My Alabama Woman:

Happy Birthday (aka New Year's Eve).

   

51 years together in March 2025. Lucky me.
We are now known as "Meee-mo & Pop."

President Jimmy Carter.

Rest in peace.

  

The Edge of Chaos?

 

 An 11 minute video that should be well worth your time.

As modern humans we experience a different world and experience than  anyone who has ever come before us. This is because we've inverted the dynamics of how our lives unfold. We live on a planet defined by local stability, but global instability. The hunter-gatherers that came before us lived in a world that was defined by local instability, but global stability, says political scientist Dr. Brian Klaas.

As hunter-gatherers, their day-to-day lives in their local environment was unpredictable. Now we have flipped that world. We experience local stability, but global instability. We have extreme regularity in our daily lives. We can order products online and expect exactly when they're going to arrive. We can go to Starbucks anywhere in the world and it's going to taste roughly the same.

But our world is changing faster than it ever has before. Consequentially, when things do go wrong, the ripple effects are much more profound and much more immediate. This is where that sort of aspect of global instability becomes very  dangerous.

'eh?

See "We don't have to destroy ourselves."

 

NOTE: A recent post-Klaas read that started me down my current exploratory path.

 

It eventually led me here today.

 

With several intermediary stops along the way (more on those in a bit). Paul Davies in particular is knocking me out at the moment. e.g.,

Re that last slide: "...from the informational architecture in their heads..."

 

Yikes. Nita Farahany, anyone?

CITE FROM THE EPILOG...

…In this book I have charted a burgeoning new area of science. As I write, scarcely a day passes without the publication of another paper or the announcement of a new experimental result having a direct impact on the physics of information and its role in the story of life. This is a field in its infancy and many questions remain unanswered. If there are new physical laws at work – informational laws, perhaps involving state dependence and top-down causation – how do we mesh them with the known laws of physics? And would these new laws be deterministic in form or contain an element of chance, like quantum mechanics? Indeed, does quantum mechanics come into them? Does it in fact play an integral role in life? In addition to these imponderables lies the question of origins. How do life’s informational patterns come into existence in the first place? The appearance of anything new in the universe is always an amalgam of laws and initial conditions. We simply don’t know the conditions necessary for biological information to emerge initially, or, once left to get going, how strong a role natural selection plays versus the operation of informational laws or other organizational principles that may be at work in complex systems. All this has to be worked out.

There will be those who object to dignifying the informational principles I have been elucidating with the word ‘law’ in any deep sense. While most scientists are happy to treat information patterns as things in their own right for practical purposes, reductionists insist that this is merely a methodological convenience and that, in principle, all such ‘things’ can be reduced to fundamental particles and the laws of physics – and hence defined out of existence. They don’t ‘really exist’, we are warned, except in our own imaginings. While reductionists may concede that certain rules ‘emerge’ in complex systems, they assert that these rules do not enjoy the fundamental status of the laws of physics that underlie all systems. The reductionist argument is undeniably powerful, but it rests on a major assumption about the nature of physical law. The way the laws of physics are currently conceived leads to a stratification of physical systems with the laws of physics at the bottom conceptual level and emergent laws stacked above them. There is no coupling between levels. When it comes to living systems, this stratification is a poor fit because, in biology, there often is coupling between levels, between processes on many scales of size and complexity: causation can be both bottom-up (from genes to organisms) and top-down (from organisms to genes). To bring life within the scope of physical law – and to provide a sound basis for the reality of information as a fundamental entity in its own right – requires a radical reappraisal of the nature of physical law, as I am arguing.

It would be wrong to think that these arcane deliberations are important only to a handful of scientists, philosophers and mathematicians. They have sweeping implications not just for explaining life but for the nature of human existence and our place in the universe. Before Darwin, it was widely believed that God created life. Today, most people accept it had a naturalistic origin. While it is true that scientists lack a full explanation for how life emerged from non-life, invoking a one-off miracle is to fall into the god-of-the-gaps trap. It would imply a type of cosmic magician who sporadically intervenes, moving molecules around from time to time but mostly leaving them to obey fixed laws. Yet within the broad scope of the term ‘naturalistic’ lie very different philosophical (even theological) implications. Two contrasting views of life’s origin are the statistical fluke hypothesis championed by Jacques Monod and the cosmic imperative of Christian de Duve. Monod appealed to the flukiness of life to bolster his nihilistic philosophy: ‘The ancient covenant is in pieces,’ he wrote gloomily. ‘[Man’s] destiny is nowhere spelled out, nor is his duty. The kingdom above or the darkness below: it is for him to choose . . . The universe was not pregnant with life, nor the biosphere with man.’12 In responding to Monod’s negative reflections, de Duve wrote, ‘You are wrong. They were,’13 and proceeded to develop his view of what he called ‘a meaningful universe’. Boiled down to basics, the issue is this. Is life built into the laws of physics? Do those laws magically embed the designs of organisms-to-be? There is no evidence whatever that the known laws of physics are rigged in favour of life; they are ‘life-blind’. But what about new state-dependent informational laws of the sort I am conjecturing here? My hunch is that they would not be so specific as to foreshadow biology as such, but they might favour a broader class of complex information-managing systems of which life as we know it would be a striking representative. It’s an uplifting thought that the laws of the universe might be intrinsically bio-friendly in this general manner.

These speculative notions are very far from a miracle-working deity who conjures life into being from dust. But if the emergence of life, and perhaps mind, are etched into the underlying lawfulness of nature, it would bestow upon our existence as living, thinking beings a type of cosmic-level meaning.

It would be a universe in which we can truly feel at home.

Davies, Paul. The Demon in the Machine: How Hidden Webs of Information Are Solving the Mystery of Life (pp. 215-217). University of Chicago Press. Kindle Edition.

More to come...

_________

  

A Star Is Born

This NYC Perp Walk Photo Op was obscene.

Luigi Mangione appeared in court in PA, whereupon he waived extradition to NY. He was then placed in a NYC police SUV and driven to a nearby airfield where he was transferred into an NYPD helicopter and flown subsequently to NY. After landing at a waterfront helipad, he exited in chains, surrounded by a huge contingent of heavily armed SWAT officers, and a group of politicians, including the Mayor (and, of course, a media throng, which was the point). A lengthy outdoor "perp walk" ensued, at the end of which he was placed in a NYPD arrest van and driven off to a NY court and subsequently the MDC. I'd love to see the total taxpayer tab for that absurd PR shitshow.

_________

  

Klaas is once again in session: Taleb's turkey.

The Zero Numerator problem.

  

I: Don’t Draw a Black Ball from the Urn of Invention

“It is an unnerving thought,” Bill Bryson once wrote, “that we may be living the universe's supreme achievement and its worst nightmare simultaneously.” Our sensations of awe and beauty, our intense ability to love, our self-aware consciousness may each be unparalleled—a rare instance of the universe perceiving itself.1

But as humans, we also possess an awesome capability known to no other species on the planet: we can make ourselves extinct. No matter how much octopuses scheme or chimpanzees twirl rudimentary tools, they cannot destroy themselves. We are in our own club, trapped in a cage of existential risk—designed by our cleverness, as seemingly inescapable as the march of progress, and with the unfortunate potential to kill us all…

…[F]or those who favor complacency, it’s important to note: just because something has been alright for a long time, doesn’t mean it will continue to be alright forever. Taleb uses the parable of the turkey on a farm, a plump bird who sees the farmer as a lovely man who comes to bring him food, without fail, every day. The farmer is his friend, his provider, his carer—until one day, right before Thanksgiving, ruin comes unexpectedly. We would be wise not to be that turkey.

V: We Don’t Have to Destroy Ourselves

If Bostrom is correct that a black ball is lurking in the urn, then he points to two possible solutions to mitigate our cataclysmic end. The first is a non-starter: create such extensive policing surveillance that “any halfwit” can’t destroy humanity because every halfwit is constantly being monitored to ensure they don’t take advantage of an “easy nukes” scenario.

The more realistic scenario is difficult, but not impossible: true global governance of existential risks. This requires unprecedented cooperation to avoid unprecedented consequences. So far, our track record is not great…

…[As] Filippa Lentzos of King’s College London explained to me previously, there still is no international organization with enforcement power that regulates or inspects all of the most potentially dangerous labs in the world—those known as biosafety level 4, or BSL-4 labs. It’s such an obvious area of potential risk—and we continue to allow a laissez-faire attitude, leaving these decisions mostly to national governments. The same is broadly true of artificial intelligence, where the technology is rapidly outpacing regulation.

But we don’t have to accept reckless courting of existential risk. If we fear a black ball is being withdrawn from the urn, we have the power to stop it. It’s a choice…

The point is not to suggest that existential risks are overblown—they’re clearly not. Whether it’s extreme climate change, nuclear apocalypse, devastation from artificial intelligence, mirror life or other biothreats, we are living in an unprecedented era of a new power—the power to destroy ourselves.

But humans can be astonishingly wise when it counts most; if we demand that our leaders take these threats more seriously; and if our politicians have the courage to create new, powerful international agencies that have the teeth to manage and mitigate the lurking black balls that could end our species, then I’d be far more willing to bet on humanity’s longevity.

Despite our cornucopia of flaws, we are worth saving; a species defined not just by our maddening defects, but by our unique curiosity, wonder, awe, love, beauty, ingenuity, and kindness. And yet, nobody can save us but ourselves…

Yeah, Klaas is once again back in session. The foregoing is excerpted from his Substack newsletter series. Do yourself a favor. Read his books and subscribe to his Stack. See also this post.

This stuff coheres nicely with two books in progress at the moment.

 

 

From The Demon in the Machine

FROM THE IDEA FACTORY

Introduction
WICKED PROBLEMS

This book is about the origins of modern communications as seen through the adventures of several men who spent their careers working at Bell Telephone Laboratories. Even more, though, this book is about innovation—about how it happens, why it happens, and who makes it happen. It is likewise about why innovation matters, not just to scientists, engineers, and corporate executives but to all of us. That the story is about Bell Labs, and even more specifically about life at the Labs between the late 1930s and the mid-1970s, isn’t a coincidence. In the decades before the country’s best minds began migrating west to California’s Silicon Valley, many of them came east to New Jersey, where they worked in capacious brick-and-glass buildings located on grassy campuses where deer would graze at twilight. At the peak of its reputation in the late 1960s, Bell Labs employed about fifteen thousand people, including some twelve hundred PhDs. Its ranks included the world’s most brilliant (and eccentric) men and women. In a time before Google, the Labs sufficed as the country’s intellectual utopia. It was where the future, which is what we now happen to call the present, was conceived and designed.

For a long stretch of the twentieth century, Bell Labs was the most innovative scientific organization in the world. It was arguably among the world’s most important commercial organizations as well, with countless entrepreneurs building their businesses upon the Labs’ foundational inventions, which were often shared for a modest fee. Strictly speaking, this wasn’t Bell Labs’ intended function. Rather, its role was to support the research and development efforts of the country’s then-monopolistic telephone company, American Telephone & Telegraph (AT&T), which was seeking to create and maintain a system—the word “network” wasn’t yet common—that could connect any person on the globe to any other at any time. AT&T’s dream of “universal” connectivity was set down in the early 1900s. Yet it took more than three-quarters of a century for this idea to mature, thanks largely to the work done at Bell Labs, into a fantastically complex skein of copper cables and microwave links and glass fibers that tied together not only all of the planet’s voices but its images and data, too. In those evolutionary years, the world’s business, as well as its technological progress, began to depend on information and the conduits through which it moved. Indeed, the phrase used to describe the era that the Bell scientists helped create, the age of information, suggested we had left the material world behind. A new commodity—weightless, invisible, fleet as light itself—defined the times.

A new age makes large demands. At Bell Labs, it required the efforts of tens of thousands of scientists and engineers over many decades—millions of “man-hours,” in the parlance of AT&T, which made a habit of calculating its employees’ toil to a degree that made its workers proud while also keeping the U.S. government (which closely monitored the company’s business practices and long-distance phone monopoly) at bay. For reasons that are conceptual as well as practical, this book does not focus on those tens of thousands of Bell Laboratories workers. Instead, it looks primarily at the lives of a select and representative few: Mervin Kelly, Jim Fisk, William Shockley, Claude Shannon, John Pierce, and William Baker. Some of these names are notorious—Shockley, for instance, who won the Nobel Prize in Physics in 1956 and in his later years steadfastly pursued a scientific link between race and intelligence. Others, such as Shannon, are familiar to those within a certain area of interest (in Shannon’s case, mathematics and artificial intelligence) while remaining largely unknown to the general public. Pierce, a nearly forgotten figure, was the father of satellite communications and an instigator of more ideas than can be properly accounted for here. Kelly, Fisk, and Baker were presidents of the Labs, and served as stewards during the institution’s golden age. All these men knew one another, and some were extremely close. With the exception of Mervin Kelly, the eldest of the group, they were sometimes considered members of a band of Bell Labs revolutionaries known as the Young Turks. What bound them was a shared belief in the nearly sacred mission of Bell Laboratories and the importance of technological innovation.

The men preferred to think they worked not in a laboratory but in what Kelly once called “an institute of creative technology.” This description aimed to inform the world that the line between the art and science of what Bell scientists did wasn’t always distinct. Moreover, while many of Kelly’s colleagues might have been eccentrics, few were dreamers in the less flattering sense of the word. They were paid for their imaginative abilities. But they were also paid for working within a culture, and within an institution, where the very point of new ideas was to make them into new things…

Gertner, Jon. The Idea Factory: Bell Labs and the Great Age of American Innovation (pp. 1-3). Penguin Publishing Group. Kindle Edition. 

NOTEWORTHY

  

 

Hmmm... "Wicked Problems?" Recent book I've read. 

 

UPDATE: CLAUDE SHANNON OF BELL LABS

 

 

I don't know that my Dad ever knew him. Pop worked in semiconductor R&D, one of myriad lower level lab technicians. 

 

More shortly...

_________

  

35 days

until the 2nd swearing in of the Oaf of Office.

  

 

12:01 pm EST January 20th, 2025.

Order 25-100% tariffs against imports from Canada, Mexico, and China;

Pardon the January 6th 2021 insurrectionists;

Jail the J6 Committtee Democrats;

End Daylight Savings Time;

End the war in Ukraine;

End the war in Gaza;

Resume Drill-Baby-Drill;
End the Department of Education;

Privatize the USPS; 

End EPA regulations;
End vaccines...

 Gonna be "interesting." (and, yeah, I know, "don't take him literally.")

 

 

A COUPLE OF QUICK NEWS UPDATES

 

I turned on CNN right after I'd initially posted. There was Donald Trump, live, holding a rather freewheeling Presser at Mar-a-Lago. He could not be more pleased withg himself, exultantly congratulating himself for being Right About Everything since his 1st POTUS term, and before.

 

Then, they cut away live to yet another "active shooter" episode, at a Christian K-12 school in Madison, WI. Multiple fatalities. Shooter dead. A female student.

OFF-TOPIC ERRATUM

Reading several new books. Playing around on B.Sky with one of them.

Alan is my favorite graduate school professor (mid-late 1990's)..

More to come...

_________

  

The Land of Fake-Believe

The internets are melting down under the
raging opportunistic #LuigiLARPerMerch wildfires.
(Gotta love the fake "American Hero" pic photoshopped onto the plain t-shirt above.)

Seen on a phone pole.

Some prior blog notes of mine on this case and some implications.

 

UPDATES

 

The CEO of United Health Group (parent company of United Health Care), felt compelled to try to Make Nice in a NY Times OpEd, after the shooting.

Yeah, "let's fix it." But, we mustn't act precipitously, 'eh?

 

I was having the same "fix-it" thoughts 30 years ago in graduate school.

FROM MY 1994 ARGUMENT ANALYSIS SEMESTER PAPER (pdf)

Overall Evaluation:

The following alternative courses of action are generally advanced in the health care debate:

1. Status quo: the system works fine, and normal incremental quality improvements at the provider level will suffice. Get a job.

2.Insurance reform: prohibit exclusion and enforce community rating to reduce the insurance premium stratification characteristic of the present system.

3. Expand existing public payer programs such as Medicare to cover the working poor and otherwise uninsurable.

4. Capitated managed competition, with “employer mandates” to provide choices and beneficiary of alliances for pooled coverage buying power, administered through the workplace.

5. Tax inducement programs such as the “Medi-Save” approach in which workers use pretax dollars to purchase catastrophic coverage and pay for routine health expenses themselves.

6. The public single payer system based more or less on the Canadian model.

No one can dispute that the healthcare industry can be improved. Any system can be improved. Problems such as lack of access, arbitrary and often wildly excessive pricing, inexplicable variations in clinical practice and outcomes are well documented and cry out for solution. That tends to rule out Option 1. The question is one of extent; has the case been made that the healthcare industry requires comprehensive national reform?

Option 2: many see the problem as an insurance reform issue rather than a health-care reform issue per se. The debate brings us face to face with fundamental questions about the nature of private insurance. Where do we draw the line on the freedom to assess and underwrite risk? Is health care insurance ethically different from ensuring cargo? Part of the image problem health insurers have is self-inflicted; arbitrary, unscientific risk assessment, payment denials and delays, and the financial imperative to “cherry pick” (attempting to only contract with those posing minimal risk” have made insurers objects of suspicion and resentment). Insurers uniformly bemoan their meager financial returns, yet even a cursory examination of their real estate furnishings portfolios and executive salaries (not to mention their highly visible and aggressive “Harry and Louise” lobbying against reform this past year) tends to discredit their apologies.

Option 3: US Representative Pete Stark proposed exactly this: it was called “Medicare, Part C” and would via Medicare expansion ensure the working poor who are neither eligible for Medicaid nor otherwise insurable. This option would extend more nearly universal coverage but would do nothing about the chronic cost shifting that is prevalent in healthcare financing. It would also fail to address the cost containment problems seen in the existing program. This proposal was seen by the insurance industry as a “Trojan Horse” for an eventual single-payer system, and, as such was successfully lobbied down.

Option 4 is exactly what comprised the Clinton legislative proposal for reform. It proved inscrutably complex. Having seen the 1,400-odd page text of the proposal I am skeptical of its Byzantine complexity. Those 1,400+ pages would have necessitated something on the order of millions of pages of implementing policy regulations, with all the potential for bureaucratic gridlock they might effect.

Option 5: “Medical IRAs” are a favorite of conservatives, and have considerable theoretical merit. The central idea is that, when people directly spend their own money, they tend to be smarter shoppers, and this would control prices. Third-party payment for health services tends to reduce the incentive to ride herd on costs. But healthcare encounters are not the psychological equivalent of shopping for a new VCR, and becoming an informed healthcare consumer is not at all easy. And finally, these may be saved accounts would do nothing for those without jobs (if they are to be funded via pretax employment compensation), or for those whose taxable incomes are so low as to nullify the tax incentive. The Medi-Save approach would have to be supplanted by additional programs or those it would not touch.

Option 6, single-payer: using the Canadian example as a model for US reform has a couple of liabilities. First the US population is roughly 10 times the size of Canada’s; we would be engineering and vastly larger institution, and there may well be unforeseen dis-economies of scale. Our record in the operation of large public bureaucracies is considerably less than stellar. Secondly, there is considerable reputable disagreement with respect to the relative virtues of the Canadian system. Many Canadians (and not only wealthy ones) routinely come to the US for treatment, and there are additional documented signals of increasing dissatisfaction in Canada. It is a more humane system in that it covers everyone by entitlement, but it does significantly impact the cost of living in Canada. There is reason to believe that same or worse would be the case here, at least in the relatively near term.

The envisioned unified computerized data system such an institution would require could well be a development nightmare that might be in many respects obsolete before it went online. The documented in adequacies of both the IRS and FAA computer systems stand as a warning. The sheer volume of health care data proposed for online storage and access is daunting. An article in the byte magazine earlier this year detailed the CPR system (computerized patient record) under development at Brigham and Women’s Hospital in Boston, and revealed that the daily data storage requirement was approximately 3.5 GB! (3.5 billion bytes) Remember, this is for one institution. Constructing a single national healthcare data system would be fraught with a breadth of imposing technical and policy difficulties. It would require the latest hardware, the finest software development teams, and an unprecedented level of policy agreement and guidance.

In sum, the authors’ argument has many strengths, particularly in their exhaustively documented enumeration of the shortcomings of our present health care system – to the extent to which it can be characterized as a “system.” There is, however, a plausible alternative to a public national single-payer system that would meet many of the goals sought by these advocates, and it is not a theoretical one. Utah’s IHC (Intermountain Healthcare) organization is a private, vertically integrated healthcare Corporation serving Utah in western Wyoming residents. It is a large network of hospitals, clinics, physicians, and related operations such as home health services. IHC is essentially a managed care system with subscribers who pay set fees and minimal copayments. Unlike other HMO type operations in the state that typically experience subscriber turnover rates of approximately 15% per year, IHC’s turnover rate is less than 0.5% (that’s 0.005), at competitive prices. They accomplish this by an organization wide, enthusiastic, almost religious commitment to the very CQI principles outlined above. IHC quality improvement programs are directed by Dr. Brent James, a surgeon and nationally respected leader in health care CQI education. Having myself undergone their healthcare CQI training course over the period of the past six months as part of my work, I can attest that IHC, while not yet perfect, effectively applies nearly all of the recommendations cited in this article, albeit on a smaller scale (and that may indeed be a significant virtue). They are in essence a microcosmic single-payer system, but one successful in the private sector, driven not by publicly impose mandates, but by their own thorough knowledge of and dedication to CQI. It is difficult to see at this point whether the asserted advantages of a national public system would add net value beyond the type of operation that IHC represents.

To be fair, IHC operates in a fairly prosperous, culturally homogeneous region enjoying a great deal of social and political unity. Here in Nevada, by contrast, though we share a common border and similar population size and geography with Utah, the social mileau could not be more different. IHC might not encounter the same level of success in other regions, and their successes do not impact those who cannot obtain coverage – and the central issue of this article has been about the significant negative impact of such a deficit. The IHC example does, however, stand in stark relief to both the inadequate business-as-usual attitude, and the proposition advanced above that a national single-payer system is the best path to effective health care reform. Other examples exist around the nation also; one that comes to mind is Northwest Hospital in Seattle, whose presentation at the Annual Quality Congress of the American Society for Quality control this year reveals yet another organization deriving significant cost savings and quality improvement from diligent application of CQI methods.

Rule number one of CQI is “listen to the customer,” and thus far the customers are prohibitively wary of the idea of creating a huge new national program, and political reality that is unlikely to shift anytime soon. The argument provided by shift at Al takes into account an enormous amount of evidence and theory generated from within healthcare and the wider quality sciences, but serious questions remain unresolved with respect to the needs and concerns of health care consumers, whose overwhelming support would be needed to implement a single-payer health care system.

30 years ago. Let's just not get in any hurry (with Trump coming back, you can pretty much rest assured that we won't).

OK, let’s back up a couple years prior to that. The following is a snip from a 2008 blog post of mine, reflecting some QIO experience circa 1992:

THE U.S. "HEALTH CARE" "SYSTEM"?

I will by no means be the first to note that our medical industry is not really a "system," nor is it predominantly about "health care." It is more aptly described as a patchwork post hoc disease and injury management and remediation enterprise, one that is more or less "systematic" in any true sense only at the clinical level. Beyond that it comprises a confounding perplex of endlessly contending for-profit and not-for-profit entities acting far too often at ruinously expensive cross-purposes.

Another quick personal story:

During my first tenure (early 1990's) serving as an analyst for the Nevada/Utah Medicare Peer Review Agency (they're now called "QIO's" - Quality Improvement Organizations), in addition to our core Medicare oversight work, we had a number of small sidebar contracts, one of which involved ongoing analytical assessments of the Clark County Nevada self-funded employee health plan. One morning I accompanied my Sup, our Senior Analyst Dr. Moore, to a regular meeting of the plan's Executive Committee, wherein we would report on our latest plan utilization/outcomes evaluation.

A portion of the morning -- perhaps a half-hour, IIRC -- was always devoted to hearing claims denials appeals brought by Clark County employees. This day, two appeals were heard: one regarding an outpatient medical claim, the other concerning a dental encounter. The total sum at issue was about $350. Both appeals were denied, thereby "saving" the plan this nominal amount.

Bored by this administrative tedium, as I sat at the conference table, I did a quick, rough estimate back-of-the-envelope calculation. About a dozen executive/professional people consumed a half hour adjudicating these disputes, or, equivalently, 6 FTE hours. Assume a plausible blended G&A-multiplied cost estimate of the total compensation time for all these folks, plus all of the clerical/administrative time consumed in the processing (and subsequently denying) of these minor claims from the moment of their filing to this very hour.

Clark County easily spent well in excess of an additional $1,000 to "save" $350 at the expense of these two hapless employees, by my reckoning.

Similar scenarios -- public and private -- surely play out every day within our "health care system." Clark County would have been way ahead to have simply vetted the initial claims for fraud and then paid them! (This is one observation implicitly at the heart of the "Universal Coverage / Single Payer" model.)

But, as my Senior Medical Director was fond of pointing out, "every misspent dollar in our health care system goes into someone's paycheck."

"16% OF GDP"

And soon to rise to 20% and beyond, it is asserted -- lest we find the political will to rein in the nationally and personally eviscerating cost of "health care" in the U.S.

Question: in my foregoing Clark County Health Plan anecdote, beyond the two denied employee claims I cited that totaled about $350, is the extra thousand or so administrative outlay also placed on the "health care" expenditure ledger? So that what should have cost $350 (plus minimal initial clerical claim processing overhead) ended up as ~$1,350? (Note that the ~$350, while denied by Clark County, still had to be paid by the respective employees.)

We really have no clear picture regarding episodes such as this. And, we have no clear picture as to how prevalent are such ongoing wheel-spinning, sand-in-the-gears activities, and to what expense ledger they get posted...

 

I have lots more. Spanning decades. Addressing myriad aspects of the domain. e.g., a decade ago:

“The art of medicine consists of amusing the patient while nature cures the disease”

Stay tuned...

_________

  

My migration continues.

@bobbygvegas.bsky.social footprint grows...

 

[12/12 update] I've only been on BlueSky for 23 days thus far. A lot of fellow TwitterX users are showing up there as well.

 

NYC ASSASSINATION UPDATE

 

_________

  

Assassination in Manhattan,

United Healthcare CEO gunned down.

  

 

It has been a chaotic few days. Culminating in a grotesque, brazen murder caught on surveillance video.

 

Social media reactions:

 

 

apropos of "Single Payer," my first grad school semester paper (pdf) 30 years ago comprised a detailed argument analysis evaluation of the Single Payer proposal published in JAMA in 1994:

Argument synopsis:
Notwithstanding public misgivings about making significant public policy driven changes in the U.S. health care industry, there is extensive and persuasive empirical evidence of costly inadequacies in the system-such as lack of access/coverage, uneven levels of quality of service and outcomes, market-driven rather clinical priorities, waste and duplication, etc.-that can best be corrected by a unified approach to improvement driven by a scientific focus on quality issues (broadly defined) rather than those of short-term cost-control, competition, and piecemeal regulatory strategies and tactics. A single-payer health care system reformed by implementation of the ten principles detailed herein would at once extend medical access to all, reduce costs, improve clinical outcomes of the sick and injured, and elevate the overall health status of the nation, resulting in win-win consequences for providers and citizens alike.

I put at least 100 hours into that 57-page project. I had just finished my first stint (of 3) with the Nevada Medicare QIO at the time.

Fast forward to 2015, and my post "The U.S. healthcare "system" in one word: "shards"

My interaction with our healthcare industry is at once lengthy, broad, and deep—Medicare analyst, next-of-kin caregiver (both daughters, both parents, spanning 16 years), and acute care patient (now a Medicare"Bene"). I'm as exasperated as anyone by our "system."

 

But you don't accomplish anything by murdering people.

 

APRIL & MAY 2017 REFLECTIONS

 

My examination of Elisabeth Rosenthal's writing. Here, here, and here. 

I can keep going. Lots more from where that stuff came. Again, though, murdering this or that CEO is not gonna do anything to mitigate things.

UPDATE

I would think the authorities will collar this perp before long.

No, neither would I celebrate the assassination of the President-Elect, In case the rhetorical point escapes you.

UPDATE

Police in Altoona PA caught the ID’d suspect, 26 yr old Baltimore native Luigi Mangione. Physical forensic evidence is piling up at warp speed. More in subsequent posts.

_________

  

Is science fully up to the coming challenges?

New issue of Science up online.

 

And, of course, as is my Jones, I head straight for the book reviews.

Bergson is all but forgotten today, a situation Emily Herring hopes to redress with her new biography, Herald of a Restless World. Herring points out that Bergson’s ideas, which included subjective experience, nuance, and open-endedness, appealed to a populace frightened by the increasing mechanization quickly transforming everyday life...

Indeed.

...A few years after his fateful decision to study philosophy, Bergson started his first teaching job. He was asked to give a speech before an assembly of students and teachers during the traditional end-of-term awards ceremony. Barely out of school himself, the young man invited the students to reflect on the “severe disadvantages of what we call ‘specialisation.’” He argued that great men of science of the past, such as the illustrious Frenchmen Blaise Pascal, René Descartes, and Louis Pasteur, had made sure to consider problems from all sorts of different angles and perspectives, using methods from a variety of disciplines. But as the nineteenth century ended, this became more and more difficult to do. The accumulation of knowledge seemed to have reached a tipping point that fragmented the sciences into increasingly narrow fields and subfields and drove a wedge between science and philosophy. In his speech, Bergson warned that this fragmentation, this loss of big-picture, synthetic thinking, impoverished human knowledge as a whole. Bergson conceded that the impulse towards specialisation was a natural one, prompted by the “miserable discovery that the universe is greater than our mind; that life is short, education time-consuming and the truth infinite.” But he urged the students to resist this impulse, to put off committing to one specialised subject for as long as possible, and instead to broaden their minds as much as they could.

The young Bergson’s aversion to specialisation had started at some point in the late 1870s, when he discovered that, unlike other academic disciplines, philosophy was not limited to a specific object but opened up an infinity of theoretical avenues. It represented an opportunity to encompass all areas of knowledge, to look at the biggest, most important problems, to embrace every aspect of reality in one sweeping gesture. By choosing philosophy, he would not have to abandon any of his interests but could keep them all under investigation. Conceivably, Bergson had also realised in that moment that mathematical problems, though fascinating, were too narrow for his intellectual ambitions. By specialising as a mathematician, he would be willingly cutting himself off from whole areas of human knowledge, whereas, as a philosopher, the entirety of human knowledge would be his subject matter.

A “BAD” SCIENTIST
Desboves was devastated when he found out about Bergson’s decision. His young prodigy, the teenager who had bested his hero Pascal, was squandering his incredible mathematical gift, and for what? To pursue his interest in an inferior subject. The teacher wrote to the boy’s parents, stating in no uncertain terms that their son was committing an irreparable folly. But Bergson did not budge, and his parents stood by his decision. The next time Desboves caught sight of Henri, he grumbled: “You could have been a mathematician; you will be a mere philosopher.” Of course, the teacher could not have foreseen that his student would in fact grow up to be anything but a “mere” philosopher.

Desboves’s comment nevertheless ended up haunting Bergson. Throughout his career, Bergson would find himself repeatedly accused of being a philosopher who rejected science because he misunderstood it. As the American journalist Walter Lippmann wrote: “Though his thinking has been about biology, mathematics, and psychology, people call Bergson an artist.” Such misconceptions about him would stick. In a scathing article published in the Monist in 1912, the British philosopher and mathematician Bertrand Russell would paint Bergson as mathematically illiterate and accuse him of promoting “anti-intellectual philosophy” that led to the absurd view that “incapacity for mathematics is therefore a sign of grace.” This view, Russell added sarcastically, was “fortunately a very common one.” In 1922, Albert Einstein dismissed Bergson’s interpretation of relativity, claiming that the philosopher did not have a sufficient grasp of the physics at play. The following year the evolutionary biologist Julian Huxley wrote that Bergson was a “good poet, but a bad scientist.”

Of all the misconceptions about his philosophy, the idea that Bergson was promoting an anti-science agenda was the one that exasperated him the most. Although he was critical of certain aspects of scientific thought, he did not reject science through and through. Just because he found limitations in the methods of science did not mean that his understanding of these methods was limited.

Bergson viewed science and metaphysics as two different but complementary forms of knowledge, each limited in its own way. The perspective on reality offered by science would always be relative to its own symbols. Metaphysics, on the other hand, could aspire to absolute knowledge but would never produce the practical results of science. Yet, if both forms of knowledge came together in a way that recognised their fundamental differences, they could progress by pushing each other forward.

This had not, however, always been Bergson’s belief. In 1878, when he became a student at the prestigious École normale supérieure, he leaned towards the side of those who placed absolute faith in the power of science, thanks in large part to the English philosopher Herbert Spencer…

Herring, Emily. Herald of a Restless World: How Henri Bergson Brought Philosophy to the People (pp. 25-27). Basic Books. Kindle Edition. 

Just getting fully underway. In Chapter 4 now.

Love it.

BLUESKY UPDATE

Also in the Science Magazine issue.

Very cool.

I continue to build my bsky.social footprint.

 

BACK TO MUSING ON SCIENCE & PHILOSOPHY...

 

 

 

OK, is it "provably unprovable" (Scientific American article) that "perception is an illusion?" (via "Big Think")

 

Lordy Mercy. Recall the tiresome subjectivist bane of undergrad Phil101—"there is no such thing as objective truth."

More shortly...

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