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Monday, December 14, 2015

Miscellany: 12/14/15

Quote of the Day
The future is purchased by the present.
Samuel Johnson

 Tweet of the Day
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Political Potpourri

A flurry of polls in RCP since my last segment. I think we can definitively identity the top 4 in the GOP pack: Trump, Cruz, Rubio, Carson. Trump has a problem: his support is very thin; if you're for him, he's your first choice. He's not really the alternate vote for the 70% or so voters preferring other candidates. This seems to suggest, as I mentioned in one of today's tweets, that other candidates will benefit from candidate withdrawals, and if Trump loses support, he may find it difficult to regain it. Also, a lot of his support comes from the less educated and/or younger voters who don't historically show up as reliability at the polls; I'm not sure how much this is factored into poll numbers.

The numbers are different for Trump. The Sunday NBC national poll has Trump at 27, just 5 over Cruz (yet another poll over 20), Rubio is the mid-teens and Carson barely in double digits. In today's Monmouth has Trump at 41, nearly triple over Cruz, followed by Rubio, then Carson. The two Iowa polls split with Trump nipping Cruz in today's Quinnipiac while yesterday's Fox News poll had Cruz at 28, nipping Trump by 2; both polls had Rubio at a distant third followed by Carson further back at fourth. NBC had pairwise head to heads with Clinton beating Trump by 10, Cruz by a smaller margin, but losing to Rubio and Carson.

Tomorrow's debate should be interesting. After some speculation, Rand Paul did make the final cut, and Christie's recent strong showings in NH have returned him to the big stage. I'm continuing to see Jeb's ads, but his campaign seems to be dying in the single digits. I would not be surprised to see a clash between Cruz and Trump given their tough words on each other, Rubio and Carson need to find ways of regaining momentum. Of course, the other candidates need to find a way to assert themselves. Bush has been falling into the lower single-digits. I will likely publish a one-off later this week, depending on other obligations and whether I watch the debate live.

The Unconstitutional Process of Putting People on the No-Fly List and the Arbitrary Restrictions on Natural Rights



Big vs. Limited Government



Facebook Corner

(Independent Institute). What I found remarkable was Dr. Parkinson’s complete focus on the costs to the doctor, not the costs to the patient, of the reduction in house calls. The almost complete elimination of house calls has not increased efficiency; it has only transferred the cost of travel from the doctor to the patient. Read more: http://ow.ly/VCKzQ
Graham is spot on. The waiting room concept is somewhat disputable but there are differences. One of my personal experiences (not that unusual) might help explain Graham's point better. I have generally had good health for most of my work career. I'm an IT professional used to hour/longer commutes. Typically, I've had to rearrange my work around physician appointments. It's not just that there's a waiting room; there are queue levels. So I've had to wait up to a half-hour after the appointment time before I get ushered into one of a round robin of office rooms; typically a nurse will weigh me, check my blood pressure, etc., and then I might have to wait up to a half hour before a doctor will finally stick his head in the door. He might talk to me for 2-3 minutes and then leave for an indefinite period of time before returning.

 In one notorious example, I felt like I was being treated like the doctor's ATM card. He was having me schedule office visits to discuss each of a series of blood tests to establish dosage for a thyroid problem. There was no reason for him to see me other than to change my prescription and/or schedule another blood test, all of which could easily have been handled by phone. Instead, I had to go through all this overhead just to talk to him for maybe 2 minutes. On one scheduled visit, I got caught in bumper-to-bumper traffic on the Baltimore loop during the lunch hour (when the appointment was made at the doctor's convenience). I ended up arriving 15 minutes late; the doctor's office refused to process me into the round robin of office rooms, insisting that I would have to schedule a new appointment. I wasn't pleased and balked at the idea of rescheduling at that time. The doctor's office after the fact supposedly mailed me a notice saying that the doctor was dropping me as a patient. (I never got the notice and found out when I had attempted to schedule an outpatient procedure; the surgeon scrubbed the appointment without notification after the doctor's office, which had made the referral, told her I no longer had a personal physician. I eventually found a new, more competent doctor much closer, maybe 15 minutes away. The original doctor had been referred to me from a clinic I had visited under insurance.)

 This Procrustean approach to medicine Graham describes needs a paradigm shift. To some extent the Internet of things can play a role. I was hoping that Graham would focus more on the perverse meddling of government with the health care sector, its role in the physician cartel, the third-party obfuscation of prices from a consumer perspective, etc.
The Economist in this person is not working very well... nor have they obviously ever worked in a physician's office and know nothing about the cost of...oh say, malpractice insurance? Even if they have never been sued that cost alone can get exorbitant. As in any business, the number of units completed in the shortest time is what keeps costs down, so seeing 4 patients in one hour vs. a home visit for one patient that may take two hours.... It does not take a college degree to understand Increased Cost to Supplier = Increased Cost to Consumer! What an idiot. The Doctor is not being self-absorbed.
You are in a state of denial; you are only looking at efficiency from the perspective of the doctor. Several responses which I won't repeat here, e.g., the State-sanctioned doctor cartel, the fact that people often sacrifice wages--which can be just as valuable as a doctor's time, there can be health/other issues in transporting the patient, etc.

Political Cartoon

Courtesy of Gary Varvel via Townhall

Musical Interlude: Christmas Hits

Celtic Women, "Hark the Herald Angels Sing".  Have mercy: when Méav hits those notes during the climax, the heavenly choir couldn't sound better. I don't have chart statistics on this track, but quite frankly, I don't care. It's not in one Wikipedia page of holiday hit songs I've referenced, but I initially heard of the performance from a glowing reference on the Web, enough to search for a video on Youtube. After playing it once, I immediately decided to buy a licensed copy. I've heard and sung this traditional song all my life, but Celtic Women made it their own.

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