Waldo Jaquith

That raises an interesting question. If the US gov’t had done *absolutely nothing* to change security procedures after 2001/9/11, the actual risk of successful attack may not have changed from what it is now. :-)

Posted by Tim McCormack on 30 December 2009 @ 6pm

US healthcare in the civilian world makes me actually miss military medical care. Which, as I look back on it was the very definition of a single-payer system (don’t get me started on Tricare, I don’t want to hear about it, I’m talking old school military from the 70s).

Posted by Jim Anderson on 30 December 2009 @ 6pm

Spending money on healthcare is not bad in and of itself; it depends on what you get for the money. (For example, if you were on your deathbed and money from your own savings could be spent to prolong your life, you may well choose to spend the dollars rather than go the cheaper route in the name of “efficiency”.)

The presented graph uses the metric of “life expectancy at birth” (where we score below average) to posit that we don’t get much for our money. But as with any statistic, the devil is in the details.

Firstly, “life expectancy at birth” (let’s abbreviate as LEAB) is heavily skewed by the rate of death in the first years of life. LEAB for the US is skewed downward because we have a high rate of infant mortality. That is primarily because we have a much higher rate of premature birth than other nations (some background information here.

Now, why do we have twice the rate of premature births that Sweden (for example) does? Is our healthcare system so bad that babies are jumping out of the womb early? Or is it that our system is actually better at keeping marginal pregnancies alive to be born prematurely – rather than not at all? Once born premature, of course, the life expectancy is low relative to a full-term baby – but infinitely higher than a baby that doesn’t make it.

So LEAB gives us a misleading basis for comparing the idea of “life expectancy”. A more meaningful metric might be life expectancy at age 5, which would remove the statistical “penalty” for actually being successful in birthing

Of course, “life expectancy” isn’t really an apples-to-apples concept at all. The US has many social/lifestyle issues – obesity, smoking, violence – that dramatically affect statistical “life expectancy” but are artifacts of our culture and society, not the cost/benefit aspects of our healthcare system. The most meaningful way to compare systems would be to compare outcomes for specific medical conditions. This author explains this much better than I could.

So it may well be that we don’t “get what we’re paying for”. But the given graph – based on skewed “life expectancy at birth” statistics and flawed assumptions about the apples-to-oranges concept of “life expectancy” as the sole proxy for the performance of healthcare systems – doesn’t meaningfully make that case.

Posted by Janus on 30 December 2009 @ 10pm

Janus, I have the same complaint about life expectancy statistics, but it’s also the best general statistic that we’ve got. No statistic is perfect, but it’s a pretty good one.

I notice that you don’t name Ann Coulter—just label her as “this author.” Given that she’s a known, serial liar, it’s tough to believe anything that she says. If you’ve got some statistics that show that, ignoring infant mortality, the U.S. has some incredibly efficient healthcare system, I’m all ears. But every calculation that I’ve ever seen shows that the United States has, per dollar, the single least efficient healthcare system in the world.

Posted by Waldo Jaquith on 30 December 2009 @ 11pm

The broader point is that it’s usually informative to examine the devilish specifics behind headlines and summary graphs.

As far as Coulter’s article. I in turn notice that you don’t address any of the actual concepts other than with an ad hominem dismissal. That particular article does seem to be based on a real study (http://www.ncpa.org/pub/ba596 and associated footnotes) and I find the concepts raised to be worth consideration.

Posted by Janus on 30 December 2009 @ 11pm

I didn’t even click through the article. It’s Ann Coulter. You might as well give me a link to a commentary by Bozo the Clown. I’m not interested in anything that she has to write because, again, she’s a known liar—time spent reading anything she has to write is time that I’m not spending peeling the skin off of my eyeballs or swallowing my own tongue, which seems like a shame. The National Center for Policy Analysis is a right-wing think-tank—not helpful.

Posted by Waldo Jaquith on 31 December 2009 @ 12am

TSA, unsurprisingly seems to be getting more heavy-handed. (See Huffington Post http://www.huffingtonpost.com/blake-fleetwood/exclusive-tsa-seizes-hard_b_407877.html or just about any other news outlet today)

It just seized travel blogger Steven Frischling’s laptop for posting the security directive dealing with security ‘enhancements’ following the Christmas Day attempt by the wannabe terrorist on NW Airlines flight 253. Mr Frischling blogs for KLM. They also made a similar demand of Chris Elliot, travel blogger for National Geographic and WaPo.

TSA says it’s looking for the person or persons who leaked the directive to the two bloggers, that they’re not available to the public. That having been said, TSA reportedly distributed the memo to some 10,000 airlines, airports and security firms around the world. I’d argue that a distribution list that wide, which includes foreign entities not under obligation to the US Government, amounts to an invitation to do with it as the recipients wish.

I’m just fed up with TSA. Despite everything we’ve spent on them, they’ve done nothing to increase the security of the flying public. The airlines provided reinforced cockpit doors and the public now knows to resist terrorist attempts. TSA provides…Security theater.

I’m just done with flying here. Given the choice between flying and driving on my own dime, I’m going to drive. My employer can compel me to fly, but that’s their time and their money.

Posted by Jim Anderson on 31 December 2009 @ 12am

Not fair to say the govt. has done nothing. The most important thing I believe is mandating hardened doors. There is no way anyone is getting to the pilot. There will not be any passenger get hijackings anymore.

Their only recourse will be to blow up a plane. I’m surprised no stingers have ever been used. After all we gave plenty away during the 1980′s.

But we have been lucky the past two attempts. It really should not be that hard to ignite plastic explosive. Why they didn’t do it in the privacy of the restroom is beyond me.

I always thought the shoe thing was stupid knowing full well plastic explosive could be anywhere in carry-on or in someone’s pocket or sewn into underwear.

Until there is a way to detect plastic explosive we will be vulnerable….and no, passengers cannot prevent it.

Posted by robert legge on 31 December 2009 @ 11am

we are overpaying ( if its overpayment its still a better deal then the rest of the world if you ask me) because our system is 50% govt entitlement and much of the rest employer provided insurance paid (due to govt regs that favor employer insurance over individuals paying for their own care and insurance). Yet we want to hand over even more regulatory power and control to the federal govt??

Posted by CitizenKnow on 31 December 2009 @ 8pm

There are a lot of reasons why we’re overpaying for healthcare, but that’s neither of them.

Posted by Waldo Jaquith on 31 December 2009 @ 10pm

So the fact that the fed govt already controls much of the industry has no effect on the individual and overall cost? interesting take.

Posted by CitizenKnow on 1 January 2010 @ 1pm

Nobody said the government has done nothing. They just haven’t done anything particularly effective. As to the Stingers, that’s a really good point. There are a number of these handheld SAMs (surface-to-air missiles aka MANPADS, short for MANPortable Air Defense Systems) out there, the most common of which are the Russian-designed SA-7 and its variants produced around the world, and the SA-16/18. While there have been MANPADS attacks against commercial airliners, most notably an SA-7 launched in 2002 against an Israeli charter airliner in Kenya (which missed its target), I don’t think these weapons present as much of a threat to commercial aviation as one might first think.

That’s because they require care and periodic preventive maintenance in order to keep them serviceable. Leave them out in dirty, dusty or overly humid conditions for long periods, and over time they become dysfunctional. I suspect, but I certainly don‘t know, that handheld SAMs in terrorist possession would probably have come through circuitous routes, and might thus already be ineffective due to age and lack of upkeep. Those Afghan stingers from the 1980’s have probably long since lost their effectiveness. Same for U.S.-supplied SAMs in Central America during the same time. The Kenyan SA-7 may have missed due to poor material condition, operator error, or just plain luck.

Several guerrilla organizations such as the Colombian FARC and the LTTE in Sri Lanka have more recently attempted to acquire handheld SAMs. Again, I don’t know, but don’t think they were successful, because I’m pretty sure that if they had ‘em, they’d have used ‘em by now. I’m unaware of any of them actually using them. Finally, while a nation state might conceivably supply a yo-yo like Mr. Underwearhead bomber, I doubt it nowadays, because there’s just not enough return on investment. Libya for one, seems to have discovered the long-term costs associated with aerial piracy. As to plastic explosives, of the two major plastic explosives, Semtex and C-4 are detectable by taggant chemicals. Semtex is readily detected by the vapor odor of its taggant, while C-4 is a little more problematic requiring use of a detector such as a dog or an ion mobility spectrometer. On the other hand, it’s very stable and requires either a detonator or flame to set it off. Not sure if it would be worth terrorists’ time and expense to manufacture their own, but anything they can come up with, we can counter.

Which brings us back to airline passengers , whom I think can and will be able to resist. So… I propose we purchase a supply of baseball bats, one of which will be issued to each passenger with instructions to beat the living crap out of anyone who tries to hijack and/or blow up the plane. The US traveling public has repeatedly shown the ability and willingness to defend itself despite TSA’s best attempts to create a passive and compliant passenger base. TSA on the other hand, has done nothing but throw good money away.

You say we might accidentally give baseball bats to terrorists? Well, we might. But stack up the five or even twenty or so of them against the hundred or more angry legitimate passengers, and well, you can figure those odds. And remember, an armed society is a polite society.

Lastly, I think our best weapon against idiot terrorists is laughter. Bullies, whether individuals or organizations, can’t stand to be laughed at, and Mr. Underwearhead is indeed a laughingstock.

Posted by Jim Anderson on 1 January 2010 @ 4pm