Thursday, January 19, 2006

The Gore speech

[Update 1/20: BlogThis! did something quite nasty to the encoded search string. Could be yet another bug. I hope I've fixed it.

As of 1/19/2006 there are over 400,000 Google hits on Al Gore We the People Must Save Our Constitution.

Not bad for a speech that the mainstream media has utterly ignored.

There's something about Gore journalists dislike. We suffer for their folly. Whenever I feel some regret about the collapse of the print newspapers, I remember how journalists covered the Gore campaign. Their current peril is not desirable, but it does have a silver lining.

... The President and I agree on one thing. The threat from terrorism is all too real. There is simply no question that we continue to face new challenges in the wake of the attack on September 11th and that we must be ever-vigilant in protecting our citizens from harm.

Where we disagree is on the proposition that we have to break the law or sacrifice our system of government in order to protect Americans from terrorism. When in fact, doing so would make us weaker and more vulnerable.

And remember that once violated, the rule of law is itself in danger. Unless stopped, lawlessness grows. The greater the power of the executive grows, the more difficult it becomes for the other branches to perform their constitutional roles. As the executive acts outside its constitutionally prescribed role and is able to control access to information that would expose its mistakes and reveal errors, it becomes increasingly difficult for the other branches to police its activities. Once that ability is lost, democracy itself is threatened and we become a government of men and not laws...

Rumor has it that the first murder is the hard one. After that, they get easier. The Bush administraiton is a serial constitutional murderer.

PS. David Brin described an alterantive universe in which Gore became President. It was a far better place, except the media hated him and the right wing was launching an indigenous American terrorist movement.

The new doctor shortage - Michigan

The pipeline to produce physicians is so long, and the costs to students so great, that it is not at all surprising that we go through boom and bust cycles. In my career I've seen family practice cycle from startup to boom to bust. Unsurprisingly the cycle may be shifting again, though I wonder what role Michigan's economic and liability issues play in their pending shortage:
Crain's Detroit Business

... The Michigan Department of Community Health on Wednesday said it will create a data clearinghouse of medical professionals to help the state’s health care providers deal with a looming physician shortage.

According to a recent state survey, about 37 percent of Michigan’s physicians are 55 or older, and more than 38 percent of physicians say they plan to practice medicine for only one to 10 more years. A separate state study indicated that Michigan will need to fill more than 100,000 professional and health care jobs in the next decade.
Normal boom/bust cycles, atypical demographic cycles, and the possibly permanent decline in the appeal of primary care practice may conspire to make this coming shortage more severe than most.

The obvious approaches are to train more paramedical staff (NP and PAs), to encourage immigration of more physicians, to do more outsourcing of services overseas (radiology, dermatology, etc), and to move more care to 'disease management' programs. I am confident all these approaches will be tried and all will have a role. I also suspect that, within 10 years, we will reinvent the GP/FP/General Internist/Pediatrician once again -- though possibly under a different "brand".

Wednesday, January 18, 2006

The publicly traded politician - and other reform proposals

Wow, political reform is back again. For a week. I read one semi-serious proposal that I quite liked. It reminded me of something. Took me a few minutes to remember what.

It turns out that in 1996 I wrote a web page with two radical and semi-serious approaches to reforming politics. The old pages are topical again ...
Campaign Finance Reform: Voluntary Mandated Sharing:

... Campaigns need money. Powerful people need good things. Both needs can be satisfied by transforming politicians into publicly owned corporations. After meeting standard accounting requirements, a politician would be sold through an IPO. The usual futures and options markets would develop. Standard reporting and accounting regulations and SEC enforcement would apply. Cheaters would be delisted, and thus be effectively removed from future campaigns.
Read the page for the other proposal.

A critical military analysis of the war on terrorism

Crooked Timber does a nice job of excerpting a longer post by a military historian
Crooked Timber: � Shadows and Fog

.... To summarize, then—sorry about that—a too-hierarchical, too-orthodox U.S. Army, and U.S. military in general, leans heavily on lumbering equipment, high technology, and major ground offensives against an enemy that relies on tactics that are often not even conventionally military in nature; we mass artillery against threatening letters and infrastructure sabotage. In equipment, doctrine, tactics, and leadership structure, we’re organized for the wrong enemy, in ways that can’t be easily or quickly changed.
The entire excerpt is quite interesting -- well worth reading. The original is a bit long.

BTW, the latest rumor is that Cheney is trying to get Saudi Arabia to fund a UN authorized Egyptian force to save the Iraqi Sunnis after the US pulls out. Blocking Iran is a not small fringe benefit.

The drug discount debacle -- one illustrative story

Just one tiny story in the midst of the immense drug discount card debacle.

The U Share - Medicare-Approved Prescription Drug Discount Card site is one of many associated with the "benefit". It lists, for example, commonly prescribed medications. Alas, any elder (or family member) navigating the list of covered drugs would be perplexed when they clicked on the 'next' button and got a page error. The site builder forgot that UNIX is case specific, and the URL uses an upper case letter when it needed a lower case letter. Of course there's no link to a webmaster to tell them what the bug is.

No feedback loop. Runaway complexity. Debacle squared.

Getting an ovation for your speech

I've never gotten a standing ovation for a speech or lecture, but I'm no Guy Kawaki. When I do some of what he says here, however, I do get applause. I can live with that.

A terrific list of tips. Use them for your next lecture, presentation, or even speech.

Kawasaki's blog, by the way, is terrific. I recommend starting from the very beginning.


Exercise and Alzheimer's: How to fix the demented media

I read yet another bulletin declaring that "exercise can prevent alzheimer's". Sigh. The elderly who exercise 3 times a week are 50% less likely to be diagnosed with dementia. All that means is that it's worth funding more research. My bet is that a loss of commitment to exercise is an early indicator of a dementing process.

Some of the stupidest coverage came from the Wall Street Journal. I was feeling annoyable today, so I did a quick study. Someone who needs a pub should write this up as a letter to Lancet. I bet they'd get a nice cite.

I googled on the news: exercise alzheimer's - Google News:
Exercise Research
WOWT, NE - 18 hours ago
... More research is needed to better understand how exercise may help protect against diseases like Alzheimer's, but for now researchers say one thing is clear ...
Research Notebook
OregonLive.com, OR - 6 hours ago
... years, 158 had developed dementia, including 107 diagnosed with Alzheimer's disease ... older adults who exercise Another study that looked at physical activity in ...
Study: Exercise May Reduce Risk of Alzheimer's Disease
ABC News - Jan 16, 2006
... Researchers emphasize that this study is not proof that exercise reduces the risk of Alzheimer's disease, but they say the results are consistent with several ...
Alzheimer's Disease May Be Prevented With Exercise
Fashion Monitor Toronto, Canada - 23 hours ago
... The six core strategies to prevent Alzheimer's disease include exercise, diet, a program of vitamin and herbal supplementation, regular brain stimulation, a ...
Exercise Not Enough to Prevent Alzheimer's Disease PR Web (press release)
all 3 related »
Exercise Significantly Reduces Risk of Dementia in Senior Citizens
SeniorJournal.com, TX - Jan 16, 2006
... growing evidence that exercise – particularly if it starts early and is maintained over time - is beneficial in preventing dementia and Alzheimer’s disease ...
Health Roundup: Alzheimer’s And Exercise, Sibling Drinking ...
NBC 10.com, PA - Jan 16, 2006
... The things that reduce our risk for Alzheimer's are: exercise, reducing our cholesterol with statins, eating a lower fat diet and lowering our blood pressure ...
Exercise associated with reduced risk of dementia in older people
EurekAlert (press release), DC - Jan 16, 2006
... Additional study also may provide information on the possible merits of varying types of exercise. For information about Alzheimer's disease, visit the ...
It turns out that about half of the top-ranking Google results used "may" and a few even used "associated with" (they get five stars). The rest, alas, were as dismal as the Wall Street Journal.

So here's how to shame the media into doing better. JAMA should run a report after each report of a finding associated with reduced cancer, dementia, etc. The journalist can simply execute a Google News search and extract the titles. Titles are then ranked for words like "may" and (best) "associated with". Report the results by dividing press into "Good", "Bad" and "Ugly" categories.

After six months on the "Ugly" list, the Wall Street Journal gets a special prize.

Eventually, they improve.

Good-bye cross country skiing

The first time I tried cross-country skiing, I wasn't done healing from chest surgery. It made my tentative pole plans particularly poignant -- I paid for each slip. Maybe that's why I remember that 1970s day particularly well. It was the start of a great relationship. I was never a competitive skier, but I loved skiing the skinny skis on skinny woods trails (classic only please -- no highways for me). It was a great sport for an outing in Montreal's big city parks, and a spectacular sport in the stubby Laurentians.

In those days we had months of decent snow cover in Quebec. In the early 1980s, I even had one very memorable ski outing in the San Gabriel mountains overlooking Los Angeles. Things were turning though. In central Pennsylvania, where I did my residency training, the nordic ski resorts were closing by the late 1980s. Since then it's been mostly downhill.

This winter looked like it might be an exception; we some great snow cover in the twin cities before Christmas. I saw a park packed with skiers. Alas, the weather has returned to form -- gray and mild. The Twin Cities now has the climate of central Indiana or Iowa.

There will still be snowy days in Saint Paul, and even some days below zero, but the world is moving on. Global Climate Change may mean Europe gets much colder, but for the northern US it mostly means milder weather.

I don't think our kids will ever cross country ski -- unless we move to altitude or to Houghton Michigan. I do miss it though.


Tuesday, January 17, 2006

iPod and iTunes: an unexpected effect

Results 1 - 30 of about 524,000,000 for ipod [2]

I have a love/hate relationship with Apple, as compared to a hate/hate relationship with Microsoft. I cannot deny, though, that Apple has brought one good new thing to an old dog -- music.

The iPod/iTunes combination has transformed an all-but-forgotten CD collection (bought, inherited [1], married) into something I'm getting to know. This is novel for me -- I was never a knowledgeable listener. It's the iTunes playlist, rating, listening, refining interaction that's helped me learn the collection, and the iPod technology has let me integrate it into a compressed modern existence.

Years ago I liked Joni Mitchell -- but I confess I'd never really paid much attention to her music. She's fallen a long way since I started hearing the lyrics. Joan Baez, on the other hand, has returned from the depths. The more I hear him, the more I like Springsteen - including his unfashionable mature work. Stan Rogers wears well. Rock, country, folk, jazz, classical, eventually opera. Names that are familiar, and those that almost no-one listens to. New and old. There's a lot to explore in 500 years of music.

The difference, which radio of any form cannot bring, is learning the music.

[1] The inheritance of digital music libraries will be an interesting story to track. There's a lot of music out there on CD, and it's not clear that new technologies will greatly change our listening experience. Unlike video, audio recording started to converge on human perceptual limits over 15 years ago. The staggering volume of what's already been purchased by families, and rarely discarded, may be as big an issue for the industry as digital file sharing. The fact that iPod/iTunes greatly enhances the value of existing music collections is very ominous for the music industry. Short of preventing encoding of extant CDs, is there anything the industry can do to escape this trap? I suspect recent falling digital music sales may be in good part due to users rediscovering old collections.

[2] A half-billion hits on Google? That's a lot of splogs!

Monday, January 16, 2006

Iran's program: what's so complicated?

The WSJ has another somewhat dull article on Iran's nuclear weapons program. There's been remarkably little informative discussion.

Iran wants a nuclear weapon and they'll likely get one sooner or later. Many nations would like Iran to get its nuke as far in the future as possible, ideally after a regime change. All the efforts being expended are to delay the acquisition date. The only real question is whether China and Russia will cooperate. That cooperation will depend on a lot of trading and swapping with the US and Europe.

One can argue that Bush's cavalier attitude towards treaties of all types, and the NPT in particular, hasn't helped. I don't have much of an opinion either way. Once Pakistan had its bomb (mostly built pre-Bush), and once the US invaded Iraq, the die was pretty much cast.

All this chatter about treaty obligations etc etc is mostly irrelevant. I can imagine that if China and Russia fully cooperated that Iran's nuclear program could be delayed for a few years, which might just allow for a less whacky Iranian President. (Maybe we'd get a less whacky US president too.)

Update 11/18/06: It looks like Russia is going to block sanctions, so it's pretty much game over now. There's nothing quite like fundamentalist zealots with nuclear weapons. At least Iranian fundamentalists don't seem to have the end-time enthusiasms of our religious extremists.

If Al Gore had been our president, would engagement with Iran have prevented the "election" of their current nut-case president? We'll never know.

Sunday, January 15, 2006

Why the democrats should filibuster Alito

Not because of Roe v Wade. Because Alito supports Bush signing a bill banning torture while issuing a 'signing statement' that he is not obliged to abide by it:
The Imperial Presidency at Work - New York Times

...Both of the offensive theories at work here - that a president's intent in signing a bill trumps the intent of Congress in writing it, and that a president can claim power without restriction or supervision by the courts or Congress - are pet theories of Judge Samuel Alito, the man Mr. Bush chose to tilt the Supreme Court to the right.The administration's behavior shows how high and immediate the stakes are in the Alito nomination, and how urgent it is for Congress to curtail Mr. Bush's expansion of power. Nothing in the national consensus to combat terrorism after 9/11 envisioned the unilateral rewriting of more than 200 years of tradition and law by one president embarked on an ideological crusade.
A filibuster would likely fail, but it is a noble cause and, given where Bush is going, history may judge it well.

Hard core libertarian praising Ted Kennedy?

Wow. The end times must be near. A friend with libertarian sympathies sends me a link to a libertarian pundit -- praising (albeit through clenched teeth) Ted Kennedy's criticisms of Alito:
Agreeing With Ted Kennedy by Anthony Gregory:

... How sad it is that we have come to the point that we have to rely on Ted Kennedy to be the voice of reason on some of the most fundamental issues of the day. How frightening it is to be agreeing with Ted Kennedy and disagreeing with nearly the entire rightwing on these issues, all while most of the talking heads ignore them nearly completely...
Rockwell's Kennedy quotes are great, and, yes, I agree the media ignored them. The mainstream media is plumbing new depths of inadequacy every day; blogs are helping but they're no replacement. We are hurting because the Fifth estate is in the toilet.

As to Alito, forget Roe vs. Wade. Alito is bad because he believes the American President can have the powers of a tyrant -- at least when the president is Republican. I rather doubt his sentiments would extend to a Democrat.

Douglass' judgment upon Lincoln

[correction: I was guilty of the great faux pas of spelling Douglass with one s.]

DeLong has put together an excellent post, combining Lincoln's words from his debates with Frederick Douglass 1876 judgment of Lincoln:
Brad DeLong's Semi-Daily Journal

...Viewed from the genuine abolition ground, Mr. Lincoln seemed tardy, cold, dull, and indifferent; but measuring him by the sentiment of his country, a sentiment he was bound as a statesman to consult, he was swift, zealous, radical, and determined...
Douglas was a terribly eloquent writer. I do recommend reading the entire post.

Listen to Stanford lectures on iTunes

Jon Udell pointed me here. You can listen to Stanford lectures -- but only on iTunes. I gather Apple is cosponsoring the project. Jon is rightly concerned about the iTunes lockin; he connects it to the DRM plague. I'm confident Microsoft will sponsor something similar -- with a lock-in to Windows Media Player.

In fairness though the lock-in part is not really DRM, it's the same old technique that made Microsoft the most dominant corporation in the past century. Apple's very good at it too, just not as clever as Microsoft.

Saturday, January 14, 2006

Medlogs is looking good on Bloglines

Jacob Reider and his cohorts recently added an RSS feed to their RSS aggregator: Medlogs.com - The News Aggregator for Medical Topics.

The initial version didn't render well on Bloglines -- it included a section of unwanted descriptive text. Jacob has just fixed that it looks quite good now.

I now get my medlogs in the same space as my other syndicated reading. (So is Bloglines a meta-aggregator, since it's getting a feed from an aggregator?)