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Wednesday, July 24, 2019

More on Medicare Advantage, and other news

Recall that Cheryl and I are now enrolled in Medicare Advantage via Kaiser-Permanente here in Baltimore.

Interesting caveats. Too early for us to tell yet. By year's end I'll have firmer views.


Intriguing article at Vox:
The science of regrettable decisions
A doctor explains how our brains can trick us into making bad choices — and how to fight back.
By Robert Pearl

As Full House actress Lori Loughlin and her husband await their next court date, they stand accused of paying a $500,000 bribe to get their daughters into the University of Southern California as crew team recruits. Their defense is said to rest on the belief that they were making a perfectly legal donation to the university and its athletic teams (their children never rowed a competitive race in their lives).

Legal strategies and moral considerations aside, this strange behavior has left many observers wondering, “What were they thinking?” Surely, Loughlin and her family must have considered someone at the university would audit the admissions records or realize the coach’s high-profile recruits had never rowed a boat.

We may never know exactly what Loughlin and her family were thinking. But as a physician who has studied how perception alters behavior, I believe that to understand what compelled them to do something so foolish, a more relevant question would be, “What were they perceiving?”

Understanding the science of regrettable decisions
Several years ago, I joined forces with my colleague George York, a respected neurologist affiliated with the University of California Davis, to understand why smart people make foolish choices in politics, sports, relationships, and everyday life. Together, we combed through the latest brain-scanning studies and decades of psychological literature.

We compared the scientific findings with an endless array of news stories and firsthand accounts of real people doing remarkably irrational things: We examined the court testimony of a cop who, despite graduating top five in his academy, mistook his gun for a Taser and killed an innocent man. We dug through the career wreckage of a once-rising politician who, despite knowing the risks, used his work phone to send sexually explicit messages. And we found dozens of studies confirming that doctors, the people we trust to keep us safe from disease, fail to wash their hands one out of every three times they enter a hospital room, a mistake that kills thousands of patients each year.

When we read about famous people ruining their lives or hear about normal people becoming famous for public follies, we shake our heads in wonder. We tell ourselves we’d never do anything like that.

But science tells us that we would, far more often than we’d like to believe…
Read all of it. "Science."

I riffed on Twitter: apropos, Kathryn Schulz noted "there is no first-person present-tense phrasing of the word 'wrong'." No one thinks or says "I am wrong."

Great book.

On deck, another awesome book, also of topical relevance:

The thoughts that come out of our minds can make us seem out of our minds. 

Some of our most potent ideas reach beyond reason, received wisdom, and common sense. They lurk at chthonic levels, emerging from scientifically inaccessible, rationally unfathomable recesses. Bad memories distort them. So do warped understanding, maddening experience, magical fantasies, and sheer delusion. The history of ideas is patched with crazy paving. Is there a straight way through it – a single story that allows for all the tensions and contradictions and yet makes sense? 

The effort to find one is worthwhile because ideas are the starting point of everything else in history. They shape the world we inhabit. Outside our control, impersonal forces set limits to what we can do: evolution, climate, heredity, chaos, the random mutations of microbes, the seismic convulsions of the Earth. But they cannot stop us reimagining our world and labouring to realize what we imagine. Ideas are more robust than anything organic. You can blast, burn, and bury thinkers, but their thoughts endure. 

To understand our present and unlock possible futures, we need true accounts of what we think and of how and why we think it: the cognitive processes that trigger the reimaginings we call ideas; the individuals, schools, traditions, and networks that transmit them; the external influences from culture and nature that colour, condition, and tweak them...

Fernández-Armesto, Felipe (2019-07-01T23:58:59). Out of Our Minds. University of California Press. Kindle Edition, location 198.
One more quick excerpt:
"In the pages that follow I intend to argue that evolution has endowed us with superabundant powers of anticipation, and relatively feeble memories; that imagination issues from the collision of those two faculties; that our fertility in producing ideas is a consequence; and that our ideas, in turn, are the sources of our mutable, volatile history as a species." (location 365)
I am reminded of this cool book I've heretofore studied and cited.


More to come...

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