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Posts Tagged ‘Interventions’

Here is a fascinating discussion on NPR’s Forum from earlier this year on the subject of mercury and fish:

If you’ve listened to this the whole way through (which you should), I’m curious as to how it will affect your habits, if at all.  And why?

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The following quotes are from a book describing a real set of events:

[The incident] is an extraordinary example of what happens when you get… a dozen people with an average IQ of 160… working in a field in which they collectively have 250 years of experience… employing a ton of leverage.

It’s hard to overstate the significance of a [government-led] rescues of a private [corporation].  If a [company], however large was too big to fail, then what large [company] would ever be allowed to collapse?  The government risked becoming the margin of safety.  No serious consequences had come about in the end from the… near-meltdown.

Was the incident:

a) The savings and loan scandal

b) The collapse of Enron

c) The sub-prime mortgage meltdown

d) none of the above

First correct answer gets to invest in an exciting new bridge project I’m involved with in New York!

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I just tweeted on a subject that I suspected would cause a stir, and so it has, I’m moving it here:

RafeFurst: I strongly support a soda tax! RT @mobilediner: check it out:  a Soda Tax? http://amplify.com/u/dvl

coelhobruno: @RafeFurst what about diet soda? Would it be exempt?

RafeFurst: @coelhobruno no diet soda would not b exempt from tax.  Tax should be inversely proportional to total nutritional content.  Spinach = no tax

Lauren Baldwin: I do as well … and while they are at it they should tax fake fruit juice too.

Kevin Dick: I think this would be an interesting experiment. I predict a tax does not cause any measurable decrease in BMI.

Kim Scheinberg: New York has had this under consideration for a year.  Perhaps surprisingly, I’m against it. In theory, people will drink less soda. In reality, it will just be another tax on people who can afford it the least.

Leaving aside the “rights” issues and just focusing on effectiveness, I guess we can look towards cigarette taxes and gasoline taxes and see what the lessons are.  What do these forebears suggest?

As an FYI, there is supposedly a new total nutritional score (zero to 100) that is to be mandated on all food in the U.S. by the FDA.  Can anyone corroborate this and its current status?  Presumably this would be the number to base a tax on.

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From Monday’s Washington Post:

The District, New York and Los Angeles are on track for fewer killings this year than in any other year in at least four decades. Boston, San Francisco, Minneapolis and other cities are also seeing notable reductions in homicides.

Full article is here, in which more sensible police approaches are given credit for the decline.

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Pursuant to my earlier post, it turns out there already is such a group:

Foreclosure Angel Foundation

Thanks to Marissa Chien who found it and pointed me to it.  She also suggests that people who are having trouble with their mortgage should seek advise from HUD.  Information is power and many people (I’ve learned) are irrationally scared of approaching their lender and negotiating.  More and more lenders are willing to cut deals to avoid foreclosures.

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Given everything I hear about obesity stats in the U.S. and malnutrition in the developing world, the last thing I was expecting to find in my inbox this morning was a plea to join a Facebook cause to help end hunger in America.  Really?

I’m usually not skeptical in this way, and I’m loath to focus on the negative when it comes to philanthropy, but I can’t get these thoughts out of my head and I’d like some perspective from those who are better informed about the alleged U.S. hunger crisis.  In the mean time, here’s my food for thought:

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What’s fascinating to me about this is not that it works so well and or that there might actually be support in the Obama administration for doing it on a national scale, but rather that there has not been a backlash against it yet.  What are the odds that something like this will actually get implemented?  Is it actually a good thing?

hat tip: Annie Duke’s mom

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Have you ever heard of anyone selflessly helping out a stranger by buying their house at a bank foreclosure auction and just giving it back to them?  Well, now you have.

More likely, you’ve probably heard of private investors taking advantage of the banks’ unwillingness (or inability) to deal with all the bad loans on their books. Like the group of investors in Act 2 of this This American Life episode, you buy a house that’s in foreclosure for a significant discount on its true market value and then “you get the homeowner into either a mortgage they can afford, or they’re able to rent it, or you pay them a bit to move somewhere else.”

Well, what if there was a way to combine these two activities so that you are doing good for someone else while doing well for yourself financially?  There are many variants of how this could work, but here’s the basic concept:

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If, like Aubrey de Grey, you believe that immortality is achievable, or you are just intrigued by the possibility, you should check out this news story on The Methuselah Foundation.

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A friend pointed me to a doubly prescient talk given by George Soros in 1994 about his theory of reflexivity in the markets.  Essentially Soros notes that there’s feedback in terms of what agents believe about the market and how the market behaves.  Not groundbreaking, but he takes this thinking to some logical conclusions which are in contrast to standard economic theory:

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A few articles on the economy that were sent my way recently.

The Good: After Capitalism (Geoff Mulgan)

The era of transition that we are entering will be disruptive—but it may bring a world where markets are servants, not masters.”  I urge you to read this entire article, and leave your ideological biases at the door.  Despite the title, this is no polemic.  Here’s the punchline:

Contemporary biology and social science has confirmed just how much we are social animals—dependent on others for our happiness, our self-respect, our worth and even our life. There is no inherent contradiction between capitalism and community. But we have learned that these connections are not automatic: they have to be cultivated and rewarded, and societies that invest large proportions of their surpluses on advertising to persuade people that individual consumption is the best route to happiness end up paying a high price.

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With his permission, I am posting an email thread between myself and Alfred Hubler.  I had contacted him on the recommendation of John Miller when Kevin and I were posting on the possibility of dampening boom-bust cycles in the financial markets through policy or other mechanisms.  Here’s what Hubler had to say:

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In part 1 I advocated photographing your completed ballot before submitting it and posting your photograph online.  Turns out that if you followed this piece of advice in Missouri, you might be in jail right now.  Oops!  Sorry :-)

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Kevin started an interesting discussion that included a thoughtful proposal for the problem of major medical care costs risk mitigation.  You should read that here before reading my proposal below.

Part 1: Major Medical Annuities. Federally mandated/funded (similar to SSI/Medicare), with a specific initial lifetime value that is the same for everyone. The concept is that you pick a number slightly bigger than the average expected lifetime major medical bill and set aside that pot of money for everyone individually. At some point (e.g. 65) you can choose to start drawing down from your pot as taxable income. Prior to then, the only way the fund can be used is for major medical expenses not covered by other insurance you may have. Such payments go directly to providers and are tax-exempt. When you die, any leftover amount gets transferred to the MMA accounts of your heirs (per your desired breakdown, or according to probate law in the absence of a will).

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There’s a cool little coffee table book called Microcosmos that features super magnified images of (mostly) living creatures.  Here’s a sample:

Macrophage (yellow) chomping on e. coli (red) [3000x magnification]

micro2

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I asked this question on twitter/facebook and got a lot of variants of “I agree” and only one person who stated disagreement (but provided inadequate reason, IMO).  Jay Greenspan put it this way:

Interesting question this morning, and something I’ve been wondering about. I’ve yet to see anyone really argue that state of non-regulation we’ve been in for the last years has been a good idea.  I’ve heard some thoughtful conservatives talk about how their views have changed radically — coming to understand that forceful regulation is absolutely necessary.

The super-conservatives I’ve seen are talking more about taxes, avoiding the subject. I’d be very interested to see a credible argument for a hands-off approach.

So how about it, anyone game to take up a considered argument for not mandating that companies who get big enough to affect the global economy should be broken up or otherwise handicapped?

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The main problem with executive pay is not that they are compensated too highly, but that there’s not enough pain for them personally when they do a bad job.  I propose that the top three executives in all public companies be required to invest 100% of their salary in their own stock each year, with a decaying lockup period before they can sell.

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1) The Quiet Coup

The crash has laid bare many unpleasant truths about the United States. One of the most alarming, says a former chief economist of the International Monetary Fund, is that the finance industry has effectively captured our government—a state of affairs that more typically describes emerging markets, and is at the center of many emerging-market crises. If the IMF’s staff could speak freely about the U.S., it would tell us what it tells all countries in this situation: recovery will fail unless we break the financial oligarchy that is blocking essential reform. And if we are to prevent a true depression, we’re running out of time.

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This is not news, health professionals of all sorts have been saying this for a long time.  ABC News features a recent study supporting this.

A relevant footnote near the end of the article though:

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Oh, and re-grow the rainforrest, strengthen the social, political and economic climate, save endangered species and increase biodiversity and resilliance all at the same time without any budget.

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This is one of the most important medical “breakthroughs” in recent memory.  You should read the entire article, because it makes some subtle points, but the upshot is that placebo has (at least) two components, one that is triggered by conscious belief in a putative cure, and another that is triggered by unconscious, Pavlovian association.

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In a March 2009 Wired article, Daniel Roth calls for radical transparency in financial reporting as the path to recovery and a more secure financial system.  He argues that the reporting requirements today allow companies to obscure what’s going on and that the way to fix things is as follows.   Embrace a markup language with which bite-sized chunks of standardly defined pieces of financial data are thrown out to the world so that users can crowdsource the true picture of a company’s financial health.

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On the Cancer Complexity forum, I pose a question: if we could somehow replace all the damaged DNA in each of the cells of your body with an undamaged copy on a continuous basis, would that prevent you from getting cancer?

What do you think?

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In Chasing the Dragon, I wondered aloud whether we could dampen boom-bust cycles in the financial system with an economic equivalent of a controlled burn.  Kevin suggested that “generic countercyclical policies” might work.  Underlying both mine and Kevin’s thinking is the idea that you can possibly do better (for the world as a whole) by (a) understanding the entire economic system better and (b) enacting policies which are in line with that understanding.  In contrast to these assumptions are a point of view articulated by one of the readers on a different thread:

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Kevin just posted about a great article by Felix Salmon in Wired.  I underlined three quotes in my reading of it:

  1. “Correlation trading has spread through the psyche of the financial markets like a highly infectious thought virus.” (Tavakoli)
  2. “…the real danger was created not because any given trader adopted it but because every trader did. In financial markets, everybody doing the same thing is the classic recipe for a bubble and inevitable bust.” (Salmon)
  3. “Co-association between securities is not measurable using correlation…. Anything that relies on correlation is charlatanism.” (Taleb)

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Whenever I have a question about health matters that is too complex for an MD or academic researcher to get right, I ask Kevin.  Nobody I know has a better combination of broad-based current knowledge of the primary literature, plus a whole-system view and understanding of compex dynamics, plus the practical will and experience in living by (and updating) his conclusions.

Here are some questions I had for Kevin recently and his answers.

Rafe: Do the BPA results (such as they are) cause you concern?  Do you still use your Nalgene bottle?  Would you let your infant or child drink from a plastic bottle or sippy-cup?

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The NY Times reports.

Here’s my theory:  someone who drinks more than three cups of coffee a day can’t possibly sit still and actually gets their ass off the couch and does shit, thereby stimulating the body and brain, a known and powerful way to reduce dementia risk.

hat tip: Daniel Horowitz

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foodonfoot

This is a picture of what Food on Foot did on Christmas.  (more…)

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He makes so much sense!  Kevin?


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Like does this mean you can cure heart disease?

She’s hesitant.  Nobody wants to say they can defeat the industrialized world’s number one killer.  Nobody wants to make promises about life, or quantify salvation.  But she fervently believes she’s got a shot.

This is what the 2008 Genius edition of Esquire Magazine had to say about Hina Chaudhry.  Her approach is to switch back on the mechanism that causes cells to divide in the heart, which doesn’t normally happen after birth in any mammal.  This is not a stem-cell approach, despite what it might sound like.

Looking on the web there appears to be very little written about this work, so I’m wondering how Esquire found her or chose her work to highlight.  I’d like to learn more if anyone has information they’d like to share.

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40% percent of terrorist groups are defeated by police and intelligence operations.  43% percent end because they give up violence and join the political process.  Only 7% end as a result of military force.

This according to the research of Seth Jones, as reported in the 2008 Genius edition of Esquire Magazine.

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An incidentaloma according to wikipedia is “a tumor (-oma) found by coincidence (incidental) without clinical symptoms or suspicion.”  The provocative NY Times article below suggests that indolent tumors (i.e. ones that do not need treatment) may come and go as a normal part of life.  With better detection tools, we are finding more and more of these.  However our protocol for dealing with tumors is based on a time when tumors found were almost always non-incidental, non-indolent and requiring of positive action (like surgery).  According to Dr. Donald A. Berry, chairman of the department of biostatistics at M. D. Anderson Cancer Center:

It’s possible that we all have cells that are cancerous and that grow a bit before being dumped by the body. ‘Hell bent for leather’ early detection research will lead to finding some of them. What will be the consequence? Prophylactic removal of organs in the masses? It’s really scary.

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Everybody has their wishlist and “must do” lists for the new President.  Back in March of 2007, the NY Times published this Op Ed piece that I personally believe is critical and outlines what needs to be done above all else.  The article goes into much more detail about specifics, but the overall thrust is threefold:

  • Restore Habeas Corpus
  • Stop Illegal Spying
  • Ban Torture, Really

I’m curious to know though, what do you think the priorities should be for Obama’s presidency?

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The following is a recent paper by Henry Heng published in JAMA.  I’ve linked concepts mentioned in the paper to corresponding explications from this blog.


JAMA. 2008;300(13):1580-1581.
The Conflict Between Complex Systems and Reductionism
Henry H. Q. Heng, PhD
Author Affiliations: Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan.

Descartes’ reductionist principle has had a profound influence on medicine. Similar to repairing a clock in which each broken part is fixed in order, investigators have attempted to discover causal relationships among key components of an individual and to treat those components accordingly. (more…)

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Okay, Kev, here’s your chance on affecting climate policy, go crazy!

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I have a bicuspid aortic valve, a congenital condition which exists in up to 2% of the general population:

Image

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One of the most poignant moments of this year’s Pop!Tech for me — which, BTW had many — was Gary Slutkin’s talk on the idea of violence being a virus.  You may have heard about his work in stopping violence in Chicago in a NY Times Magazine cover article earlier this year.  The premise is simple: if you throw out what you think you know about violence and just look at the etiology of how it manifests in the world, you find incredible similarities to the etiology of microbial viruses.  This includes not only how it spreads from person to person, but also the larger epidemiological patterns, and importantly, how it can be stopped via interventions which logically follow from the hypothesis that violence is a virus.  Not that violence is caused by those invisible critters we call viruses, but rather that violence itself is a virus.

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One of the talks at Pop!Tech this year sparked intense emotions regardless of whether people agreed with the premise or not:

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To address these intense feelings and the demand for public discussion, a wiki was created, in which you are invited to join the discussion.  This forum was designed as “a place for a rich, lively, respectful and facts-based dialog on what’s necessary to address the serious economic challenges confronting America today.”  Hope to see you there.

Click here to go to the policy debate.

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I recently alerted Rafe to the latest Copenhagen Consensus, which aims to set priorities for the most cost effective interventions to improve global welfare. Items (1) and (3) were micronutrient supplementation and fortification. Rafe expressed concern that these were a “band aid approach”. After pondering this characterization for a bit, I have some thoughts on when to apply a “band aid approach” and the conditions we should attach to such approaches.

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Yesterday I blogged about personal vote verification.  At the group level, I recommend supporting the National Popular Vote.  While most people (70%) favor a popular vote for president, the U.S. Constitution calls for an electoral college system.  The National Popular Vote movement is extremely clever in that it doesn’t require a constitutional change:

Under the U.S. Constitution, the states have exclusive and plenary (complete) power to allocate their electoral votes, and may change their state laws concerning the awarding of their electoral votes at any time. Under the National Popular Vote bill, all of the state’s electoral votes would be awarded to the presidential candidate who receives the most popular votes in all 50 states and the District of Columbia. The bill would take effect only when enacted, in identical form, by states possessing a majority of the electoral votes—that is, enough electoral votes to elect a President (270 of 538).

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As I mentioned in my introductory post, I hope you’ll pay particular attention to interventions where Rafe and I agree something should be done. Whenever such agreement emerges, we plan on letting you know. Hopefully, we’ll inspire you to support them as well. As it happens, we have just identified such an intervention, WaterAid. I stumbled across this worthy cause while researching a slightly different problem. What follows is the long version of the story. Please bear with me; it sets the stage for future posts.

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