Month: August 2009

The View From Your Sickbed

by Patrick Appel

A reader writes:

For a few months, I worked at an electronic medical billing company. I was astounded at how complicated and convoluted medical billing is, and this is ultimately why we need to have significant health insurance reform. What happens is a doctor's office will decide on a price for a procedure – for instance, a checkup typically costs around $180. Say I have Tufts. They might pay out $100 for a checkup – the rest the doctor writes off. Why not just charge $100 and not have to write off $80? Well, that's because other insurance companies – say Blue Cross and AETNA – might pay $120 and $150 respectively. So it make sense for doctors to charge significantly more than they would expect from most insurance companies. However, if somebody doesn't have good insurance or has no insurance, they are billed for the full amount -$180, even though the doctors office might expect to write off up to $80 dollars of that charge from somebody with good insurance. Given that the majority of the people without health insurance are lower income, this can cause crippling financial problems, or result in a denial of service. And why? Is someone with insurance "better" than somebody without? Are they more deserving of good health because they happened to not get laid off during a particular bad recession?

The problem with predicting medical expenses is that, even though you can find the codes (they're called CPT codes and you can find them here) you would have to get the price from the doctors' billing coders, which they would probably be loathe to give out- how can we expect the market to work when the consumers don't get to know the price BEFORE consuming? And your other reader didn't include that if you get an ultrasound, you're billed for the ultrasound and the use of the ultrasound machine. If you have the time to sit down and do the research, it would be nearly impossible for the average person to make an accurate decision about the most cost effective doctor to have. Imagine trying to make that decision in a panic.

Are Dogs Just Parasites?

by Robert Wright

Apparently we don’t have to worry about Jonah Goldberg writing a book called “Canine Fascism.” Turns out he loves dogs—and indeed approaches liberal levels of sappiness in talking about them. I love dogs too (especially Frazier). But I must take issue with Jonah’s formulation of a question that, he says, is now raging in philosophy-of-dog circles: Are dogs “social parasites” or do they “actually love you”? Putting the question this way suggests that Jonah may be confused about doggy love—and, indeed, about person love. I’m here to help!

With all due respect for the intelligence of Jonah’s dog, I doubt he/she is consciously choosing to be a parasite. Then again, you may say, neither is a tapeworm—but it’s still a parasite. Exactly my point! Parasites can be parasites without any awareness of the fact. Parasitism is a behavioral relationship—profiting at the expense of the host–not a state of mind. So in principle Jonah’s dog (in contrast, by the way, to the average liberal) could be feeling deep love for Jonah even while harming him. 

In fact, in principle the love felt by the dog could be something evolution built into dogs as a way to aid in the parasitization of people. After all, any good Darwinian would expect animals to feel love when it is in their interest (or, strictly speaking, the interest of their genes) to feel love—regardless of whether it is in the interest of the animal being loved. 

I suspect the historical relationship between dogs and humans has been mutualistic, not parasitic; humans have probably been pragmatic in choosing what kinds of dogs to associate with during dog-human co-evolution, thus keeping wantonly exploitative tendencies out of the canine gene pool. (If anything, the parasitism has probably worked in the other direction.)  

And as for the question of whether, evolutionary history aside, the average dog is now parasitic upon its owner: Well, these days we own dogs mainly for the joy they bring us, not to warn us about wild animals. So the question is simple: Does your dog bring you more joy than pain? With Frazier that’s a no-brainer (unlike Frazier himself, I hasten to add!). I’ll let Jonah speak for his dog.

And as for the implications of this Darwinian view of love for human-on-human affection: Well, it turns out I don’t have time to get into that. But that’s probably just as well. The last thing I want to plant in the mind of Jonah or any other married person is the idea that their spouse could feel love for them yet be exploiting them. Best not to think about it.

From Buckley To Palin

by Chris Bodenner

A reader writes:

The clip with Buckley and Chomsky was fascinating to watch and only emphasizes how far the Republican Party has fallen from its own intellectual tradition.  As a centrist Democrat I respect the tradition represented by Buckley, Noonan, Brooks, Will, etc.  They often present reasoned and clear arguments that provoke me to think more clearly about my own positions, sometimes changing them. Unfortunately, sometime after Reagan the Republican party changed its political philosophy to the belief that any Joe six-pack with common sense can run the country, consequently rejecting its own solid intellectual tradition.  In the current GOP, being smart and thinking cogently about issues is now considered a liability.  We are now seeing the apex of this philosophy in rise of Sarah Palin and the ugliness at the townhall meetings.

My headline is inaccurate on its face, since Buckley was an intellectual journalist and Palin a populist politician – apples to oranges. But when Newt Gingrich, an unquestionably smart guy who's been the brain trust of his party since the Republican Revolution, defends Palin's "death panel" on national television, the headline is apt.

Creepy Ad Watch

by Chris Bodenner

A reader writes:

Why bother sourcing a Swedish advert terror when we’ve got our very own? Yes, I’m talking about Palm Pre Girl. My dreams are haunted by this clearly overmedicated ginger/albino woman, who pops up out of nowhere to harass me with her random, Facebook-update thoughts. She appears to live in an animated Windows desktop, uses a tone that’s far more familiar than I like, and the entire thing has a sinister element to it. You know, like maybe the twist is that she’s dead. Or that I’m dead. Or that sometime in the near future, she’ll crawl out of my desktop and kill me in my sleep.

Dog Bites Man

by Patrick Appel

Erik Tarloff finds the media's love of sex scandals unseemly:

There are always reasons besides prurient interest — beyond entertainment value — adduced for publicizing sexual turpitude. It's never, we're assured, about the sex per se, it's always about some other perceived errancy. He lied. There were pay-offs to the mistress and her family. State funds were used for travel. A Congressional page was, at least in some jurisdictions, underage. And so on. The truth remains that these stories are stories because sex was involved; the rest is window dressing. It might be different if actual harassment were part of the scenario, and God knows the definition of sexual harassment has been evolving over the past couple of decades, and rightly; but with the arguable exception of Mark Foley, and the contested — although likely incontestable — case of Clarence Thomas, harassment has rarely been raised as an issue.

Chart Of The Day, Ctd

by Patrick Appel

Calculated Risk puts this graph in context. Women are not almost a majority of the workforce because women are more likely to hold down more than one job:

Say there were 50 women and 100 men in the work force, and each women worked two jobs (men only one). The [Current Employment Statistics]  would report 200 payroll positions; half for men, and half for women. The [Current Population Survey] would report 150 people had jobs, 50 women and 100 men. Would it be correct to say there were as many women in the work force as men? No.