John McCain mourning shows that the path to national hero is paved with other folks’ hard work?

My Facebook friends are solemnly mourning the death of John McCain, a man whose presidential bid they opposed in 2008 (they cheered when Madonna compared McCain to Hitler (US News)). Here’s an example post (from a woman who is not in her “first youth”):

Greatest human being of all mankind. Thank you for many years of service. Rest in peace, Senator McCain.

Much of this seems to be based on McCain voting against an advertised “repeal” of Obamacare. Yet this vote to continue pouring tax dollars into the health care industry did not cost McCain anything personally. Most of his wealth was based on the $350 million beer distributorship founded by his second wife’s father. The profits from this corporation are distributed directly to owners and don’t go through the Obamacare 3.8 percent tax on dividends (see this 2008 nytimes article, which notes that the distributorship is an S Corp (also that Wife #2 for McCain got a prenup to guard against paying a Wife #3)). So McCain had nothing at stake personally and voted to spend other folks’ tax dollars on an arguably worthy program. If that qualifies him for “greatest human being of all mankind” then plainly there is no hope for a fiscal conservative in our national pantheon!

[McCain did vote for the Trump 2017 corporate tax bill (nytimes), which cut McCain’s personal tax rate on pass-through income.]

This seems to be a bipartisan phenomenon, as evidenced by “The Forgotten Man, Ted Kennedy, and Warren Buffett“:

I thought about this the other day when a friend’s wife was praising Ted Kennedy as a paragon of charity and good will towards America’s young and unfortunate. It occurred to me that voting to spend other folks’ tax dollars is not necessarily an indication of personal virtue. A politician in a liberal state such as Massachusetts might do that merely in order to get votes and not out of any sympathy for the common man. As Ted Kennedy has spent virtually all of his personal wealth on personal consumption of mansions, private jets, women, booze, etc., any help that he has provided to Americans has come at the expense of the “forgotten man” paying taxes. Ted’s own contributions to charity have been minimal (source).

Calvin Coolidge was never called a hero for vetoing an expensive farm subsidy bill. Grover Cleveland (a Democrat) was not a hero for vetoing dozens of spending programs.

Are we pretty much doomed to deficit spending if the American public swoons with grief at every death of a politician who voted to bury our country a little deeper in debt? Homer chronicled how ancient Greeks were motivated to fight and die for kleos. When earning kleos is as simple as voting to spend money that someone else earns, who could resist that?

Related:

  • “Why do women love John McCain?” (“Why would these women celebrate a guy who divorced his crippled-by-a-car-accident wife to marry a rich woman 18 years his junior?”)
  • Can we congratulate ourselves for U.S. Government aid to Haiti?” (“If I borrow your car and donate it to charity, does that make me a charitable person?”)
  • Wile E. Coyote tax and tariff policy” (“How about McCain? His [2008 Presidential Campaign] economic plan starts off with a section by Wile E. Coyote. He is going to cut gas taxes. He wants to tax renters to help homeowners. He wants to put more money into student loans (most of which ends up inflating the cost of attending college). He wants to tax people who suffer from infertility to give big tax credits to parents blessed with a bunch of children (combined with the gas tax holiday, that family of six can finally help boost the economy by buying a 7-passenger SUV). Buried after a couple of pages is a section that Ronald Reagan might have written, proposing to cut taxes in order to generate economic growth. The apparent schizophrenia is not addressed.”)
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Why is it illegal to pay people not to say bad-sounding stuff?

My Facebook friends are super excited about media attention around Robert Mueller’s Russia investigation establishing that payments were made to various (non-Russian?) women in exchange for them not talking about the men with whom they allegedly had sex back in 2006. Supposedly this violates Federal campaign finance laws.

Two questions…

Prostitution is illegal in most U.S. jurisdictions. But the women have not said that they were working as prostitutes or that Donald Trump hired them as prostitutes. From what I have read, the women say that they were affiliating with a rich old married guy because they had an inner fondness for rich old married guys. Therefore, whatever happened between them and a rich old married guy (if anything did actually happen) was perfectly legal. I can see why it would be illegal to use cash to cover up evidence of a crime, but why would it be illegal to pay women to keep quiet about an embarrassing, but legal, event? If a political candiate had once ordered a Ford Pinto in a 1970s orange color, would it be illegal to pay a car salesman to keep quiet about that unfortunate lapse of taste?

Why do my Democrat-voting friends want Trump impeached? Wouldn’t that elevate Mike Pence, currently a non-entity, to Presidential status and therefore make it easy for him to win the next two elections as an incumbent (Americans are always fearful of change)?

[Rolling back the clock a bit, why did Republicans want Bill Clinton impeached back in the 1990s? Woudn’t that just have made it easy for Al Gore to win the following elections?]

Separately, if these women had not been paid to keep quiet back in 2016, what would the news media have done with their stories? A big headline: “Candidate had sex back in 2006”? Wouldn’t the New York Times need some corroboration for a story like that? Without paperwork around a payment, what corroboration would there have been? No photo or video evidence of the events described seems to have been uncovered. In the Ford Pinto hypothetical above there would be a signed order for the embarrassing car, but did Stormy Daniels issue cash register receipts for her work in 2006? Even with corroboration, what would be the relevance to an election? We’re not supposed to judge peoples’ legal lifestyle choices in our society, are we? The NYT does not take the position that the American who is faithful to his or her spouse is a superior human being to the American who has sex with various neighbors and sues his or her spouse for divorce, alimony, and child support, right? If there is no official position that stable and faithful marriage is evidence of superior morality, why would it be news that someone was having sex outside of marriage 10 years previously?

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Big Data will send Medicare and Medicaid patients to the worst doctors

More lessons from my sojourn among the medical students…

As they gather more data, the insurance companies are getting smarter every year about kicking incompetent providers out of their networks. Eventually your private insurance company’s network will include only doctors with reasonably low rates of complications.

What about the doctors who are no longer in any private insurance company’s network. The good news for them is that Medicare/Medicaid can’t kick out anyone. They pay anyone who is licensed and legal to treat patients. When they do work with private insurers they make them sign contracts forbidding them from steering patients away from bad providers.

Big Data will thus inevitably create doctors, hospitals, etc. who see only Medicare/Medicaid patients? And these will be the worst providers in the U.S.?

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Trump Winery picks a holiday to celebrate

As a mail-order customer of the Trump Winery (nothing starts a conversation faster in Massachusetts than bringing Trump-brand sparkling wine to a party!), I get periodic emails from the enterprise. Today they picked a holiday to celebrate. August 26 is National Dog Day and Women’s Equality Day (celebrating the 1920 19th Amendment). Possibly due to the fact that the winery offers leashes and collars, the marketeers decided to pick National Dog Day. (But maybe Eric Schneiderman and his ladyfriends were customers for these Trump logo items?)

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Some things that I learned about the health insurance business

Some of the stuff that I learned about the health insurance business during a month at Harvard Medical School (earlier this year)…

Forcing people to get a second opinion prior to surgery was a “a stupid idea” and did not change costs or outcomes. [I don’t understand why. “Christopher had 323 doctor visits and 13 major surgeries. Here’s why his mom was arrested” (Fort Worth Star-Telegram) is an unfortunate story about a healthy child enduring a lot of medical torture. Wouldn’t he have had a lot fewer surgeries (maybe none?) if second opinions had been required? The media blames the mom, but could this even have happened in a country where doctors are on fixed salaries rather than being paid fee-for-service? And how much could have happened with a two-opinion system?]

The normal profit margin for health insurance is 1-2 percent (except for ACA/Obamacare, where the expectation is to lose money so it makes sense to withdraw). The Holy Grail for health insurers is to find an unregulated corner of the health care market in which high growth and high profit margins can be obtained.

Customers on the ACA/Obamacare exchanges are much more likely to go to the Emergency Room (“ED”), which represents a disaster for an insurer. (There are some differences in ER/ED usage due to age and gender ID. This article says “about 20 percent of women said they went to the ER, compared with 16 percent of men”. Young people are more likely to go as well, presumably because they can’t be bothered to put down their videogames for the hours of phone calls that it would take to find a non-ER solution.)

Insurance companies have limited outcome/health data. They know if a customer was readmitted to a hospital, but in a world where consumers are chased with surveys they never call up or email members to ask “How is your health?”

Much of “health insurance” is actually “healthcare billing administration.” The headline “health insurer” is not taking any risk. They are just negotiating rates with providers, haggling over bills, etc., on behalf of the real party at risk: your employer. If you’re upset because “the insurance company doesn’t cover X” it is actually your employer who decided that X wouldn’t be covered.

Employers (“plan sponsors”) start out wanting to cover everything. Then they find out what their generosity will cost and change their minds. In-vitro fertilization (IVF) is a good example. The employers are initially thrilled to help add more children to Spaceship Earth. Then they find out that 30% of IVF births are multiple, that the risk of prematurity is higher with multiple births, and that an average triplet birth is a $300,000 event compared to $11,000 when one baby emerges. IVF generates 1.6% of US births, but 16% of all twins and 38% of all triplets.

(Which plan sponsors are so stuffed full of cash that they don’t care about these costs? Universities and the U.S. military’s TRICARE.)

Why are premature babies so expensive? A NICU bed averages $3,000 per day on average (times 3 with triplets!). Advances in technology enable extremely premature infants to survive.

[There are new ethical questions to go with the new tech. For example, it is legal to abort a pregnancy up to 24 weeks of gestation in Massachusetts, but some of these would have been viable babies if born. Massachusetts also says it is legal to abort a child after that if it will harm the mother’s mental health. But what is more harmful to mental health than having a kid around? (see also: abortions sold for cash in Massachusetts)]

Enormous sums could be saved if patients could be moved around a little. There is at least a 2:1 ratio in cost of knee replacements, with the same quality, between higher cost and lower cost geographical areas. IVF is $25,000 in New York City; it is $7,000 in Baltimore (two and half hours away by AMTRAK Acela).

Enormous sums could be saved if patients could be redirected away from hospitals. The inefficiency of hospitals is truly staggering. In what other industry does buying the same service from a bigger enterprise cost 10X as much? Getting a shot or a pill at a hospital could cost 10X what it costs at an urgent care center such as a CVS clinic. But if you go to a big Petsmart you don’t pay 10X for dog grooming compared to what a local one-groomer shop would charge. The insurance companies spend a lot of time thinking about how to keep patients away from the ER/ED, but maybe it would be worth looking at why stepping through the front door of a hospital costs $1,000.

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Practical difference between Democrats and Republicans in Colorado

I recently visited a family in Boulder, Colorado whose 8-year-old son has figured out which way the political winds blow in that town: “I hate Trump.” Mom was in full accord with the child, but the father was unwilling to devote a large amount of brain space to righteous hatred. “Our neighbors find out that we’ve gone to Colorado Springs and they’ll say ‘How could you do that? I would never spend any time with people there.’ But if aliens visited Boulder and Colorado Springs they would say that people lived in exactly the same way in the two towns. They drive SUVs. They shop at Whole Foods. Hardly anyone walks or bikes. Maybe the Colorado Springs SUV has a ‘Focus on the Family’ bumper sticker and the Boulder SUV has a ‘Free Tibet,’ bumper sticker, but there is no practical difference in lifestyle.”

What about folks in Boulder? Don’t they spend more time and money helping the vulnerable? “No,” the father said. “Probably the Colorado Springs residents do more because they work through their churches instead of just posting on Facebook.”

How about the climate change alarmists at NCAR? Do they practice what they preach regarding CO2 reduction, at least when they’re not jetting off to climate change conferences? “I bike up that hill all the time for exercise. Most of the traffic on that road is SUVs occupied by one person.”

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Economic output should be proportional to the age of consent?

“Asia Argento, a #MeToo Leader, Made a Deal With Her Own Accuser” (nytimes):

The Italian actress and director Asia Argento was among the first women in the movie business to publicly accuse the producer Harvey Weinstein of sexual assault … Argento quietly arranged to pay $380,000 to her own accuser: Jimmy Bennett, a young actor and rock musician who said she had sexually assaulted him in a California hotel room years earlier, when he was only two months past his 17th birthday. She was 37. The age of consent in California is 18.

… the 2013 hotel-room encounter was a betrayal that precipitated a spiral of emotional problems, according to the documents.

Mr. Bennett’s notice of intent asked for $3.5 million in damages for the intentional infliction of emotional distress, lost wages, assault and battery. Mr. Bennett made more than $2.7 million in the five years before the 2013 meeting with Ms. Argento, but his income has since dropped to an average of $60,000 a year, which he attributes to the trauma that followed the sexual encounter with Ms. Argento, his lawyer wrote.

Ms. Argento asked the family member to leave so she could be alone with the actor. She gave him alcohol to drink…

For my late-1970s high school classmates, drinking alcohol and having sex were popular after-school activities (albeit not with movie stars). Today, however, it seems that an afternoon of consented-to sex can result in millions of dollars of harm to a teenager. Assuming that sexual activity among the young tracks the age of consent, I wonder if we should be able to see a correlation between age of consent and economic output. European countries have different ages of consent (Wikipedia), typically within a range of 14-16. Most U.S. states set the age at 16 (Wikipedia), but there are a substantial number at 17 or 18.

[Separately, I wonder if Donald Trump is running a time machine. When the New York Times accuses him of having encounters ]with various paid women back in 2006, these are reported as recent event. Yet for Ms. Argento, sex in 2013 is “years earlier” when viewed from the perspective of 2017. Does time move at a different pace for Donald Trump than for other people?]

Readers: Could teenage sexual activity explain the U.S.’s lackluster GDP per capita growth rate?

Related:

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Ukelele lessons for Angolans and Congolese

“Strummers in the city: Ukulele program gives Portland immigrant students head start” (The Forecaster):

PORTLAND [Maine] — Two dozen students filed into a classroom at Portland High School Monday for a ukulele lesson, strumming with determined fingers as part of a program to help them acclimate to the coming school year after emigrating to the city.

The students are housed at the city’s shelter for homeless families and are participating in a five-week-long Portland Public Schools’ summer program designed to give them a head start on school success and connect their families to school and city resources.

The theme this year, its second, is “Summer in the City.”

Most students are from Angola and the Republic of Congo, and communicate through interpreters during their time in the program.

Customers at Tony’s Donuts thought that ukulele skills would be useful: “They’re probably going to be on welfare for their entire lives so they need something to keep busy.”

 

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Female-to-male gender transition is a smart move for a 17-year-old applying to college?

A friend’s 17-year-old asserts a male gender ID (I refrained from pointing out that a room packed with cosmetics is not traditionally part of the male teenager lifestyle). The incomplete and non-surgical/non-hormonal transition is from heterosexual female to homosexual male.

Given that this gender-fluid person will soon be applying to colleges, I’m wondering if the new gender ID will be helpful. Except for elite schools, I think that admissions standards are lower for students identifying as “men” (the majority of college students identify as “women” and schools seek to avoid a gender ID imbalance).

Readers: What do you think? Is this 17-year-old best-off applying as (1) simply male, (2) transgender, or (3) gay male? College admission forms are heavy on race-related questions, but do they even ask if someone falls into an unusual gender or sexual-preference category?

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A new film camera system introduced in 2001

Digging through some old content I found this article on the Contax N1 system, a film SLR system to compete with Canon EOS and Nikon. It was introduced in 2001! (The Kodak (/Nikon) DCS digital SLR came out in 1991. The Canon D30 came out in May 2000; the professional EOS 1D in 2001)

There were a lot of bright people at Kyocera and Zeiss behind this. Let’s forgive ourselves next time we miss a trend that seems obvious in retrospect!

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