Monday, July 11, 2011


Sometimes state flags…”

Scientists insert artificial human livers into mice.

How China’s new rich are stimulating the trade in illegal elephant ivory. Also, how China’s bad debts are cause for concern. Discovering the mysteries of the Chinese consumer.

Microsoft’s patent shakedown.

Australia is proposing a radical carbon emissions plan.

We’re about to experience one of the harshest droughts in decades, since a little old thing called the Dust Bowl. But remember: climate change isn’t real, climate change isn’t real, all that weird weather stuff that you didn’t notice before is just random chance, climate change isn’t real LA LA LA. IT'S NOT HOT OUT.

When the Mainstream is easy to shun

Julian Sanchez writes this, of Ta-Nehisi Coates’s pretty excellent New York Times essay on the ease of acquiring knowledge about your obscure tastes in music:
Developing non-mainstream tastes in almost anything used to be pretty hard.

The driver for this is a good thing, but I’m not sure this particular effect is. If you had non-mainstream tastes back in the day, it was a sign you were honestly committed to those beliefs as evidenced by all that effort you put into it. Maybe you became a bit close-minded as a defensive mechanism (otherwise all that work was wasted), but overall you were an interested person, and interested people are more likely to be interesting and do interesting things.

There are a large number of people these days who seem weird for weird’s sake, and I don’t find this particularly interesting.

War on Salt

So there’s this:
This week a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure. In May European researchers publishing in the Journal of the American Medical Association reported that the less sodium that study subjects excreted in their urine—an excellent measure of prior consumption—the greatertheir risk was of dying from heart disease. These findings call into question the common wisdom that excess salt is bad for you, but the evidence linking salt to heart disease has always been tenuous.

This should make Mayor Bloomberg look ridiculous, who personally led the anti-salt crusade from the front, loudly. To hear the rest of the Scientific American article tell it, the evidence linking salt intake to hypertension has always been flimsy, which should make everyone have a good think and particularly the technocrats: what other common nutritional advice is based on similarly flimsy evidence? What are we doing to study this?

I was always suspicious of the salt-cutting initiative because it seemed much too easy and too obvious. People are capable of surpassingly dumb omissions, but this seems a bit too much.

Saturday, July 9, 2011


Developed-world deleveraging will take an awfully long time.

How to reduce the costs of universities.

China appears to be getting a big appetite for corn.

Shelia Bair’s exit interview in the NYT Magazine supposedly is excellent; haven’t yet read it.

NYT writers’ fiction recommendations. Some are strange (Jaws), some are a bit surprising (if you had to guess one Gabriel Garcia Marquez book that would be recommended, it’d be the sublime One Hundred Years of Solitude or the slightly-less-sublime Love in the Time of Cholera, but no—it is “Strange Pilgrims,” which I have never even heard of.)

40 people die in Mexico at the hands of drug gangs.

Looks like Pakistan v. the U.S. government is escalating, particularly over this dead-journalist contretemps.

When theories go wrong: automatic enrollment in 401(k)s decrease saving.

What summer camp inflation tells us about education.

Congratulations, But Sarcasm

So a few days ago, this headline was blared:

Now, 3,000 hits is quite the feat and deserves congratulations. Nevertheless, the aggression with which we're being told to respect Derek Jeter is more than a bit patronizing, as if we can't be trusted to respect Derek Jeter on his own. I mean, "RESPECT DEREK JETER" is right up there with these sentences:

"It's time to respect Michael Jordan."
"It's time to respect the troops."
"It's time to respect our firefighters."
"It's time to respect our police officers."
"It's time to respect our new alien overlords."

There is no one on the You Ess of Ehh that has not been informed about the necessity of respecting Derek Jeter, and I doubt there's anyone who doesn't have at least a smidgen, a soupcon, a mite of respect for Derek Jeter. So why are we being informed, over and over, that we must respect Derek Jeter? Don't we have at least a bit of intelligence?*

* the RESPECT DEREK JETER campaign is eerily similar to the RESPECT KOBE BRYANT campaign, in that you sense sportswriters are a beleaguered group searching for human beings who fit the archetype from which they can propagandize endlessly from, as they were endlessly propagandized by their sportswriters in the forms of the same archetypes. (And what's a sportswriter but the truest believer, anyway?) So they have to force people into their archetypes and ignore flaws: i.e. that Bryant and Jeter, while both very good players and among the best players to play their games, are nowhere near as good as sportswriters' limited yet creatively exaggerating imagination would have them be.


Questions are being asked, whether this is the time that Rupert Murdoch will finally get it. I'm skeptical, though when I see this picture:

I think late Marlon Brando in Godfather. Astute readers (or, really, anyone) will recall that this look features right before Don Corleone dies.

Thursday, July 7, 2011


Some commercially valuable fish are going to be on endangered species list.

What happens if the U.S. breaks the debt ceiling.

Scientific knowledge and democracy—what happens when people don’t have scientific knowledge.

What’s drug resistance worth to governments?:
For every death from AIDS, the US federal research establishment awards approximately $69,000 in grant funds. And for every death from MRSA, it awards $570…. the research budget at the National Institutes of Health has been rising, from $13.1 billion in 1998 to $28.7 billion in 2008; within that, so has the research budget at NIH’s National Institute of Allergy and Infectious Diseases (NIAID), from $1.4 billion to $4.6 billion over that same decade. They wondered how much of that research funding was going to this resistance problem that health authorities nationally and globally have pronounced a crisis. MRSA, let’s remember, kills an estimated 19,000 Americans a year: more than HIV, and more than pneumococcal disease, meningococcal disease, H. influenzae and group A Streptococcus combined.
MRSA, remember, is a big, big deal—it’s the nasty antibiotic-resistant disease that we should be looking out for.

China’s cities’ debt overloads.

Why illegal immigration from Mexico is less appealing (Mexicans are better off).

Using satellite data to predict cholera outbreaks.

The final space shuttle liftoff—what it’s like in the astronaut’s words.

A interview with Bill James on crime.

Chicago by boat: A timelapse journey from Philip Bloom on Vimeo.


The theory that health information technology will contribute to further disparities in health care outcomes remains an interesting one; I’m just not sure we’ll realize the results any time soon. The NYT has an interesting story with a less-interesting anecdote in the middle. Naturally, I’ll focus on the less-interesting anecdote (the story is about genomics and cancer; a Duke lab announced too-good-to-be-true results that turned out to be just that, with fraud discovered…here’s the less-sensational anecdote):
The Duke case came right after two other claims that gave medical researchers pause. Like the Duke case, they used complex analyses to detect patterns of genes or cell proteins. But these were tests that were supposed to find ovarian cancer in patients’ blood. One, OvaSure, was developed by a Yale scientist, Dr. Gil G. Mor, licensed by the university and sold to patients before it was found to be useless.

The other, OvaCheck, was developed by a company, Correlogic, with contributions from scientists from the National Cancer Institute and the Food and Drug Administration. Major commercial labs licensed it and were about to start using it before two statisticians from M. D. Anderson discovered and publicized its faults.

I realize this is not precisely what the theorizers have in mind when they talk about widening inequality, but it does show that health tests are generally less accurate than you’d think.


Roger Ebert, in talking about The Great Gatsby, copies its opening paragraphs:
In my younger and more vulnerable years my father gave me some advice that I've been turning over in my mind ever since.

"Whenever you feel like criticizing any one," he told me, "just remember that all the people in this world haven't had the advantages that you've had."

He didn't say any more, but we've always been unusually communicative in a reserved way, and I understood that he meant a great deal more than that. In consequence, I'm inclined to reserve all judgments, a habit that has opened up many curious natures to me and also made me the victim of not a few veteran bores. The abnormal mind is quick to detect and attach itself to this quality when it appears in a normal person, and so it came about that in college I was unjustly accused of being a politician, because I was privy to the secret griefs of wild, unknown men. Most of the confidences were unsought -- frequently I have feigned sleep, preoccupation, or a hostile levity when I realized by some unmistakable sign that an intimate revelation was quivering on the horizon; for the intimate revelations of young men, or at least the terms in which they express them, are usually plagiaristic and marred by obvious suppressions. Reserving judgments is a matter of infinite hope. I am still a little afraid of missing something if I forget that, as my father snobbishly suggested, and I snobbishly repeat, a sense of the fundamental decencies is parcelled out unequally at birth.

And, after boasting this way of my tolerance, I come to the admission that it has a limit. Conduct may be founded on the hard rock or the wet marshes, but after a certain point I don't care what it's founded on. When I came back from the East last autumn I felt that I wanted the world to be in uniform and at a sort of moral attention forever; I wanted no more riotous excursions with privileged glimpses into the human heart. Only Gatsby, the man who gives his name to this book, was exempt from my reaction -- Gatsby, who represented everything for which I have an unaffected scorn. If personality is an unbroken series of successful gestures, then there was something gorgeous about him, some heightened sensitivity to the promises of life, as if he were related to one of those intricate machines that register earthquakes ten thousand miles away. This responsiveness had nothing to do with that flabby impressionability which is dignified under the name of the "creative temperament."-- it was an extraordinary gift for hope, a romantic readiness such as I have never found in any other person and which it is not likely I shall ever find again. No -- Gatsby turned out all right at the end; it is what preyed on Gatsby, what foul dust floated in the wake of his dreams that temporarily closed out my interest in the abortive sorrows and short-winded elations of men.

My family have been prominent, well-to-do people in this Middle Western city for three generations. The Carraways are something of a clan, and we have a tradition that we're descended from the Dukes of Buccleuch, but the actual founder of my line was my grandfather's brother, who came here in fifty-one, sent a substitute to the Civil War, and started the wholesale hardware business that my father carries on to-day.

You can’t be perfect, but you can get asymptotic to it. I can’t really think of much I’d change, and I bet if I tried I’d remove a comma and then, upon further revision, put the comma right back where I removed it. So there’s that.

This comes in the context of Ebert discussing a bowdlerized version of the novel, which may be either intended for schoolchildren or learners of English as a second language; it’s almost immaterial, isn’t it? The simplified version uses a word base of about “1,600 basic words,” and proves once and for all that it’s not the words that are important, it’s the way they’re used.

Look at the words used in the excerpt above: very few, if any, are obscure and you might hear any on any day. No, the magic is that they’re arranged in a certain way and in that certain way they happen to combine and do something special.

Other than that very basic demonstration, bowdlerization is pretty offensive (if that’s what this is).

Tuesday, July 5, 2011


Parties, nominations, Bachmann and trust.

South African government v. journalists.

What actors tarnished their Oscars most in 2011?

The tennis triangle—the three dead kings.

Interesting: the Netherlands are a net agricultural exporter.

Nice slideshow of the High Line.

The space shuttle’s Southern California legacy.

Nate Silver casts skepticism on the NBA’s poverty claims (the NBA protests.)


The release of the top conservative books here is a funny one. I’m not talking about regular-version funny, like Witness (because of the enduring relevance of fighting the Communist moles in our society), as there’s one book that really distinguishes itself in terms of weirdness: J.S. Mill’s On Liberty

Which is written by a guy so ahead of his time, liberalness-wise, that some of the stuff he did might still be controversial. Funny choice, good for the comedy.


Well then:
What is it about consumer protection that Republican lawmakers don't like? Is it that they want to see their constituents fleeced and flimflammed by businesses? Is it that they don't care?

Whatever the reason, the Republican-controlled House Appropriations Committee has approved a spending bill that not only slashes the budget of the Consumer Product Safety Commission but also cuts off all funding for a recently launched database of product-safety complaints.

To be fair, I suspect much of it has to do with the cut-everything-and-cut-it-now attitude currently prevailing through Washington. $3 million may be utterly insignificant, but sometimes you have to show your constituents you care. (Otherwise, why would the open government initiatives be in danger despite a similar low cost?)

I mean, this seems like something everyone can get behind: liberals, for obvious reasons. But free marketeers too; after all, we’re told by free market people like Hayek that the market works best when it has information to make its decisions, and surely information about product safety is the kind of information the market would value. Or not. Who knows?

It’s actions like this that make Republicans look less like brave soldiers for conservatism and instead like brave mercenaries for corporate interests.

Monday, July 4, 2011


Brazil risks a bust after its boom cycle.

A global race to match American drones.

On Thailand’s new Prime Minister and her family.

Indian call centers and British call centers are now equally costly.

Looks like the PRI is back in Mexico.

On how “smart irrigation” might save water. (The description of how they figure out what the weather is at any given place sounds like a huge technical feat.)

More Hispanics are identifying themselves as Amerindian.

The New Yorker on Facebook’s COO and women in Silicon Valley. Very interesting read.

Lastly, this photo gallery on tennis’s men’s number one players has to be seen for Ilie Nastase.

Another Cliche I Hate

OK, so a cliché I hate: “Let the players decide the game,” in reference to some controversial, important referee’s decision. That argument attempts to move from the back-and-forth of arguments about fact (“He was out of bounds!” “No, he wasn’t!”) to an abstract argument that sounds good. Yes, we do want players to decide the game primarily.

But of course, a referee making a decision for one team or player and deciding the game thusly is the equivalent of a referee not making a decision for the other team or player and hence deciding a game. The referee always decides the game by his or her particular version of the rules. The game is meaningless without the rules.

In practice, people are rarely consistent about this: if you’ve ever said, “Let the players decide the game,” you should applaud many or most potentially game-deciding non-decisions or missed calls. Yet most fans I know will not be so understanding in that event (as well they should.) Fine, so people are hypocrites—that doesn’t necessarily invalidate the overarching argument. Except we know better: if we could count on noncalls being made in inflection points, most players would resort to egregious cheating. That’s letting the players decide the game, I suppose, but it completely removes any artistry from the game and often means we’ll be watching a scrum rather than, say, a beautifully-arced jump shot over an outstretched hand to clinch a game. What’s better?

New Standards of Turpitude

For those of us who haven’t been following, the Rupert Murdoch empire broke through yet another standard of evil today with fresh revelations in the News of the World phone hacking case. Essentially, the tabloid would hack into the phone messages of various people and use the information gained thereby for various tabloid purposes. Well, that’s what was known before. Now we know they hack into the phones of grieving victims and interfere with police investigations:
The News of the World illegally targeted the missing schoolgirl Milly Dowler and her family in March 2002, interfering with police inquiries into her disappearance, an investigation by the Guardian has established.

Here’s the chain of events: the tabloid hacked into Dowler’s phone to listen to the messages left after her abduction. The problem was that so many people were calling her phone and leaving messages that the mailbox would fill up, denying space for later people to leave messages. So the tabloid deleted the old messages. That’s a problem because the family believed it was Dowler deleting the messages (raising hope that she was still alive), and the police would’ve been interested to listen:
According to one senior source familiar with the Surrey police investigation: "It can happen with abduction murders that the perpetrator will leave messages, asking the missing person to get in touch, as part of their efforts at concealment. We need those messages as evidence. Anybody who destroys that evidence is seriously interfering with the course of a police investigation."

Now, is Rupert Murdoch personally an evil man? It’s hard to say. But it’s easy to say, when looking at the businesses he controls, that his results are nothing to be proud of: you could excuse Fox for being a partisan outlet when this is merely an American tradition; but then again you’d also have to blame Fox for the continuing derangement of the Republican Party. There’s really no excuse available for this phone-hacking business. So it seems to me that, if you were to value the net impact of Rupert Murdoch’s business activities, you’d value it at a net negative, probably a large one. So Murdoch might not be evil, but he’s done a lot of wrong.

This seems to be an increasingly prevalent standard for businessmen these days. Most bankers around the time of the financial crisis were not personally evil, I believe. At the same time they’ve caused millions of people unnecessary suffering and have permanently stunted the growth of this country. In a complex society, where our actions often have consequences far away from our persons, this often happens. The key is to align actions and consequences closely. Culturally, if you have an ethic of greed and personal-orientation, things like pursuing the next story or getting the big bonus assume an outsized importance relative to the far-off person who may or may not get hurt down the road. In terms of accountability, it’s striking how often these people get away with it: according to the Guardian story the police seem to have known the tabloid was hacking mobile phones (though not that they were deleting messages), and let them get along with it. These types of moral compromises only embolden a self-oriented ethic, and end up creating bigger dilemmas for everyone to deal with.

Sunday, July 3, 2011


On Greece—James Surowiecki on tax dodging; on the wider effects to the Euro; on how Greek government debt will be like a CDO.

Decent story on ACOs.

Chinese corruption and official support of certain charities has apparently sparked Chinese distrust of philanthropy. Also: ominous signs in Chinese debt for local governments.

Big banks are preemptively reducing loan sizes…while other people can’t get a modification.

Some interesting stuff on data overload.

Didn’t realize the loopholes in Prop 13:
Even if an owner sells his entire interest in a piece of commercial real estate, the property is not reassessed if no single entity acquires more than a half-ownership stake. It is easy for corporations to structure deals to avoid a tax increase.
Apparently they’re lobbying to get that changed. Personally, wouldn’t mind the entire thing being abolished, along with the entire proposition system.

Congestion pricing—not coming to an American city near you.

Things We Now Know

I’m probably late to the funeral, but still, this has to be a bad sign:

Who is that, you ask. Excellent question, hypothetical person I’ve created for rhetorical purposes. It’s newly-declared Republican Presidential candidate Thaddeus McCotter. This makes the second year in a row an older white gentleman has run for the Republican nomination while also fancying himself a guitarist. Now, odds are, he is not very good and does not have very good taste. Nevertheless, this is the perfect opportunity to remind ourselves that rock and the guitar specifically are very much uncool now. If it’s safe enough for a Republican nominee to touch, it’s not edgy and not cool.

Now, deep down, we always knew this. We knew that when we noticed the kid playing the acoustic guitar in high school, singing some nonsense song in a falsetto voice. Nevertheless, now we really know and have no excuse. It’s time to officially deny the genre, or at least come up with some controversial figures.

Wimbledon Final

Djokovic out-Nadaled Nadal. His ability to cover all parts of the court might even surpass Nadal's peak (which was a few years ago.)

Djokovic remains a strange, grass-eating human being, and his father's fashion sense is still wonderfully bad.

ESPN put it best by headlining it "New World Order."


ADDITIONALLY: Apparently ESPN will get the exclusive rights to Wimbledon next year. Good. NBC manifestly does not get sports and does not show them live. Therefore they don't deserve it.

Saturday, July 2, 2011


Can Silicon Valley culture be transplanted in San Francisco?

A dispatch from the Guardian on the mess with the Dodgers.

An interesting column in Slate about Michele Bachmann, paternalism and evangelism (How can Bachmann run for President and promise to be subservient to her husband?)

Michael Lewis reviewing Mark Twain’s autobiography. (Self-recommending.)

What would a post-Chavez Venezuela look like?

What does the developing world need, regulation-wise?

World Bank opening up its data.

Angry Birds and great stagnation.

Everything is a Remix Part 3 from Kirby Ferguson on Vimeo.


Nick Kristof has an excellent point:
If you look at my coverage of Africa, I’ve spent far more time in Congo, Sudan, Zimbabwe and Niger — some of the most forlorn countries on the continent — than in bustling dynamos like Botswana or Ghana. The upshot is that I fear we sometimes create a public perception of Africa as a basket case, in a way that discourages tourism and business investment. If that’s the case, then our efforts to help Africa only hurt it.

On the other hand, it seems to me that the basic problem with eastern Congo is that it’s undercovered rather than overcovered: this is the most lethal conflict since World War II and has had far fewer column inches than any other major conflict. Likewise, the 1 million kids a year who die of pneumonia, overwhelmingly in Africa, deserve more coverage, not less. Same with maternal mortality, malaria, fistula, hunger and so on.

I’m proud that my coverage on some African challenges feels as if it has helped spotlight the challenges and led to lives saved. So what do we do to call attention to problems without exaggerating them in the public mind?

I don’t think there’s any easy answer to this conundrum…

I’m not sure of some of his specific points—anecdotally from the media, business investment does not exactly seem to be a problem for Africa (most of the investment seems to be in commodity extraction, which is not exactly winning the future but probably preferable to some of the alternatives)—but the overall point is sound: listening to the media tell it (rarely and loudly), Africa is in terrible shape. Yet when viewed from the statistical perspective, Africa looks to be in much better shape than ever before.

Charles Kenny makes the point at length here, but in general signs look good—life expectancy up, child mortality down, GDP per capita. If it weren’t for the AIDS crisis, Africa would be in better shape still. Obviously there’s a long distance between where Africa is and where we’d like it to be, but life is still much better than before and we haven’t quite heard that enough.

This is part of the psychology of the media. Quiet successes, occurring over the course of decades, are hard for journalists to pick up upon and explain. It’s difficult for historians to explain, even long after the fact, so it’s hard to be too harsh on journalists. The problem comes when we allow our partial regard of reality to become the entire thing.

Savings Glut

Chart from Krugman, then commentary:

Before the crisis, businesses were net borrowers, and to the extent that they preferred to rely on internal finance, anything that increased their profits might have led to at least some extra investment. Now, however, businesses are by and large taking in more in profits than they want to invest in expanding their businesses, so they’re lending out the excess, parking it in various securities. There’s absolutely no reason to believe that taxing their corporate jets would reduce investment, or that giving them a tax holiday on repatriated funds would increase investment.

So I suspect the problem here is from a corporate perspective, there’s nothing much to invest in (say, The Great Stagnation thesis): they’re uncertain of future returns, and can maintain a certain level of productivity with minimal staffs, and that’s fine for them. The key here would be for the government to find a way to kick it up into a higher equilibrium.

(I suspect most of this money that businesses are loaning out is finding its way to Brazil, China, India, et. al., which is why they have such high inflation rates despite—in Brazil’s case, at least—having such high interest rates. Well, because of, actually.)

Friday, July 1, 2011


Are we close to usable food allergy therapies?

What’s up with Mikhail Prokhorov’s officially-approved new opposition party in Russia?

Prison terms for crack cocaine offenses reduced. Well done.

State slogans ranked and saluted.

African GDP growth, in graph form.

Hackers attacked Arizona state police again.

Cisco’s ambitions to create several new smart cities (with the forthcoming New Songdo near Seoul being a demonstration piece). Very interesting.

The collision of creativity and cash at Pixar.

“Microsleep” to improve smartphone battery life.

How the definition of “Santorum” will reveal what kind of search engine Google is.

Off-the-shelf organs: too hard for science?

So why are they so angry again?

The article linked to a few days ago arguing that Germans were very angry is worth thinking about, but ultimately has to be clarified a bit. Here’s the basic thesis:
Germany's western flank has become the greatest exporter in the Western world, second only to China and far ahead of the United States. The container ports along the Rhine are working day and night to deliver record orders of German products to southern and western Europe, the U.S. and especially to China. Shops are busy. Home sales are rocking. Unemployment hasn't been so low since the eighties. In terms of growth, profits and productivity, the current German economic boom has surpassed even the “wonder years” of the 1950s. These are, by several measures, the most successful people in the world.

Yet it is very hard to find anyone here who is happy about this state of affairs. Unlike the great Rhineland industrial booms of the 1950s and 1970s, this one is provoking Germans to turn against their government, against Europe, against technology and growth, against outsiders. It is an inward-looking, self-questioning moment in a country that the rest of Europe very badly needs to be involved in affairs outside its borders.

OK, so there are a few ways to resolve this paradox: either Germans aren’t as successful as they really are, or they are ungrateful twits. Not knowing enough Germans, I decline to speculate on the latter (though all the Germans I’ve met have been fun, worthwhile people, so….). I think it’s the former.

Let’s take the opportunity to demarcate two distinct entities: Germany is doing great; the Germans may not be. While recent times have seen a great boom in the official, top-line statistics, it’s generally ignored—in the telling of the German story—that German wages have actually declined over the previous decade, by 4% in real terms. This may seem strange, as German unemployment is quite low and its productivity fairly high. These are conditions that should, in isolation, demand wage hikes rather than stagnancy in nominal terms. If your wages had declined over the previous decade, despite making more and better stuff than ever before, while everyone told you how super awesome you were…you might get angry! So ze Germans are angry.

Now, as most countries do when they get collectively angry, they are getting angry at the wrong people—typically it’s the immigrants and other minority groups that receive the venting—but when the facts justify anger, it shouldn’t be particularly surprising when people decide to get angry.

For those who aren’t inclined to get angry because of other people’s misfortune, it nevertheless raises some uncomfortable questions: that is, the Germans are a productive people who are employed, and yet they cannot get wage raises. What more could you really ask from them? It implies disturbing things about the economy that this is true, though I’m unsure what the exact implications are besides something’s gone wrong.

Things We Don't Know

An interesting article in Scientific American about prescription drugs and elderly people makes the case that we’re doing it wrong. After noting that most clinical drug trials don’t have very big samples of old people (and goes so far to say “guidance on practice are not science based [sic].”), the author writes:
A recent study of elderly ICU survivors found that 85 percent were discharged with 1 or more potentially inappropriate medicines, with more than 50 percent in that group discharged with medications deemed more harmful than beneficial (Morandi et al, 2011). The authors press for more attention to appropriateness reviews, with the rationale for starting each therapy in the ICU, and discussion of when it can be stopped.

Brian Strom, MD, professor of public health and pharmacology, University of Pennsylvania, describes the issues this way: "The problem is Congress and our research agencies. They fund so little work on the pharmacology of the aged and other demographic subgroups, and their risk of drug interactions. And, there is phenomenally small, and shrinking by 60% (down to $5.1 million/year), amount of money being spent supporting the Centers for Education and Research and Therapeutics, who are charged with doing studies that industry would not fund, and with changing prescribing to be more rational."

The more you read about health care, the more you’re struck by the amount of stuff we don’t know at all about health care—the lack of knowledge is accentuated by the realization that much of the stuff we think we know is actually unknown, possibly right but possibly wrong. (There are problems with large numbers of studies—see this article on biomarkers for one example—and then there’s the excerpted article above.)

My personal hunch—given facts like the above—is that more substantive, thorough studies will show health care to be much in terms of quantity, with much of the surplus detracting from people’s health.