Category: Government

Recording a Pain of “5” and Then Leaving Without Relieving

If health care was provided by free market companies whose success depended on voluntarily attracting customers, instead of by bureaucratic, hyper-regulated, CYA incentivized, and competition-insulated bureaucracies, would the surreal experience reported below be as common as it is?

(p. 11) A FRIEND was recently hospitalized after a bicycle accident. At one point a nursing student, together with a more senior nurse, rolled a computer on wheels into the room and asked my friend to rate her pain on a scale of 1 to 10.

She mumbled, “4 to 5.” The student put 5 into the computer — and then they left, without further inquiring about, or relieving, my friend’s pain.
This is not an anecdote about nurses not doing their jobs; it’s an illustration of what our jobs have become in the age of electronic health records. Computer documentation in health care is notoriously inefficient and unwieldy, but an even more serious problem is that it has morphed into more than an account of our work; it has replaced the work itself.
Our charting, rather than our care, is increasingly what we are evaluated on. When my hospital switched to bar code scanning for medication administration, not only were the nurses on my floor rated as “red,” “yellow” or “green” based on the percentage of meds we scanned, but those ratings were prominently and openly displayed on printouts left at the nurses’ station.
. . .
We need to streamline our records so that they serve just one master: the patient. We should focus on the most important information in guaranteeing accuracy of diagnosis, efficacy of treatment, continuity of care and patient safety. Otherwise the content of our care will be increasingly warped by the demands of our e-record systems — and patients like my poor friend will lie in hospital beds in pain, uncomforted by the knowledge that the electronic record of that pain is satisfyingly and exactingly complete.

For the full commentary, see:
THERESA BROWN. “Patients vs. Paperwork.” The New York Times, SundayReview Section (Sun., DEC. 20, 2015): 11.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date DEC. 19, 2015, and has the title “When Hospital Paperwork Crowds Out Hospital Care.”)

Anti-GMO Chipotle No Longer Wears Health Halo

(p. A13) . . . if you need an anecdote for how the year unfolded for the anti-GMO movement, look no further than Chipotle. Last spring the fast food company announced with great fanfare that it would take GMO ingredients off its menu. It was all downhill after that. As was quickly pointed out, Chipotle wasn’t being fully truthful, since its soft drinks and cheese contain genetically modified ingredients, and its meat comes from animals fed genetically modified grains. A lawsuit filed in California, which is pending, accused Chipotle of false advertising and deceptive marketing.
Then cases of food-borne illnesses hit Chipotle locations across the country. Supporters of traditional agriculture, who have felt maligned by the burrito company, started keeping a tally of the number of people sickened by Chipotle’s food (ongoing, but more than 300) versus the number sickened by GMOs (zero). As the year winds to a close, the company that once wore the restaurant industry’s health halo is apologizing, preparing for lawsuits, recentralizing its vegetable preparation and cutting locally sourced ingredients.

For the full commentary, see:
JULIE KELLY. “The March of Genetic Food Progress; ‘Farmaceuticals’ and other GM products are slowly being approved, despite political scare campaigns.” The Wall Street Journal (Weds., Dec. 30, 2015): A13.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date Dec. 29, 2015.)

In Poor Province, Chinese Communists Spend Over $400,000 Building Giant Golden Statue of Mao, Starver of Millions of the Proletariat

(p. B1) ZHUSHIGANG, China — Just two days after images of a giant gold-colored statue of Mao in the bare fields of Henan Province spread across the Internet, the statue was gone — torn down apparently on the orders of embarrassed local officials.
Villagers said demolition teams arrived on Thursday morning [January 7, 2016], and by Friday morning [January 8, 2016], only a pile of rubble remained.
The 120-foot-tall statue, which local media reports said cost $465,000, had been under construction for months and was nearing completion when it began to attract attention.
Some commenters on social media denounced the extravagance of the colossus in a poor, rural part of China, where the money might have been better spent on education or health care.
. . .
Others pointed out the historical irony of erecting the statue in one of the provinces worst hit by the famine caused by Mao Zedong’s Great Leap Forward.
. . .
Statues of Mao, the founder of the People’s Republic of China, were once ubiquitous in China, and many survive. President Xi Jinping has often praised Mao as a model for China today, saying Mao’s era was one when officials were selfless and honest.
But some of his policies were disastrous, including the forced agricultural collectivization and industrialization of the Great Leap Forward, which historians blame for a famine in which tens of millions of people died.

For the full story, see:
DIDI KIRSTEN TATLOW. “An Outcry Helps Topple a Mao Statue 120 Feet Tall.” The New York Times (Sat., JAN. 9, 2016): A4.
(Note: ellipses, and bracketed dates, added.)
(Note: the online version of the story has the date JAN. 8, 2016, and has the title “Golden Mao Statue in China, Nearly Finished, Is Brought Down by Criticism.”)

Madison Revised Notes to Aid Jefferson’s Attack on Hamilton

C-SPAN Book TV today played an extended interview with Mary Sarah Bilder about her book on James Madison’s notes on the constitutional convention. Madison revised his notes to share with Jefferson, who had not been present during the convention. Chernow, in his biography of Hamilton, reports how Jefferson criticized Hamilton for aristocratic tendencies. What is most surprising about Bilder’s comments is that Madison had made comments at the convention similar to Hamilton’s discussing whether there might be merits to monarchy. But in his revision of the notes, he deleted those comments before passing the notes to Jefferson, presumably as part of his desire to ally himself more closely with Jefferson and to join in Jefferson’s vilification of Hamilton.
This is not an earth-shattering finding, but it adds support to Chernow’s defense of Hamilton. Jefferson was the slave-holding aristocrat in practice, while Hamilton opposed slavery, and Hamilton’s intellectual speculations on the best form of government were not notably monarchist within the context of the time.

The book discussed on C-SPAN, was:
Bilder, Mary Sarah. Madison’s Hand: Revising the Constitutional Convention. Cambridge, MA: Harvard University Press, 2015.

The Chernow book I mention above, is:
Chernow, Ron. Alexander Hamilton. New York: The Penguin Press, 2004.

North Dakota Plans a Drone Silicon Valley

For many years state governments and universities have been trying to plan the creation of new Silicon Valleys in their own backyards. Success has been elusive. Now North Dakota is tying to create a drone Silicon Valley. My take: Silicon Valleys cannot be planned, though they can be encouraged by low taxes and limited regulations.

(p. A1) FARGO, N.D. — “California and New York want what we’ve got,” said Shawn Muehler, a 30-year-old Fargo resident, gazing at a horizon of empty fields, silos, windbreak trees and hardly any people. A winged craft traces the air, mapping a field with pinpoint accuracy for his start-up, a drone software company called Botlink. “They like drones, but they’ve got a steep learning curve ahead.”

For years, entrepreneurs have come here to farm and to drill for oil and natural gas. Now a new, tech-savvy generation is grabbing a piece of the growing market for drone technology and officials want to help them do it here, where there is plenty of open space and — unlike in other sparsely populated states — lots of expertise already in place.
Silicon Valley has the big money and know-how, Mr. Muehler and others say, but North Dakota can take unmanned aerial vehicles, as the officials prefer to call drones, from a fast-growing hobby to an industry. And just as Silicon Valley got its start with military contracts, entrepreneurs and cooperative universities, they believe they can do the same with drones.
“The potential up here is tremendous,” said Jack Dalrymple, the state’s governor. “It’s not about supporting a company or two; it’s creating the leading edge of an industry.”
North Dakota has spent about (p. B7) $34 million fostering the state’s unmanned aerial vehicle business, most notably with a civilian industrial park for drones near Grand Forks Air Force Base. The base, a former Cold War installation, now flies nothing but robot aircraft for the United States military and Customs and Border Protection.

For the full story, see:
QUENTIN HARDY. “A Silicon Valley for Drone Craft in Great Plains.” The New York Times (Sat., DEC. 26, 2015): A1 & B7.
(Note: the online version of the story has the date DEC. 25, 2015, and has the title “A Silicon Valley for Drones, in North Dakota.”)

Entrepreneurs Who Pay Taxes “Expect Services–Like Justice”

(p. B3) ATHENS — Demetri Politopoulos, the founder of a midsize beer producer in northern Greece, says he nearly fainted when he heard the news late one night in October.
The Greek Parliament was planning to pass a law that would increase the tax he paid for each hectoliter of beer he sold by 50 percent.
Just like that, the microbrewery he started 17 years ago would go under, as his new tax bill of 1.6 million euros would wipe out his expected 1.45 million euros in profit for the year.
. . .
He started his business in 1998, but even as demand for his Vergina beer grew, his share of the market stayed in the low single-digits as the market leader did all in its power to prevent shops and restaurants from selling his product.
. . .
In 2005, Mr. Politopoulos took his case to the Hellenic Republic Competition Commission, citing numerous examples of what he said were unfair business practices by Heineken, from persuading retailers to not stock Vergina to more serious examples of bullying and intimidation.
But as is often the case in Greece, his petition went nowhere.
With Greece under unremitting pressure to find new revenue sources, the idea to close the gap between the way small and large brewers are taxed may have seemed a good idea.
That is, until Mr. Politopoulos took the floor in Parliament on Nov. 2.
“We are proud to pay taxes in Greece, but this is going to put us out of business,” he said. “And when we do pay our taxes, we expect services — like justice. Without justice in a society, there is nothing.”
His 10-minute declamation hit a cord. A video of the speech went viral and parliamentary members rallied to his cause.
Indeed, concerns are growing here that in a rush to raise much-needed revenue, Greece and its creditors are placing an unfair burden on an already decimated private sector.

For the full story, see:
LANDON THOMAS Jr. “A Greek Dvid Lands Some Big Punches.” The New York Times (Sat., DEC. 12, 2015): B3.
(Note: ellipses added.)
(Note: the online version of the story has the date DEC. 11, 2015, and has the title “In Greece, Brewer’s Woes Reflect Struggle of Business Owners.”)

The Filth, Slaughter and Disease, That Was Rome

McCloskey’s “Great Fact” says that life was very bad for tens of thousands of years until the capitalist industrial revolution started to make it better. The tens of thousands of years can be thought of as a horizontal hockey stick handle, with the capitalist industrial revolution represented by a sharply ascending blade. Rome was a bump on the hockey stick handle, but as the last paragraph quoted below suggests, not too much of a bump.

(p. C4) . . . Ms. Beard is competent and charming company. In “SPQR” she pulls off the difficult feat of deliberating at length on the largest intellectual and moral issues her subject presents (liberty, beauty, citizenship, power) while maintaining an intimate tone.

“In some ways, to explore ancient Rome from the 21st century is rather like walking on a tightrope, a very careful balancing act,” she writes. “If you look down on one side, everything seems reassuringly familiar: there are conversations going on that we almost join, about the nature of freedom or the problems of sex; there are buildings and monuments we recognize and family life lived out in ways we understand, with all their troublesome adolescents; and there are jokes that we ‘get.'”
“On the other side, it seems completely alien territory. That means not just the slavery, the filth (there was hardly any such thing as refuse collection in ancient Rome), the human slaughter in the arena and the death from illnesses whose cure we now take for granted; but also the newborn babies thrown away on rubbish heaps, the child brides and the flamboyant eunuch priests.”

For the full review, see:
DWIGHT GARNER. “Early Rome: Its Warts and Wonders.” The New York Times (Weds., Nov. 18, 2015): C1 & C4.
(Note: ellipsis added.)
(Note: the online version of the review has the date Nov. 17, 2015, and has the title “Review: In ‘SPQR: A History of Ancient Rome,’ Mary Beard Tackles Myths and More.”)

The book under review, is:
Beard, Mary. SPQR: A History of Ancient Rome. New York: Liveright Publishing Corp., 2015.

On the hockey stick, see:
Diamond, Arthur M., Jr. “McCloskey’s Great Fact; Review of: McCloskey, Deirdre N. Bourgeois Dignity: Why Economics Can’t Explain the Modern World.” Journal of Entrepreneurship and Public Policy 1, no. 2 (2012): 200-05.

Behavioral Economists Ignore Biases and Irrationalities of Governments

(p. A4) . . . it is quite a leap between acknowledging markets sometimes fail and arguing they are inherently flawed. Policy makers who work from the second assumption risk overreaching, by seeing market failure where there is none and ignoring their own behavioral biases, in either case leaving people worse off, not better. Public trust in free markets hasn’t wavered notably in the U.S. or Britain from precrisis levels and even in the pope’s native Argentina, attitudes aren’t much more negative than in 2009.
. . .
. . . , consumers don’t seem irrational when they evaluate fuel economy; one study found changes in gasoline prices are closely reflected in the relative prices of less fuel-efficient used cars.
Besides, as Mr. Viscusi and Mr. Gayer note, the government has behavioral biases of its own. Courts and regulators assign more value to the potential harm of a new drug than its potential benefits. Politicians take actions out of proportion to the risks, for example by closing schools during the Ebola scare or imposing onerous airline-security checks to prevent terrorist hijackings.

For the full commentary, see:
GREG IP. “Market Critics Shouldn’t Overreach.” The Wall Street Journal (Thurs., Sept. 24, 2015): A2.
(Note: ellipses added.)
(Note: the online version of the commentary has the date Sept. 23, 2015, and has the title “Critics of Free Market Shouldn’t Overreach.” Where there are minor differences between the print and online versions of the article, the sentences quoted above follow the online version.)

The Vicusi and Gayer paper mentioned above, is:
Viscusi, W. Kip, and Ted Gayer. “Behavioral Public Choice: The Behavioral Paradox of Government Policy.” Harvard Journal of Law & Public Policy 38, no. 3 (Summer 2015): 973-1007.

Brits Attack Freedom, the Poor and the Environment, by Taxing Plastic Bags

(p. A4) LONDON — Some warned of “bag rage” by irate shoppers. The Daily Mail predicted, “Plastic Bags Chaos Looms.” Chloe Metzger, a 21-year-old blogger and student, wrote on Twitter: “I understand the whole #plasticbags thing but it couldn’t be more annoying.”
Nerves were rattled, jokes were made and the annoyance of it all was duly noted in Britain this week. Nevertheless, shoppers pulled off something that has also occurred in other cities, states and countries: They began weaning themselves off plastic shopping bags.
Starting this week, the government introduced a 5 pence charge for plastic bags for most groceries, clothes and other purchased items. And while it did not lead to a nationwide mutiny, as some had warned, it did create some tension in cashier lines.
. . .
The TaxPayers’ Alliance, an anti-tax group, said the new measure would burden families struggling to get by.
A 2013 study by the National Center for Policy Analysis in Washington, which champions laissez-faire economics, argued that paper and reusable bags were worse for the environment than plastic bags when it came to energy and water use, and to greenhouse gas emissions. “Every type of grocery bag incurs environmental costs,” wrote H. Sterling Burnett, the author of the study.
Whatever the arguments, the charge has inspired a mix of applause, resentment, fear and humor.
It has also inspired ingenious new ways to try to get around paying the new fee. The Daily Express, a British tabloid, noted that there was “nothing to stop Brits buying loose vegetables, being rewarded with their free plastic bag and ramming it full of the rest of the shopping.”

For the full story, see:
DAN BILEFSKY. “British Begin Attack Aimed at a Scourge of the Realm.” The New York Times (Weds., OCT. 7, 2015): A4.
(Note: ellipsis added.)
(Note: the online version of the story has the date OCT. 6, 2015, and has the title “Charge for Plastic Bags in Britain Draws Applause, Anger and Humor.”)

The 2013 bag report, referred to above, is:
Burnett, H. Sterling. “Do Bans on Plastic Grocery Bags Save Cities Money?” National Center for Policy Analysis, Policy Report # 353, Dec. 2013.

Was “the Naturally Aloof” Washington, an Introvert?

(p. C6) In “The Washingtons,” an ambitious, well-researched and highly readable dual biography, Flora Fraser has worked hard, despite the limited documentation that is available, to portray George and Martha, and their extended family, as fully rounded, flesh-and-blood people, freeing them from the heavy brocade of hagiography.
. . .
Her social graces, . . . , served the naturally aloof George well during his eight increasingly trying years as president. Martha had a way of keeping conversation flowing around her, Ms. Fraser says, while George’s “silences could unnerve the most confident.” An official dinner with the Washingtons could be an ordeal, since George was a terrible conversationalist and was known to sit silently tapping his spoon against the table, obviously impatient for the evening to end.

For the full review, see:
FERGUS M. BORDEWICH. “Domestic Tranquility; Martha kept conversation flowing at dinner; George’s silences ‘could unnerve the most confident.'” The Wall Street Journal (Sat., Nov. 14, 2015): C6.
(Note: ellipses added.)
(Note: the online version of the review has the date Nov. 13, 2015.)

The book under review, is:
Fraser, Flora. The Washingtons: George and Martha, “Join’d by Friendship, Crown’d by Love”. New York: Alfred A. Knopf, 2015.

“We’re from the Streets and We Want Change”

(p. A9) CARACAS, Venezuela — On a sunny afternoon, Jorge Millán, an opposition candidate for congress, walked through the narrow streets of a lower-middle-class neighborhood, pressing the flesh in what was once a no man’s land for people like him.

. . .
With the economy sinking under the weight of triple-digit inflation, a deep recession, shortages of basic goods and long lines at stores despite the nation’s vast oil reserves, the opposition has its best chance in years to win a legislative majority.
. . .
“I was a Chavista, but Chávez isn’t here anymore,” said Mr. Omaña, referring to the followers of the former president.
“It’s this guy,” he said, referring to Mr. Maduro. “It’s not the same.”
Mr. Omaña complained about having to stand in long lines to buy food and about the fast-rising prices, saying that for the first time since Mr. Chávez was elected in 1998 he would vote for an opposition candidate.
“Enough is enough,” he said. “We need something good for Venezuela.”
Venezuelan politics was dominated after 1998 by Mr. Chávez and the movement he started, which he called the Bolivarian revolution, after the country’s independence hero, Simón Bolívar. Mr. Chávez died in 2013, and his disciple, Mr. Maduro, was elected to succeed him, vowing to continue Mr. Chávez’s socialist-inspired policies.
. . .
Opposition candidates said one of the biggest surprises of the campaign has been the warm reception they have received in what were once hostile pro-government strongholds.
Carlos Mendoza, 53, a motorcycle taxi driver and former convict who works in the district where Mr. Millán is running, said that he belongs to a group, known as a colectivo, that in the past was paid by the government to help out during campaigns, attend rallies and drive voters to the polls. Such groups were also often used to intimidate opposition supporters.
“They called us again this time,” Mr. Mendoza said. “I told them, ‘No way, you’re not using me again.’ ”
“We’re from the streets,” he said, “and we want change.”

For the full story, see:
WILLIAM NEUMAN. “Venezuela’s Economic Pain Gives Opposition Lift Before Vote.” The New York Times (Sat., DEC. 5, 2015): A9.
(Note: ellipses added.)
(Note: the online version of the story has the date DEC. 4, 2015, and has the title “Venezuela’s Economic Woes Buoy Opposition Before Election.”)