Different River

”You can never step in the same river twice.” –Heraclitus

February 28, 2005

Carnival of the Capitalists

Filed under: — Different River @ 11:11 am

This week’s Carnival of the Capitalists is hosted by one of my favorite blogs, Coyote Blog. It’s one of my favorites because of the content too, not just because of the cute picture of the coyote at the top!

February 27, 2005

Great Moments in Socialized Medicine

Filed under: — Different River @ 10:00 pm

Here’s an amazing story, this time (as usual) from the British National Health Service (NHS). This time they didn’t remove the healthy kidney instead of the diseased one (killing the patient), or amputate the wrong leg (the other one still had to be removed), or leave an aborted fetus in a jar in the mother’s room.

No, this time they just caused an little girl an incredible amount of inconvenience for seven and a half years of her so-far eight-year-old life.

From the time Tilly Merrell was a year old, doctors told her family she would never have a normal life — or even a normal meal.

British [National Health Service] doctors found that the food she swallowed went into her lungs instead of her stomach, causing devastating lung infections. They said she had isolated bulbar palsy, and their solution was to feed her through a stomach tube. Forever.

But having a backpack with a food pump wired to her stomach wasn’t much of a life for a girl whose favorite smell is bacon frying — a girl who once broke through a locked kitchen door in an effort to sneak some cheese. So her family got help from their community of Warndon, about 120 miles north of London, raising enough money to take Tilly, now 8, on a 5,000-mile journey they hoped might change her life, a journey to Lucile Salter Packard [i.e., privately funded] Children’s Hospital at Stanford University.

Doctors at Packard were intrigued that she had no neurological symptoms often associated with the palsy. In all other ways, she was a normal child with a mischievous smile and a truckload of energy. After seeing her Feb. 7, they ran three tests and found out what was wrong with her.

Nothing.

She had infections, certainly, but they were long gone. And when she swallowed something, it went into her stomach, not her lungs.

Doctors prescribed occupational therapy, figuring that Tilly’s body and mind needed to be conditioned, after 7 1/2 years of struggling, so that it would be all right to eat normal food.

Did it work? The proof is in the pudding. Or maybe in the breakfast sandwich that Tilly sampled at a Palo Alto Jack in the Box.

“I had a burger with cheese, bacon, egg and ham,” she said Wednesday, relishing the moment like a kid in a candy store. “And some hash browns with grease.”

But after being on normal food for more than a week, ice cream is the flavor of the month.

[G]one is the black backpack she wore to school. It held a liquid food concoction that had to be pumped into her stomach three times a day for two hours at a time. Those were her meals.

Until this month, Tilly often had to go off into another room with her PlayStation during family meals. She would always try to sneak morsels of food, not fully understanding the British doctors’ warnings about how much harm they could cause.

After five years of searching the Internet, Sonia Merrell found a story about how a girl with a similar condition was trying to get treated at Packard.

She faxed Tilly’s records to the hospital, and doctors said they might be able to help but would have to see her. The family and the community held fund- raisers to bring in more than 10,000 pounds (almost $20,000) to pay for the trip and what they thought might be surgery for Tilly. Children at a community center even collected more than 300 pounds (about $575) to give their playmate some spending money.

After all, England is not exactly a backward nation when it comes to medicine. [Really? Sure looks like it is!] Tilly had several cases of severe pneumonia as a baby, and her mother said that doctors in the socialized British system clung to the palsy diagnosis.

[Occupational therapist Marianna] Thorn is confident her patient will do well, but the family will need to monitor her weight to be sure it doesn’t drop. “Tilly was talking today about how she’s taking tiny bites because she used to try to sneak food,” she said.

(Hat tip: James Taranto.)

This is how a Palestinian cease-fire works

Filed under: — Different River @ 2:47 am

This is how a Palestinian cease-fire works:

  • February 8: After going three months without a single Palestinian terrorist attack against Israel Mahmoud Abbas and Ariel Sharon agree to a cease-fire.

    SHARM EL-SHEIKH, Egypt (CNN) — Palestinian Authority President Mahmoud Abbas and Israeli Prime Minister Ariel Sharon announced a cease-fire Tuesday, hailing it as a new opportunity for peace in the Middle East.

    “We have agreed with Prime Minister Sharon to cease all violence against the Israelis and against the Palestinians, wherever they are,” Abbas said after talks at their summit in Egypt.

  • February 25: Almost four months after the last Palestinian terrorist attack, and 17 days after the cease-fire, there is another terrorist attack:

    TEL AVIV, Israel — A Palestinian suicide bomber blew himself up in a crowd of young Israelis waiting outside a nightclub near Tel Aviv’s beachfront promenade, killing at least four other people, wounding dozens and shattering an informal Mideast truce.

  • February 27: Israel announce it will not do anything in response to the terrorist attack:

    Israel will not launch major military action in retaliation to Friday night’s suicide bombing in Tel Aviv, which killed four people and wounded 50 others, senior government sources said yesterday. The government, however, will increase political pressure on Syria for backing Islamic Jihad, which claimed responsibility for the attack, and the Palestinian Authority to act against terror.

    Oh no, you say, there are doing something — didn’t you read the paragraph you just quoted? — Israel is going to “increase political pressure on Syria.” Um, with all due respect, does Syria have a long history — indeed any history — of responding to political pressure from Israel? My point exactly.

  • You might be thinking now that there was not much point to declaring this “cease-fire.” After all, there were three months of relative peace, then they declare a “cease-fire,” and — BOOM! — two and a half weeks later they blow up a nightclub. But now, there most certainly is a point to the cease-fire — if you are one of the terrorists. Because now you can send your recruits to blow themselves up in Tel Aviv without any fear that Israel is going to blow up your car hours after a suicide bombing, like happened last April before the “cease-fire”:

    GAZA CITY (CNN) — Abdel Aziz Rantisi, the leader of the militant group Hamas in Gaza, was killed Saturday in Gaza City by an Israeli missile strike, Israeli officials and Palestinian security sources said.

    An Israeli helicopter launched the strike on Rantisi’s car, the sources said, also killing two others — one of them a bodyguard. Rantisi was taken to a hospital, where he died shortly afterward.

    The strike came hours after a Palestinian suicide bomber launched an attack in the Erez industrial zone Saturday, killing a border police officer and wounding three others.

    See, in this particular conflict, a “cease-fire” means Israel agrees to cease firing back at terrorists, so they can pursue their occupation in peace.

In Memoriam, Uli Derickson

Filed under: — Different River @ 2:00 am

A hero of the fight against terrorism (pre-2001 edition) has passed away:

Uli Derickson, the Trans World Airlines flight attendant honored for saving passengers’ lives in 1985 by confronting and mollifying terrorist hijackers, died on Friday at her home in Tucson. She was 60.

Though the two hijackers spoke almost no English, Derickson was able to speak with one of them in German and occasionally calm him by singing a German ballad he requested.

She also intervened during beatings, often putting herself in harm’s way.

“Don’t you hit that person,” she would shout, a passenger later told the New York Times. “Why do you have to hit those people?”

The most terrifying moment for her, she later told Glamour Magazine, was when the crueler of the two hijackers asked her to marry him.

At one point they asked Derickson to sort through the passengers’ passports to single out people with Jewish-sounding names. Although various news organizations initially reported that she had followed their orders, she in fact hid the passports, her son said.

From another account:

Born in what is now the Czech Republic, Derickson and her parents were expelled to East Germany in 1945. The family later escaped to West Germany, and Uli made it to the United States in 1967, where she became a flight attendant for TWA.

During a stop in Algiers, the ground crew wouldn’t give them fuel without payment — and the terrorists promised to kill a passenger every five minutes until they got some. “I asked for permission to go to my purse, and I got out my [credit] card and gave it to them. They put 6,000 gallons of jet fuel on my Shell credit card.”

That is one gutsy and resourceful lady. I hope someone paid her back for the jet fuel.

From another obituary:

“Everybody looked to her for courage and guidance,” Tom Cullins, an architect in Burlington, Vermont, who was a hostage on the plane, said in an interview Wednesday. “She was clearly in control. She even made demands of the hijackers.”

Cullins added, “We have nothing but the utmost respect for her and a debt of gratitude for really heroic acts.”

For those of you who might remember, this was the same hijacking in which the terrorists murdered Navy Steelworker Second Class Robert D. Stethem, who now has a Navy ship named after him.

The dominoes are beginning to fall

Filed under: — Different River @ 12:41 am

One of the arguments raised against the invasions of Iraq (and Afghanistan) was the claim that yes, Iraq is a brutal, human-rights-ignoring dictatorship, but there are lots of dictatorships in the world, and we can’t democratize all of them, so we shouldn’t go into Iraq, either. This always seemed to me like arguing that since we can’t cure all cancers, we shouldn’t treat any of them. However, it turns out there’s another response to this argument as well: Justice anywhere is a threat to injustice everywhere (with apologies — no, appreciation — to Martin Luther King, Jr.).

In other words, deposing Saddam Hussein and establishing democracy in Iraq can have a “domino effect,” causing dictatorships to fall, perhaps even peacefully, throughout the Middle East. The first sign of this came in December 2003, when Muammar Qaddafi of Libya agreed to give up it’s pursuit of biological, chemical and nuclear weapons.

The second sign is the renewed attempt by Lebanon to throw off the yoke of Syria, which has occupied and de facto rules Lebanon for nearly 30 years. And Walid Jumblatt, the leader of the Lebanese opposition and patriarch of the Druze Muslim community in Lebanon has specifically credited the American invasion of Iraq and the successful Iraqi elections last month:

“It’s strange for me to say it, but this process of change has started because of the American invasion of Iraq,” explains Jumblatt. “I was cynical about Iraq. But when I saw the Iraqi people voting three weeks ago, 8 million of them, it was the start of a new Arab world.” Jumblatt says this spark of democratic revolt is spreading. “The Syrian people, the Egyptian people, all say that something is changing. The Berlin Wall has fallen. We can see it.”

(Hat tip: Coyote Blog.)

Granted, the recent assassination of the anti-Syrian Lebanese leader Rafiq Hariri was a setback, but there were plenty of setbacks on the road to the Iraqi elections as well; setbacks do not mean the project is doomed.

The third sign came yesterday, when Egyptian President Hosni Mubarak, who has held office for 24 years (since the assassination of Anwar Sadat in 1981), took to first step toward amending the Egyptian constitution to allow candidates to run against him in presidential elections. Believe it or not, other candidates have not been allowed so far. (No wonder he keeps winning!) Geoff Smock explains:

Egyptian President Hosni Mubarak called for changes in that country’s election laws today. The new reforms would allow more than one candidate to compete for the presidency, much different from the current system, where the Egyptian Parliament selects a candidate and a referendum takes place within the country where voters are allowed to check either “yes” or “no”. If the new law passes, election of the presidency will be a direct election with multiple candidates.

This is encouraging news, but talk alone never accomplished anything. Mubarak needs to follow through on this promise and the elections, set for September, must be free and fair. Mubarak must also allow all parties to participate, for elections can only be free and fair when everyone is given an equal chance to run. It is the responsibility of America and the world to keep the pressure on Mubarak, and we must demand full transparency so the international community may rest assured that these elections are not tainted.

But with all that said, this announcement is further validation of our efforts in Afghanistan and Iraq. Just as the Lebanese are demanding their full democratic rights, Egypt can see the train is headed towards democracy in the Middle East and they don’t want to be left behind. Freedom is contagious, and democrats in the Middle East who saw Iraqis vote last month are asking themselves, “Why not us?” Leaders in the region are all admitting that times are changing, and that no longer can regimes deny their people their full democratic rights.

If it weren’t for the United States and President Bush, none of this would be possible and the train would still be in the station.

February 25, 2005

Can people choose socialism?

Filed under: — Different River @ 4:05 pm

George McGovern was quoted as saying during his 1972 presidential campaign that “If the people of the Soviet Union want to live under Communism, we have no right to interfere.” (I don’t have a source for that quote, so maybe it’s apocryphal — send me an e-mail or post a comment if you know a source.) The truth, of course, is that the “people of the Soviet Union” never got to chose anything, so if McGovern actually did say that, it was an idiotic thing to say.

It was often said during the Cold War that the different between Communism and Socialism was the Communism was imposed by dictators, but Socialism (e.g., in Sweden, etc.) was democratically chosen.

Now, Ashish Hanwadikar takes on the question of whether it is even possible for socialism to be democratically chosen, with specific reference to the case of India:

[D]o you think people, whose properties were appropriated by Indira Gandhi’s Govt. in the name of Nationalism, choose to have socialism? If they indeed “choose” to have socialism why was force necessary to take their property.

Oh, I see. You mean to say MOST of the people chose to adopt socialistic pattern of economic “development”. Indeed, according to same logic a village can “choose” to make a widow sati. You see, in socialism people have freedom to choose for others. What a craze!

Indeed, if Socialism is the right of some people to choose how to dispose of other people’s property, then it’s not just an economic system different from free enterprise; it’s also a political system different from democracy.

Joe takes on the French Consul

Filed under: — Different River @ 3:38 pm

The French Consul General to New England, Thierry Vankerk-Hoven, made a visit to Dartmouth College, and during the question period Joe of Joe’s Dartblog asked him some rather pointed questions.

When he was done I asked, “Will you comment on why France, and consequently the EU, has refused to name the Islamist militant group Hezbollah as a terrorist organization.” I got more than a few stares from the consul’s assistant and Prof. Rassias, who was sitting next to her.

The consul’s answer was absolutely laughable. He went on for a while about how sensitive an issue this is in France- in an attempt, I presume, to temper his response by putting it in the context of, “Well some French people disagree”- but in the end his response was this: Hezbollah is not merely a militant organization. They are also a political organization, and thus they cannot be considered terrorists.

As far as Hezbollah is political, their only tenet is that Israel must be destroyed. To the French, whose obstruction prevented the EU from listing the group as terrorists, ‘the destruction of the Zionist state’ is simply a political objective.

A simple counter might have been, “Would France consider a British organization with the stated goal of destroying France and all of the French people, and which has successfully carried out homicidal missions in the past, but which happens to state these goals in political rhetoric, a terrorist group?” But I wasn’t feeling all that snarky.

The Consul General also discussed EU enlargement, “soft power,” and the to what extent the EU is meant to be a counter to US power. Read the whole thing.

Joe concludes with some comments that reflect very well on his French professor (who is both a professor of French and a professor from France), but rather poorly on the intellectual climate at Dartmouth:

I must add that my French professor, Brigitte Mosenthal, who I am certain disagrees with me politically, was very supportive. After the talk was over, she thanked me for livening it up. She acknowledged that everyone seems to have the same opinions at Dartmouth and so some questioning of the norm is healthy. Being as she was the one who brought me to the talk, she could have been angry that one of her students bucked the liberal hardline in front of the department chair, but she wasn’t. That was awfully big of her, and I was impressed and thankful.

February 24, 2005

Event-based Health Insurance

Filed under: — Different River @ 9:17 pm

One of the problems with health insurance is that it isn’t really insurance. Normally, the idea behind insurance is you trade a small probability of a large loss (say, a 0.0001% chance that your house burns down) for a certain (100% probability) small loss (the premium you pay). Homeowner’s, renter’s, car insurance, and even term life insurance work this way. Health insurance doesn’t — with health insurance you (and/or your employer) pay a premium designed to cover not only small-probability events (heart attacks in 30-year-olds) but near-certain events (childhood vaccinations and check-ups, antibiotics for occasional bronchitis), and events known in advance to be certain for particular individuals (insulin for diabetics, medicine for asthmatics). Arnold Kling discusses this issue in more detail here.

Another problem is that once a health problem is diagnosed, there are often several treatment options, and once your deductible is met there is no reason not to go for the most expensive treatment available. For example, if treatment A has a 95% chance of working and costs $500, but treatment B has a 97% chance or working but costs $5,000, any normal person would try A first and use B only if A didn’t work — but a person with insurance (with, say, a $100 deductible) would rationally choose B first, since the person pays the same for either one and B has a better chance of working.

Both in the article linked above and here on the EconLog blog, Arnold Kling proposes to solve this problem using something he calls “event-based insurance.” The idea is:

Event-based insurance means receiving a lump-sum payment at the time of diagnosis. Thus, even if the treatment goes on for years, the consumer has money to pay for it. The consumer does not have to worry about losing coverage with a pre-existing condition, because the consumer already has received benefits for that condition.

It would be reasonable to include a disability component to event-based insurance. If an ailment is going to cause a lapse in work, then the insurance payment can include a lump sum based on the typical amount of work time lost with that ailment.

For Discussion. What problems would event-based insurance solve, and what problems would it create?

In principle, this is a great idea. It would make health insurance more like regular insurance, and — more important — it would also rationalize the market for health care by giving patients incentives to consider the monetary costs, as well as the benefits (and side-effect costs) of various treatment options and various health care providers. (The reason for this is that if they get cured for less than the lump-sum payment, they could keep the change — and if they couldn’t get cured for that amount, they’d have to pay the difference or do without.)

However, one problem with event-based (better, “diagnosis-based”) insurance is that it doesn’t interact well with the technology of how medicine is actually practiced. In particular, event-based health insurance would make payments after a diagnosis is determined — but a huge percentage of medical costs these days is in diagnostic tests and images. (MRIs and CAT scans are expensive!). For example, in 2002, 17.7% of Medicare spending was for diagnostic images and tests (see page 78 of the document in this PDF file), and that’s not including the substantial share of physician visits devoted to diagnosis — not to mention things like biopsies and exploratory surgeries (which, since they involve surgery, count as “procedures” not “tests”). I would not be surprised if it turned out that more than a third, maybe more than half, of total health care spending is for diagnosis rather than treatment.

Furthermore, medicine is often practiced in a “sequential” manner, in which treatments lead to diagnoses, as well as the other way around. For example, suppose a patient comes in with chronic breathing trouble. The doctor could immediately order a CAT scan of the lungs and an MRI, looking for everything from lymphoma to pulmonary fibrosis to lung cancer. All of these diagnoses are possible, but the highest probability event is that it’s asthma. So, instead of ordering all these tests, the doctor writes a prescription for a couple of asthma drugs, and tells the patient to try them. If it works, the problem is solved and the diagnosis is simultaneously confirmed. The doctor may not even order the definitive test for asthma. If the asthma drugs don’t work, then the doctor goes on to try other asthma drugs and/or test for asthma, then test for other diseases, most likely in order of their probability (unless some tests are very cheap, in which case they’ll be done anyway).

Because some tests are very expensive, and some treatments are relatively cheap, this could actually be the optimal approach to treatment given both the costs of treatments and tests, and the probabilities of various diseases. If the probability (given known symptoms) of a disease is high, and the treatment for that disease is low in cost (both in terms of money and side-effects), and the tests for alternative, low-probability diseases are expensive, then it can be optimal to “treat and see if it works” rather than “test for everything before treating for anything.”

However, event-based health insurance is dependent on the latter approach, since no payment is given without a definitive diagnosis. As a result, event-based health insurance could actually increase the cost of health care for some classes of symptoms, and could delay treatment for a majority of patients — since tests take time and by definition most patients have the common diseases.

In other words, part of the reason health insurance is not “real” insurance is due to historical and regulatory issues, but part of the reason is due to the inherent nature of health care.

I should add, however, that the case for event-based (or diagnosis-based) insurance is not completely lost. It is possible that an optimal health insruance system could involve a diagnosis-based component for certain well-defined diseases and conditions. For example, I have actually received in the mail offers for something called “cancer insurance” that pays a set amount for any diagnosis of cancer. They sell it as a way to pay for deductibles, co-payments, and items not covered by ordinary health insurance, but in principle there’s no reason why an insurance scheme couldn’t have a complex system of different payments for different types of cancers, perhaps will additional payments if cancers proceed beyond specificed stages. However, not all diseases are as well-defined as all that, and you still need a way to cover the diagnostic tests.

Another problem I’d like to see dealt with is insurance for chronic conditions. For example, a diagnosis of Type I (“juvenile”) diabetes is basically a guarantee of a lifetime of large health expenses. It would be nice to have insurance against this. There are two problems, however.

First, diabetes (and many other chronic conditions) is usually diagnosed in children and adolescents, but most of the payments are made when those same people are adults. So by the time you get to buy insurance, you already have the event that should trigger payment. Insurance would have to be purchased by parents for their children, but that’s not likely to happen as long as parents have the reasonable expectation that their children will be able to obtain, as adults, health “insurance” that will pay these expenses.

Second, people diagnosed with chronic conditions by definition live a long time after they are diagnosed. And, medical technology is developing quickly and all indications are it will continue to do so. It’s not all that difficult to calculate the cost of treating diabetes for a lifetime — if you get to assume that technology will remain at today’s level for that entire lifetime. But it won’t. Improvements in medical technology can either increase or decrease costs (I have written on this in my “real life” and should post about it some time). A patient insuring against diabetes would want to have enough to pay for (say) an artificial pancreas in case one is invented in his/her lifetime, even if it’s more expensive than a (remaining) lifetime of test strips and insulin shots. An insurance company has no good way to estimate that cost — and furthermore, the insurance company would want to be “protected” against the chance that test strips and insulin injections become much cheaper over the patient’s lifetime.

By the way, diabetes is just an example — the same sort of concerns would hold true for numerous other chronic conditions, including genetic conditions.

How much does it cost to invent a new drug?

Filed under: — Different River @ 7:57 pm

In a historic 1991 paper, Joseph DiMasi and colleagues calculated an estimate of the total cost to a drug company of developing a new drug. The innovative part of the paper was that they took into account the fact that most drugs fail to reach the market, and the drugs that do reach the market take many years, maybe even decades to develop. So, instead of just taking a couple of case studies of drugs that made it, they calculated total research costs, including for drugs that didn’t make it. This is the right way to do it, since a drug company doesn’t know in advance which of the (say) 5,000 compounds it tests will turn out to be the one that becomes the new drug. In any case, they calculated that the average drug costs $231 million to produce, counting only costs of research and development, and of getting the drug through the FDA approval process (i.e., not including actually producing the pills, or marketing). The $231 million is in 1987 dollars, which if you adjust for inflation, is equivalent to $350 million 2000 dollars.

In 2003, DiMasi and his colleagues published another paper available here, recalculating the cost based on more up-to-date data. They found that the cost had risen to $802 million (2000 dollars) — in other words, the cost of developing a new drug more than doubled in 13 years.

Needless to say, the issue is much more controversial now than it was in 1991, and anti-drug-company lobbyists came up with some rather silly criticisms of the methodology. Alex Tabarrok of George Mason University debunks one of the big criticisms here.

Now, Alex points out a paper by two other economists, Christopher Adams and Van Brantner, have tried to validate their data in a new paper entitled, “Estimating the Costs of New Drug Development: Is it really $802m?” Their answer is … no, it costs more. As in, between $839 million and $868 million (in 2000 dollars).

In other news, the new survey by the Pharmaceutical Research and Manufacturers of America (PhRMA) finds that drug company research spending in 2004 is up 12.6% over 2003, to $38.8 billion.

That’s a lot of money.

References:

  • DiMasi, Joseph A., Hansen, Ronald W., Grabowski, Henry G., Lasagna, Louis, 1991. “Cost of innovation in the pharmaceutical industry,” Journal of Health Economics 10:107–142.
  • DiMasi, Joseph A., Hansen, Ronald W., Grabowski, Henry G., 2003. “The price of innovation: new estimates of drug development costs,” Journal of Health Economics 22:151-185.
  • Adams, Christopher and Brantner, Van V., “Estimating the Costs of New Drug Development: Is it really $802m?” (December 2004). http://ssrn.com/abstract=640563

FDA Resisting Cancer Drug

Filed under: — Different River @ 7:13 pm

I’ve mentioned before, in connection with COX-2 inhibitors that for a long time, the FDA has focused too much on risks and not enough on benefits, and has implicitly assumed that the risk-benefit trade-off is the same for all patients with a given disease.

This problem is not about COX-2 inhibitors as such, its a more general FDA problem. They are delaying approval of a innovative new prostate cancer drug that works by “harnessing the body’s natural immune cells to seek out the cancer and destroy it” rather than just killing all rapidly-dividing cells and hoping it kills the cancer before the patients.

When the company first submitted its evidence to the FDA almost three years ago, asking for permission to sell it, the FDA said no. When the agency looked at all of the patients enrolled in the company’s trial, the vaccine didn’t show an overwhelming benefit in the short-term study of more than 100 prostate cancer patients. But when Dendreon looked at a smaller subgroup of the patients in the trial, those with a certain less aggressive form of prostate cancer, the results looked great. The FDA, however, does not allow “retrospective” analysis, which is statistically impure and can lead to cooked results. So Dendreon was asked to do a new trial, studying the vaccine just in patients who had the less aggressive form of the cancer. There was evidence that the vaccine worked for certain patients, but the FDA wanted more convincing data.

It turns out, however, that when Dendreon continued to follow the patients in the original study for another two-and-a-half years, the results continued to get better–for all the patients, not just those with the less aggressive cancer. Thursday evening, Dendreon announced that 34% of those who received Provenge in that original trial were still alive after three years, compared with 11% of those who took a placebo. …

Dendreon’s vaccine product seems on track to win approval, the question now is whether the FDA will wait for the company to finish the trial it has underway or approve the product based on the mounting strength of the results of that original trial. If the FDA sticks to its rules, it will wait for the new study to finish, and patients will pay a significant price: denied access to a largely safe product that looks to be a real advance in cancer care.

The problem is that at the Food and Drug Administration, creativity is not a virtue. The Agency prides itself on developing fixed approaches to regulatory problems, striving to set clear requirements on how it reviews and approves new drugs and applying these criteria consistently across its different divisions and through the review of different products in different diseases. That really stings new medical technologies like cancer vaccines, which require a different regulatory approach. One of the big problems is that patients who get the vaccines in clinical trials are less likely to benefit from these products because regulatory rules compel companies to test them on the sickest patients.

The vaccines work by stimulating the immune system to begin fighting off the cancer on its own. Since most of the patients receiving these vaccines are already on death’s doorstep, their depleted immune systems are hard pressed to respond to the treatments. As a result, the trials are unlikely to yield the statistically favorable results preferred by the FDA.

Invade Lebanon?

Filed under: — Different River @ 6:57 pm

Lebanese are demonstrating against the Syrian occupation of their country, and at least one leader called for an American invasion of Lebanon.

“Syria out. Syria out,” they shouted as Arabic pop music blared, amid calls for a “peaceful intifada” or “uprising” against a government that was put into place and remains controlled by neighboring Syria.

“We are with the Muslims, the Druze, together for a free Lebanon,” said one member of a Christian militia. “Tell America we are waiting for them to invade, all of us.”

(Hat tip: James Taranto.)

Oppose the troops!

Filed under: — Different River @ 6:24 pm

Here in the U.S., almost everybody claims to “support the troops” regardless of their position on the war. Even hard-core liberals who hate the military generally claim to support the individual soldiers (and sailors and airmen and marines) even if they view them as victims of the war (“Support the troops by bringing them home!), a position most in the military would not exactly find supportive.

Nevertheless, there are some people who think even this is too much. These are people who think those who join the military are parasites “leeching off of our tax dollars.” They say military pay is too high, since military members do “very little work” (HUH?). And in rare case where they admit military members actually work, they admit their pay is much lower than for comparable civilian work, and say this is “as it should be.”

They say the military and police should be abolished as a waste of taxpayer dollars. They also consider this person a prime example of why military people are selfish leeches, and this wounded Marine as a prime example of someone who should not get veteran’s health benefits. Those were the only examples I saved, but there were a lot more. Makes me wonder if these people live on the same planet as I do.

I saw their web site yesterday at www DOT forsakethetroops DOT info (my intent was not to link, which would give them a high Google profile, but have you type in the name yourself if you want to see it). But it turns out that they are sort of leeches themselves — they web hosting provider shut them down for failing to pay their bills and starting an e-mail-writing campaign of threats and obscenities against said hosting provider. (Which proves they are not only vile and cheap, but stupid, too!) They also made the mistake of buying their domain name through their hosting provider, so they lost that, too. Go to that same web address for the hosting provider’s explanation.

Nevertheless, their viewpoint survives in a letter to the editor published in the Syracuse Post-Standard and archived here, which contains the following gems:

I don’t support our troops. Anyone who joins the military is leeching off society and draining our tax resources. We should all be so lucky – free housing (on the taxpayers’ dime) and inexpensive medical insurance, as well as a multitude of other obscene benefits.

It is no good for America. If we must have a military, make them pay for everything – just like everyone else. Eliminate free “base housing” and make them pay rent. Eliminate the “dependent allowance” and the “uniform allowance.”

I know this is obvious, but certain life experience have taught me that one has to refute even argument that are obviosuly preposterous, so I will:

What’s this this about, “If we must have a military, make them pay for everything – just like everyone else.”? Do employees normally pay for everything used to do their jobs? Do secretaries pay their employers for their desks and telephones and rent for their offices? Do plumbers pay homeowners for the right to fix their toilets? What sort of “everyone else” is this guy talking about?

It is a fitting tribute to the power of the First Amendment that they weren’t taken out and shot, too.

(Hat tip: Poisoning Pigeons)

SHA-1 Broken (Update)

Filed under: — Different River @ 6:09 pm

Updating this post:

Slashdot reported that:

The findings are that SHA-1 is not collision free and can be broken in 2^69 attempts instead of 2^80. This is about 2000 times faster. With todays computing power and Moores Law, a SHA-1 hash does not last too long. Using a modified DES Cracker, for the small sum of up to $38M, SHA-1 can be broken in 56 hours, with current computing power. In 18 months, the cost should go down by half. Jon Callas, PGP’s CTO, put it best: ‘It’s time to walk, but not run, to the fire exits. You don’t see smoke, but the fire alarms have gone off.’ As Schneier suggests, ‘It’s time for us all to migrate away from SHA-1.’ Alternatives include SHA-256 and SHA-512.”

So, I’m not particularly worried, but quite properly PGP is moving to a more secure version of the SHA algorithm.

This is a good argument for keeping your software upgraded.

Gay Rights vs. Biodiversity

Filed under: — Different River @ 5:51 pm

Now which side is a good progressive supposed to take on this situation?

SHA-1 Broken (Update)

Filed under: — Different River @ 5:45 pm

Updating this post:

Slashdot reported that:

The findings are that SHA-1 is not collision free and can be broken in 2^69 attempts instead of 2^80. This is about 2000 times faster. With todays computing power and Moores Law, a SHA-1 hash does not last too long. Using a modified DES Cracker, for the small sum of up to $38M, SHA-1 can be broken in 56 hours, with current computing power. In 18 months, the cost should go down by half. Jon Callas, PGP’s CTO, put it best: ‘It’s time to walk, but not run, to the fire exits. You don’t see smoke, but the fire alarms have gone off.’ As Schneier suggests, ‘It’s time for us all to migrate away from SHA-1.’ Alternatives include SHA-256 and SHA-512.”

So, I’m not particularly worried, but quite properly PGP is moving to a more secure version of the SHA algorithm.

This is a good argument for keeping your software upgraded.

No, it wasn’t really the kissing scene

Filed under: — Different River @ 5:28 pm

When I first saw this headline on Drudge:

Oscar-nominee Portman infuriates religious Jews over kiss scene

I thought, gee, this is an actress who’s done nude scenes, and they object to the kissing scene? What kinds of prudes are these “religious Jews”? Which is, no doubt, the impression the headline-writer, and perhaps the article-writer, wanted to create. However, when you actually read the article, it’s not quite that simple:

JERUSALEM (AFP) – Hollywood star Natalie Portman, nominated for a best supporting actress award at this month’s Academy Awards, stirred a scandal over a kissing scene by Jerusalem’s Wailing Wall — the most sacred spot in Judaism, the top-selling Israeli daily said.

But a kissing scene with co-actor Aki Avni in a car park next to the Wailing Wall infuriated religious Jews praying at the site, who slammed the smooch as an act of “lewdness” before chasing the pair and the crew off the set.

The paper said director Amos Gitai had not asked for permission prior to shooting the scene, but reached a compromise after the incident that he and his crew could come back to the site at a later hour.

AHA! So it wasn’t the kissing scene per se that was objectionable, it was a kissing scene filmed at a holy site without permission.

That’s entirely different. See, Jews — even religious Jews — aren’t opposed to kissing as such, especially between people who are married (to each other! get your mind out of the gutter!), but there is a time and a place for everything. There are always people praying at that spot and Judaism places a high value on concentration during prayer, and such concentration is not exactly enhanced by the presence of an unauthorized film crew, let alone one filming a scene containing a very famous actress engaging behavior not exactly appropriate to that location.

I doubt the response would have been much different if the film crew had shown up without permission and started filming a kissing scene (or any other scene) in the Sistine Chapel. Of course, if they’d done that in Mecca, the reaction probably would have been much different — they would have been arrested by the mutawwaeen (Saudi religious police), unless they got stoned to death first. If you don’t believe me, click here, here, here, and if you are of strong stomach here, and if you are of really strong stomach, here.

Larry Summers round-up

Filed under: — Different River @ 4:59 pm

Reactions from all sides:

Matthew Yglesias, an self-described liberal, writes:

Now that the full text of the speech is out, I’m surprised so much of the discussion has focused on the genetics issue to the number one item on the Summers list — women’s alleged unwillingness to work long hours because they’re too busy having kids and taking care of them. This is, I think, undoubtedly a major factor.

Indeed it is. And Jane Galt, who if not from the right is at least normally to the right of Matthew Yglesias, writes:

Larry Summers made some suggestions about the causes of female underrepresentation in the “hard” sciences. They were based on research, more than adequately caveated, and eloquently put. The hysterical reaction to his remarks by women at the conference, followed by the indignant bluster of Mr Summers’ colleagues, make Harvard, and academia, look more than a little bit silly.

And as she points out, Robert Brown, commenting on Yglesias’ blog, finally hits the essential point:

[I]f the university maintains that tenure is intended to foster a climate of free debate of a wide range of unpopular hypothesis, then it seems hypocritical for the tenured faculty to demand multiply apologies from Summers and threaten his job because he offered a hypothesis that certainly should be open to scientific verification.

To the outside observer it makes Harvards faculty look like a bunch of immature people unwilling to entertain ideas that conflict with their narrow view of the world.

In fact, I think it would be a good idea in general for academia to take a look at things from the standpoint of the “outside observer.”

Doctor sues doctor for “sperm theft distress”

Filed under: — Different River @ 4:48 pm

Folks, I can’t make this stuff up. Here’s proof that (a) being a doctor is no proof of intelligence, and (b) people do some really weird things, (c) lawyers sue about them, and (d) courts take them seriously.

I’m trying to keep this website clean, so instead of quoting the story, I’d like to suggest you click over to the mainstream media outlet which, having the high standards of professional journalists, wasn’t concerned about publishing stuff like this.

Spy-cams don’t stop crime

Filed under: — Different River @ 4:42 pm

The Evening Standard, a newspaper in London, the city with perhaps the most surveillance cameras per square mile kilometer than anywhere else, is reporting that even the government there admits that the cameras don’t reduce crime. The only exception they found was for cameras in parking lots. But the cameras on public streets, the ones that were supposed to eliminate crime in central London, aren’t doing that. All they do is infringe people’s privacy without conferring any countervailing benefit.

Closed circuit TV systems are of little use in the fight against crime, a surprise government report claims today.

Home Office researchers who studied 14 schemes across Britain found that only one had brought a clear fall in the local crime rate.

The findings come as a blow to the Home Office, which has trumpeted CCTV as a key crime-fighting weapon for the past 10 years.

The report’s author, Professor Martin Gill of the University of Leicester, said: “For supporters these findings are disappointing. For the most part CCTV did not produce reductions in crime and did not make people feel safer.”

Note that they not only did not reduce crime, but they “did not make people feel safer.” I guess according to professor Gill, if they did not reduce crime, but fooled people into feeling safer, that would be better than doing neither.

I find the emphasis on “feeling safer” very disturbing — the implication is that “feeling safer” is a benefit separate and distinct from “being safer,” and that it is a good thing to at least make people feel safer even if we can’t make them actually safer. This is not only wrong, it’s backwards — if you feel safer than you are, you are likely to take actions that make you even less safe. If you feel too safe in a car, you may not wear your seatbelt, which makes you less safe than you would be if you felt a bit unsafe and wore it. Likewise, if you feel more safe from crime than you really are, you might not take precautions that are actually justified given the actual level of safety you have.

The goal ought to be to make people actually safer, and have them feel exactly as safe as they are, no more and no less. (You don’t want people to feel too unsafe either, because then they will wastefully take unnecessary precautions.)

The article ended with the following curious statement:

On the plus side, only one in six people objected to CCTV on civil liberties grounds.

Well, there’s unbiased journalism for you! How would they feel about someone writring this: “On the plus side, only one in six people objected to censorship of the press on civil liberties grounds.”

I rather think it’s on the minus side, that so few people think that centralized surveillance in the tradition of 1984 is objectionable on civil liberties grounds.

Discrimination in Brookline (2)

Filed under: — Different River @ 12:23 pm

A couple of weeks ago I mentioned the story of an Army Lieutenant living in Brookline, Massachusetts, who was denied renewal of his gun permit for reading in the “wrong” section of a public library.

I neglected to include — but should have — another angle to the story: Nearly all non-white gun owners in Brookline have been denied renewal of their permits.

It was the faces of three disillusioned and angry residents that told a story in the lobby of Brookline District Court earlier this week.

There was Kang Lu, a Chinese-born U.S. Army second lieutenant and future military doctor, dressed in uniform, hoping, finally, for redemption in the form of a restored license to carry firearms. Next to him was longtime resident Yat Lau, also Chinese-born, who was similarly rejected in his bid to renew a license to carry a permit that was first issued to him four years ago in Newton.

And finally, sitting quietly on a bench outside the courtroom, was diminutive law paralegal and gospel choir singer Jacqueline Scott, a 53-year-old African-American woman and former domestic abuse victim, who said she has heard “nothing, nothing, nothing,nothing ” from the Brookline Police on her first-time application to carry a gun which she completed in October 2003.

Asked if the he felt as though he and others on hand were being targeted for revocation or non-action on licenses by police because of their race, Lu said only, “If you look around here today, we can let you make that assessment.”

(Note that this is a permit to own, not to carry, a gun, and not just a handgun. So you needed even if you own a hunting or target rifle or shotgun.)

Mass Backwards has been following the excellent coverage of the Brookline TAB on this story, and they report that in addition to denying him his permit renewal, while his old permit was still valid, the Brookline police searched his apartment and seized his guns, without a proper warrant. So they are not only violating his rights under the First Amendment (to use a library) and the Second Amendment (to keep, never mind bear, arms), but also his Fourth Amendment right to be free of unreasonable searches and seizures without a warrant:

Part of Lu’s complaint is that he was called by Raskin to arrange a visit “to discuss” his license application at Lu’s apartment in June 2003. But Raskin used the visit to hand Lu a license denial letter, at which point Raskin – accompanied by several additional officers – confiscated Lu’s firearms.

And, after the story got out, more people are coming out of the woodwork with similar complaints, and they are calling Lieutenant Lu’s lawyer.

After the TAB first reported about Lu’s inability to secure a gun permit, his lawyer Jesse Cohen says he has been besieged by calls from other residents who also have complaints about discourteous treatment and trumped-up reasons for denial of licenses by Brookline police.

He said the complaints focus on the decisions made by Brookline Sgt. Michael Raskin, who is in charge of processing and investigating gun license applications.
“When the TAB printed the first story [Feb. 3], many people came out of the woodwork and contacted me … talking about similar experiences with Sgt. Raskin,” said Cohen, who this week was granted a postponement of the hearing in Brookline to April 7 in order to collect all of the testimony from those who since contacted him.

Cohen also said they are considering filing a federal civil rights lawsuit against the Brookline Police Department. I say go for it.

As I said before, , you would never know from the situation now that the American Revolution started just outside Boston, with a conflict over the (British) government’s confiscation of guns.

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