this really is only a hoax, it is an extraordinarily interesting and inventive one, and some other Californian should be persuaded to try this on himself for real.
I await developments.
The Times, Tuesday, Feb 25, 1913; pg. 10. Click to enlarge
Healthy life expectancy is shorter in the UK than abroad
People in the UK enjoy fewer years of good health before they die than the citizens of most comparable European countries as well as Australia and Canada, a major report shows.
The health secretary, Jeremy Hunt, said Britain’s performance was “shocking” compared with that of other countries, and called for action to turn it around by local health commissioners, who are about to take up their new responsibilities.
The UK ranked 12th out of 19 countries of similar affluence in 2010 in terms of healthy life expectancy at birth, according to a detailed analysis from the Global Burden of Disease data collected by the Institute for Health Metrics and Evaluation (IHME) in Seattle.
Despite big increases in funding for the NHS in recent years and many reform initiatives, the UK was in exactly the same place as in the league table for 1990, according to the IHME report, published in the Lancet medical journal.
Emphasis added. The report’s authors, and the Guardian article from which I quote, are at pains to say that
the problem is only in part to do with hospital care – much of it is about the way we live. Our diet, our drinking and continuing smoking habits all play a part
In other words, Britain’s relatively poor average life expectancy partly is to do with NHS hospital care, but they would rather not say so. As for the remainder of the problem that is not caused directly by the failings of the NHS, I wonder if the report’s authors have considered the possibility that the “despite” might be a “because”? Why do the British do worse than other nationalities of similar wealth when it comes to living an unhealthy lifestyle? It is no answer to just say “culture”; why is our culture as it is? Have we always been thus? We have a long tradition of getting drunk, I grant you, but my impression is that the British were not considered any fatter or any more drug-addled than comparable nations a few decades ago… before 1947, let us say for the purposes of discussion.
It is often said that one of the great blessings of the NHS is that it has lessened the fear of illness. The fact that they do not have additional worries about costs or insurance does come to those already worried about illness as a huge relief, and NHS-sceptics like me have to engage with that, sometimes in our own lives. So let us do so. I submit the hypothesis that a certain amount of fear of getting ill is salutary – both in the general sense of producing a beneficial effect and in the more specific, and original, sense of promoting health.
Naturally, I speak here of averages over a large population. Many illnesses cannot be avoided by human action; that is what insurance is for. When considering any one individual, I doubt that when making the many small bad decisions that have the cumulative effect of making him or her unhealthy, “hey, I don’t have to worry about paying for healthcare” often comes consciously to mind. But, like the proverbial mills of God, the mills of incentives grind slow but they grind exceeding small. In some countries those many small decisions take place under the shadow of “I might end up with a bill for this”. In Britain they do not. My hypothesis might go some way to explaining Britain’s anomalously poor average health. Something must explain it.
By the way, I shall take it as read that every human being has a perfect right to eat, drink, smoke and inject as he or she pleases. I shall also take it as read that the authors of the report and 95% of its readers wish to deny others that right. If the hypothesis above is correct, Britain has set up a system that, besides the inherent wrong of being based on coercion, removes one of the incentives for people to take care of their own health. How to solve that? More coercion, of course.
In April, my friend Elena Procopiu is going on a trek through the Atlas Mountains of Morocco, to raise money for a charity called the Moroccan Children’s Trust. Elena writes about MCT’s activities,and her fundraising activity for it, here.
There are hundreds of children on the streets of Taroudant suffering daily harassment, humiliation, physical abuse and exploitation as they try to earn a living off the streets. …
… and MCT is trying to do something about that.
Elena’s many friends have started chipping in. I will shortly be doing likewise. I have already learned some geography, by googling Taroudant.
I am looking forward to hearing about this expedition when Elena returns to London. Just as interesting as her report of the trek in the mountains will be what else she will then be able to tell us all about the work of MCT. After the trekking is done, the trekkers will spend a further few days meeting some of the local Moroccans involved, and some of the children and parents they are trying to help. If anyone reading this is inclined to donate also, Elena assures us that this is the sort of thing that all their donations will be spent on. The trekkers are all paying their own travelling expenses.
It makes a difference to me that Elena is personally acquainted with the people who run MCT, which as of now seems to be quite a small operation, with no big London HQ or any such nonsense. The boss of the enterprise is a British doctor. I’m guessing that MCT began when he was doctoring in Morocco, but then realised that many of his patients, or potential patients, had other problems besides medical problems.
I say “or potential patients”, because it is a sad sign of the times we live in that an important part of MCT’s work is helping people fill in forms, so that they can then visit doctors, attend schools, and so on. Sadly, being a bureaucratic un-person can be a slow sentence of death to someone already on the poverty line, in a country like Morocco.
Really helping total strangers can be very difficult. Time and again, people who are trying to help, or who say they are, only end up making matters worse (for coincidental evidence of which you need only note the immediately previous post here this very morning). Which is why, for me, having a personal friend involved in a particular charitable effort makes the difference – all the difference, actually – between me saying no and me saying yes, to a request for a donation. That way I will get the lowdown on how the money is really being spent, and whether it is reasonable to go on hoping that it is doing some actual good. Meanwhile I am genuinely doing a favour for a friend, who I already know I really will be helping.
I hope to be reporting further about this, perhaps with photos that Elena says she will be taking on her travels.