Alan Jacobs about Amerian health-care, or what passes for it:
I think the first thing to understand about the American health-care system is this: some people lose money from illness, and some people make money from illness. Some people pay, and some people get paid.
…
I don’t think there are many doctors who consciously make medical decisions based on their lust for money. But I do think there are a great many doctors who go along with the incentives established by the system, without thinking about it too much or at all, because on some level they know that thinking about it could well lead to their losing money.
Of course, most people getting paid from the illness of others are not the doctors, the nurses, or the pharmacists. In fact, outside of lucrative procedure-based specialties — and there aren’t as many of those as a Top Docs glossy would make you think — most doctors, certainly most of those who deal with chronic medical conditions, have no idea how much treatments and tests they order actually cost.
This is, in fact, not a feature but a bug of the system, and one of its main ones. Most doctors work not for their patients, but for amorphous “health systems” graced with all the charm and efficiency of a lumbering bueracracy. They, in turn, deal not with the patients directly, but rather with medical insurance companies or, worse yet, “benefits managers” who insert themselves as mediators nominally there to simplify the process but instead further increasing its complexity. And presto, you now have a series of matryoshka dolls each doing its part to create the mother of all principal-agent problems.
Should the patients’ perspective be the primary consideration in improving American health-care? Absolutely! But lets not fool ourselves into thinking that the mess we are in is due to doctors’ priorities overwhelming everyone else’s.
Magpie Murders were an absolute delight, even if the modern-day mystery was somewhat predictable. Looking forward to the Moonflower Murders, whenever they come out. 📺
Finished reading: Alexander Hamilton by Ron Chernow 📚
Three remarkable achievements here: Hamilton’s for having lived the life he did, Chernow’s for assembling his remarkable tale, and Miranda’s for distilling and rearranging it into a Shakespearean work of art. Will read again.
Today I learned that the IMDB rating of This Is Spinal Tap… goes up to 11!
Many thanks to Russ Roberts and his recent critique of utilitarianism for pointing this out. The essay itself is a perfect Thanksgiving weekend read for both its topic and length.
This is the perfect number of times a year to have cranberry sauce: one.
John Roderick (or was it Ken Jennings) on the Omnibus podcast.
Happy Thanksgiving to all who celebrate.
In a last-minute change of plans we will be roasting our own turkey for the first time since 2015. Is this a good recipe and does anyone have a better one?
Signed: Clueless
“…and Neymar will fall and cry like a baby”, predicts a boy in Belgrade about tomorrow’s match. Even if his 3–0 win for Serbia against Brazil doesn’t materalize, the fall almost certainly will. ⚽️
The next time you crack your backdoor to let your cat outside for its daily adventure, you may want to think again. For a cat, the outdoors is filled with undesirable potential. Like the risks of catching and transmitting diseases, and the uncontrollable drive to hunt and kill wildlife, which has been shown to reduce native animal populations and degrade biodiversity.
So starts a University of Maryland press release about this paper, which analyzes interactions between domestic cats and “eight native mammal species common in urban areas” in Washington D.C.
Now, if you ever stepped foot in D.C. you will notice that the most abundant mammals are neither cats, dogs, nor humans, but rats. But these District mascots do not make an appearance among the species analyzed, which were eastern chipmunk, eastern cottontail, eastern gray squirrel, groundhog, white-footed mouse, raccoon, red fox, and Virginia opossum.
Ah yes, the red fox. So very common in Washington D.C.
Look, I don’t doubt that domestic cats roaming around the suburbs are the scourge of bunny rabbits and chipmunks. But downtown D.C. has a bit of a rat problem and this study could have been a way to learn more about them.
Found on Mastodon via @m_clem@econtwitter.net, a passage from The Enchiridion by Epictetus, translated by Elizabeth Carter in 1758.
What a lovely sentiment to have, and not only with regards to social media.
Niall Ferguson in one of last year’s Conversations with Tyler:
The epistemic problem, as I see it is — Ian Morris wrote this in one of his recent books— which is the scenario? Extinction-level events or the singularity? That seems a tremendously widely divergent set of scenarios to choose from. I sense that — perhaps this is just the historian’s instinct — that each of these scenarios is, in fact, a very low probability indeed, and that we should spend more time thinking about the more likely scenarios that lie between them.
This is bananas thinking! [Note: Probability space replacing the river in this well-known Talebism. ] If the probability space is 4 feet deep on average you don’t just wade into it as if every part is just 4 feet. You need to know the variance, and from Ferguson’s own telling it goes from unlimited upside to complete ruin.
Worse yet: Ferguson is confusing improbable with the impossible. [Note: And also hasn’t heard of ergodicity, again courtesy of Taleb. ] Given a long enough time span, an extremely low-frequency event is a near-certainty. If you don’t believe me, how about a game of Russian roulette?
Is it because Ferguson is a historian? Everything he encounters professionally would have ex post likelihood of 100% so probability theory may not be his area of strength. Don’t ask a historian for predictions, I guess.