Going Back: On Health Care

The Health Care Repeal Bill is out, short and clear and to the point.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

 
SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Repealing the Job-Killing Health Care Law Act’’.
January 3, 2011 (5:41 p.m.)

SEC. 2. REPEAL OF THE JOB-KILLING HEALTH CARE LAW AND HEALTH CARE-RELATED PROVISIONS IN THE HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010. 

(a) JOB-KILLING HEALTH CARE LAW.—Effective as of the enactment of Public Law 111–148, such Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted. 

(b) HEALTH CARE-RELATED PROVISIONS IN THE HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 12 2010.—Effective as of the enactment of the Health Care and Education Reconciliation Act of 2010 (Public Law 111–152), title I and subtitle B of title II of such Act are repealed, and the provisions of law amended or repealed by such title or subtitle, respectively, are restored or revived as if such title and subtitle had not been enacted. 

A good start but what next? 

Books and Their Covers

I have to admit that I am one of those people who remove dust jackets, I like the binding, and I read the contents. I thought of this today when I read a piece in the NY Times about designer dust jackets. I keep the jackets, in large dusty boxes and I know what is where. You see I have over 10,000 books, all neatly arranged, my biographies are alphabetical, compulsive, no, my lovely wife was a librarian, and and organized mind is well something.

The statement which was to amaze was:

Mr. Hermann designed a glassy Neutra-like house with a 60-by-14-foot shelving system, which has room for 4,000 books, he said. 

“But who has 4,000 books?” he said. “I always stage my houses, so it was up to me to fill the shelves.” He ordered 2,000 white-wrapped books from Mr. Wine and deployed them in tidy, horizontal stacks (watch for the white-wrapped book to become this year’s version of the deer head).

But at 4,000 one is just starting. You see they are all neatly organized, with my little yellow tags from when they were read and used as a reference. I know every book, I personally selected it, and knew where it would fit on both the shelf and the knowledge base.

Would I ever buy a Kindle, hardly, a great deal of what I have is electronic, some ends up on paper, and used as reference materials. But some of those old books, 150-200 years ago, are true friends. I have a history book used in grammar school in 1807, in New Jersey, and surprise, there were still slaves, in New Jersey. Somehow that fact never came up before.

Then there are the books with names in them, from people I actually knew decades ago, and one wonders what trip this book took to get to where it is now.

So books are not decorations, although I am somewhat surrounded by them and dust jackets are like Greek statues with the private parts hidden by drapes. The true beauty is what is in the book and it should sit there and shout it out, not be hidden behind some chi chi cloak.

Money for Washington?

The Christian Science Monitor reports on the European states confiscating private pension plans.

People’s retirement savings are a convenient source of revenue for governments that don’t want to reduce spending or make privatizations. As most pension schemes in Europe are organised by the state, European ministers of finance have a facilitated access to the savings accumulated there, and it is only logical that they try to get a hold of this money for their own ends. In recent weeks I have noted five such attempts: Three situations concern private personal savings; two others refer to national funds.

Possibly this will give some ideas to the folks in Washington.

Dreadful thought, but then there is the Tea Party .... it may not happen ...

Income Inequality and Redistribution: A March Towards the Old Soviet Union

One of the left wing's economic voices wrote today that re-distribution is essential to have the economy recover. The idea is that if one looks at the ratio of highest income to average income then at some point the economic rate of growth reaches a peak and then declines.

Namely the assumption is that more money goes to the very wealthy and that they somehow are stashing it away somewhere so as to be non-productive. That means that the very wealthy have found some Shangri La for investments which has no nexus to the US economy, yet manages to get returns, perhaps they are stuffing the money into Mongolia, yak farms?

This economist states:

Inequality is already high, and if it continues to grow it could reach the point where it becomes morally intolerable, and there is evidence that social ills grow as inequality widens. But there is an economic reason to care, as well.

There is an equivalent of a Laffer curve for inequality, but the variable of interest is economic growth rather than tax revenue. We know that a society with perfect equality does not grow at the fastest possible rate. When everyone gets an equal share of income, people lose the incentive to try and get ahead of others. We also know that a society where one person has almost everything while everyone else struggles to survive – the most unequal distribution of income imaginable – will not grow at the fastest possible rate either. Thus, the growth-maximizing level of inequality must lie somewhere between these two extremes.

But somehow one wonders if there is any truth to this. The really rich still live here if they are paying the alleged low taxes and thus must be spending or investing via some let us assume legal vehicles.  These folks think that Government is a wiser investor of capital, that the smarts that allowed people to make the money somehow are redistributed to some GS 9 in DC after they get it and that the GS 9 can be more adept at placing it for economic return. Why should the person who made it be allowed to decide where to invest it?

Somehow the mindset of these economists is without any understanding of the entrepreneur. The ivory towers of academe are without any touching point with reality. These are the same folks who got us in the mess we are in now, and they want more. Knowing that an opportunity is there to be had is what drives innovation.

If you get just a medal from the GS 9 in DC then you are back in the Soviet Union. What good are medals as rewards, to academics perhaps, but not to those creating the true value in society.

The Cancer Chip

There was a Press Release today covered in Technology Review regarding the chip which will catch cancer cells in the blood. The Tech Review states:

The prototype, developed by Mehmet Toner and collaborators at MGH, consists of a business-card-size silicon chip dotted with tens of thousands of microscopic posts. Each post is coated with a molecule that binds to a protein unique to cells from a specific type of tumor, such as breast, lung, or prostate cancer. As blood flows through the chip, tumor cells stick to the posts. In 2007, the researchers first showed that the chip could capture these rare cells--which make up just one in a billion cells in blood--in high enough numbers to analyze them for molecular markers.

The ultimate goal is to use the device to tailor cancer treatments to individual patients by monitoring cancer cell counts and by identifying the molecular attributes of an individual's cancer. For example, specific markers can highlight a more aggressive form of cancer or a tumor that will respond to specific cancer drugs, while genetic changes in the tumor might signal the need to change treatments. MGH and four other research institutions, have already received a $15 million grant from the organization Stand Up to Cancer to test the prototype. But that technology is expensive and complicated to use, with each chip costing about $500, according to the Boston Globe.

There are however some concerns:

1. By the time the cancer cells are freely circulating they may most likely have metastasized. Take a prostate cancer, PCa, which may be Gleason 5 to 7, and it is most likely still encapsulated. It must generally get to an 8-10 to met. At that point there are PCa cells circulating. If so, what is the benefit, because the PSA most likely is well over 10.

2. There is the conundrum of the stem cell theory of cancer, namely that there are stem cells and these are the cells which will spread the cancer. Can we distinguish stem cells from plain old cancer cells. Not yet clear we can do it if we have them, no less looking in the blood stream.

3. A cell which may be cancerous, say morphologically with large nucleoli and other markers must be examined in more detail. Say PCa, can we see if it has no PTEN, what of mTOR, c-myc, and the list of other genes, and what of the miRNAs which we may now suspect to be markers as well. We have to look at a single cell. May be tough, since it is already tough in a path study.

Not that this is not a good idea, but the Press seems to have said more than is there. Shame, since if it does not deliver to the level expected that in itself is negative. Nano technology has greater potential possibly, since with it we can send them through organs with surface collectors and look for the cell markers.

Medals or the Market

When I ran my company in Central Europe I was invited to a partner's home once to talk of the past. He was a highly respected member of the community and had reached the pinnacle of his profession. I thought highly of him and he was a tremendous performer. He was a former member of the Communist Party and educated at the University of Moscow and a member of the Russian Academy.

On that day we went through his attic to get something and in the process I saw a box filled with medals. He dragged them out and he described that the Soviets would award medals for this and that, since true monetary rewards were forbidden. He had a box overflowing with medals.

I was reminded also of Admiral King during the beginning of WW II who frankly disliked the Brits, yet recognized the importance of working with them, and his main issue was they was the British Navy wore so many medals on their uniforms. Then, in the US Navy, wearing medals was far and few between, and generally for official dress uniforms only. The award by the state of something of that type was somehow un-American.

Combining these two historical facts I was surprised when I saw the White House and its Reward program. They state:

The America COMPETES Act passed by Congress today provides all agencies with broad authority to conduct prize competitions as called for by President Obama in his 2009 Strategy for American Innovation.  By giving agencies a simple and clear legal path, the America COMPETES Act will make it dramatically easier for agencies to use prizes and challenges to spur innovation, solve tough problems, and advance their core missions.

In a world of widely dispersed knowledge, prizes and challenges are an essential tool for every agency’s toolkit.  As the co-founder of Sun Microsystems Bill Joy once famously said, “No matter who you are, most of the smartest people work for someone else.” This fact calls for a fundamental shift in the way an institution solves problems. Prizes and challenges are part of the solution.

In the Free Market we have prizes, it is called economic wealth.Anyone in the US is allowed to risk it all for that prize and many make it. If you want a pension and lots of awards for work well done, become a Government worker. If you want to contribute to civilization, start a company. This idea of there being some Government GS 9 who selects based on some Beltway Bandit consultant's report who should get an award and reward for doing something is nonsense. Again, the market makes that selection. The Sun folks saw that first hand, as did Google, and then again as did Enron on the flip side.

The Government should stay out of the way. Americans, unlike Brits, Russians, French, Italians, etc do not wear medals on their clothes, except perhaps for a Medal of Honor recipient. We have no royalty dispensing goodies, or do we?