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Roubini on Inequality

By John Ballard

Snip here from Nouriel Roubini's latest.

...free markets don't generate enough final demand. In the United States, for example, slashing labor costs has sharply reduced the share of labor income in GDP. With credit exhausted, the effects on aggregate demand of decades of redistribution of income and wealth—from labor to capital, from wages to profits, from poor to rich, and from households to corporate firms—have become severe, owing to the lower marginal propensity of firms/capital owners/rich households to spend.

The problem is not new. Karl Marx oversold socialism, but he was right in claiming that globalization, unfettered financial capitalism, and redistribution of income and wealth from labor to capital could lead capitalism to self-destruct. As he argued, unregulated capitalism can lead to regular bouts of over-capacity, under-consumption, and the recurrence of destructive financial crises, fueled by credit bubbles and asset-price booms and busts.

In other words, if you ain't got cash or credit you can't buy anything. What's not to understand?

What Climate Change?

Commentary By Ron Beasley

Via Barry Ritholtz

 

HCR -- Yet Another PSA Commentary (Follow-up/Update)

By John Ballard

I'll get right to the point. 
Routine PSA screening is (again) not recommended.

Cancer screening tests are vastly overused in the United States, with about 40% of Medicare spending on common preventive screenings regarded as medically unnecessary, an iWatch News investigation reveals. Millions of Americans get such tests more frequently than medically recommended or at times when they cannot gain any proven medical benefit, extracting an enormous financial toll on the nation’s health care system. Doctors disregard scientific guidelines out of ignorance, fear of malpractice suits or for financial gain, as patients inundated by medical advertising clamor for extra tests.

This is old news for readers of Newshoggers. When it's a slow news day it never hurts to beat the same old drum in case somebody hasn't heard it yet. 

• How to Rein in Medical Costs, RIGHT NOW  (August 2009)
• Plain Talk by a Doctor  (October 2009)
• PSA Testing is NOT a Test for Prostate Cancer   (March 2010)
• Active Surveillance of Prostate Cancer  (November  2010)

So guys, read and decide for yourself.
I have decided in advance for the Swedish Option (see that November link). 

In my job as a senior caregiver, mostly for other old men, I have changed more disposable underpants than a mother with a toddler. I'm just a layman, but I don't think little kids pee as often as old people who are incontinent. Scanning the main link above, this part caught my eye...

“Screening is about fifty times more likely to ruin your life than it is to save your life,” says Dr. Otis Brawley, chief medical officer of the American Cancer Society, citing the results of one key study.

Yet prostate cancer screening remains a huge industry in the United States. Hospitals can generate enormous profits from them and sometimes offer free screenings to recruit new patients. By offering free tests to just 1,000 patients, a hospital can bill Medicare and insurance companies $4.9 million in follow-up procedures, Brawley said — a figure calculated by previous administrators at an Atlanta hospital where he once worked.

HealthFair, which takes screening vans to corporations and community events, used to advertise its services to hospitals on the Internet, saying: “With patient revenue being down as much as 30% in some specialty physician groups, a partnership . . .can bring tremendous value to you.”

Zero, the Project to End Prostate Cancer, meanwhile, now takes its vans to 60 locations around the country each year, offering free PSA tests — a practice that Brawley believes is unethical. Mass screening programs, he says, “actually deceive men into thinking that screening is better than the science tells us.” Jamie Bearse, Zero’s chief operating officer, said every man receives information about early detection, adding “the American Cancer Society condemns some men to death with its stance on PSA testing today.”

Even Kimberly-Clark, the maker of Depends adult diapers, has launched campaigns to end prostate cancer, donating money to Zero.

Says Brawley: “While it is a question as to whether prostate screening saves lives, it definitely sells diapers.” A Kimberly-Clark spokesman said its campaign’s intent was not to sell diapers. The campaign’s goal was “bringing an end to this terrible disease,” according to a company press release.

Medicare reimburses health care providers large sums for some prostate cancer treatments, paying as much as $40,000 a patient for intensity-modulated radiation therapy. The government insurance program spent an estimated $1 billion in 2008 on this therapy, according to an analysis of Medicare records by The Wall Street Journal .

“I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster,” Dr. Ablin wrote in a New York Times op-ed column last year. Eliminating routine PSA screening, he said, “would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments.”

Time permitting, do read the entire iwatch report. Over five thousand words, it covers lots more than PSA testing.  

~~~~~~~~~~~~~~~~~~~~~~~~~

Joe Paduda has more.

The test, which ostensibly screens for prostate cancer, is notoriously inaccurate, delivering a high rate of false positives and false negatives. And, men who get these tests have no greater chance of surviving the test than men who don't.

Seventy percent of positive PSA tests are false positives; the patient does not have prostate cancer. Worse, these false positive tests often result in more tests and treatments that then result in impotence and incontinence and in some cases, premature death. According to the chair of the Task Force, "This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does."

Over a twenty year period, about a million men got prostate surgery, radiation, or a combination as a result of a PSA test. Of those, about 5000 died soon after surgery, and from 10,000 to 70,000 suffered serious complications, and 200,000 to 300,000 were incontinent, impotent, or both. The dimension of the problem was starkly illustrated when the test's developer called its widespread use "a public health disaster."

Alabama Jobs Stimulus Plan

By John Ballard

Anti-immigrant animus is the new Jim Crow. 
And Alabama is trying to outdo Arizona with it's new anti-immigration laws.
Seems to be working.

Tomatoes rotting on the vine in Alabama. Not a single worker in sight

 

 

Israel's Defense Against a "Demographic Demon"

By John Ballard

This fascinating video via Notes from a Conflicted Land by Michael Omer-Man, an American writer living in Israel, illustrates in graphic form how two or three easy to understand principles are being deliberately used to shrink Palestinian power in an uneven conflict between Israel and Palestine. He provides English subtitles which would not likely be furnished by the source. I find this video to be more than a little disturbing. 

When the phrase "right of return" is used by Israel it applies only to Jews (whether or not born in Israel), but not former residents or their families who fled or were driven away as the result of the extablishment of Israel. 

Many in Israel say there is no such thing as Palestine. (See this video)

Reference to the "demographic demon" strikes me as nothing more than a variation of eugenics, an ironic resource to be found in any Jewish toolbox.  References to time is on our side clearly indicates that the more "resolution" of the I-P conflict can be delayed, the better the outcome will be for Israel. 

Bring Back Conscription

By John Ballard

The so-called "all-volunteer" military is not working.
What more evidence do we need?

For the second year in a row, more American soldiers—both enlisted men and women and veterans—committed suicide than were killed in the wars in Iraq and Afghanistan. Excluding accidents and illness, 462 soldiers died in combat, while 468 committed suicide. A difference of six isn't vast by any means, but the symbolism is significant and troubling. In 2009, there were 381 suicides by military personnel, a number that also exceeded the number of combat deaths.

Earlier this month, military authorities announced that suicides amongst active-duty soldiers had slowed in 2010, while suicides amongst reservists and people in the National Guard had increased. It was proof, they said, that the frequent psychological screenings active-duty personnel receive were working, and that reservists and guardsmen, who are more removed from the military's medical bureaucracy, simply need to begin undergoing more health checks. This new data, that American soldiers are now more dangerous to themselves than the insurgents, flies right in the face of any suggestion that things are "working." Even if something's working, the system is still very, very broken.

One of the problems hindering the military's attempt to address soldier suicides is that there's no real rhyme or reason to what kind of soldier is killing himself. While many suicide victims are indeed afflicted with Post Traumatic Stress Disorder after facing heavy combat in the Middle East, many more have never even been deployed. Of the 112 guardsmen who committed suicide last year, more than half had never even left American soil.

"If you think you know the one thing that causes people to commit suicide, please let us know,” Army Vice Chief of Staff General Peter Chiarelli told the Army Times, "because we don't know what it is."

Had a military draft been in place from the start of the wars in Afghanistan and Iraq these adventures would have long since come to an end. Body bags and crippling life-long injuries have political consequences that are smarter and safer than what is causing this tragedy.

Instead...

• Many young men and women imagine that life in uniform is more promising than the bleak civilian alternatives they face,
• civilian contractors become aggressively patriotic as visions of profitability dance in their heads,
• Ike's warnings of the military-industrial complex have been forgotten amid careless use of the word war (War on Drugs. War on Cancer. War on Poverty. Etc.), 
• and as memories of conflicts in Vietnam, Korea and WWII fade so, too, do memories of the horrors of war.

Military service is a patriotic duty and for some a career. Like many family occupations military service often follows from one generation to the next (entertainers, politicians, craftsmen, entrepreneurs, sports figures). That is a historic tradition reflected in most societies. 

A well-prepared military, both active and reserve, is as essential as police, fire protection and emergency medical services. But we don't advocate arson in order to give firemen something to do any more than we encourage tooth decay to help dentists pay the rent. Neither should we advocate wars simply because we have armies. Professional warrior classes have a poor record in history. Military coups, though occasionally instrumental in advancing the cause of representative government, are more often associated with despotism.

When I was a draftee in 1965 I truly hated being forced to give up two years of my life for what I considered an empty waste of time. But once I was past Basic and AIT I got over it. And when I finally returned to school (taking eight years to get an undergraduate degree) the GI benefits helped make it possible to afford college. The Vietnam Era had many casualties and I don't know the suicide stats. But my guess is that a big part of today's tragic numbers derives from a combination of (a) unrealistic expectations and (b) desparation on the part of many that if a military career is their best hope for the future they would rather be dead than continue.  

Military service, properly understood, should be regarded as one of the more disagreeable parts of good citizenship. No one should celebrate combat and that is the core reason that military service exists. There are bright spots and benefits to be sure. Churchill famously said there is nothing more exhilarating than to be shot at without result. But the main mission, together with the risk of death or injury, is nothing to feel good about.

I believe that a draftee on active duty has a healthy expectation that there is a light at the end of the tunnel and once back into civilian life may feel relieved that one of life's more disagreeable chapters is finally behind him. I'm convinced that a military draft would result if fewer suicides both on and off the battlefield. 

GIGO

By Dave Anderson:

Mark Thoma catches an interesting article on the reliability of US corporate finace data:

Deviations from Benford's law have increased substantially over time, such that today the empirical distribution of each digit is about 3 percentage points off from what Benford's law would predict. The deviation increased sharply between 1982-1986 before leveling off, then zoomed up again from 1998 to 2002.  Notably, the deviation from Benford dropped off very slightly in 2003-2004 after the enactment of Sarbanes-Oxley accounting reform act in 2002, but this was very tiny and the deviation resumed its increase up to an all-time peak in 2009....

I looked at Benford's law for three industries: finance, information technology, and manufacturing. ... [shows graphs] ... While these time series don't prove anything decisively, deviations from Benford's law are compellingly correlated with known financial crises, bubbles, and fraud waves. And overall, the picture looks grim. Accounting data seem to be less and less related to the natural data-generating process that governs everything from rivers to molecules to cities. Since these data form the basis of most of our research in finance, Benford's law casts serious doubt on the reliability of our results...

The game is fixed and our elite overlords are happy to continue to get their skim from the everpresent 401(K) incomef stream as us dupes have to go to the casino with the loaded dice. 

 

HCR -- Reader Comment Nugget

By John Ballard

I waste too much time slogging aound in a swamp, otherwise known as the comment threads of The Health Care Blog.  
Sometimes I find a treasure. This is worth keeping...

Mr. Lane is edging back to the conversation about what to do with all those poor people. Mr. Ogden worries about the national budget. The big question is how we meet both concerns ?

We have wasted a TR!LL!ON $$$ on richard nixon’s failed War On Marijuana. Legalizing and taxing the stuff would make a huge difference in our national finances, besides dramatically cutting the income (and ability to buy assault weapons) Mexican gangsters make.

We squandered $$$4TR!LL!ON in the Bush crime family’s OFF BUDGET Iraq Fiasco II, and continue to waste $1 B!LL!ON/day there for no good purpose. We could make a huge difference in our national finances if we followed our allies out. The savings would be even more if we ended the Bush crime family’s failed Afghanistan Fiasco. In the end, by staying on focus, Obama caught bin laden. Now we can go.

The US navy ensures both allies and enemies alike of the safe transfer of oil from the ports of the Middle East, Alaska, Indonesia, Mexico and Venezuela. Without this protection, the oil companies would have to arrange for their own security. Let the oil companies save the expense of trying to establish their own defense forces, by making them pay the US navy for their services. This will easily bring in a TR!LL!ON $$$ per annum.

We spent a couple of TR!LL!ON $$$ bailing out Wall Street, and put several more TR!LL!ONs at risk to prop up ‘vital’ banks. We could have arrested, charged, held in custody as high risks for flight, tried, convicted, and, imprisoned the scores of bankers who engaged in the massive securities fraud that precipitated the crisis, and who put federally guaranteed deposits at grave risk. One felony and one gross misdemeanor. That would have prevented future generations of greed-driven pencil pushers and bean counters from doing it again, although some business men will commit crime no matter what. It’s in their nature.

The convictions would enable the banks to strip the malfeasor’s of their funds, which B!LL!ONS of $$$ would have greatly aided our national finances.

Finally, whereas both poverty and wealth appear to be heritable, and whereas the US has contended since 1776 that all men are created equal, and whereas the lack of a Federal Estate Tax tends to make men increasingly less equal, and whereas estates are windfalls for the heirs, and whereas the national finances need annother revenue stream, it is advisable that the nation re-institute the Federal Estate Tax as it was before 2001. Do all these things and the US will be so well funded that the cost of a single payor universal health care system will not be a problem. Universal health care will decrease the burden on large corporations, allowing them to expand their work forces, further increasing the revenue stream.

What won’t work is continually pinch pennies, downsize, coddle corporate criminals, engage in expensive military projects that have no point, and police projects that are counter-productive. To deny health care coverage for Americans because you want to squander money on failed republican policies is worse than immoral, it is stupid.

Wow. Just, wow!.

Because Taxing the Wealthy is Evil

By BJ Bjornson

We’ll just have to forgo a couple of not-too-important services, like, you know, locking up wife-beaters.

Domestic abuse advocates in Topeka are outraged after the Shawnee County District Attorney's Office said that they will no longer be prosecuting domestic violence cases, and now the city of Topeka is talking about repealing its anti-domestic violence law.

Shawnee County prosecutors, dealing with a 10 percent budget cut, told city officials that they will no longer prosecute misdemeanor cases, including domestic violence. The move has left domestic violence victim's advocate Claudine Dombrowski furious, saying that the move leaves victim caught in the middle.

"It's appalling, it's disgusting," said Dombrowski. "A week after this started there were over 30 cases that had been dismissed because the county dropped it on the city, and the city says we can't do it."

This all part of that “shared sacrifice”, I’m sure. And don’t worry, I’m sure there will continue to be more than enough law-enforcement personnel to continue harassing, arresting, and prosecuting people who are deluded enough to think that this whole “shared sacrifice” should include the wealthy paying a bit more in taxes, and that the criminals amongst the financial elite shouldn’t be any more able to avoid the consequences of their crimes than Topeka’s wife-beaters will soon be able to.