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30 January 2008

Sadly, This is Not a Parody

Now that George Bush will be leaving office in 2000, Ralph Nader is very helpfully reminding us of how he got there. Yes, Ralph Nader now has an exploratory committee for a 2008 presidential run.

Let us instead weigh the possibility of pulling together half a million dedicated citizens collectively rising up off our couches and organizing a ground force in every Congressional district in the country.

That would be nice. It would also be nice if the Green Party leaders who are listed on that site were capable of organizing more than the odd candidate or two for state representative every election. For a "grassroots" party, the Greens resemble the Libertarians more than anyone else in their penchant for running for as few races as organizationally possible. (Yes, there are exceptions to this rule, but in no state are the Greens a political force of any sort.)

Every time Ralph Nader runs for president, I am reminded of his appearance on a Sesame Street special from 1988. As a "consumer advocate" he manages, whilst inspecting Bob McGrath's cardigan from his Aunt Myrtle, to pull off all of the buttons, rip off a pocket, and rend a sleeve to bits. And somehow, his effort is supposed to be worthwhile.

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Posted by Tim W at 1/30/2008 02:11:00 PM

25 January 2008

Big Pharma

Every man, every man for himself. Big Science. So said Laurie Anderson a generation ago. And Big Pharma is showing today just how knackered the American health care system is. The profitability of a drug has very little to do with its efficacy. Marketing to consumers leads to gross overuse of marginally useful drugs. And doctors, who one might think might be able to afford to be objective, are too often swayed by financial incentives, whether small (free lunches, pens, and the like) or large (consulting contracts). How do you know if your doctor is on the take? You don't. You just have to hope not.

Business Week, whose editors are once again deciding that what is bad for people might actually be bad for investors, made the sad finding that modern medical miracles are too often overstated.

Martin Winn's cholesterol level was inching up. Cycling up hills, he felt chest pain that might have been angina. So he and his doctor decided he should be on a cholesterol-lowering medication called a statin. He was in good company. Such drugs are the best-selling medicines in history, used by more than 13 million Americans and an additional 12 million patients around the world, producing $27.8 billion in sales in 2006. Half of that went to Pfizer for its leading statin, Lipitor. Statins certainly performed as they should for Winn, dropping his cholesterol level by 20%. "I assumed I'd get a longer life," says the retired machinist in Vancouver, B.C., now 71. But here the story takes a twist. Winn's doctor, James M. Wright, is no ordinary family physician. A professor at the University of British Columbia, he is also director of the government-funded Therapeutics Initiative, whose purpose is to pore over the data on particular drugs and figure out how well they work. Just as Winn started on his treatment, Wright's team was analyzing evidence from years of trials with statins and not liking what it found.

Yes, Wright saw, the drugs can be life-saving in patients who already have suffered heart attacks, somewhat reducing the chances of a recurrence that could lead to an early death. But Wright had a surprise when he looked at the data for the majority of patients, like Winn, who don't have heart disease. He found no benefit in people over the age of 65, no matter how much their cholesterol declines, and no benefit in women of any age. He did see a small reduction in the number of heart attacks for middle-aged men taking statins in clinical trials. But even for these men, there was no overall reduction in total deaths or illnesses requiring hospitalization—despite big reductions in "bad" cholesterol. "Most people are taking something with no chance of benefit and a risk of harm," says Wright. Based on the evidence, and the fact that Winn didn't actually have angina, Wright changed his mind about treating him with statins—and Winn, too, was persuaded. "Because there's no apparent benefit," he says, "I don't take them anymore."

In some cases, treatments for nasty diseases work splendidly. The antibiotics given to treat stomach ulcers kill the bacteria in almost all patients, and heal those ulcers in many of them: one in five by the end of treatment, and one in two by the end of a year. In medical terms, the number needed to treat NNT is about 1.1 for the antibiotic cocktail in terms of killing the ulcerating bacteria and about 5 for healing the ulcers.

For statin drugs, the NNT is about 20 to prevent heart attacks in high-risk patients. The NNT is between 75 and 200 to do the same for lower-risk patients. And for Zetia, the NNT is at least 1000 and may be infinite.

Think about that. All Zetia does is lower cholesterol, but it does not protect against heart disease. As long as Merck/Schering-Plough can keep reminding consumers about the cholesterol reduction, useless though it may be, it can keep selling its well-nigh useless but nonetheless profitable drugs to a populace that is mostly ignorant about current medical research.

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Posted by Tim W at 1/25/2008 04:32:00 PM

24 January 2008

What a Country

I thought that deporting citizens was supposed to be something that only failed states were supposed to do. But when the ruling party operates under the premise that government is a bad thing, then it has no incentive to run the government efficiently.

After he was arrested in Colorado on a minor drug charge, [Thomas] Warziniack told probation officials there wild stories about being shot seven times, stabbed twice and bombed four times as a Russian army colonel in Afghanistan, according to court records. He also insisted that he swam ashore to America from a Soviet submarine.

Court officials were skeptical. Not only did his story seem preposterous, but the longtime heroin addict also had a Southern accent and didn't speak Russian.

Colorado court officials quickly determined his true identity in a national crime database: He was a Minnesota-born man who grew up in Georgia. Before Warziniack was sentenced to prison on the drug charge, his probation officer surmised in a report that he could be mentally ill.

Although it took only minutes for McClatchy to confirm with Minnesota officials that a birth certificate under Warziniack's name and birth date was on file, Colorado prison officials notified federal authorities that Warziniack was a foreign-born prisoner.


Posted by Tim W at 1/24/2008 10:42:00 PM

AAA Ball

Now there's a shock. Did anyone really think that just $15 billion would somehow avoid the financial train wrecks now known as Ambac and MBIA?

America's biggest mortgage bond insurers collectively need a $200 billion (£101 billion) capital injection if they are to maintain their key AAA credit ratings, a figure that dwarfs a plan by New York regulators to put together a capital infusion of up to $15 billion, a leading ratings expert said yesterday.

The ratings expert is hardly the alpha and omega of company ratings, of course. But it is clear what Ambac and MBIA have insured a whole lot of junk: collateralized debt obligations and mortgage-backed securities, none of which is getting better as the housing crisis deepens. And just wait until the option ARMs start resetting in earnest in the next 12 to 24 months.

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Posted by Tim W at 1/24/2008 10:20:00 PM

Strong on Defense?

I can imagine how Willard Mitt Romney would run his campaign, should he win the Republican nomination—besides running like crazy away from his given first name, the commandment about honoring thy mother and father be damned.

Mitt Romney: strong on defense. Mitt Romney: for secure borders. And so on.

So it is with more than a bit of glee that I report that for the second time in six months, the Romney campaign has been unable to secure its very headquarters.

A security guard called police shortly before 1 a.m. to report a breaking and entering in progress. Police arrested Daniel J. Bradley, 28, and Michael J. Sauer, 30, both of Cambridge, according to the Suffolk District Attorney's office....

It was the second burglary at the Commercial Street building since September, when thieves stole seven laptop computers and their docking stations and a 37-inch plasma television, the personal property of Spencer Zwick, the candidate's finance manager and close personal adviser.

I wonder if the burglaries are karmic payback for putting the presidnetial campaign headquarters of a known teetotaler two blocks from the site of America's deadliest industrial alcohol accident—indeed, when the huge molasses tank at Purity Distilling burst on 15 January 1919, the block of Commercial Street that includes Romney's headquarters wound up under two to three feet of sticky goo.

Perhaps there is a metaphor there.


Posted by Tim W at 1/24/2008 10:03:00 AM

23 January 2008

Clueless Near Gaza

What a sinecure it must be to be a conservative columnist at a so-called liberal newspaper. If you write the most ludicrous things, it is so very difficult to get fired, for the bosses as so afraid of being red-baited, even today.

So it must be in Boston, where the Globe keeps printing the nuanced and illuminating prose of Jeff Jacoby. One of his latest columns laments that the Bush administration is giving up the hard line on the Palestinian Authority that has worked so well for the past seven years.

the president who once insisted that a "Palestinian state will never be created by terror" now insists that a Palestinian state be created regardless of terror. Once the Bush administration championed a "road map" whose first and foremost requirement was that the Palestinians "declare an unequivocal end to violence and terrorism" and shut down "all official . . . incitement against Israel." Now the administration says that Palestinian terrorism and incitement are nothing "to get hung up on."

Whatever happened to the moral clarity that informed the president's worldview in the wake of 9/11? Whatever happened to the conviction that was at the core of the Bush Doctrine: that terrorists must be anathematized and defeated, and the fever-swamps that breed them drained and detoxified?

Bush's support for the creation of a Palestinian state was always misguided—rarely has a society shown itself less suited for sovereigntyRbut at least he made it clear that American support came at a stiff price.

Let us leave aside the notion that somehow Palestine has anything that amounts to a civil society given the astoundingly fragmented territory that the Palestinian authority controls in the West Bank; given the chronic use by Israeli governments of settlements in both Gaza and the West Bank; and given the chokeholds that Israel places on the economies of those states. And let us leave aside the fact that no other country dares place a "security fence" along its border in such a way that it cuts off large chunks of its neighbors' territory.

Jacoby is clearly upset that the Palstinian government is linked to the clear use of terrorism against the current Israeli state. Three words come to mind: King David Hotel. Perhaps Jacoby's editors are daft enough to know that the current state of Israel was founded by men and women who were clearly linked to terrorism against the British. But not everyone is so completely stupid.

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Posted by Tim W at 1/23/2008 08:06:00 PM

22 January 2008

Now This is Great News


Soi-disant maverick John McCain has as his chief economics advisor none other than Phil Gramm, the midwife of Reaganomics.

The one good aspect of this news is that it increases the possibility that McCain's economic proposals, should he win the Republican nomination, will prove so transparently ludicrous that even the mainstream press will recognize them as such.

On the other hand, were McCain to win the presidency, it would mean that Phil Gramm, who has been lying low since his wife's tenure on the Enron board of directors went so well for all concerned, would be back in a position of power.

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Posted by Tim W at 1/22/2008 10:31:00 PM

19 January 2008

Bad News for Big Pharma

One hospital group in Minnesota has done what we have been urging for years—thrown out promotional items from pharmaceutical companies.

When a Duluth-based operator of hospitals and clinics purged the pens, notepads, coffee mugs and other promotional trinkets drug companies had given its doctors over the years, it took 20 shopping carts to haul the loot away.

The operator, SMDC Health System, intends to ship the 18,718 items to the west African nation of Cameroon.

The purge underscored SMDC's decision to join the growing movement to ban gifts to doctors from drug companies.

SMDC scoured its four hospitals and 17 clinics across northeastern Minnesota and northwestern Wisconsin for clipboards, clocks, mouse pads, stuffed animals and other items decorated with logos for such drugs as Nexium, Vytorin and Lipitor....

The backlash against the cozy relationships between doctors and drug makers gained steam from article in the Journal of the American Medical Association in 2006. It said research had shown that even cheap gifts, such as pens, can affect doctors' prescribing decisions.

It woiuld have been nice for the article to mention No Free Lunch, whose inclusion in the Bear Left Link Library dates from 2001, but one cannot have everything.

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Posted by Tim W at 1/19/2008 12:35:00 PM

18 January 2008

This Is Not Good

It is time to put the bear back in bear-left.com.

For this news ought to thoroughly put paid to the notion that the stock market is just fine and dandy.

Ambac Financial Group Inc. said on Friday that it's scrapping plans to raise new capital by selling equity after the bond insurer's shares collapsed in recent days.

Fitch Ratings cut the AAA ratings of Ambac's main bond insurance subsidiaries after the announcement and Standard & Poor's warned that it may do the same.

Hundreds of billions of dollars of municipal bonds and mortgage-related securities guaranteed by Ambac may now be downgraded too. That sparked concern about more write-downs at banks and brokers and added to turmoil in the muni bond market.

That reminds me. From Vanguard's fund returns page, through 31 December 2007, the 500 Index Fund returned 5.83% annually over 10 years. The Total Stock Market Index fund returned 6.25% annually. Its Total Bond Market Index returned 5.71% annually, and its Intermediate and Long Bond Funds returned 6.32% and 6.97%, respectively.

Since the beginning of the year, the two stock funds are down about 10% each, and the bonds funds are up slightly. Remind me why equities are always supposed to outperform bonds over long stretches. And definitely remind me why investing Social Security funds in the stock market is supposed to be such a great idea.

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Posted by Tim W at 1/18/2008 11:07:00 PM

17 January 2008

Stupid Advertising Tricks

Sony wants you to believe that you need its wicked cool digital camera with 11-point autofocus and 5-frames-per-second capability to take great photographs. And to do so, Sony hacked a famous photograph to make it lousy.

When Charles Ebbets took his famous 1932 photograph of 11 men having lunch on a beam 69 floors above Rockefeller Center, he (a) did not use a Sony camera, (b) did not use a digital camera, (c) did not use autofocus, and (d) was not relying on a 5-frame-per-second gizmo on his camera. But when you work in advertising, even basic logical inferences are so very hard to come by.

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Posted by Tim W at 1/17/2008 03:32:00 PM

The Belly of the Beast

How rotting is the culture at a major television "news magazine"? At "Dateline," it is worse than I ever feared.

At the moment [NBC Entertainment president Jeff] Zucker blew in and interrupted, I had been in [Dateline executive producer David] Corvo's office to propose a series of stories about al-Qaeda, which was just emerging as a suspect in the attacks. While well known in security circles and among journalists who tried to cover international Islamist movements, al-Qaeda as a terrorist organization and a story line was still obscure in the early days after September 11. It had occurred to me and a number of other journalists that a core mission of NBC News would now be to explain, even belatedly, the origins and significance of these organizations. But Zucker insisted that Dateline stay focused on the firefighters. The story of firefighters trapped in the crumbling towers, Zucker said, was the emotional center of this whole event. Corvo enthusiastically agreed. "Maybe," said Zucker, "we ought to do a series of specials on firehouses where we just ride along with our cameras. Like the show Cops, only with firefighters." He told Corvo he could make room in the prime-time lineup for firefighters, but then smiled at me and said, in effect, that he had no time for any subtitled interviews with jihadists raging about Palestine....

I did [...]point out to the corporate-integrity people unhelpful details about how NBC News was covering wars in Iraq and Afghanistan that our GE parent company stood to benefit from as a major defense contractor. I wondered aloud, in the presence of an integrity "team leader," how we were to reconcile this larger-scale conflict with the admonitions about free dinners. "You make an interesting point I had not thought of before," he told me. "But I don't know how GE being a defense contractor is really relevant to the way we do our jobs here at NBC news." Integrity, I guess, doesn't scale.

Where does this useful, albeit depressing, article by Jeff Hockenberry appear? In a major newspaper? In a weekly newsmagazine? In a popular monthly magazine whose editors ought to be eager to show how today's networks seem to be copying dark movie satires for ideas?

No. It appeared in the MIT alumni magazine. Sic transit gloria hominis.

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Posted by Tim W at 1/17/2008 03:03:00 PM

14 January 2008

Pill Pushers

I should have know that this was forthcoming.

A clinical trial of Zetia, a cholesterol-lowering drug prescribed to about 1 million people a week, failed to show that the drug has any medical benefits, Merck and Schering-Plough said on Monday....

This trial was designed to show that Zetia could reduce the growth of those plaques. Instead, the plaques actually grew almost twice as fast in patients taking Zetia along with Zocor than in those taking Zocor alone....

Dr. Steven Nissen, the chairman of cardiology at the Cleveland Clinic, said the results were "shocking." Patients should not be prescribed Zetia unless all other cholesterol drugs have failed, he said.

"This is as bad a result for the drug as anybody could have feared," Dr. Nissen said. Millions of patients may be taking a drug that has no benefits for them, raising their risk of heart attacks and exposing them to potential side effects, he said.

Zetia is the anti-cholesterol drug whose current marketing campaign features actors not playing doctors (the usual direct-to-consumer pharmaceutical advertising trick) but actors playing other professions, such as television chef and a waitress, who explain why Zetia "works differently." (This campaign came after one featuring actors playing a medical school professor and medical students stopped airing.)

Oh, it works differently, all right. It doesn't do a damned thing for you.

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Posted by Tim W at 1/14/2008 04:00:00 PM

13 January 2008

Not My Party and I'll Laugh If I Want To

So Willard Mitt Romney was governor of Massachusetts for four years. And how healthy is the Republican Party that he left behind?

Healthy enough, if you call having walking pneumonia healthy.

The likely candidate to run against John Kerry in November 2008 is a fellow whose claims to fame are:

  • His brother was killed on 11 September 2001
  • His political experience consists of losing a special election last year in one of the state's two most conservative House districts to a candidate whose political experience was being Paul Tsongas's widow
  • He was a staunch enough Republican that he did not want George Bush to campaign with him

If only Romney could do for the country what he did so well around here.

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Posted by Tim W at 1/13/2008 12:17:00 PM

09 January 2008

Leading Questions

Some questions that I would like to hear in any future Republican presidential debate:

  • Governor Romney, you have said that you thought that gay marriage in Massachusetts would harm the institution of marriage. As a longstanding Massachusetts resident, how has gay marriage hurt your marriage? Please be specific.
  • Governor Huckabee, you are an ordained Southern Baptist minister. Why did you choose that denomination, whose very existence stems from a desire to continue slaveholding when some Baptists considered it to be an abomination?
  • Congressman Paul, you have criticized the speed at which President Lincoln emancipated slaves in 1863. Do you think that the Confederate states were right to secede from the union? Would you have voted for the 15th amendment?
  • Mayor Giuliani, why did you suggest that your term as mayor be extended into 2002? Should a president try the same thing?

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Posted by Tim W at 1/09/2008 12:39:00 AM

Sample versus Population

Why would one expect that most drug samples go to wealthy and insured patients rather than the poor or uninsured?

Because if one remembers that pharmaceutical companies recruit their new drug representatives from the ranks of collegiate cheerleaders, then one might come to a couple of realizations. First, drug companies are very interested in, literally, flirting with doctors who might write lucrative prescriptions. Second, drug companies do not have the public's best interests at heart.

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Posted by Tim W at 1/09/2008 12:32:00 AM

Free for the Downloading

If you are looking for a good introduction to using statistical reasoning in the social sciences, you can do far, far worse than reading Edward Tufte's Data Analysis for Politics and Policy. Reading it before firing up a statistical package will help you better understand what statistical tests mean and how they ought to be applied.

Through the magic of the Internet, it is available for free from Tufte's own website.

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Posted by Tim W at 1/09/2008 12:28:00 AM

(Cold) Snap!

Poor Jeff Jacoby. Even Mother Nature is tired of his wingnut hackery. On Sunday, his column blustered about how cold it was this winter. Interspersed among quotes from the usual contrarian climatologist was this nugget: "Closer to home, 44.5 inches of snow fell in New Hampshire last month, breaking the previous record of 43 inches, set in 1876. And the Canadian government is forecasting the coldest winter in 15 years."

On Tuesday, Boston had a record high temperature of 67 degrees, three degrees higher than the previous mark.

Should we wait for a retraction?

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Posted by Tim W at 1/09/2008 12:16:00 AM

01 January 2008

A Site for Sore Eyes

The Internet can truly be a wonderful thing. Sesame Workshop has unveiled its own video player, which is still in beta but looks promising.

Lots of clips from Sesame Street are not yet available, but there are some great ones that you can see now. Monster In a Box ("Written by Spalding Monster and starring Spalding Monster—no ego problem there!") is there. Several Super Grover episodes ("do not thank me; I live to serve") is there. But best of all, Grover's monster workout video is there ("Jane Fonda, eat your heart out") is there.

Posted by Tim W at 1/01/2008 01:06:00 PM

Just Wondering

David Brooks had 4 days between his column on 28 December and his column today on Willard Mitt Romney and his amazing technicolor PowerPoint candidacy.

His own prescription for pundits is very clear:

One of the best pieces of career advice I ever got is: Interview three people every day. If you try to write about politics without interviewing policy makers, you’ll wind up spewing all sorts of nonsense.

Therefore Brooks had times to interview 9 people in the three days that he had to prepare his latest column for publication. How many of them did he allude to in that column, let alone quote?

We find several references to polls and history, but only vague allusion to Republican "leaders"—not quite the policy makers one is supposed to be talking to.

The leaders of the Republican coalition know Romney will lose. But some would rather remain in control of a party that loses than lose control of a party that wins. Others haven’t yet suffered the agony of defeat, and so are not yet emotionally ready for the trauma of transformation. Others still simply don’t know which way to turn.

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Posted by Tim W at 1/01/2008 12:56:00 PM

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