Wednesday, November 25, 2009

Poorly Rationed Reasoning

So my new goal here at Hogs is to play around with some of the big arguments of the day. On Monday I dove into the troubles that erupted around the climate change debate after the computers were hacked at CRU. The most interesting comment for me was Karmavore's distinction between "Climate Change Skeptics" & "Climate Change Disbelievers." The difference is important, and it will affect the way I engage in that discussion in the future.

I hope that kind of thing will happen more often here. I want to look at the divisive issues that are too often cast in black and white and then seek out the gray areas.

The hot button issue for today is health care, more specifically last week's ruckus around the word rationing. The issue came into sharp focus after the results of a study on mammography were released by the Preventive Services Task Force. The study recommends that women do not need to start regular screenings for breast cancer until the age of 50. The previous recommendation had been to start screenings at 40.

Patients can ignore the study and get screened in their 40s anyway. However, the people signing the check for those screenings may object, and since most people do not sign the check for their own health care, there is a conflict. People are nervous that the check signers might listen to the experts and certain tests won't get paid for.

Of course that nervousness spilled over into the health care reform debate.

Last week the WSJ's opinion page suggested a lot of things that might happen if the government tried to reduce health care spending. The piece critiques how the government plans to decide what medical procedures to pay for? The idea is to put experts in place, experts like the ones who put out the study on mammography.

With that study out, suddenly we have a stand-in for "the bureaucrat that will get between you and your doctor." And that bureaucrat is advising us to reduce breast cancer screenings. I understand the uproar. Women have been told that regular screenings can save their lives. Now some acronym is telling them to forget about that. It is a powerful reminder of the fact that personal heath care decisions are not always up to the individual. And with the reform bill ready for debate next week, powerful reminders like that are explosive.

My concern is that such explosive material can be misused. Private insurers are also likely to take note of the mammogram study. No matter the insurance scheme, there is a limited amount of money in a pool, and someone needs to decide how to best spend it.

Peter Singer's July piece in the NYT Magazine asks readers to do the following: think about the spending limits you would put on another person's medical treatment if experts claimed that the treatment was not effective in most cases. Singer asks for a number. It's a tough call.

This is the decision any insurer must make. The pro-reform people have cast the private insurers as heartless for refusing service, but the measures up for debate in Congress will put similar decisions in the hands of government appointees.

And that is the heart of the matter: Who do you want making those decisions about rationing?

I like the government appointed panel of experts, because we can demand transparency. The debate over the mammogram study is an example of how a government panel's findings are open to the public and up for debate.

What do you think?

Monday, November 23, 2009

Why the CRU Leak Isn't the Biggest of Deals

I can't speak to the details around the leak at CRU, as the data is out of context. But at first blush it does look like the scientists at that facility are doing some less-than-ethical work. And less-than-ethical is not a euphemism here. It's an accusation. Data needs to inform the theory, not vice versa. When this all get sorted out, if the science was bad, then the results from that lab are tainted.

But CRU isn't the only body of scientists looking into climate change. Here's an article that cites data from 2 peer review journals. The data does not come from CRU, nor is it interpreted by the people at CRU. The results are not pretty: Even if we could cut greenhouse gases by tomorrow, the ocean levels look like they will rise a meter by 2100. If I have grandchildren, they will see coast lines and island nations disappear.

The movement to slow our contribution to climate change isn't going to stop this. According to most experts, however, we might be able to mitigate the damages.

So here's my question for skeptics of anthropomorphic climate change: Why/how would scientists from a variety of fields, policy makers, and business leaders collaborate to execute a hoax on a global scale?

The groups involved are not like-minded. What could possibly motivate them to work together to forward a false cause?

Job security? The scientists at UT studying "nearly seven years of data on ocean-icesheet interaction... collected by the twin GRACE satellites" do not need global warming to ply their trade. They have tremendous analytical and technical skills. They'll find work.

Political motives? Have you ever met a research scientist? Seen one on TV? Probably not. They are not political creatures.

Greed? Well, Gore is set to make a lot of money if the energy sector goes green. If his motive was just money, however, why not buy a drilling platform? That would produce faster returns that are more secure?

Stupidity? Are we to believe that a select few have convinced top scientists, world leaders, and savvy business people to believe in something that is baseless? Who are these evil geniuses, where is their secret underground base, and why are they doing this?

The CC skeptics are claiming that disparate groups of well trained specialists have either met in secret to dupe the world OR that they have themselves been duped by a group with a desire to transition the planet to clean energy for unspecified reasons.

The moon landing conspiracy theory looks rational by comparison. You'll have to excuse me for siding with the diverse group of experts who have found something to agree on despite it's challenging implications. While the other side's accusations of conspiracy allow me to comfortably continue my life unchanged, the accusations are asking me to believe in something much more unrealistic than greenhouse gases.