August 2006 – artdiamondblog.com

“DDT Saves Lives, Environmentalists Take Lives”

Connecticut hedge-fund trader, and malaria-fighting activist and philanthropist. Source of image: online version of the WSJ article cited below.

Inside of a year, and working with George Ayittey of the Free Africa Foundation, Mr. Laifer’s efforts have spawned five "malaria-free zones" in Ghana, Nigeria and Kenya. Expansion to Ivory Coast and Benin is in the works. He adds that he has the financing to roll out additional zones this year but — ever the searcher — first wants to assess what’s working and what isn’t. If all is going well, "next year I see us doing something like 100 villages."

Mr. Laifer says a future focus will also be DDT, the pesticide used by Americans and Europeans in the 1940s to win domestic fights against malarial mosquitoes. Indoor spraying of DDT is by far the cheapest and most effective way to control the disease. One South Africa province employing DDT saw malaria infections and deaths drop 96% over a three-year span.

Yet Rachel Carson-inspired environmentalists have convinced many public health agencies that the chemical is dangerous. African nations, fearful that lucrative European and U.S. markets might ban their agricultural exports, make do with less-effective DDT substitutes. Though DDT, like any chemical, can be harmful in high doses, there’s no evidence that using it in the amounts needed to combat malaria has any ill-effect whatsoever on humans.

Mr. Laifer’s been unable to spray DDT in any of his malaria-free zones. "It’s the best thing in our arsenal," he says. "We have a prodigious supply, it’s cheap and we know it works. Our world leaders need to legalize DDT, and people in America need to get mad about this. . . . We need to have people walking around with signs that say, ‘DDT saves lives, environmentalists take lives.’"

For the full commentary, see:

JASON L. RILEY. "Malaria’s Toll." Wall Street Journal (Mon., August 21, 2006): A11.

(Note: the ellipsis is in the original.)

Distorted Incentives in Medicine

Source of book image: http://www.harpercollins.com/books/9780061130298/The_End_of_Medicine/index.aspx

The problem right now, as Mr. Kessler sees it, is that we fight the "big three" — cancer, stroke and heart attack — with treatment rather than early detection. Cancer cells and blood-vessel plaque can be handled much more easily in the early stages, but we spend most of our money on the later ones. More than 80% of health-care dollars are paid by insurance companies and the government, and neither is especially interested in detecting disease when it first appears. Doctors, regulators, researchers and payers of all kinds are locked into what Mr. Kessler calls — a bit ungenerously — the "cholesterol and cancer conspiracies."

A complicated system of mutual dependency distorts the incentives. "The FDA is like the FCC and Big Pharma is like the regional Bells" is what Mr. Kessler hears from Don Listwin, a former Cisco executive who now heads the Canary Foundation, a Silicon Valley-based effort to promote preventive medicine. In other words, in medicine as in telecom, the big players end up exploiting regulations more than opposing them, if only to preserve their monopolies. The Food and Drug Administration — understandably but narrow-mindedly — wants "cures" for cancer and other diseases. Thus tens of thousands of chemicals are screened, only a handful make it even to Phase I trials, and by the time a new drug is approved a billion dollars has been spent. Even then the new drug may help only 10% of patients.

Yet if someone were to invent a device with a wide, preventive usefulness — say, a nanotech implant that would spot the proteins that indicate the first minute presence of cancer — it would have to go through the same process of billion-dollar testing. Since the government and insurance companies are reluctant to add anything to their repertoire of coverage — and since such a device would be targeted at the much broader pool of people who are not sick — research might well stall in its earliest phases for lack of reimbursement-funding.

For the full review, see:

WILLIAM TUCKER. "Bookshelf; The Art of Navigating Arteries." Wall Street Journal (Tues., July 18, 2006): D6.

A full reference to the book reviewed, is:

Kessler, Andy. The End of Medicine: How Silicon Valley (and Naked Mice) Will Reboot Your Doctor. HarperCollins, 2006.

Welfare Reform Increases Number Employed

Source of graphic: online version of the NYT article cited below.

WASHINGTON, Aug. 20 — Ten years after a Republican Congress collaborated with a Democratic president to overhaul the nation’s welfare system, the implications are still rippling through policy and politics.

The law, which reversed six decades of social welfare policy and ended the idea of free cash handouts for the poor, was widely seen as a victory for conservative ideas. When it was passed, some opponents offered dire predictions that the law would make things worse for the poor. But the number of people on welfare has plunged to 4.4 million, down 60 percent. Employment of single mothers is up. Child support collections have nearly doubled.

“We have been vindicated by the results,” said Representative E. Clay Shaw Jr., Republican of Florida and an architect of the 1996 law who was vilified at the time. “Welfare reform was one of the most successful policy changes in our nation’s history.”

For the full story, see:

ROBERT PEAR and ERIK ECKHOLM. "A Decade After Welfare Overhaul, a Shift in Policy and Perception." The New York Times (Mon., August 21, 2006): A12.

Money Buys Happiness, and Governments Tax It Away

We are . . . all constantly reminding each other that "money doesn’t buy happiness."

Economists aren’t so sure. They note that people with a lot of money tend to express a higher subjective happiness than people with very little. According data from surveys by the National Opinion Research Center, for example, people in the top fifth of income earners are about 50% more likely to say they are "very happy" than people in the bottom fifth, and only about half as likely to say they are "not too happy."

There is, however, generally very little change in the average level of happiness in populations getting richer over the years. For instance, the percentage of the U.S. population saying it was "very happy" in 1972 was exactly the same as it was in 2002: 30.3%. Social critics of "consumerism" explain this by claiming that what makes rich people happy is not money per se, but rather the fact that they have more of it than others — so if everybody gets richer, happiness remains unchanged. The critics go on to say that income differences lead to unwholesome feelings of superiority, so taxes can improve our moral fiber simply by bringing us closer to the same income level.

Perhaps you’re unconvinced. In fact there is another explanation for unchanging happiness levels over time which is rather less supportive of income redistribution. As incomes rise, so generally do levels of government revenues and spending, and there is evidence that these forces work against personal income on the overall level of happiness. For example, a $1,000 increase in per capita income is associated with a one-point decrease in the percentage of Americans saying they are "not too happy." At the same time, a $1,000 increase in government revenues per capita is associated with a two-point rise in the percentage of Americans saying they are not too happy. In other words, not only can money buy happiness, but it may be that the government can tax it away as well.

For the full commentary, see:

ARTHUR C. BROOKS. "Money Buys Happiness." The Wall Street Journal (Thurs., December 8, 2005): A16.

Power to the People

Cooling towers at the Vogtle nuclear power plant in Georgia. Source of photo: the online version of the NYT article quoted and cited below.

A long, and informative cover-story in the NYT, discusses the costs and benefits of nuclear power. My read is that, on balance, the considerations in the article favor nuclear energy. Here are a few passages from near the end of the article:

(p. 64) Gary Taylor, . . ., the C.E.O. of Entergy Nuclear, says he believes a doubling of the number of nuclear plants around the world is inevitable, both to satisfy energy demands and to counter global warming. As Taylor puts it: ”The reality is, what is scalable in the time frame that addresses the issues? If it isn’t this technology, I don’t know what it would be.” Diaz, the former head of the N.R.C., told me he sees a similarly bright future for nuclear. ”The world is going to go nuclear, because they do not have any other real alternatives,” he says. I met plenty of other engineers within the industry who went even further. Their feeling about nuclear power is close to evangelical, in that they seem to approach the technology with moral certitude while being loath to acknowledge any of its many negatives. Would that include the utility executives who will ultimately decide if — and what — to build? I’m not sure it would. To those I spoke with in the uppermost ranks, nuclear power isn’t a belief system. It’s a business. And to them, what might come out of, say, Vogtle Units 3 and 4 — the waste and the power and the profits — would be nearly identical to what comes out of Units 1 and 2.

At least that was my conclusion in Georgia, where Jeff Gasser, the Southern Company’s chief nuclear officer, took me through a long tour of the plant. He was smart, meticulous and intensely committed to the obscure safety protocols that go on at nuclear power facilities. Most of all he was forthright about the advantages and disadvantages of the nukes business. When we went to visit the spent-fuel pool in Vogtle, where the used fuel-rod assemblies are stored under 20 feet of protective water, Gasser let me know that we would die if we pulled one of the fuel assemblies out of the pool. ”We would receive, before we could get to the exit door a few feet away, a lethal radiation dose,” he said. I quickly had to check the radiation dosimeter I was wearing — another legal requirement of the N.R.C. — to see if I was already glowing. (It read zero.) ”The communications people hate it when I use words like ‘lethal’ and ‘irradiated,’ ” Gasser continued. ”But the fact is, there is no perfect way of generating electricity. There are byproducts for every type.” Like many others, he went through the positives and negatives of coal, gas, solar, wind and nuclear. In his opinion, he added, with Vogtle’s engineering, redundancy of safety systems and its trained operators, it was a safe, reliable and efficient way of making electricity. That was his sales pitch.

We had already passed through the containment buildings, where the reactors heat the pressurized water. So Gasser took me through the turbine building, an enormous room the size of a soccer field, where the steam turns the fan blades. Eventually, we went out a back door into the sunlight. The deafening sounds of turbines and machinery subsided to a dull thrum. We removed our earplugs and walked over to a small forest of electrical transformers, our backs to the plant. The electricity from the turbines inside comes out here, Gasser explained, its voltage is transformed, and it is then put into the grid.

Gasser made a pushing motion toward the green hills before us.

”Once the power is sent out of here, it can go everywhere,” he explained. And I could see that it did go everywhere. The high-tension wires stretched away from where we stood, in several directions, through deep cuts in the pinelands, as far as I could see.

For the full article, see:

JON GERTNER. "Atomic Balm? ‘ The New York Times Magazine, Section 6 (Sunday, July 16, 2006), 36-47, 56, 62 & 64.

Canon Prospers By Ignoring the ‘First Mover Advantage’

Canon’s new HV10 high definition camcorder. Source of image: the NYT article cited below.

In the dot-com era, many believed that in each niche, the future belonged to the company that got-in, and got-big, first. Sometimes this was called the ‘first mover advantage.’ There are many counter-examples. Here is one more:

(p. C1) Next month, Canon will release the world’s smallest and least expensive high-definition tape camcorder, a one-handable beauty called the HV10.

. . .

This image-quality business, as it turns out, is the new Canon’s specialty. Talk about being blown away the first time you play back your recordings — let’s hope you have a sturdy couch.

Several advances are responsible for the brilliant picture quality. First, Canon has paid extra attention to two of the most important aspects of HD recording: focus and stability. Because the high-def picture is so sharp and so wide, moments of blur-(p. C11)riness or hand-held jitters are far more noticeable and disturbing than in regular video.

So the front of the HV10 bears a special external sensor that, when you change your aim, handles the bulk of the refocusing extremely rapidly. A standard through-the-lens focusing system does the fine tuning after that. Together, these two mechanisms nearly eliminate the awkward moment of blurry focus-hunting that mars other camcorders’ output.

. . .

. . . , by entering the high-def camcorder market a year and a half after its rivals, Canon has played the same conservative waiting game it once used with digital cameras and camcorders. Its goal, of course, is to watch and learn as the pioneers get all the arrows in their backs.

If the HV10 is any indication, the company is off to a very good start.

For the full review, see:

DAVID POGUE. "A Head Start On the Future Of High-Def." The New York Times (Thurs., August 10, 2006): C1 & C11.

“Al Gore’s Penguin Army”

Source of screen capture: http://www.youtube.com/watch?v=IZSqXUSwHRI

"Al Gore’s Penguin Army," a funny satire of Al Gore’s movie "An Inconvenient Truth," has been posted to the popular YouTube web site. A bee’s nest of folk are agitated that this satire may have been created by someone with some tie to an oil company. My response: who cares? (Don’t those who produce oil for us, have the same right to free speech that the rest of us have?)

View the video at:

http://www.youtube.com/watch?v=IZSqXUSwHRI

“Financial Incentives Can Change the Way Medicine is Practiced”

An angioplasty being performed in Eyria, Ohio. Source of photo: online version of the NYT article cited below.

Medicare patients in Elyria receive angioplasties at a rate nearly four times the national average . . .

. . .

. . . some outside experts say they are concerned that Elyria is an example, albeit an extreme one, of how medical decisions in this country can be influenced by financial incentives and professional training more than by solid evidence of what works best for a particular patient.

“People are rewarded for erring on the side of an aggressive, highly expensive intervention,” said Dr. Elliott S. Fisher, a researcher at Dartmouth Medical School, which analyzed Medicare data and found Elyria to be an outlier.

Medicare pays Elyria’s community hospital, EMH Regional Medical Center, about $11,000 for an angioplasty involving use of a drug-coated stent.

The cardiologist might be paid an additional $800 for the work. That is well above the fees for seeing patients in the office. And with the North Ohio doctors performing thousands of angioplasties a year — about 3,400 in 2004, for example — the dollars can quickly add up.

Some medical experts say Elyria’s high rate of angioplasties — three times the rate of Cleveland, just 30 miles away — raises the question of whether some patients may be getting procedures they do not need or whether some could have been treated just as effectively and at lower cost and less risk through heart drugs that may cost only several hundred dollars a year.

. . .

Experts know that changing the financial incentives can change the way medicine is practiced.

For example, Kaiser Permanente, the big health system that employs its own doctors, says its patients in Ohio, including some in Elyria, are slightly less likely than the national average to undergo the type of cardiac procedures the North Ohio Heart Center doctors perform so prolifically.

Kaiser’s cardiologists, who work on salary instead of being paid by the procedure, typically treat patients in that region at the Cleveland Clinic, where they have hospital privileges. And they follow established protocols about when a patient should undergo an angioplasty, when drugs might suffice and when bypass surgery might be the best resort.

“It’s not just individual doctors making up their minds,” explained Dr. Ronald L. Copeland, the executive medical director for Kaiser’s medical group in Ohio. With no financial reason to perform expensive procedures, the Kaiser doctors frequently choose to manage the patients’ heart disease with drugs only. “Our doctors have no disincentive to do that,” Dr. Copeland said.

. . .

For many cardiologists, the natural tendency when they see a patient with heart disease is to perform a procedure to try to clear arterial blockages. And patients, cardiologists say, tend to rely on their doctors’ judgment.

“It’s sort of like, you go to a barber and ask if you need a haircut,” said Dr. David D. Waters, chief of cardiology at San Francisco General Hospital, who is currently studying the effectiveness of different kinds of treatment for heart disease. “He’s likely to say you do.”

. . .

Experts say it can be difficult to detect cases in which doctors cross a medical line and are clearly performing unnecessary treatments.

“A lot of decisions are discretionary,” said Dr. Harlan M. Krumholz, a cardiologist and professor at Yale.

“It’s about where the thermostat is set,” he said, arguing that doctors in a particular geographic area tend to be unaware if the way they are treating their patients is markedly different from the practices of their peers in other areas.

Traditional measures of medical quality are not set up to detect whether patients are being treated too much, he said, unlike the kinds of safeguards that prompt credit card companies to call their customers to discuss unusual spending activity. “Right now there are no ‘smart’ systems in place,” Dr. Krumholz said.

In the absence of any real monitoring or oversight, doctors in most places, including Elyria, have few incentives not to favor the treatments that provide them the most reimbursement. Dr. Waters, the San Francisco cardiologist, said that the way physicians are typically paid — more money for more procedures — results in too many decisions to give a patient a stent.

“You can’t be paying people large sums of money to do things without checks and balances,” he said.

For the full story, see:

REED ABELSON. "In Ohio City, a Heart Procedure Is Off the Charts; SIDE EFFECTS; A Stent Epidemic." The New York Times (Fri., August 18, 2006): A1 & C4.

Source of graphic: online version of the NYT article cited above.

Cuban Bureaucrats Fooled by Castro Impersonator

Castro impersonator Eddy Calderón. Source of photo: online version of WSJ article cited below.

(p. A1) Mr. Calderón says the work can be risky. Once, he recalls, a woman whose relative had been executed by the revolution hurled a dinner plate at his head. At a recent gig, a tiny, white-haired lady shouted at him: "Why did you ruin the country?" Mr. Calderón, as Fidel, answered that she should thank him because if it hadn’t been for him, she’d be stuck in Cuba instead of living well in Miami, "where you can buy hair dye and dentures."

After the Aug. 13 performance, a ballroom attendant, Armando Montes de Oca, approached Mr. Calderón while he was still in his Castro beard and told him: "If I didn’t know you were Calderón behind that beard, you would never leave (p. A9) this room alive."

"Thank you," Mr. Calderón replied.

Mr. Calderón has been doing his imitation of Fidel for about a dozen years. He became a local superstar two years ago when a cable-TV channel started weekly broadcasts of a skit called "La Mesa Retonta," or "The Idiots’ Table," a takeoff on a weekly "Meet the Press"-style show Mr. Castro has done in Cuba, called "La Mesa Redonda," or "The Roundtable."

Mr. Calderón’s Fidel voice is so good that on about 50 occasions, he has telephoned Cuban bureaucrats in Havana or Cuban diplomats abroad and fooled them into thinking they were on the line with the man himself. Mr. Calderón taped the calls, which he still often plays on a Miami radio show.

Two years ago, Mr. Calderón held a 12-minute conversation with Cuba’s deputy construction minister, ordering him to build a giant retractable roof over Havana’s Latin American stadium, as a way to improve conditions for Cuban baseball players and dissuade them from defecting.

"We need a revolutionary roof to uphold the pride of the Cuban Revolution," said Mr. Calderón during the taped telephone call, in a dead-on imitation of Mr. Castro’s edgy, high-pitched, nasal voice.

"I am your unconditional soldier," replied the hapless minister, who promised to get the job done.

That same year, Mr. Calderón telephoned a luxury hotel at Cuba’s Varadero beach resort and ordered the hotel manager to provide a week-long all-expense-paid vacation for one of Cuba’s leading dissidents, whose movements are shadowed by the secret police, to show the government’s good will. Before hanging up, the hotel manager, Mr. Calderón says, promised to make the reservation.

A year earlier, Mr. Calderón as Fidel told transport official Gumersindo Gómez to round up 200 scarce buses for an outing of some 700 priests of the Afro-Cuban religion Santería, and to find room for their sacrificial goats and chickens. Make sure the buses don’t have any graffiti saying "down with You-Know-Who," he added.

"Fatherland or death," Mr. Calderón said.

"Onwards to victory," replied Mr. Gómez, according to the tape of the phone call.

For the full story, see:

JOSÉ DE CÓRDOBA. "Fidel Castro’s Illness Has Impersonators Scrambling to Adapt In Miami; Mr. Calderón Does El Jefe’s Voice Perfectly; New Role for Brother Raúl." Wall Street Journal (Fri., August 18, 2006): A1 & A9.

Eleven-Year-Old Crippled for Life by Mao Supporters

Source of book image: http://www.holtzbrinckpublishers.com/henryholt/Search/SearchBookDisplayLarge.asp?BookKey=1524294

(p. B29) This improbable journey, from Maoist orthodoxy to the entrepreneurial quasicapitalism officially described as “socialism with Chinese characteristics,” is the main theme of “Chinese Lessons,” but Mr. Pomfret, a reporter for The Washington Post, gives his tale a twist. He tells it not only through his own experiences as a student and journalist but through the life stories of five university classmates, who suffered through the Cultural Revolution as children, found inspiration and hope in the growing democracy movement and lived to see a China that neither they nor their parents could have imagined. . . .

All the lives Mr. Pomfret explores are extraordinary, and each sheds its own light on recent Chinese history. Perhaps the most endearing of his characters is Guan Yongxing, better known as Little Guan, who as an 11-year-old suffered social ostracism after accidentally using a piece of paper with “Long Live Chairman Mao!” on it to wipe herself in the bathroom.

After classmates threw her to the ground, no doctor would treat her dislocated shoulder, leaving her crippled for life. Her father’s job as a schoolteacher made the Guan family a prime target for abuse, and Little Guan, rather than endure ridicule and torment at school, picked cotton and sprayed fertilizer on the fields, her back constantly burned by chemicals leaking from the tank on her back. Tough, determined and highly intelligent, she survives and eventually prospers in the new China.

. . .

Zhou Lianchun, called Book Idiot Zhou by a contemptuous Communist Party official, meted out insults and torture as part of a Red Guard brigade. “I did what I was told and, being 11, I liked it,” he tells Mr. Pomfret.

. . .

More even than sex, students want just a little bit of the good life that seems to be in reach as China’s rulers relax their economic policies. To get it they master a strange kind of doublethink, pledging allegiance to the party and Communist ideals while scheming to start a business.

Book Idiot Zhou, a history teacher by day, jumps into a business partnership to process urine for the pharmaceutical industry. “Several days a week, he taught Marxism, Leninism and Maoist thought and railed against the exploitation of the capitalist class,” Mr. Pomfret writes. “The rest of the time he spent as a budding entrepreneur, employing dozens at rock-bottom wages, working the system to enrich himself, his partners and his family.”

. . .

His classmates have done well. But their lives, and the China described in “Chinese Lessons,” bear a heavy load of suppressed grief, terrible compromises and boundless cynicism. At a new drive-in called the Happy Auto Movie Palace, Mr. Pomfret notices something strange about the concrete slabs underneath his feet. They show the marks of tank treads. The drive-in owner bought them after the government repaved Tiananmen Square.

This strikes Mr. Pomfret as bizarre, but not the owner. “It was a good deal,” he says.

For the full review, see:

WILLIAM GRIMES. "Books of The Times; Twisting Along China’s Sharp Curves." The New York Times (Fri., August 4, 2006): B29.
(Note: ellipses added.)