Teddy's Health Care

My gut reaction to Teddy's passing was unsympathetic. He was a man who, in both his personal and political life, was a bulwark against individual responsibility and accountability. For all his power and influence, his actual achievements were limited. To call someone a Lion of the Senate, is to damn with faint praise.

On the other hand, writing in the Journal, Noonan captures what was great and compelling and fundementally American about Kennedy, even for those repulsed by his political idealogy. Un-, or rather, very softly-, spoken in her column is an implicit compare and contrast extremely unfavorable to our current President.

Another, Journal op-ed reminds us that it wasn't long ago that pro-business conservatives were on the Government Health Care bandwagon, and, so, how badly the Administration has played what once was a winning hand.

The attempt to rebrand Universal Health Insurance as TeddyCare is of conflicting value. On one hand, it may make legislation more palatable to seniors. On the other hand, it risks serious backlash. As the Times delicately reported:

...He chose what he called “prudently aggressive” treatments.

“He always admired people who took risks, like Teddy and Kara did,” Mr. Dodd said, referring to two of Mr. Kennedy’s children, who both beat cancer with bold treatments...

Mr. Kennedy deputized Dr. Horowitz, who lives in the San Francisco Bay Area, to research all treatment options before deciding on an intensive regimen of surgery, chemotherapy and radiation — hardly a clear-cut choice with an almost inevitably lethal disease and a patient of Mr. Kennedy’s age. Some physicians assembled at Massachusetts General Hospital considered his tumor inoperable — and measured his likely survival time between six weeks and a few months.

Voters can be expected to resent that Teddy, for his own care, ignored the evidence-driven medical care, we are being told he made the cause of his life to impose on others.

Smart Diplomacy

Amongst the campaign promises the President has had difficult living up to was his commitment to smart diplomacy.

If this Drudge post is accurate, he appears about to, in his own way, deliver.

The gist of the four way deal is the US takes a much harsher line on Iran, in particular the promise of meaningful sanctions, Israel agrees to a very limited -- basically in name only -- settlement freeze, Arab states agree to very limited moves towards normalization, Palestinians agree to resume stalled negotiations.

According to the article, both Israel and the Arab States are primarily motivated by a desire to see the current administration grow a pair vis a vis Iran, it is less clear why the Palestinians agreed to play along. The promised shift in Obama's Iran policy is, in fact, the only real commitment in this whole deal. There is no indication of a genuine diplomatic breakthrough between Israel and the Palestinians that might lead to an actual agreement.

In the end, a skeptic might wonder if all this window dressing is entirely for the benefit of allowing our Government to save face as it drops a failing approach. More practically, perhaps the President felt he required the mirage of peace process progress to sell a more aggressive policy towards Iran to his core supporters.

Netanyahu is, perhaps, the biggest political winner. Israelis -- even those who generally oppose settlement construction -- being less aware of American domestic political calculations, will see this deal as being very well bargained by their Prime Minister.

Texas

It is obviously very early, but of prospective GOP 2012 Presidential candidates, Rick Perry has the best story. He is a rock solid conservative, who said no to stimulus money, governs the best state economy and is more telegenic than Bobby Jindal.

His path to the presidency, however, goes through fellow Republican Kay Bailey Hutchison, who is challenging him in the primary for the 2010 gubernatorial election.

This primary well serves republican interests. Perry seems likely to emerge victorious, more battle tested and so more prepared for the 2012 elections. If he proves unable, better to find that out in 2010 then 2012.

A Wonderful Suggestion

A Times op-ed reports that Rhode Island plans a new law requiring health insurance policies be written such that the average person can understand them.

This sounds like a wonderful idea whose utility is not limited to health insurance policies. If only financial derivative contracts had been required to be written that way! Or, more importantly, the Health Care Bill.

Income Inequality

A NY Times article quotes a Harvard economist who makes an almost entirely reasonable argument:

"I think incredibly high incomes can have a pernicious effect on the polity and the economy,"... Much of the growth of high-end incomes stemmed from market forces, like technological innovation... But a significant amount also stemmed from the wealthy’s newfound ability to win favorable government contracts, low tax rates and weak financial regulation, he added.

It is certainly true that income disparity creates serious issues in our society. In particular -- as he notes -- the wealthy have a greater ability to bend government policy towards their economic interests. His latter two examples of such bending, however, are foolish.

The charts included in the article demonstrate that increases in the highest incomes do not lead to tax cuts. (Perhaps one of his students can explain him how to run a regression... )

Secondly, he repeats the oft-heard, but couldn't-be-farther-from-the-truth, cant that Wall Street excess was enabled by "weak" financial regulation. In the context of his argument it is more thoughtless than usual. If the wealthy are able to bend government policy to their interest, why would they modestly settle for weak regulation, when they could get regulation that more affirmatively served their interest? (Do they really call it Government Sachs for nothing?) And as he understands that the wealthy strongly influence government policy, how can he take for granted that strong regulation would, in any way, work against their interest?

On a related topic, one Ronald Dworkin (no, not that one) argues in the journal that the upper middle class today is more responsive to marginal disincentives to work then it was in the past, as work is less considered itself a virtue and professionals are increasingly swayed by quality of life concerns.

His argument strengthened another argument that has been bubbling in the back of my head: Progressive taxation increases income disparity. To construct a crude model -- a company with $100 revenue and two employees, one highly silled ("A") making $66 and one not ("B") making $34. If both are taxed at 33%, A takes home $44. If taxes are changed such that A pays 50%, her take home would initially be reduced to $33. A's natural response would be to ask for a $22 raise to restore her take home value. Any raise for her comes out of B's pocket. If A recieves half her request, she is now making $77 and B $23. The increased tax progressiveness producing an increase in income disparity.

This is a rough model by any stretch, but its core contention is strengthened by the argument that A will meaningfully reduce her hours in response to a meaningful reduction in her after-tax wage. In theory, the company could hire an additional person to share A's role. In practice, it will often be more cost effective to pay A more.

IoC

As I am moving from Java to DotNet, i am re-evaluating IoC containers.

I've been naively using Spring for a while, and unfortunately, missed out on Guice, which, best I can tell is the IoC of my dreams (now lost to me forever, or at least as long as I am on DotNet).

That said, I am growing skeptical of the concept of an IoC container. To take an example from the Guice site. Is this:

public class BillingModule extends AbstractModule {
  @Override 
  protected void configure() {
    bind(TransactionLog.class).to(DatabaseTransactionLog.class);
    bind(CreditCardProcessor.class).to(PaypalCreditCardProcessor.class);
    bind(BillingService.class).to(RealBillingService.class);
  }
}

Really so much more awesome than:

  public static void main(String[] args) {
    CreditCardProcessor processor = new PaypalCreditCardProcessor();
    TransactionLog transactionLog = new DatabaseTransactionLog();
    BillingService billingService
        = new RealBillingService(creditCardProcessor, transactionLog);
    ...
  }

?

The primary differences -- best I can tell -- are:

• Without an IoC container, every class ideally announces every dependency via its constructor. This can result in a lot of constructors requiring, e.g.: Loggers, which is, arguably, displeasing aesthetically. This also may not work smoothly with tools that want a no-arg constructor.
• If your object graph changes, w/o the IoC container, you'd have to change constructors forcing changes to your wiring code before you could compile. With an IoC container, things can, but are not guaranteed, to adapt more magically. You may not be notified that your code is now broken until it fails in run-time.

It is not clear to me that these trade-offs arguing for using an IoC container.

SSIS != ETL

I've started to use Microsoft Sql Server Integration Services @ work. On first impression, like many ms products: its purty.

The second impression is less favorable. An ETL tool has two by-definition requirements: The E-L, pulling data from some source(s) and pushing it to some target(s), and the T, meaningful transformations of the data.

SSIS does a service-able job at the E-L. Which is, by itself, no win. DTS, once upon a time also did, and SSIS leverages already existing Microsoft Technologies to do most of the work.

As far as the T goes, SSIS is, at best adequate. Relatively basic and common tasks are difficult even, if, more or less do-able.

The over-arching issue for SSIS is there is little reason to use it. As there are plenty of tools out there providing data transfer between heterogeneous sources, an ETL tool has to provide a reason to embed transformation logic in its platform instead of natively in database procedures, which, for me, SSIS, so far, fails to do:

• A firm seeking database vendor independence wouldn't choose SQL Server Integration Services.
• An ETL developer requiring drag and drop GUIs (and so, unable to code procedures) likely lacks the ability to handle reasonable complicated transformation logic.
• SSIS does not, yet, provide useful few-click implementations of common ETL tasks. For example, while it has a SCD transformation, I've found it does not always behave as one, or at least I, would like. Or, more egregiously: the nightmare that is the pivot transformation.
• Finally, the most frustrating to me is that, at the very least, I expect an ETL tool to give me robust logging and auditing reasonably free. If I write a stored procedure, I have to manually intermingle code capturing and loggic basic metadata (e.g.: How many rows were retrieved from a source, how many were inserted into the various destinations) with my transformation logic. An ETL tool can capture and log that behind the scenes. What makes SSIS' failure in this regard completely fustrating is that MicroSoft understands, exactly the sort of logging a real world project would desire and how clunky and intrusive it is to implement in SSIS.

I have not played yet with huge data sets, it is possible that SSIS offers some advantages over t-sql for those. The general defense of SSIS seems to go: It is a relatively new platform and all its limitations will be addressed as it matures.

As it exists, I suspect the best way to make it useful is to build some template packages, an internal (xml) package definition configuration file and dotnet code which programmatically builds packages, which entails an awfully high start up cost. In my current implementation I am limiting my use of SSIS, mostly, to its E-L ability, and, for the moment, as a stored procedure runner.

In the end, of course, it is unfair to hold to basically free SSIS to the bar set by far more expensive alternative tools.

Systemic Risk

The WSJ reports that dems seek to regulate VCs out of fear that Hedge Funds might otherwise avoid the yoke of regulation by labelling themselves VCs. Hedge Funds, of course, must be regulated in the name of "Systemic Risk". As a stress tested matter of fact, they actually pose little such.

The most common notion of systemic risk is: the risks imposed by interdependencies in a system/market, where the failure of a single entity can bring down the entire system/market.

This is simply not true of most Hedge Funds. There have been many notable blow-ups with only one -- LTCM -- raising the spectre of systemic risk. And, as described in a previous post, in any reasonable frame, the systemic risk posed by the LTCM collapse had far more to do with reckless (despite being regulated) banks then the fund. In the current crisis, while Hedge Funds are hemorrhaging capital, only those owned by banks have received Government support.

As a software developer, I tend to see systemic risk, in the sense above, as one type of, for lack of a better term: "structural risk". By which I mean: bad architecture; A system designed, or structured, in such a way that it will more often than not produce bad outcomes.

To take an example from my undergrad EE, imagine a chain of Christmas lights designed such that if any one bulb died, all bulbs follow. Such a chain would not long last. Re-architecting the chain to decouple a bulb's life from its neighbor's would be a far more sensible strategy then adding intrusive and expansive monitoring and micro-control on top of the flawed design. Which, if you are following the analogy, is what financial regulators -- eschewing the simpler "too big to fail is too big" -- seem to have in mind.

Large public banks fundementally pose "Structural Risk" in that their behavior is dominated by agency costs. Public shareholders are almost guarranteed to be absent and incapable owners. Banks are not subject to meaningful market discipline (which would be a structural check on agency risk) both because (a) their biggest clients are large institutional investors (eg: pension funds) who themselves personify agency risk and FDIC insured account holders who, as such, are more concerned with cheap promotions then sound operation, and (b) being too big to fail they operate in the market with implicit Government guarrantees. Given this environment, large public banks can be expected to, more often then not, behave irresponsibly. This is not true of most Hedge Funds which tend to be managed by expert owners, with, historically, wealthy individual or family office clients and, of course, no Government backstop.

Which is all to say that, while it is reasonable to tightly regulate exceptionally large funds, funds owned by banks and funds who manage a meaningful amount of institutional money, there is little reason to regulate most funds. The push for unnecessarily expansive regulation is especially unseemly given the far weaker push for meaningfully re-designing regulation controlling those companies most directly responsible for the current mess -- Fannie Mae, Freddie Mac, the credit rating agencies, the large banks, etc -- all of whose behavior was strongly influenced by existing regulation.

A cynic might note that more regulated companies make better donors and are more responsive to the desires of government officials. Perhaps the ultimate structural risk is having racketeers at the top of the food chain.

She's Back

Sarah Palin is back in the news declaring that ObamaCare is evil:

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care," the former Republican vice presidential candidate wrote.

The AP reports this as a lie

The nonpartisan group FactCheck.org, a project of the Annenberg Public Policy Center at the University of Pennsylvania says the claim is false...

Obama addressed the controversy during a July 28 AARP-sponsored town hall.
"Nobody is going to be forcing you to make a set of decisions on end-of-life care based on some bureaucratic law in Washington," he said.

Fact Check actually goes farther in asserting the claim that this legislation "may place seniors in situations where they feel pressured to sign end of life directives they would not otherwise sign [which] may start us down a treacherous path toward government-encouraged euthanasia" is false:

We can’t argue with Boehner’s claim that counseling “may” cause more seniors to refuse treatment... but we see no evidence that it will. There’s certainly no requirement in the bill that seniors decline life support or extraordinary measures of medical treatment.

Furthermore, seniors have had control over the end-of-life issues the Republicans are concerned about for a long time...

As for the argument claiming that this is the first step on a slippery slope leading to government-encouraged euthanasia, that’s a stretch. The right to draw up an advance directive is federally guaranteed, but doctor-assisted suicide is legal in only three states. It would take a lot more than Medicare-funded counseling for voluntary euthanasia to become a standard government recommendation.

The original author of this part of the legislation responded... saying that "nothing could be further from the truth."

FactCheck's "non-partisan" reasoning is exceptionally weak. The facts that there is no requirement that seniors decline care and that seniors have ultimate control over their care speak in no way to the question of whether seniors may be pressured by counselors to make decisions they would not otherwise make. Even the intent of the original author, we all well know, is subsumed by the plain meaning of the authored words. Their evidence that this would not be a step on a slippery slope has even less to do with price of tea in china. In other words, Fact Check has a different basis for its conclusions than the available evidence.

In the long term, Boehner and Palin's claims are almost certainly true and Obama's FactCheck claim false. The key fiscal motivation for health care reform is spiraling medicare costs. End of life care is a major cost contributer: ~30% in the last year and 15% in the last 60 days. Bending the curve, then, requires meaningfully reigning in end-of-life care. Under the current rules, where seniors have, more or less, control over their care, this demands convincing them to refuse expensive treatment they would have otherwise opted for. Should persuasion fail to produce the required savings, some form of rationing can reasonably be expected.

I suspect that the most just means of rationing care -- end of life or other -- and the one -- I fear -- least likely to be adopted by the current administration, is to ensure that price signals are exposed to patients. If subsidized patients were required to pay a meaningful (as determined by individual financial situation) portion of the cost of their treatments, individuals could make personal choices in the context of their own values while, in aggregate, producing a result that best reflected the values of society.

Opposite Marriage

I've always thought it impossible to rationally oppose state certification of gay marriages. If two people are determined to pay extra taxes, well why not?

Conservatives are on stronger ground when they make it a question of process rather than outcome. There are good reasons to prefer state certification of gay marriage as the legislated product of a democratic process rather than imposed by judicial fiat (even if I suspect that that is what judges today looking only to law and precedent and ignoring political implication would do).

In a WSJ op-ed Princeton University Law Professor Robert George, takes his stab at arguing against same marriage, and, at first blush, succeeds in not looking the fool:

...
[The state's interest in regulating marriage is] to make it more likely that, wherever possible, children are reared in the context of the bond between the parents whose sexual union gave them life.

If marriage is redefined, its connection to organic bodily union—and thus to procreation—will be undermined. It will increasingly be understood as an emotional union for the sake of adult satisfaction that is served by mutually agreeable sexual play. But there is no reason that primarily emotional unions like friendships should be... legally regulated at all.

The most apparent weaknesses in his argument: We take for granted -- but it might not be the case -- that children are best reared in that context. Also the notion that Government regulation ought be limited to where it has a strong reason is not, unfortunately, shared by all Americans.

And, most fundementally, it would seem an awfully narrow view that limits the social value of opposite marriage to creating a context for rearing children.

Freedom Highway

I've been watching the wonderful The Clearwater Concert in celebration of Pete Seeger's 90th birthday party on PBS.

Springsteen anchored the show:

And then came Bruce. As the last artist of the night, Springsteen had the lengthiest remarks, with a speech that was an appreciation of Pete's place in history... Bruce spoke of ... Seeger as "the stealth dagger through the heart of our country's illusions about itself." ... and he described preparing for their duet on "This Land is Your Land" at the Inauguration, when Pete said: "I know I want to sing all the verses—all the ones that Woody wrote, even the two that usually get left out." Bruce summed up: "He sings all the verses, all the time—especially the ones we'd like to leave out of our history as a people."

What is good for the goose is, as always, not for the gander: While Michael Franti and Patterson Hood did cover Dear Mr President, no one was impolite enough to mention Songs for John Doe