Scandal in LA: Poor Hospitals Deliver Poor Care

Yahoo! News - Report: L.A. Nurses Left Patients Alone

Nurses at a public hospital serving the poor in south Los Angeles left critically ill patients alone for hours and were ordered to lie about patients' conditions, according to a federal report.

The unreleased report obtained by the Los Angeles Times could lead to a criminal investigation and the loss of the hospital's federal funding, a county official said.

Federal inspectors had previously reported that nurses failed in providing basic patient care, doctors allowed problems to fester and Los Angeles County was guilty of poor oversight at Martin Luther King Jr.-Drew Medical Center...

...The hospital, established as a response to the 1965 Watts riots, is the only public hospital in the south Los Angeles area and serves a largely poor population...

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We could repeat this study across the nation and find a hundred such facilities. Few would be as bad, but many would come close.

I'd assumed people knew that poor underfunded institutions delivered very poor care to poor people. Heck, relatively well funded teaching hospitals used to deliver poor care to "charity" cases (they're somewhat better now).

Alas, there will be no outrage and no call for a national examination of care for the poor. We've succumbed to so some vile meme that the poor deserve only to be ignored.

We need a modern Dickens to stir our outrage.

TIME.com: So Much For the WMD: Greed, Corruption and power

TIME.com: So Much For the WMD -- Feb. 09, 2004

What CIA analysts imagined to be dispositive evidence of Saddam's nuclear ambitions turned out, in Kay's judgment, to be proof of plain, old-fashioned greed. For months the Administration claimed that finely machined aluminum tubes, imported with ever higher tolerances—that is, precision in their specifications—were part of a campaign to produce gas centrifuges for the production of weapons-grade nuclear fuel. But after examining the tubes and talking to the scientists who procured and used them, Kay became convinced that the increasing tolerances were to meet not technical requirements but financial ones. The ever changing tolerances meant new purchases, which in turn meant that the engineers who were working on Saddam's missile programs, for which the tubes were in fact destined, had continuing contracts from which to skim money. Kay concluded, 'An analyst looks for rational explanations and usually finds them in the technical realm they're used to, but Iraq was almost like a parallel universe. The explanations were driven not by technical reasons but by the moral and personal depravity engendered by the regime. A rational person would look at it one way, and it would be completely wrong, because in this parallel universe there was a different set of rules.

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Greed, corruption, telling the powerful what they want to hear, a ruthless ruler who expunges the disloyal, a mystique of faith, power and confidence rather than reason and rationality, yes, it's easy to see how Americ... err, I mean, Iraq could have deceived itself.

Remember when the CIA claimed that the Soviet Union was close to acheiving missile superiority? That was in the Reagan administration, just prior to the collapse of the Soviet Union. Later we found that their military was in an advanced state of collapse.

I wonder when someone will make the connection between the mistakes made in Iraq and those made 20 years ago. Maybe after the investigations are complete, and we read internal CIA documents making exactly this comparison. I'm willing to bet that there were intelligent and honest analysts who suspected what was happening, and that their careers have not gone well.

WaPo: Chemical and bioweapon attacks on planes

Flights Cut on Fear Of Al Qaeda Attacks (washingtonpost.com)

Intelligence indicating that al Qaeda terrorists are seeking to release a chemical or biological agent aboard an airliner, or transport a radiological device in cargo, was one of the factors that prompted the cancellation of six international flights scheduled for today and tomorrow...

Small amounts of chemical, biological or radiological material would be difficult to detect...

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Difficult being an understatement. I've long wondered why al Qaeda hadn't yet released a bioweapon or chemical agent on an airplane. It doesn't require any imagination, just a passing familiarity with movies. I've supposed that al Qaeda has indeed been very distrupted.

In 2001 there was talk of an accelerated program to develop chemical and bioweapon detectors that could be placed in public places and on airplanes. It's obvious one cannot prevent such an attack -- I don't think even Israel's El Al could do it. The goal needs to be early detection. I wonder what happened to those detectors? If there was a "Manhattan Project" to develop such detectors it was kept very secret -- so secret that they're not now available.

Maybe Rove felt such programs would generate negative vibes, and thereby impair someone's reelection.

Fighting AIDS: Bush is more hat, less cattle

Bush Scaling Back Dollars for Third World

President Bush plans to scale back requests for money to fight AIDS and poverty in the third world, putting off for several years the fulfillment of his pledges to eventually spend more than $20 billion on these programs.

Hardest hit would be the United Nations-supported Global Fund to Fight AIDS, Tuberculosis and Malaria, whose contribution from the United States would drop to $200 million in fiscal year 2005 from $550 million, according to Congressional officials who have been briefed on the president's budget proposal.

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I'm shocked, shocked, to hear that a grand promise will be broken. Were I less naive, I might suspect that the residual funds are earmarked for Bush campaign donors.

GWB's lack of integrity is not noteworthy. This is significant because GWB's actions constitute a major threat to our national security. If we don't control HIV in Africa our children will pay the price.

Georgia Takes on ’Evolution’ - The Decline and Fall of American Education

NYT: Georgia Takes on ’Evolution’

A proposed set of guidelines for middle and high school science classes in Georgia has caused a furor after state education officials removed the word 'evolution' and scaled back ideas about the age of Earth and the natural selection of species.

Educators across the state said that the document, which was released on the Internet this month, was a veiled effort to bolster creationism and that it would leave the state's public school graduates at a disadvantage.

'They've taken away a major component of biology and acted as if it doesn't exist,' said David Bechler, who heads the biology department at Valdosta State University. 'By doing this, we're leaving the public shortchanged of the knowledge they should have.'

Although education officials said the final version would not be binding on teachers, its contents will ultimately help shape achievement exams. And in a state where religion-based concepts of creation are widely held, many teachers said a curriculum without mentioning 'evolution' would make it harder to broach the subject in the classroom.

Georgia's schools superintendent, Kathy Cox, held a news conference near the Capitol on Thursday, a day after The Atlanta Journal-Constitution published an article about the proposed changes.

A handful of states already omit the word 'evolution' from their teaching guidelines, and Ms. Cox called it [evolution] 'a buzz word that causes a lot of negative reaction.' She added that people often associate it with 'that monkeys-to-man sort of thing'.

Still, Ms. Cox, who was elected to the post in 2002, said the concept would be taught, as well as 'emerging models of change' that challenge Darwin's theories. 'Galileo was not considered reputable when he came out with his theory,' she said.

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Fortunately they still teach science in China and India. Minnesota is no different from Georgia, our new Republican administration is writing a biology free set of science standards. (You can't teach biology without natural selection; heck, you can't even teach cosmology without natural selection.)

The degradation of public education may have some unanticipated consequences. Private schools, where the elite are educated, will continue to teach science. I'll wager even catholic (private) schools in Georgia and Minnesota will teach modern biology. The transformation of schools into agents of evangelical christianity may make vouchers acceptable to a wider group, and accelerate a movement away from public education.

If the evangelicals continued their steady victories, there will eventually be a public evangelical educational system and a private secular/other system. The private secular system would attract the educated elite, and they in turn would attract parents seeking social networks. The evangelical school system of 2010 could become a stigmatized backwater of ever growing ignorance (ok, so it might produce an incompetent President or two ...).

The evangelical right can indeed win this war, but they may not like what they get. Perhaps they should reconsider ...

Understanding Bush: It's all about faith

NYT, Friedman: Budgets of Mass Destruction

It should be clear to all by now that what we have in the Bush team is a faith-based administration. It launched a faith-based war in Iraq, on the basis of faith-based intelligence, with a faith-based plan for Iraqi reconstruction, supported by faith-based tax cuts to generate faith-based revenues. This group believes that what matters in politics and economics are conviction and will — not facts, social science or history.

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Yep. Among this group conviction is a virtue. Machiavelli covered this in 'The Prince'. Sometimes this strategy works, sometimes it doesn't. If you defy gravity long enough you discover abrupt deceleration.

Africa: Outsourcing 2008?

BW Online | February 2, 2004 | Africa: The Next Wide-Open Wireless Frontier

For a telecommunications industry hungrily seeking new avenues of growth, a surprising opportunity is emerging. Sub-Saharan Africa -- home to more than 650 million people, three-quarters of whom live on less than $2 per day -- has become the world's fastest-growing market for mobile-phone service. Last year alone, the number of mobile subscribers in the whole region shot up 37%, to 34.4 million, compared with a 32% rise in Eastern Europe, the No. 2 growth region, according to researcher Gartner Dataquest. 'It's just a huge opportunity,' says Ali B.M. Conteh, chairman of Vodacom Congo (DRC), the No. 1 mobile provider in the continent's third-largest country.

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Do the math. 650 million people. Say, because of disease and famine only 1 in 10,000 live to be an adult genius. That's 65,000 adults smarter than almost anyone you or I know. Smart enough to learn english, then take thin scraps of material from the web and learn most anything. Back in the good old days, say @ 1995, I used to say Africa would one day be considered a prosperous rising nation.

Hey, I remember when Bangladesh was "the basket case of the world".

Remember when, in the boom years, we wanted to gird the world with high speed wireless via low earth orbit satellite? Gates liked the network that, by an accident of design, would have brought cheap net access to all of Africa. He's not all bad.

We never built those satellites (though Iridium is still hiring, but Africa won't build analog phone networks. By the time they build, 3G will be the only option.

Maybe Africa won't be the next India by 2008. But, by 2018? Bangaloreans will be furious about jobs lost to Lahore.

Or not. If we don't put furious effort into mitigating the ravages of HIV, Africa may truly fail, and in dying spawn a thousand al Qaedas -- with better weapons and smarter operatives.

Maybe we shouldn't let that happen?

Clear Channel (Republican Radio): Kill all the Bicylists

Business 2.0 - 101 Dumbest Moments in Business

We deeply regret that comments made by on-air personalities were misinterpreted. Clear Channel does not condone advocating violence in any form.'—Clear Channel Radio CEO John Hogan, after disc jockeys at three of the company's stations urge listeners to attack bicyclists with tactics that include slamming on car brakes, throwing open car doors suddenly, and beaning riders with soda bottles.

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(Clear Channel is the American Republican version of Pravda -- an organ, along with Fox, for a focal political agenda.)

There's something about adults on bicycles that enrages a certain kind of person. That person almost always votes Republican, often lives in the south, and may be female or male. It's enough of a personality marker that it ought to be a part of online dating personality profiles.

Someone should do a sociology thesis on this.

PS. Ever notice that no President, no matter how active, would ever confess to riding a bicycle?

Brad DeLong: why the rational middle despises Bush

Brad DeLong's Brad DeLong's Semi-Daily Journal (2004): a Weblog

Jeffrey Frankel is not, by nature, a bitter or a partisan person. Yet today a huge number of people who--like me--do not think of themselves as by nature bitter or partisan neverthless find that we are bitter, very bitter, and have become partisan, very partisan. Consider that back before the George W. Bush administration even a figure like Paul Krugman was careful to stay even-handed: to balance a criticism of the supply-siders in the Republican Party with one of the strategic traders in the Democratic Party, to balance a condemnation of the Republican establishment for thinking that boosting corporate profits solves all ills with a condemnation of the Democratic establishment for thinking that neoliberal reforms in developing countries solve all their ills.

Why do so many of us who worked so hard on economic policy for the Clinton administration, and who think of ourselves as mostly part of a sane and bipartisan center, find the Bush administration and its Republican congressional lapdogs so... disgusting, loathsome, contemptible? Why are we so bitter?

After introspection, the answer for me at least as clear. We worked very hard for years to repair the damage that Ronald Reagan and company had done to America's fisc. We strained every nerve and muscle to find politically-possible and popularly-palatable ways to close the deficit, and put us in a position in which we can at least begin to think about the generational long-run problems of financing the retirement of the baby-boom generation and dealing with the rapidly-rising capabilities and costs of medicine. We saw a potential fiscal train wreck far off in the future, and didn't ignore it, didn't shrug our shoulders, didn't assume that it would be someone else's problem, but rolled up our sleeves and set to work.

Then the Bush people come in. And in two and a half years they trash the place. They trash the place deliberately. They trash the place casually. They trash the place gleefully. They undo our work for no reason at all--just for the hell of it. Reading Suskind's The Price of Loyalty shows just how casual and unthinking it was. As the Economist writes:

Economist: On the other side of the Atlantic, the budget is even less balanced--thanks in part to three rounds of tax cuts enacted since President George Bush took office--and the controversy just as bitter.... Paul O'Neill, Mr Bush's former treasury secretary... laments Mr Bush's style of leadership (disengaged), his case for invading Iraq (disingenuous) and his fiscal record (dismal). The last of those flaws has excited the attention of the International Monetary Fund, which gave a warning in a report last week that America's deficits, if left unchecked, posed a gathering threat to America and the world. Mr O'Neill says that when he raised his concerns about fiscal profligacy with Dick Cheney, the vice-president, he was told "deficits don't matter." The IMF insists they do. The decade of deficits that lies ahead for America will put upward pressure on interest rates, crowd out private investment and erode longer-term productivity growth...

And every single senior Republican economic policy appointee comes out of a look back at the past three years looking very badly. X fails to organize meetings so that the long-run budgetary consequences of short-run policy moves are properly considered. Y pirouettes in midair and transforms from a deficit hawk into a deficit dove so as not to offend White House Media Affairs. Z lowballs the interest rate effects of higher deficits--and manages not to talk about the savings and investment effects at all. W mutters in the privacy of his own office about the importance of maintaining a surplus--but doesn't have the nerve to say "Boo!" to a goose (let alone to George W. Bush) once he steps outside his office door. V remains silent while the clown show that is the Bush economic policy process--a process he cannot view with equanimity--rolls forward. U cuts his own agency staff off at the knees and shows no interest in the very important and interesting work on the long-run fiscal options that they have done. Outsiders like R who assured me back in the fall of 2000 that Bush understood and would tackle the long-run problems of funding entitlements and the social-insurance state manage not to emit a public peep of complaint. Q talks about how much the president wants to reduce the deficit without daring to put his own position on the line within the administration by demanding that words like "deficits are bad" be accompanied by an actual plan to reduce the deficit. Every one. Every single last one.

And it is worth pointing out that it's not just the economic policymakers. The same holds true of all the other executive-branch Republican political appointees: defense, international affairs, science policy, social policy. Is there anybody (with the exceptions of John Donaldson and Mark McClellan) who has emerged or well emerge from this administration like a reputation? And it's all the Republican senators and members of congress as well. People who used to have some claim to respect--paging Pete Domenici, anyone?--have simply rolled over and played dead.

"Is George W. Bush the worst president ever?" is the question that George Akerlof asks. A fish rots from the head, yes. But this fish is rotted all the way down to the tail.

So we sit here out in the Alpha Quadrant, bitter.

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Perfectly said. GWB has managed to transform rationalists into rabid partisans. Quite a trick.

Krugman: What's Happening to America?

Op-Ed Columnist: Where’s the Apology?

...Still, the big story isn't about Mr. Bush; it's about what's happening to America. Other presidents would have liked to bully the C.I.A., stonewall investigations and give huge contracts to their friends without oversight. They knew, however, that they couldn't. What has gone wrong with our country that allows this president to get away with such things?

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The brilliant Mr Delong has raised a similar question lately, with an additional focus on what's happened to our press.

This is the fundamental question a lot of people are starting to ask themselves. Maybe the issue is not Bush, or the Republican Party, or media consolidation. Maybe, as Pogo once said, "We've met the enemy and he is us".

Saddam and GWB: a consensual hallucination (NYT, Dowd)

Maureen Dowd: Dump Cheney Now!

The awful part is that George W. Bush and Saddam Hussein were both staring into the same cracked spook- house mirror.

Thanks to David Kay, we now have an amazing image of the president and the dictator, both divorced from reality over weapons, glaring at each other from opposite sides of bizarro, paranoid universes where fiction trumped fact.

It would be like a wacky Peter Sellers satire if so many Iraqis and Americans hadn't died in Iraq.

These two would-be world-class tough guys were willing to go to extraordinary lengths to show that they couldn't be pushed around. Their trusted underlings misled them with fanciful information on advanced Iraqi weapons programs that they credulously believed because it fit what they wanted to hear.

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It's rare that Dowd says something interesting -- she's a once solid journalist that got hooked on the "insider bitch" schtick. This is an exception; she's right to point out that GWB shared a set of delusions with Saddam. (I, like most of the people I know and read, also thought Saddam had weapons and malicious intent -- but GWB should have had better intelligence than I have.)

USATODAY.com - Declining testosterone might put men at risk for Alzheimer's - or NOT

USATODAY.com - Declining testosterone might put men at risk for Alzheimer's

The researchers found that higher levels of free testosterone seemed to protect men from Alzheimer's. The team reports that for every 50% increase in free testosterone in the blood, there was a 26% reduction in the risk of developing the disease.

Testosterone usually declines with age, but the team found that men who later developed Alzheimer's had testosterone levels that fell dramatically, in most cases below what is considered normal. By the end of the study, men with Alzheimer's had blood levels of testosterone that were half the levels of the men who remained healthy.

In some cases, the drop in testosterone was detected up to a decade before the men were diagnosed with Alzheimer's.

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The researchers found a possible correlation between testosterone drops and the diagnosis of Alzheimer's type dementia. The journalist found that higher testosterone is "protective" (though I bet the researchers hinted strongly that this was so).

It's tiresome and annoying. I put the blame on editors and reviewers of academic journals. They should insist that authors expunge leaps to causation and insert text making it harder for journalists to "sex up" the results.

Alzheimer's appears to be a longterm, maybe lifelong, degenerative process. If there really is an association with a decline in free testosterone I suspect the decline is a manifestation of the same disease process. If high testsosterone reduces the risk of Alzheimer's, I suspect it would be related to some increase in mortality among people with early Alzheimer's -- such as risk taking behavior coupled with declining judgement.

Alzheimer's excitement: apoE clears key proteins

BBC NEWS | Health | Proteins 'hold Alzheimer's key'

Scientists have identified two proteins that may help prevent the brain plaques that are linked to Alzheimer's disease.

The proteins appear to work in tandem to orchestrate removal of potentially hazardous molecules from the brain.

However, unless the two are in the correct balance they actually seem to promote deposition of the amyloid protein which forms the plaques.

The research, by Washington University of Medicine, St Louis, is published in the journal Neuron.

The key proteins are called apoliprotein E (apoE) and clusterin.

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We've known for a few years that mutations in the apoE gene increase the risk of Alzheimer's. So this is an amazing extension of those results. Very exciting.

It will not be the whole story. We've seen in Parkinson's Disease that a single "disease" is really the endpoint of a number of different genetic and environmental combinations. Alzheimer's Disease (really Alzheimer's Syndrome) is likely similar; when we're done we'll have redefined the syndrome and named the pathways.

Since Alzheimer's appears to be an acceleration of the "normal" aging of the human brain, it's possible that any treatments for Alzheimer's will extend the elasticity and capability of most adult brains. Were that to happen, our social security crisis may evaporate.

On the other hand, there's evidence that prions are critical to memory formation. Some Alzheimer's treatments may erase existing memories, or interfere with memory formation.

What would you do with Microsoft's 10 billion? (a quarter)

MacInTouch Home Page

Microsoft yesterday reported record revenue of more than $10 billion for its latest fiscal quarter.

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Once upon a time JP Morgan bailed out a bankrupt federal government. At this rate, given our leadership, Microsoft will acquire the US government after Washington enters Chapter 13.

Even this staggering number is an understatement. Microsoft makes most of its money from monopoly rent on a product which costs them pennies to produce. Most of this revenue is profit. I suspect they don't pay much tax on it though.

If the average cost of a senator's vote is $250,000, Microsoft can buy the senate many times over -- every fiscal quarter. People like John McCain and a few others can take the role of Apple -- an independent with some entertainment value.

NYT, Tom Friedman: War of Ideas -- Why we must sacrifice American jobs to avert more 911s

Op-Ed Columnist: War of Ideas, Part 6

...Just read the numbers and weep: of the 90 million Arab youth today (between the ages of 15 and 24), 14 million are unemployed, many of them among the 15 to 20 million Muslims now living in Europe. "There's not enough jobs and not enough hope," Jordan's King Abdullah told the Davos economic forum. According to the 2003 Arab Human Development Report, between 1980 and 1999 the nine leading Arab economies registered 370 patents (in the U.S.) for new inventions. Patents are a good measure of a society's education quality, entrepreneurship, rule of law and innovation. During that same 20-year period, South Korea alone registered 16,328 patents for inventions. You don't run into a lot of South Koreans who want to be martyrs.

I was at Google's headquarters in Silicon Valley a few days ago, and they have this really amazing electronic global map that shows, with lights, how many people are using Google to search for knowledge. The region stretching from Morocco to the border of India had almost no lights. I attended a breakfast at Davos on the outsourcing of high-tech jobs from the U.S. and Europe to the developing world. There were Indian and Mexican businessmen there, and much talk about China. But not a word was spoken about outsourcing jobs to the Arab world. The context — infrastructure, productivity, education — just isn't there yet.

So what to do? A lot of help can and should come from Europe. Although America is often the target, Europe has been the real factory of Arab-Muslim rage. Europe has done an extremely poor job of integrating and employing its growing Muslim minorities, many of which have a deep feeling of alienation. And Europe has done a very poor job of investing in North Africa and the Middle East — its natural backyard.

America is far from perfect in this regard, but by forging the Nafta free trade agreement with Mexico, the U.S. helped create a political and economic context there that not only spurred jobs and the modernization of Mexico, but created the environment for its democratization. Former Mexican President Ernesto Zedillo remarked to me: "I don't think I would have been successful in political reform without the decent economic growth we had [spurred by Nafta] from 1996 to 2000. Those five years, we had average growth of 5 percent." It was in that optimistic environment that Mexico had its first democratic transition from the ruling party to the opposition.

So if you take anything away from this series, I hope it's this: The war of ideas among Arabs and Muslims can only be fought and won by their own forces of moderation, and those forces can only emerge from a growing middle class with a sense of dignity and hope for the future. Young people who grow up in a context of real economic opportunity, basic rule of law and the right to speak and write what they please don't usually want to blow up the world. They want to be part of it.  

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Friedman is simplifying, and he knows it. Looking at the whole picture modernization is very disturbing and disruptive; it will promote serious short term violent response. It's also irrelevant that Europe is not helping matters; the US will still be the lightning rod.

In general though, I agree with him. To avoid 9/11 reenacted many times by many parties, with far better weapons and technologies, we need the developed world to have hope. The only way we've found to do that is globalization and trade. That means we create great pain in this country; pain in blue collar workers, knowledge workers, an front line managers (Directors and below.)

There are things to do to alleviate that pain; so that reducing poverty abroad can also improve the lives of everyone in America. I've outlined them in earlier posts. Not all that hard, easier than travel to Mars. All it takes is some smart political leadersh .... Ok, easier than traveling to Alpha Centauri.