The KHIT Blog: Happy Celebrity Apprentice Acting President's Day, 2025.

Monday, February 17, 2025

Happy Celebrity Apprentice Acting President's Day, 2025.

Are we having fun yet?

Four weeks in...

"Modern societies, as Americans are soon to learn, cannot function without experts in every field, especially the many thousands who work in public service. The first step in containing the damage is to see Trump’s and Musk’s goals for DOGE clearly: It is a project rooted in resentful arrogance, and its true objective is not better government, but destruction."

DESTRUCTION

Science Based Medicine

Three months ago, after Donald Trump had won the 2024 election—and even before he had chosen longtime antivax activist Robert F. Kennedy, Jr. as his nominee for Secretary of Health and Human Services (HHS)—I characterized RFK Jr. as an “extinction-level threat to federal public health and science-based health policy.” The reason was simple. Last summer, RFK Jr. had abandoned his quixotic and doomed campaign for President as an independent and bent the knee to Donald Trump. As a result, he was rewarded with a promise to be, in essence, Trump’s health policy czar and to have a prominent role in health policy in his administration if he won. During the campaign, RFK Jr. even came up with a slogan that riffed on the long familiar Trump slogan “Make America Great Again” (MAGA) by changing it to “Make America Healthy Again” (MAHA). Cleverly, he said nothing at all about vaccines in his “MAHA manifesto“—an absence that his antivax minions noticed right away and were dismayed by—instead planning to “reform” the FDA, emphasize healthy food (depending on your definition), and legalize psychedelics and stem cell clinics. A couple of weeks after the election, President-Elect Trump nominated RFK Jr. for HHS, a nomination that I referred to as a “catastrophe for public health and medical research.”

Of course, RFK Jr. was “controversial” (translation: a batshit) nominee. I will even admit that, after RFK Jr.’s disastrous confirmation hearings, in which he lied repeatedly and blatantly about being “pro-vaccine” and in which Sen. Bernie Sanders embarrassed him over the organization that he founded, Children’s Health Defense, selling baby onesies with antivax slogans on them—asking RFK Jr, “Are you supportive of these onesies?“—and Sen. Elizabeth Warren pointed out how much money he makes assisting a law firm suing vaccine manufacturer, I briefly held out a tiny hope that a few Republicans would vote against him, denying him the nomination, but I soon realized that none of it mattered and that he would definitely be confirmed…

A long-read. Worth it. RFK Jr, ugh. Exigencies proliferate. One can hardly keep apace.

ANOTHER INTERESTING READ

During my years in the European Parliament, I progressively came to see technology through the lens of power. Technology could help emancipate people and raise unheard voices, or it could transform disruptors into monopolists who ruthlessly pursued efficiency, surveillance, scale, and profit. In either case, technology is not neutral. As I will elaborate in this book, systems are themselves designed with values built into them, even if that is unintended. Additionally, given that most technologies are developed by private companies, these technologies are ultimately deployed for profit maximization, and profit maximization incentives are often misaligned with what is best for society. Sam Altman’s Worldcoin, for example, aspires to build a global identity database by asking people in developing countries to scan their irises, in return for a bit of cryptocurrency; the firm is either blind or completely cavalier to the risks of concentrating so much sensitive biometric data under one roof. Social media platforms seek to extend online engagement time of their users with little concern for the negative effect on teenagers’ mental health. Tech firms and their products now also make potentially life-altering decisions. Commercial algorithms designate triage statuses in hospitals and analyze medical images. All the while, democratically elected representatives remain in the dark about key details of how these products work, since independent research is often impossible. For too long, too much trust has been placed in tech companies without making sure that their technology operates within the parameters of the rule of law and supports democratic outcomes.

Schaake, Marietje (2024). The Tech Coup: How to Save Democracy from Silicon Valley (Kindle loc 216). Kindle Edition.

Timely.

And the hits just keep on comin’

The Washington Post canceled plans to run a front-and back-page advertisement that would have earned the paper $115,000 — and ran straight into fresh fury.

The ad, reportedly sponsored by the watchdog group Common Cause, demanded that President Donald Trump fire Elon Musk, who is working as a special government employee endeavoring to slash spending, and purging federal government workers.

Now many Washingtonians and political experts are furious with the paper, which Amazon founder and billionaire Jeff Bezos purchased in 2013. It follows recent anger after Bezos announced the newspaper would buck historical precedence by not endorsing a political candidate last year.

Democracy defender and elections lawyer Marc Elias pointed out that in October, the paper ran an ad from a right-wing group funded by Musk to attack Elias personally for his work…

TUESDAY UPDATE

More shortly...

_________

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
___

"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
___

"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
___

"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
___

"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
___

"'Solutions' exist only in mathematics."

- Karen Martin
___

"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
___

"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Monday, February 17, 2025

Happy Celebrity Apprentice Acting President's Day, 2025.

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