ClimateGate: the gift that keeps on giving

In the German sense of “Gift” (poison), that is. (PJTV ClimateGate roundup.) My own top picks on the subject:

  • Richard Fernandez at Belmont Club: “Homogenized, sterilized, and pasteurized data”. Must-read as always. With bonus Michael Crichton (RIP) video.

In my previous post on Climategate I blithely said that nothing in the climate science email dump surprised me much. Having waded more deeply over the weekend I take that back.

The closed-mindedness of these supposed men of science, their willingness to go to any lengths to defend a preconceived message, is surprising even to me. The stink of intellectual corruption is overpowering. And, as Christopher Booker argues, this scandal is not at the margins of the politicised IPCC [Intergovernmental Panel on Climate Change] process. It is not tangential to the policy prescriptions emanating from what David Henderson called the environmental policy milieu. It goes to the core of that process.

Eduardo Zorita, a researcher on past temperature trends at the Institute for Coastal Research in Germany, is calling for prominent Climategate reseachers, Phil Jones, Michael Mann, and Stefan Rahmstorf, to be banned from any future work on the Intergrovernmental Panel on Climate Change’s reports. But Zorita makes an even more interesting and very disturbing observation:

By writing these lines I will just probably achieve that a few of my future studies will, again, not see the light of publication. My area of research happens to be the climate of the past millennia, where I think I am appreciated by other climate-research ‘soldiers’….

I may confirm what has been written in other places: research in some areas of climate science has been and is full of machination, conspiracies, and collusion, as any reader can interpret from the CRU-files. They depict a realistic, I would say even harmless, picture of what the real research in the area of the climate of the past millennium has been in the last years. The scientific debate has been in many instances hijacked to advance other agendas.

These words do not mean that I think anthropogenic climate change is a hoax. On the contrary, it is a question which we have to be very well aware of. But I am also aware that in this thick atmosphere -and I am not speaking of greenhouse gases now- editors, reviewers and authors of alternative studies, analysis, interpretations,even based on the same data we have at our disposal, have been bullied and subtly blackmailed. In this atmosphere, Ph D students are often tempted to tweak their data so as to fit the ‘politically correct picture’. Some, or many issues, about climate change are still not well known. Policy makers should be aware of the attempts to hide these uncertainties under a unified picture. I had the ‘pleasure’ to experience all this in my area of research.

Zorita evidently expects to be punished by reviewers and journal editors for his call for scientific honesty.  It will be interesting to see many more researchers will now step forward to discuss the subtle and not so subtle biasing of climate change research. Stay tuned.

Whole Zorita statement here.

Anthem of the heart, anthem of the mind.
A funeral dirge for eyes gone blind.

Update: (via Correspondence Committee ): Document reveals UN’s goal of becoming rule maker in global environmental tasks.

Environmentalism should be regarded on the same level with religion “as the only compelling, value-based narrative available to humanity,” according to a paper written two years ago to influence the future strategy of the United Nations Environmental Program (UNEP), the world’s would-be environmental watchdog.

Good. Fecking. Grief.

“An army of Davids” going after the ClimateGate Goliath

Thus Glenn Reynolds (author of the book of the same name) describes the picking apart of ClimateGate.

More ClimateGate links:

I’d rather trust a man who doesn’t shout what he’s found
There’s no need to sell if you’re homeward bound
If I choose his side
He won’t take me for a ride….

(Genesis, “The Chamber of 32 Doors“)

Postscript: Heh. (H/t: Ace)

62 years ago to the day

In Jerusalem (and several other Israeli cities) there is a “kaf-tet be-November” (November 29) street. It is not uncommon for a street to be named after an important date in such a history-conscious country, but unusual for the Gregorian (rather than the Hebrew) date to be employed.

November 29, 1947 was of course the date on which the UN voted to partition the British Mandate of “Palestine” into a Jewish and an Arab state.

Below Suzy Eban (the widow of former UN ambassador and foreign minister Abba Eban) reminisces about the vote, accompanied by some archive video.

Here you will find an interview with Abba Eban himself.

Andy Revkin turning on AGW true believers?

Ian Wishart (hat tip: James Delingpole at the Daily Telegraph, who’s been tracking ClimateGate quite closely) notes that AGW evangelist Andy Revkin (famously called ‘unpredictable’ in the ClimateGate emails) has joined George Monbiot in criticizing his own side:

“This whole concept of, ‘We’re the experts, trust us,’ has clearly gone by the wayside with these e-mails,” said Judith Curry, a climate scientist at Georgia Institute of Technology.

She and other scientists are seeking more transparency in the way climate data is handled and in the methods used to analyze it. And they argue that scientists should re-evaluate the selection procedures used by some scientific journals and the Intergovernmental Panel on Climate Change, the panel that in 2007 concluded that humans were the dominant force driving warming and whose findings underpin international discussions over a new climate treaty.

[Comments Ian: But it’s not just Judith Curry. In the past 24 hours, senior climate scientist Mike Hulme has confessed the UN IPCC Copenhagen stunt has become far too politicized:]

[It] is about raw politics, not about the politics of science. But in the Internet worlds of deliberation and in the ‘mood’ of public debate about the trustworthiness of climate science, the reverberations of this episode will live on long beyond COP15. Climate scientists will have to work harder to earn the warranted trust of the public – and maybe that is no bad thing.

But this episode might signify something more in the unfolding story of climate change. This event might signal a crack that allows for processes of re-structuring scientific knowledge about climate change. It is possible that some areas of climate science have become sclerotic. It is possible that climate science has become too partisan, too centralized. The tribalism that some of the leaked emails display is something more usually associated with social organization within primitive cultures; it is not attractive when we find it at work inside science.

It is also possible that the institutional innovation that has been the I.P.C.C. has run its course. Yes, there will be an AR5 but for what purpose? The I.P.C.C. itself, through its structural tendency to politicize climate change science, has perhaps helped to foster a more authoritarian and exclusive form of knowledge production – just at a time when a globalizing and wired cosmopolitan culture is demanding of science something much more open and inclusive.

Read the rest.

Eric Raymond again on ClimateGate

‘Open Source’ guru Eric Raymond, who is “armed and dangerous” with the pen as well as with the sword, is opening up with both barrels again (make sure to visit his blog for many more posts about ClimateGate):

AGW alarmists, led by the “hockey team”, have dismissed criticisms that urban heat-island effects have been distorting surface temperature measurements upwards. Now Vincent Gray, a reviewer of the 2007 IPCC report, says this: not only is the single paper on which this dismissal is based fraudulent, the hockey team knows it’s fraudulent and keeps citing it anyway!

Paleoclimatologist Eduardo Zorita writes: “I may confirm what has been written in other places: research in some areas of climate science has been and is full of machination, conspiracies, and collusion, as any reader can interpret from the CRU-files.”

A Franco-Russian geomagnetics research group who was rebuffed when it tried to get primary temperature datasets from the CRU has assembled its own series of average temperature efforts by going back to ground-station measurements that the hockey team has never had an opportunity to “correct”. The result?

Aside from a very cold spell in 1940, temperatures were flat for most of the 20th century, showing no warming while fossil fuel use grew. Then in 1987 they shot up by about 1 C and have not shown any warming since. This pattern cannot be explained by rising carbon dioxide concentrations, unless some critical threshold was reached in 1987; nor can it be explained by climate models.

The report on this is well worth reading, as it goes into some detail on how the geomagneticians’ statistical methods produced a different — and much higher quality — result than the IPCC did. Among other things, they used daily rather than monthly averaging and avoided suspect techniques for statistically inferring temperature at places it hadn’t actually been measured.

Interestingly, their calculation of average temperature in the U.S. says “The warmest period was in 1930, slightly above the temperatures at the end of the 20th century. “. Could this inconvenient warm spell be what the VERY ARTIFICAL correctionwas intended to suppress?

I can almost pity the poor AGW spinmeisters. Perhaps they still think they can put a political fix in to limit the damage from the CRU leak. But what’s happening now is that other scientists who have seen the business end of the hockey team’s fraud, stonewalling, and bullying are beginning to speak out. The rate of collapse is accelerating.

The “Lincoln moment” of AGW? (“You can fool some of the people all of the time, all of the people some of the time, but not all the people all of the time.”)

I personally regard myself as an AGW agnostic. It may well be that AGW is indeed a major perturbation on climate; or it may be a minor perturbation compared to some man has no control over; or it may get buried in the noise. Studying it more and deeper, and in more detail, will only benefit us all. And there are plenty of non-AGW reasons to get serious about looking for clean and renewable energy resources. (Among other things, finite oil supplies will one day be far more valuable as feedstocks for the chemical industry than as fuel.)

The behavior of the ‘strong AGW’ camp, however, is increasingly becoming a negative role model for any intellectually honest scientist. “Dear G-d, bring me in the company of those who seek the truth and spare me from those who have found it.”

Eric S. Raymond on ClimateGate

Reboot Congress (hat tip: Insty) has a summary of the thoughts of ‘open source’ software guru Eric S. Raymond (he of The Cathedral and The Bazaar) on the ClimateGate scandal. It’s all must-read material: let me give one or two teasers:

There is only one way to cut through all of the conflicting claims and agendas about the CRU’s research: open-source it all. Publish the primary data sets, publish the programs used to interpret them and create graphs like the well-known global-temperature “hockey stick”, publish everything. Let the code and the data speak for itself; let the facts trump speculation and interpretation.

We know, from experience with software, that secrecy is the enemy of quality — that software bugs, like cockroaches, shun light and flourish in darkness. So, too. with mistakes in the interpretation of scientific data; neither deliberate fraud nor inadvertent error can long survive the skeptical scrutiny of millions. The same remedy we have found in the open-source community applies – unsurprisingly, since we learned it from science in the first place. Abolish the secrecy, let in the sunlight.

and “On 11/26, esr examines the Facts to fit the theory:”

On 12 Oct 2009, climatologist and “hockey-team” member Kevin Trenberth wrote:

The fact is that we can’t account for the lack of warming at the moment and it is a travesty that we can’t. The CERES data published in the August BAMS 09 supplement on 2008 shows there should be even more warming: but the data are surely wrong.

Eyebrows have quite rightly been raised over this quote. It is indeed a travesty that AGW theory cannot account for the lack of warming, and bears out what I and other AGW critics have been saying for years about the fallaciousness and lack of predictive power of AGW models.

But the second sentence is actually far more damning. “The data is surely wrong.” This is how and where most scientific fraud begins.

Scientific fraudsters are not, in general, people pushing theories they know to be false. Outright charlatanism is not actually common, because it’s relatively easy to detect. Humans are evolved for a social competitive environernt and are rather good at spotting lies, except when they’re fooling themselves because they want to believe.

Again, read the whole thing. Better still, go straight to Eric’s blog and keep scrolling.

A more humorous note is being struck by Iowahawk.


Friday night video: Dream Theater, “The answer lies within”

Dream Theater’s John Petrucci is probably my favorite living rock guitarist — and without discussion one of the technically most accomplished ones ever. Watching the guy play is a study in ‘economy of motion’.

I’m more ambivalent about his lyrics — they tend to straddle the border between the heartfelt and the cheesy, and do not always lean to the good side. Yet, despite myself, I’m quite fond of this song: “The answer lies within”:

Life is short / so learn from your mistakes

And stand behind / the choices that you make

Face each day / with both eyes open wide

And try to give / don’t keep it all inside…

WSJ: Climate Change Game Is Rigged

Or: “Manufacturing consent” on anthropogenic global warming…

Update: Instapundit is on a roll:

HMM: Vincent Gray on Climategate: ‘There Was Proof of Fraud All Along’.

UPDATE: More here.

ANOTHER UPDATE: National Post: A French scientist’s temperature data show results different from the official climate science. Why was he stonewalled?

MORE: Col. Douglas Mortimer writes:

You know, when you consider that “We’re Saving The Planet” is the biggest power/money grabbing scam since “We’re Saving Your Souls,” whoever leaked/released those e-mails and such is kind of like the modern scientific equivalent of Martin Luther. This person/persons may well have broken the backs of the Global Warming Priests who did everything in their power to make sure that the common man, and those who would oppose them, had no direct access to the Spoken Word of God.

I’ve been arguing for years that ‘carbon credits’ are today’s equivalent of the indulgences sold by Johann Tetzel to fund the Sistine Chapel.

Well, when it comes to computer models, if you can’t see the code or the data, there’s no particular reason to trust them, even when the graphics are pretty.

More AGW data ‘massaging’

Drive-by mopost:

Top story on Memeorandum: Watts Up With That on how ‘creative’ data manipulation techniques revealed warming in New Zealand that wasn’t in the original data.

Related: BBC journalist was sent ClimateGate emails a month before scandal broke; and, flying turkey moment of the day, George Monbiot (the original ‘moonbat’) saying basically: ‘yes, AGW skeptics cheat, but that’s precisely why we should set especially high standards for ourselves’. And:

Some people say that I am romanticising science, that it is never as open and honest as the Popperian ideal. Perhaps. But I know that opaqueness and secrecy are the enemies of science. There is a word for the apparent repeated attempts to prevent disclosure revealed in these emails: unscientific.

Which earns him unexpected praise from Rand Simberg:

We will continue to vehemently disagree on political issues, but henceforth (not that I did it much, or paid him that much attention in general), I shall refrain from calling him George Moonbat. He seems to recognize the damage that these people are doing to his cause, even if they cannot.

Happy Thanksgiving again!

Stay classy, New York Times

Ed Driscoll and Dan Riehl note some really “nice” comments along the following lines:

franglosaxon Says:


suddenly all these people are feeling persecuted by taxes. ’cause the money is all being handed out to black people by the black president. can we have more of them drowning their kids and trying to make it look like murder, plz?

and noticed they all came from an IP address This address belomgs to:

OrgName: The New York Times
OrgID: NYT-1
Address: 229 West 43rd Street
City: New York
StateProv: NY
PostalCode: 10036
Country: US

Here are some more samples of mindless dreck posted by the same troll:

If you don’t know what in blazes you are talking about, then by all means, STFU, Glenn Reynolds.

Ooooh, Dick Gephardt did something in 1991 and therefore wingnuts are justified in being idiots today.

Great life program, wingtard.

And legacy media journalists are entitled to feel superior to bloggers because of…?

Keep plucking that chicken turkey, NYT!

The first Thanksgiving

John Stossel has an interesting and timely piece on how the first Thanksgiving almost did not happen due to the “Tragedy of the Commons“. (Hat tip: Pi Guy.)

Because of sharing, the first Thanksgiving in 1623 almost didn’t happen.


When the Pilgrims first settled the Plymouth Colony, they organized their farm economy along communal lines. The goal was to share everything equally, work and produce.

They nearly all starved.

Why? When people can get the same return with a small amount of effort as with a large amount, most people will make little effort. Plymouth settlers faked illness rather than working the common property. Some even stole, despite their Puritan convictions. Total production was too meager to support the population, and famine resulted. Some ate rats, dogs, horses and cats. This went on for two years.

The people of Plymouth moved from socialism to private farming. The results were dramatic.

“This had very good success,” Bradford wrote, “for it made all hands very industrious, so as much more corn was planted than otherwise would have been. … By this time harvest was come, and instead of famine, now God gave them plenty, and the face of things was changed, to the rejoicing of the hearts of many. … ”

Because of the change, the first Thanksgiving could be held in November 1623.

What Plymouth suffered under communalism was what economists today call the tragedy of the commons. But the problem has been known since ancient Greece. As Aristotle noted, “That which is common to the greatest number has the least care bestowed upon it.”

Go read the whole thing. A happy Thanksgiving to all American and expat American readers!

AGW hack link dump

Whew, has this become a firestorm in the blogosphere…

Charlie Martin: Global Warminggate, what does it all mean?

The hackers released about 172 megabytes of data, and we can be sure examining it closely will take some time. But after a few days, certain things are beginning to become clear.

* The data appears to be largely, perhaps entirely, authentic.
* The emails are incendiary.
* The implications shake the scientific basis for AGW, and the scientific reputations of some of AGW’s major proponents, to their roots

Wretchard @ Belmont Club weighs in.

The Washington Post has a good summary of where things stand. Some juicy quotes (also discussed by Ann Althouse):

In one e-mail, the center’s director, Phil Jones, writes Pennsylvania State University’s Michael E. Mann and questions whether the work of academics that question the link between human activities and global warming deserve to make it into the prestigious IPCC report, which represents the global consensus view on climate science.

“I can’t see either of these papers being in the next IPCC report,” Jones writes. “Kevin and I will keep them out somehow — even if we have to redefine what the peer-review literature is!”

In another, Jones and Mann discuss how they can pressure an academic journal not to accept the work of climate skeptics with whom they disagree. “Perhaps we should encourage our colleagues in the climate research community to no longer submit to, or cite papers in, this journal,” Mann writes.

“I will be emailing the journal to tell them I’m having nothing more to do with it until they rid themselves of this troublesome editor,” Jones replies.

Ann Althouse also notes this gem:

“In other exchanges, one climate researcher said he was ‘very tempted’ to ‘beat the crap out of’ a prominent, skeptical U.S. climate scientist.”

The “don’t you step out of line” approach to scientific discourse.

Update: The strange case of the deleted Emails. Or: when FOIA becomes FOAD.

Update 2: William Briggs, “statistician to the stars”, has a must-read piece on how scientists are just people.

I am a scientist and I have lived around fellow scientists for many years and I know their feeding habits well. I therefore know that the members of our secular priesthood are ordinary folk. But civilians were blind to this fact because our public relations department has labored hard to tell the world of our sanctity. “Scientists use peer review which is scientific and allows ex cathedra utterances. Amen.” But… “[C]limategate” … ha[s] revealed the truth that scientists are just people and that peer review is saturated with favoritism, and this has shocked many civilians. It has shaken their faith and left them sputtering. They awoke to the horrible truth: Scientists are just people!

Now all the world can see that scientists, like their civilians brothers, are nasty, brutish, and short-tempered. They are prejudiced, spiteful, and just downright unfriendly. They are catty, vindictive, scornful, manipulative, narrow-minded, and nearly incapable of admitting to a mistake. And they are cliquey.

Go read the whole thing, as they say. See also this commentary at The Blogmocracy.

Update 3: Tom Maguire points out a major howler in the WaPo story linked above:

The evidence that humans are changing the world’s climate is “unequivocal”?  Cmon! Here is the [IPCC] summary report.  What is described as “unequivocal” is the proposition that global warming is actually occurring (p. 2).  As to whether that warming is caused in part by human activity, well, that is viewed as “very likely”, i.e., more than a 90% probability.

Note “in part” (emphasis mine). If you happen to think that human activity is a minor perturbation compared to natural changes, then you would still agree to this statement, yet you would be considered an “AGW denier” by the more overheated AGW advocates.

Update 4: Nigel Lawson weighs in, in The Times (of London) “Copenhagen will fail, and quite right too”. A teaser:

Astonishingly, what appears, at least at first blush, to have emerged is that (a) the scientists have been manipulating the raw temperature figures to show a relentlessly rising global warming trend; (b) they have consistently refused outsiders access to the raw data; (c) the scientists have been trying to avoid freedom of information requests; and (d) they have been discussing ways to prevent papers by dissenting scientists being published in learned journals.

Update 5: former climatology professor Tim Ball weighs in.

Update 6: programmer’s annotations tell a fascinating story.

Update 7: Declan McCullagh weighs in.

Update 8: Mark Steyn: “Eine Decliner Nachtmusik

Update 9: And here comes… John Holdren!

Update 10: ‘snork’ at The Blogmocracy has a roundup.

Friday night beauty: Beethoven, Adagio Sostenuto from Piano Sonata no. 29, Op. 106, “Hammerklavier”

Here is, in two parts, Alfred Brendel’s performance of the Adagio Sostenuto from Beethoven’s 29th Piano Sonata, opus 106, best known as the “Hammerklavier” sonata. While the sonata is nominally in Bb major, the main tonal center of its ethereal slow movement — this “mother of all nocturnes” — is actually F# minor.

The first video should start at 5’43” in. (“Thanks” to youtube/ limitations, you may need to manually wind it there, or open in a new viewer window. Alternatively, click here to hear the audio of the whole piece via GrooveShark.)

The second video should start right from the beginning (it’s actually split at a musically meaningful point, just before the recapitulation of the main theme in varied form):


A major embarrassment for AGW evangelists?

On screen (hat tip: YKWYA, thanks!):

The University of East Anglia’s Hadley Climatic Research Centre appears to have suffered a security breach earlier today, when an unknown hacker apparently downloaded 1079 e-mails and 72 documents of various types and published them to an anonymous FTP server. These files appear to contain highly sensitive information that, if genuine, could prove extremely embarrassing to the authors of the e-mails involved. Those authors include some of the most celebrated names among proponents of the theory of anthropogenic global warming (AGW).

The FTP link first appeared on a blog called The Air Vent. The blog’s owner, identified as “Jeff Id”, downloaded the file, examined it, and posted a brief summary on his blog. Another commenter, identified as “Steven Mosher,” passed the information on to Steven McIntyre’s Climate Audit blog and to another blog, The Blackboard, run by a blogger identified as “Lucia.” Most recently, blogger Anthony Watts, who runs a blog titled “Watts Up With That?” mentioned the FTP archive in his own blog.

Read the whole thing. If true, this is dynamite stuff.

Socialized Medicine. Part 4: Summary and Outlook

In the three previous parts of the series, we have discussed three paradigmatic examples of socialized medicine systems outside the USA: Germany, Israel, and Belgium.

Few voices in the US debate on healthcare advocate outright state-run care on the UK or Canadian NHS (National Health Service) model. Therefore, these three examples focused on state-regulated, rather than state-operated, systems.

Each of these systems offers some degree of competition between HMOs, but primarily on quality of services, not on price or coverage offered (which is regulated by the government). Israel’s historically had separate risk pools for each of the HMOs, but these were eventually abolished as they led to de facto bankruptcy of one of the HMOs.

Note that none of these systems would even come close to solvency were it not for mandatory insurance, which dilutes the risk pool by forcing many young, healthy, low-risk patients to join the pools. (The case of Israel, which had 95% of its population in the four authorized HMOs even before membership became mandatory in 1995, is a bit exceptional.)

Of the three systems, Israel’s comes closest to workability, and arguably offers one of the best cost/benefit ratios anywhere, possibly the very best. It however enjoys a unique confluence of favorable circumstances: a sound population pyramid (highest childbirth in the developed world), availability of a reservoir of underemployed primary care workers, and (to a lesser extent) long-standing cultural traditions concerning medicine. Yet even here, the system is showing cracks (notably in terms of long waiting times for seeing specialists, advanced diagnostic procedures,…), and increasing numbers of people are opting for private supplemental insurance. Access to the best specialists and surgeons may not be as much a function of the ability to pay as it is in the US, but it is most definitely a function of personal connections.

Germany’s is the oldest system of its kind. Relatively cost-effective, it has come under the strain of an inverted population pyramid, with ever less young and healthy people paying less and less into the system and ever more aged and frail people draining it. Germany is taking the route of increasingly paring its mandatory coverage down (eventually to bare bones), with private insurance available as an alternative for those who want better coverage.

Belgium’s system has never been particularly noted for its cost-effectiveness, and thanks to a glut of doctors (of variable quality), people take immediate access for granted. The system is coping with the same inverted population pyramid as Germany, plus (thanks to Belgium’s ultra-liberal asylum laws) an ever larger number of refugees and unemployed immigrants taking their toll on the system. The radical course in terms of liberalization and advocacy of euthanasia taken in Belgium (and the Netherlands) cannot, in my opinion,  be understood outside the context of cost containment pressures. (But as per Robert Heinlein: “some things, the more you understand the more you loathe them”.)

A few more general remarks are now in order. First, one should keep in mind that, in all these countries, government or quasi-governmental service is considered a respectable career path, and people of real ability are attracted to it. In contrast, it appears that in the USA, government service is a ‘negative career choice’, and this is inevitably reflected in the quality of the human material staffing any US government office. Even under optimal circumstances, a European (or Israeli) health care system transplanted to the USA would work considerably less well than in the original country.

Second, the phenomenon of ‘going John Galt’ (i.e., abandoning or deliberately cutting back a professional career because of diminishing returns) is not restricted to the USA. Germany actually has known doctors’ strikes, while in Israel, medicine is becoming a less attractive career path due to the combination of long hours and low government-set reimbursement rates. Others scale back the hours in which they are willing to see HMO patients, in favor of ‘private rate’ hours.

Third, none of the systems above have anywhere near the tort/malpractice suit culture that is endemic to the USA. On the credit side, it keeps down malpractice insurance premiums (and, indirectly, cost of treatment to much more reasonable figures). On the debit side, opportunities for redress in the event of true malpractice are very limited.

Virtually everybody agrees that the US system as it stands now has a number of problems that cannot remain unaddressed. However, the wholesale adoption of a Euro-style healthcare system would, at best, only trade one set of problems for another. More likely, it would entail importing the bad while leaving behind the good. At worst, it would also destroy the culture of innovation that has been making US medicine unique.

Dean of Harvard Medical School eviscerates 0bamacare

(Hat tip: Roger Simon @ Pajamasmedia)

Read the whole thing. A few grafs follow below:

As the dean of Harvard Medical School I am frequently asked to comment on the health-reform debate. I’d give it a failing grade. Instead of forthrightly dealing with the fundamental problems, discussion is dominated by rival factions struggling to enact or defeat President Barack Obama’s agenda. The rhetoric on both sides is exaggerated and often deceptive. Those of us for whom the central issue is health—not politics—have been left in the lurch. And as controversy heads toward a conclusion in Washington, it appears that the people who favor the legislation are engaged in collective denial. Our health-care system suffers from problems of cost, access and quality, and needs major reform. Tax policy drives employment-based insurance; this begets overinsurance and drives costs upward while creating inequities for the unemployed and self-employed. A regulatory morass limits innovation. And deep flaws in Medicare and Medicaid drive spending without optimizing care. Speeches and news reports can lead you to believe that proposed congressional legislation would tackle the problems of cost, access and quality. But that’s not true. The various bills do deal with access by expanding Medicaid and mandating subsidized insurance at substantial cost—and thus addresses an important social goal. However, there are no provisions to
substantively control the growth of costs or raise the quality of care. So the overall effort will fail to qualify as reform. In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it. Likewise, nearly all agree that the legislation would do little or nothing to improve quality or change health-care’s dysfunctional delivery system. The system we have now promotes fragmented care and makes it more difficult than it should be to assess outcomes and patient
satisfaction. The true costs of health care are disguised, competition based on price and quality are almost impossible, and patients lose their ability to be the ultimate judges of value.

Winds of change coming?

Rasmussen Reports (hat tip: Powerline) finds a 6-point Republican lead in a generic Congressional race. Adds Powerline: “This survey offers more evidence that independent voters are decisively turning away from the Democrats, as independents favor the generic Republican candidate by a rather shocking 41 to 24 percent.”

Chairman Little Beach is definitely losing the center — without whom he would never have gotten elected in the first place.

Socialized Medicine. Part 3: Belgium

Belgium, like Germany (covered in our first installment) and Israel (covered in our second installment), has a hybrid system that is basically state-regulated rather than state-run.

Belgium has six authorized HMO federations, called “ziekenfondsen” (sick funds) in Dutch and “mutualités” (mutual aid associations) in French. Three of these have always been affiliated with the three major political parties, as part of the peculiarly Belgian and (historically) Dutch phenomenon known as “pillarization” or “vertical pluralism” — where you voted for one major political party, belonged to the trade union affiliated with it, joined the sick fund associated with that,…

Of the two biggies: (1) The Christian Mutualities (CM) belong to the “pillar” of what used to be called the Catholic Party, later the Christian-Democratic party (a Catholic, socio-economically center to center-left, socially somewhat conservative party). (2) The Socialist Mutualities (SM) were always connected to the Belgian Workers Party, later the Socialist Party.

The smaller Liberal Mutualities (LM) are within the ambitus of Belgium’s pro-market party, which (confusingly for Americans) has been called the Liberal Party for most of its existence — the Dutch-speaking branch used to be called the Party for Freedom and Progress.

Desire for a “mutualité” not affiliated with a major party eventually led to the Neutral Mutuality, while self-employed people and professionals are catered to by the Professional Mutuality. There is also a small niche player restricted to railroad employees.

Much like Israel, people pay a social security tax, and the part set aside for healthcare goes to the State Institute for Health and Disability Insurance (Dutch acronym: RIZIV; French acronym INAMI), which manages a joint risk pool for the HMO federations.

Unlike Israel, healthcare at HMO polyclinics is the exception and care by private physicians the norm. Part of the reason is a longtime glut of doctors in Belgium: according to this table, Belgium has nearly twice as many physicians pro capita as the USA. The absence of admission exams to medical school until quite recently, as well as lack of incentives for the universities to weed out the unfit, led to serious quality control problems: while some Belgian doctors are as good as any you will find in the USA or Israel, I would not entrust my worst enemy to the “care” of some others. One has very limited opportunities for redress in  case of malpractice (which is distressingly common): in theory the Board of Medicine may suspend or cancel medical licenses, but in practice this step is rarely taken.

Access to physicians and procedures is not a major problem in Belgium: the real problem is locating competent ones. As these tend to build up clientele by word-of-mouth, particularly well-regarded specialists may have long waiting lists.

Dentistry in Belgium is cheap, and generally worth what you pay for it.

At least until recently, the HMOs had only limited incentives for cost containment, as they generally had no connection at all with GPs and specialists, and generally do not operate their own hospitals (which are either governmental, affiliated with various Catholic Church organizations, or university hospitals).

An “inverted population pyramid” (aging population, low childbirth) and Belgium’s traditionally ultra-liberal policy concerning immigrants have led to a situation where  the system in its current form is basically unsustainable.

A number of proposed measures in the USA have been given the controversial sobriquet “death panels”. Belgium, in fact, shares with The Netherlands the dubious distinction of having the most radical pro-euthanasia legislation (both passive and active) in the world. And in fact, there is serious evidence that the majority of such euthanasia takes place without patient’s consent.

When talking to medical professionals and others in Belgium, it is very hard to escape the conclusion that the enthusiasm of many Belgian politicians for legalizing euthanasia (except for a rearguard battle fought mainly by the Christian-Democrats)  is at least in part motivated by cost containment considerations — no matter how wide the rivers of mealy-mouthed, patronizing, condescending cant about “quality of life” and “dying with dignity”.

I cannot believe for even one moment that this is a road the USA would like to go down.

Friday night music video: Brian Auger, “Pavane”

Our first-ever Friday night music video is by jazz-rock keyboardist Brian Auger, who turned 70 this year. One of his signature tunes was not an original composition, but an arrangement of Gabriel Fauré’s “Pavane in F# minor, Op. 50” that, despite turning the stately classical piece into a blistering uptempo piece, makes the most of the harmonic potential of that haunting tune. (Even nicer is a solo piano version Auger recorded for the “Steinway to Heaven” compilation album.  Unfortunately, I was unable to find embeddable audio or video for that.)

Below is a historical recording from 1969 at a music festival in Belgium. The Pavane ends at 4:47 into the clip. Enjoy!

PS: those with absolute pitch will surely notice that Auger’s version is transposed half a step down to F minor.