Commentary from a practical perspective
page includes posts from July 7-13, 2002 in the usual reverse order. Each week's postings
on the home page are perma-linked to these pages.
Its news again when people forget it was news before
This was a famous little cultural dust-up that in fact led to some spirited debate about family roles and single parenting. Perhaps one of the best results of the brouhaha was Barbara Dafoe Whiteheads article in The Atlantic, Dan Quayle Was Right, which thankfully is still available on the Web.
The odd thing about todays news item, however, is that it wasnt news.
Bergen was quoted in the Washington Post and Los Angeles Times just over four years ago saying much the same thing:
Im not suggesting that repetition of prior statements is a bad thing, but the tenor of todays piece gives the mistaken impression that Bergens agreement with Quayles argument was a new development in an old story.
July 11, 2002
Now heres a story combining medical ethics and detective work that should warm the hearts of health insurance companies throughout the country. (This assumes, of course that such companies have hearts, figuratively speaking):
In fairness to orthopedic surgeons who performed these procedures in the past, the Washington Post article makes clear that there were plenty of reported instances where the scoping was deemed beneficial. The problem was to determine whether it was the surgery that actually provided the relief, or whether there was some other explanation.
On the other hand, once this report achieves wide circulation, it will be hard to show any good reason for the scoping techniques continued use for these purposes.
Unlike other placebo studies, its very difficult to set up a test regimen to figure out if invasive surgery is truly necessary. In this case, the researchers managed to devise an ethically sound methodology:
Scoping a knee, after all, carries just a tad less direct impact and risk if one's mistaken about a medical condition than, say, an amputation or a liver transplant.
The placebo methodology could also help determine whether other popular surgeries actually prove nothing more than the possible power of suggestion:
Millions of dollars are spent each year on surgeries for a variety of aches and pains, including carpal tunnel syndrome.
There are other costs as well. I once handled the workers' compensation defense work for a city government. It was largely self-insured for these claims, so there was a strong incentive to keep costs down as low as possible. Nonetheless, there was also an inevitable political element to the city's treatment of the cases.
My clients tried very hard to return injured employees to productive work. It was far better for the employee in the long run, and it saved the city many dollars in recruitment and training if no replacements were needed. The city's comp staff also attempted to convince the employees and their physicians to try other techniques for pain relief short of surgery, for the same reasons.
In my eight years of workers' comp experience, none of the employees who underwent disc surgery ever made a full recovery. In fact, the debilitating effects of the surgery itself often seemed to make the employees' situation worse.
These placebo studies could be truly beneficial to patients and the health insurance system, by helping to shift health care dollars from paying for the knife to paying for less dangerous but potentially equally beneficial therapies.
July 10, 2002
All the recent talk about the potential for yet another Major League baseball strike had just the right effect on me.
I didnt bother to watch the All-Star Game last night.
Oh, Im sorry. Did I call it a game? As others much younger than me might say, "My bad."
Calling the game off with the score tied was simply unbelievable.
Just when you thought baseball couldnt sink any lower in public esteem, the lords of the diamond take it down yet another notch.
I suggest that any further media references to the Baseball Commissioner must always use the word "hapless," as in this example:
The added word seems to fit the current situation. It can also be used in a family newspaper or other publications where sensitive eyes might be offended by a somewhat coarser description.
Note: This posts title is a play on a bit of dialogue from A League of Their Own, a great movie about a real baseball team. Heres the passage in full:
No conflict with the companys interests
Sometimes its refreshing to see such a direct connection between ones desires and the means chosen to attain them.
Thomas Siebel is the CEO of a California software company. The company developed software that they believe will be highly beneficial to the federal government, a major purchaser of information technology.
The company also contends that their products will be particularly beneficial in the burgeoning market for new software to enhance the nations homeland security.
Thanks to the new campaign finance reform legislation and rulings by the Federal Election Commission, the company is now poised to follow through on one of the most effective means of obtaining valuable federal government contracts--lobbying through a Political Action Committee (PAC).
Setting up a PAC is not all that unusual. Siebel took things a step further, however. He gave those employees with a substantial stake in the companys fortunes a clear path to show that they understood how to make their own contribution to the eventual bottom line.
It worked. Siebel Systems staffers raised $2.1 million in very short order, making it the second largest single corporation PAC behind only UPS ("Big Brown?").
As Jim VandeHei wrote in todays Washington Post, the new PAC and the companys other marketing efforts seem to be working quite nicely:
What I liked about this arrangement is its utter transparency.
Theres nothing high-falutin or pretentious about what Siebel and his employees are trying to do here. There are no soaring platitudes or patriotic bromides about the private sector and what it can do for the rest of us.
Siebel simply made the direct connection between political contributions and eventual contracting with the Federal government. The link could not be made any more obvious than what occurred here.
Thanks to the internet and folks like PoliticalMoneyLine, we can eventually follow the money from the PACs to elected officials, and then watch how the money flows back to the companys coffers.
If anyone has a problem with the eventual results, at least we know how it happened and who benefited.
We should applaud the near-total lack of hypocrisy that this arrangement illustrates.
The title of this post may be a new word, but it seems to fit.
Blogrolling, as Ive seen the term used, refers to recommending blogs to owns one readers and other bloggers.
Networking, as Ive seen the term used, refers to finding ways to knit together folks with common interests, professional or otherwise.
Netblogging, as I suggest the term be used, refers to the phenomenon of blogging or blogrolling that leads to networking opportunities.
Here's an example that provoked the new word's creation.
As I mentioned recently, one of the surprising benefits of blogging has been to meet a wide range of fascinating people I wouldnt have come across otherwise, either personally, in correspondence, or by reading their blogs.
For instance, William Sulik often writes about legal matters, but also posts graceful commentary on theological matters and other intriguing topics. It just so happens that Sulik likes how I write about Supreme Court cases and other stuff, and was kind enough to mention this on his blog. He also wrote similarly pleasant compliments about Ann Salisburys new blog. Pretty standard blogrolling, in other words.
Considering Suliks obvious ability to recognize real talent when he saw it in me <g>, I naturally took him up on his invitation to read Two Tears in a Bucket.
Sulik was right. Salisbury is a self-described Orange County, California lefty, but shes open to discussion on what that means. Salisbury also enjoys reading and commenting respectfully on ideas and arguments from all sides of the political spectrum, which is a welcome relief from the tone set by some other blogs that I dont feel like mentioning right now.
Salisbury started reading this site, and found something in my stuff she liked.
Without more, this story would simply be a three-way backpatting, blogrolling episode--except that there is more to it, in fact.
Salisbury, Sulik, and I discovered that we share common professional responsibilities and interests in our work as lawyers.
Salisbury and I talked recently and sent each other materials relating to these professional issues. I telephoned Sulik yesterday to thank him for the Salisbury referral and its unexpected professional benefits. We also discussed some work-related shared responsibilities, and plan to do lunch when I next travel to DC on business.
Sounds like networking to me.
In this context, however, its more like netblogging--and I appreciate it.
An odd limitation on HIV/AIDS reporting
In matters of HIV/AIDS disease control, the unfortunate fact remains that denial is not just a river in Egypt:
The sad but ultimately unsurprising news that some folks either dont know or dont want to know about the potential consequences of their actions is bad enough. In addition, there were other disturbing points raised in the NYT article.
For example, the ability to develop accurate data about the scope of the HIV/AIDS disease continues to be hampered, for reasons that must be more political than practical:
This makes no sense to me.
Theres absolutely nothing sacred about infectious communicable diseases, no matter which segment of the population seems to be suffering more from their existence at a given time. Surely there have been enough other instances involving other diseases, such as TB or syphilis, where effective reporting regimens are universally followed by all states.
What keeps HIV reporting in such an especially sensitive condition that some states fail to require and disclose the information about new infections?
Heres one reason why this is an important issue. The following graphic shows the variance in AIDS rates among the states, based on the information thus far available or estimated.
When the CDC and others are forced to extrapolate from limited data, and the variances are as wide as shown on this map, there is an increased risk that the resource and medical decisions to be made about detection, treatment, and prevention will be seriously flawed.
Why should this reporting limitation be permitted to continue to exist?
A related issue discussed in the piece also helps illustrate the risks of insufficiently valid data:
The reason this information is troubling, of course, is that reported syphilis cases are a proxy of sorts for assessing the spread of HIV/AIDS, over and above the problems associated with syphilis. Considering the rate at which syphilis cases are now rising, it would be far better to have the actual HIV data, rather than being forced to rely on proxies and estimates.
I live in a state with a higher than average incidence of AIDS. It's an issue that does generate discussion among Delawareans, but much of the dialogue I've heard seems to involve arguments that run past each other on the way to scoring some kind of political point.
For those who argue against such reporting from a variety of perspectives, tell me again why this is a good thing. Tell me again why its not important to report all new HIV infections in every state. Tell me again why confidentiality is more important than public health and safety. Tell me again that confidentiality cant be managed successfully while continuing to obtain useful information. Tell me again that this disease is limited to the homosexual "lifestyle" and therefore not worth pressing the effort. Tell me again that the disease is limited to minority populations, and therefore not really putting the rest of "us" at risk.
Tell me again why I should give those who actually make these arguments any credibility at all.
I realize that Ive been in government service for most of my career. I try to keep that in mind when considering the limitations of public action. On the other hand, there are some responsibilities that governments should undertake at a minimum, for the sake of all of us. Public health and disease control is not something that should be left to the tender mercies of political agendas of the left or the right.
Ask your states public health agency if your state doesnt report new HIV infections. If they dont, ask them why.
Then ask them to change their rules.
NOTE: For a thoughtful comment on another aspect of the NYT article, check out Andrew Olmsteds post.
Hazy days of summer, thanks to Canada
Early yesterday morning I completed my third round of match play in the clubs annual Cup competition (Winning 1-up on the 18th hole, and thank you for asking).
As I drove north to the golf course before the match, I saw the gray haze of what I assumed was the normal Delaware 3-H summer combination (hazy, hot, humid). When I left the car in the parking lot and walked toward the putting green, however, it didnt feel right. The humidity that would normally leave my shirt sticking to me before I walked a hundred feet simply wasnt there.
Everything looked normal but wasnt. As it turned out, we had the Canadians to thank for the odd atmospheric condition:
The haze continued all day Sunday and into the early afternoon today.
During the summer we usually look forward to a blast of cooler air from our friends in The Frozen North. While the slight break in temperature was indeed welcome, the smoke was certainly an odd accompaniment.
Help for the insufficiently self-aware
If you love to watch people, just come to the beach.
Every minute of the day, on the boardwalk or on the sand, theres an endless parade of humanity in all its forms.
Shopkeepers complained after being subjected to the sight of just a bit too much skin. Fortunately, the town developed a pretty fair policy for how to enforce the new code:
I tend to doubt that the French police will issue coverlets that say anything along the lines of "My parents went to La Grand-Motte and all I got was this lousy T-shirt!"
We see a truly astounding variety of shapes and sizes here in Rehoboth Beach, usually with a high percentage of skin exposed for easy access to the sun's rays. Most of the shops carry the traditional warning, "No shirts, No service," but that prospect doesn't seem to phase many people.
For some of those on display, the only truly honest thing to murmur to oneself is "Thank you, God."
For others, well, T-shirts might not be enough.
Even so, reactions such as pointing, hooting, or crying out "My eyes! My Eyes!" are considered bad form, and should be discouraged.
Official small print disclaimer: This is, after all, a personal web site. Any opinions or comments I express here are my own, and don't necessarily reflect the official position of my work as a government attorney or any of my clients.
That fact may become obvious later on, but it needs to be said here anyway.
© Frederick H. Schranck 2002