Commentary on politics and technology from a libertarian perspective. It's an exercise in thinking outside the box and challenging conventional norms. This is the blog for my website at http://www.unconventional-wisdom.org.

Wednesday, February 24, 2010

The Conservative Argument FOR Same Sex Marriage

With California's prop 8 being challenged, I thought I would outline an argument for conservatives that would support Same Sex Marriage. That's right, I said supporting. For a conservative, there are actually good reasons that SSM should be accepted.

First, married couples live longer and healthier lives. Studies have show that people in stable relationships are happier and more content than their single counterparts. If you forget the fact that these individuals are of the same sex, approach it from a fiscal conservative side. You want people to prosper so that society doesn't have to shell out cash for supporting or incarcerating them. In other words, SSM is cheaper than the alternative.

Second, removing freedom is not small government conservatism. Creating rules to enforce undesired criminal behaviors is justified. Doing the same to enforce moral codes is fascist (Think Mussolini). Enforcing morality is the purpose of Islamic Sharia law. If you think that Christian moral codes are somehow different than Islamic, think again. Both are Abrahamic religions and share the same origins. The reason their societies seem brutal is BECAUSE they enforce old testament beliefs.

Third, it doesn't harm marriage. The argument that it leads to the individuals marrying animals or trees is ridiculous on it's face. Marriage is a contract. Plants and animals cannot legally give consent to marriage, thus it can't happen. Therefore, existing laws protect us from this possibility and no additional laws are needed.

The conservative case for SSM is quite strong. The opposition however, is rooted in the same tired religious arguments that opposed civil rights and women's suffrage. We all know how those turned out.


Monday, February 15, 2010

The Purveyors of Cyberjustice

It's official. Anonymous has declared war on Australia. Is the outback ready for the Internet's grand legion of cellar dwellers at 4chan? This isn't the first time Anonymous has taken up a cause, and probably not the last. What is interesting is that random, interconnected groups of people are pooling resources and causing havoc for a cause. Vigilante justice isn't unusual and is older than governments themselves. Which leads one to an interesting thought experiment. On the Internet we see virtual versions of the constructs that are part of our corporeal life; Communication, Gaming, Dating, Sex, etc. It's a wild west with no form of control or authority and it works pretty well. And now we have Anonymous. Could we be seeing a form of organization emerging from the chaos? The beginning of a permanent anarchical justice force, perhaps?

In the case of 4chan, there is an urge to do something bigger than themselves, either due to outrage or just for the lulz. I have no doubt that in the old west some people joined in on posses for the kicks. And we see that here. Like so many things, the beginnings are a little raw. But through this constructive chaos could we see something bigger than the sum of it's parts? Several years ago a company created a anti-spam concept called “Blue Frog” that used the power of the Internet collective to rain terror on spammers. It worked for a while, until the company came under attack and folded. The weakness with Blue Frog wasn't the idea. It was the centralized command and control of that managing organization. But Anonymous doesn't suffer from this limitation. It is a swarm and essentially headless. And capable of instantly responding when attacked. Spammers and malware authors have the edge in lead time compared to our justice system which is used to prosecute them. Anonymous doesn't suffer this limitation.

There may be a role for Internet justice in the future. Whether it involves Anonymous is an open question.

Sunday, January 31, 2010

Healthcare - Market Reform

A core problem with the American health care system is that its market is fundamentally flawed. Part of this is due to laws created to provide humanitarian treatment during medical emergencies. In 1986, congress passed the Emergency Medical Treatment and Active Labor Act. Before EMTALA, if you showed up at an emergency room without proof of insurance, you could be turned away. Under this new law, hospitals would be required to provide services no matter the financial status of the patient.

Under EMTALA, there became less of an incentive for people to get insurance since emergency care would always be provided. And since the uninsured will be will be far less likely to pay their bill, someone has to cover these costs which are estimated at 55% of all emergency services. This results in hospitals raising their prices for services, which typically falls on the insured, raising premiums. Thus, you have a perverse incentive for the purchase of health insurance.

A large percentage of the uninsured are young healthy Americans. These individuals would contribute more to insurance revenues rather than costs. Therefore, a possible solution is to require obligatory coverage. By doing so, we expand the risk pool of Americans to lower per capita insurance costs. Since most Americans are now insured, the cost of EMTALA is reduced, which lowers costs across the board. This is a market based approach to the concept of socialized medicine.

There is another positive side effect. Since insurance is mandatory, anyone showing up for treatment without insurance would most like be an undocumented alien. These individuals could be treated and turned over to immigration officials thus easing the loads on ICE. However, it is also likely that illegals would purchase insurance to prevent easy discovery. Either outcome is a net positive for health care.

As a libertarian, the thought of mandated insurance is in exact opposite to my core principles. But the other solution is to turn away people at the hospital that are not insured or don't have an insurance bond. I'm not sure any libertarian could support that ideal.

Saturday, January 30, 2010

Healthcare - Cost Benefit Analysis

People complain about HMO's and “drive-by medicine." They say that hospital stays should be longer and more comprehensive. But what happens when the controls are released and the floodgates are open? Let’s say that an indigent mother gives birth to a premature child. We have the medical technology to save the child. But at what cost? $100,000 to $1,000,000 is not uncommon for this type of service today. Perhaps you think it's ok for the taxpayer to foot this bill at this level. But, what happens when it becomes $10,000,000?

We have not come to the point of accepting that actuarial decisions MUST be part of health care. If you have X dollars to spend and there is a request for $1,000,000 in treatment for a single case, it has to be determined how that money is best spent. A bleeding heart liberal would say the insurance companies make too much profit so make them save everyone. But the insurance companies just pass those costs on to the consumers, which is our current problem.

On a related note, will someone please take Sarah Palin moose hunting and not bring her tired ass back? Her idiocy in blabbering about supposed “Death Panels” was the stupidest thing that a conservative could have done. End of life counseling was the one sound fiscally conservative aspect of the heath care reform bill. But no, politics are more important than real reform.

Friday, January 29, 2010

Tough Questions on Healthcare Reform

I was watching Dateline last night when they covered problems people were having getting insurance companies to cover treatment. The show was named "Critical Condition" and it was pretty heartbreaking to watch. The theme of the show was that insurance companies were denying critical treatment for patients. My thinking is there were much bigger issues at play. And these issues didn't have as simple answers as you were led to believe.

The first segment was on Patrick Gannon, who suffered a heart attack at 41. The doctors applied $1,000,000 worth of treatment to the man to save his life over the course of several weeks. The result was a man that required full time care, unable to walk, talk or mange his own life. After paying out all that money, the insurance company opted for a cheaper rehabilitation route that the one that family wanted. The claimed result is that this approach drastically affected Patrick outcome.

Let's remove the emotion. The doctors performed $1M of treatment on a poor outcome that left Patrick in a predicable state and probably wouldn't have knowingly consented to. It destroyed his family financially in the process. To apply that much medical intervention on an infarction, you have to be dealing with little more than a corpse. Someone during this period should have realized that this was going to be a very bad outcome and let him die peacefully. The emotional and financial toll on his family will continue and it's unknown how it will affect his daughter. There isn't a good answer to all this, but I'm really not seeing the insurance company as the bad guy here. I'm surprised they covered as much as they did.

The second was a firefighter named Rick Crusoe with a rare form of cancer. The insurance company balked at an experimental treatment that had a 10%-15% chance of prolonging his life an undetermined length of time. I can't speak specifically to the numbers involved, but they were requesting an authorization of up to $250,000. Would you give up your house for a 15% of helping someone live for a couple of months maybe years? I'm not sure many people would take that bet. Maybe a grieving mother or husband. How many lives could that money save if put to better use like paying for vaccines or other more certain treatment?

For last patient, we have Nataline Sarkisyan who was in need of a liver transplant. It was about $500,000 for a bridge to keep her alive for many months while they continued to treat her leukemia. My reading is that the treatment will probably kill her new liver and she would have to have another later on. They had already authorized a bone marrow transplant that could run up to $700,000. We could be looking at a total of $1.7M and that's assuming she could find the second liver. Again, where is this money best spent?

In summary, I got the following from this report. First, medical costs are too high. This is obvious, but they always will be as long as research is expensive and risky. Therefore, we need to deal with this reality. Second, if you have insurance, you hope that your money isn't being wasted on questionable medical decisions that will increase your costs. However, if it's your loved one, you want them to spend everything they have. This is referred to as
The Prisoner's Dilemma. Someone external to the situation needs to make those decisions. Currently, only the insurance companies will do it because it affects their bottom line. And perhaps that's the best way. Honestly with the material presented, I didn't fault them for their decisions.

Third, doctors need to understand long term quality of life issues relating to the decisions that they make. Traumatic Brain Injury or Neurological Impairment with regard to heroic lifesaving measures are life shattering and a poor outcomes can usually be predicted early. Present the facts clearly so families can make sound decisions. But even then, people will override medical advice. And Patrick Gannon may have well been one of those cases.




Thursday, January 28, 2010

What is the iPad?

I'm watching all the Apple fanboys buzzing over the new iPad. General consensus seems to be that it's underwhelming, but I think Apple may have found an interesting market niche. It's not a computer and it not a competitor for the netbook segment. It's a media/surf terminal. A little toy you piddle with while you're watching TV to answer questions that pop up like "Who played Lumpy on leave it to beaver?" or "What else was that actor in?". Or perhaps you look up the playoff scores and read your email. Just Plain Old Surfing. New acronym - JPOS (tm)- you heard it here first! :)

A lot of people use their laptops for this type of stuff (me included). But if you don't have a laptop and you find your iPhone or Droid is a little inadequate for regular couch surfing, this would be a better replacement that a $$$ macbook. IMHO, a netbook is a better and more versatile option, but for an Apple person, it isn't as desireable. As for mass market adoption, you might snag some ebook people and perhaps some that find it a sexier alternative to the eeePC. But I don't see another iPod craze on the horizon.

My only question is ergonomics. What does it do to your wrists to balance that thing for a couple of hours? You can't read it if you lay it down. And how do you use the keyboard on your lap? Time will tell.

Monday, January 18, 2010

On the Nature of Human Intelligence

What is the nature of intelligence? Is it just you or the sum of you and any tools you have at your disposal? For the purposes of an IQ test, it would be just the organic part. However, on your job were it really counts, all bets are off. You are allowed any trick in the book to achieve your goal. And in your personal life, you set the rules. I submit that we have already entered the Cyborg age. It may not be exactly what you expected from reading science fiction, but the details are just speed and interface.

The typical techie has some type of wireless Internet access at most times, be it 3G, EVDO or wifi hotspot. With this technology, you are able to access such on-line resources such as Wikipedia, Wolfram Alpha, or the Internet Move Database. If you can access this information at any time and place, doesn't it make it part your smarts? I mean you can get the information, perhaps not with the speed of Marilyn vos Savant. But you could easily wax her tail with the sheer volume of information available. Who played Lumpy on leave it to Beaver? Suck on that, Marilyn. It's given that only part of intelligence is pure recall, but it's an important part. Original and theoretical constructs are key piece of total cranial horsepower. But even each of these are based on a foundation of basic recall.

You could argue based on the premise that we have been in the Cybernetic age since the first written word. But I submit that carrying around the Library of Congress is impractical. It is only the confluence of wireless devices and the Internet that finally makes the total of human knowledge available on demand.

There was a time when students weren't allowed to use calculators during a test. Now its pretty common if not encouraged. And now we are seeing Internet access accepted on tests as well. Thus, the total of the human experience now includes handheld devices.

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