Mike Kueber's Blog

July 17, 2012

Meritocracy and The New York Times

Filed under: Issues,Philosophy,Politics — Mike Kueber @ 4:01 am
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My most fundamental political value is a belief in meritocracy, which I define as a system where individuals get ahead based on ability (merit) instead of connections or inheritance.  Although this seems like an utterly uncontroversial concept, like Mom and apple pie, I should have known that the liberal New York Times would see it as a mixed blessing.  According to an op-ed piece in the Times yesterday, Mitt Romney’s unabashed endorsement of meritocracy raises significant concerns. 

The author of the piece, Thomas Edsall, warns that Romney’s meritocracy may enable people to achieve success and rewards through hard work, education, risk taking, and even a little luck, but it also has unintended consequences – i.e., aggressiveness, ruthlessness, dominance-seeking, victimizing behavior, acquisitiveness and the disciplined pursuit of self-interest.  Edsall believes that over the past two decades, these latter traits have resulted in government policies that favor the wealthy and those with connections, mostly achieved through lobbying.

Most right-thinking people agree that lobbying has improperly influenced and corrupted many a politicians.  But to blame this corruption on meritocratic influences is ludicrous.  Does Edsall think America would have less corruption if it were less meritocratic?  Hardly.  Does Edsall think Americans would have less self-interest or ruthlessness if success depended on inheritance or connections?  That’s so silly that only an intellectual could believe it.

February 25, 2011

David Brooks and the Mitch Daniels bandwagon

Filed under: People,Politics,Uncategorized — Mike Kueber @ 8:34 pm
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Just as I was penning a blog entry in support of Mitch Daniels, the NYTimes’ David Brooks was writing a column that did the same thing.      His column is ironically titled, “Run Mitch, Run.”  The title is ironic because on October 19, 2006 Brooks wrote a column titled, “Run, Barack, Run.”  We all know how that turned out.

My blog entry relied heavily on a column by Joe Klein in Time magazine.  Brooks’ column on Mitch Daniels covers much of the same territory as Klein’s.  According to Brooks, Daniels believes that America’s runaway debt is the greatest moral challenge of our time, but Daniels also believes that creating opportunity for the disadvantaged is a major governmental objective – “Our first thought is always for those on life’s first rung, and how we might increase their chances of climbing.”

It’s interesting how similar the columns are.  Even though one columnist is a liberal and the other a conservative, they both read this guy the same way.

February 23, 2011

Sunday book review #14 – The Last Boy (Mickey Mantle) by Jane Leavy

The Last Boy was #4 on the NYTimes’ 2010 list of best nonfiction books in America, and clearly deserves that place.  But I am not an impartial judge.  I grew up at a time when Mickey Mantle exemplified America’s greatness – the quintessential small-town boy with big-time talent who made it all the way to the top.  Although I preferred Hank Aaron to Mickey Mantle when they were both playing, my affection shifted to Mickey after they retired from baseball.  This shift probably has something to do with my falling in love with NYC, for nothing embodies the fascination of NYC better than Mickey Mantle.

The structure of The Last Boy is unusual.  Instead of being organized chronologically or by subject, author Leavy tells Mickey’s story by focusing on 20 watershed days in his life:

  1. March 26, 1951 – The Whole World Opened Up.  Mantle is a rookie participating in his first spring training with the Yankees.  On a trip to Los Angeles to play USC, Mantle hits two tape-measure homeruns and a triple to deep center before using incredible speed to beat out an infield hit.  This was the day that the world got its first glimpse of how special this player was.
  2. October 5, 1951 – When Fates Converge.  While playing in the World Series in his rookie year, Mantle is playing right-field and Joe DiMaggio was playing center.  Willie Mays hits a ball between them, which DiMaggio calls for and catches at the last instant.  To avoid colliding with DiMaggio, Mantle slams on his brakes and twists his knee of a small drain in the outfield.  Result – “he blew out his knee,” but due to medical ignorance, the diagnosis is “no surgery needed.  Go home and rest.” 
  3. October 23, 1951 – Undermined.  I can’t figure out the significance of the cited date.  Mantle grew up in Commerce, OK, which was in the middle of the toxic Tri-State Mining District (MO, OK, and KS).  This chapter describes how difficult the mining life was, especially since the mines had begun to play out before Mick was born.
  4. May 27, 1949 – Patrimony.  Mick graduates from high school and signs with the Yankees for $1,150.  His first year in the minors, he is mediocre.  Before his second year in the minors, he suddenly bulked up – “He looked like a blacksmith and sprinted like a cheetah.”  He batted .383 with 199 hits, 30 doubles, 12 triples, and 26 homers and was named league MVP.
  5. May 20, 1952 – In the Ground.  Mick’s dad Mutt, a miner, dies at age 40 of non-Hodgkin’s lymphoma.  Mick’s marriage on December 24 to Merlyn Miller is described in this chapter.  I’m not sure why the marriage didn’t deserve its own chapter.
  6. April 17, 1953 – One Big Day.  Mick hits perhaps the longest home-run of his career out of Washington, D.C.’s Griffith Stadium.  After exhaustive research, the author concludes that the ball flew 535-542 feet.
  7. November 2, 1953 – Fish Bait.  Mick has knee surgery.  Although he probably has an acute combination of torn medial collateral and anterior cruciate ligaments and a medial meniscal tear, the surgical limitations at that time focused their attention on the meniscal tears and loose bodies.  ACL reconstruction was rarely attempted in 1953, and Mickey soon returned to play – “How did Mantle play with a torn ACL?  It can be done (according to the medical director for the NFL Players Association).  Mickey Mantle can be classified as a ‘neuromuscular genius,’ one of a select few who are so well wired that they are able to compensate for severe injuries like this and still perform at the highest levels.
  8. September 26, 1954 – No Other Time.  Another confusing chapter.  The chapter date is the day of the last game of the first season that didn’t involve a World Series.  Much of the chapter compares Mick to two other NYC centerfielders – Willie Mays and Duke Snyder.
  9. May 30, 1956 – A Body Remembers.  His Triple Crown year, Mick tears up the league.  On this day, he hit one off the façade in right field.
  10. May 16, 1957 – Returns of the Day.  The famous brawl at the Copacabana while celebrating Billy Martin’s birthday with drinking buddies Hank Bauer, Yogi Berra, and Whitey Ford.  The partying Yankees cut a wide swath in Manhattan.
  11. August 14, 1960 – Season Under Siege.  Mantle is doubled up because he fails to run out a grounder.  Manager Stengel pulls Mantle as the Yankees fall into 3rd place.  Properly chastised, Mantle leads the Yankees to their pennant, although they fall in a huge 7-game upset in the Series by the Pirates.
  12. September 25, 1961 – Dr. Feelgood.  This is the year that Mick and Rog go after Ruth’s record of 60 homers, but in the end Mick’s body didn’t hold up.  On the 25th, Mick receives an injection from a private doctor, probably for clap.  As the Mick, often jokes, he led the league in clap for six consecutive years.
  13. May 18, 1962 – His Best Self.  This is the day Mick injured himself while trying to beat out an infield hit; the remainder of the chapter provides examples of Mick’s generosity.
  14. June 5, 1963 – The Breaking Point.  Two weeks after his hardest-hit homer (380 feet long, 103 feet high, and five feet from the top of the right-field façade), Mick crashes into the centerfield wall in Baltimore, breaking his foot.
  15. September 26, 1968 – Last Licks.  Mick ends his career with the Yankees dynasty in total disarray.  His 535th homer was hit on September 17, with Denny McClain intentionally feeding up a homer.  At the time, Mick was 3rd on the all-time list, behind only Ruth and Mays.
  16. June 8, 1969 – Half-life of a Star.  His first Mickey Mantle day as a retired superstar.  Ever since Maris beat him to Ruth’s record, Mick has become such a revered figure in NYC that he dwarfs even Jolting Joe.
  17. December 19, 1985 – 18 Below in Fargo.  Funeral for Roger Maris.  “Maris’s funeral was held in his hometown, Fargo, North Dakota, where he is memorialized in the only museum willing to have him, in the West Acres Shopping Center.  Cooperstown’s snub was as cold as Fargo on the day he was buried.”  The remainder of the chapter focuses on Mick’s increased drinking as he worked for the Claridge Hotel in Atlantic City.
  18. February 5, 1988 – Top of the Heap.  Mick opens the Mickey Mantle Restaurant on Central Park South.  He is still the king of the town.
  19. February 4, 1994 – Getaway Day.  Mick checks himself into the Betty Ford Clinic to deal with his alcoholism.  The treatment succeeds and Mick makes amends with family and friends who he had treated shabbily for years.
  20. August 13, 1995 – The Last Boy.  Mick dies of cancer that had spread from his liver to his bile duct into the pancreas and eventually his lungs.  A few weeks earlier, he had received a liver transplant, and there were rumors that Mick’s fame had helped him receive the liver sooner than he should have.  Author Leavy investigated this issue and confirmed that no favoritism was given.

The book is subtitled, Mickey Mantle and the end of America’s Childhood.  According to the author, “The transformation of the Mick over the course of eighteen years in the majors and forty-four years in the public eye parallels the transformation of American culture from willful innocence to knowing cynicism.  To tell his story is to tell ours.  And mine.”  And mine.

The Last Boy works for me because, after reading the book, I feel like I understand the man.  And although the author is not shy about revealing Mick’s warts (major-league carousing, neglect of his family), and although she makes no attempt to embellish his goodness (a world-class teammate), I remain as much a fan as I ever was.

February 20, 2011

Medical tourism and managed medical care

Earlier this week, a local TV news program (KENS 5) did a story on medical tourism.    The story focused on an uninsured 60-year-old man who needed hip-replacement surgery.  Because the cost of surgery in Texas was $70,000, the man decided to have the surgery done in India for less than $10,000, which included the cost of transportation.   Patient Mike Sakalauskas of Buda, TX is back home and doing fine.

Yesterday there was a related article in the San Antonio Express News (borrowed from the NYTimes).  According to the article, new research shows that “too many women with abnormal mammograms or other breast problems are undergoing surgical biopsies when they should be having needle biopsies, which are safer, less invasive and cheaper.”  The article goes on to suggest that greed may be driving the practice because, not only are needle biopsies half as expensive, but they are performed by a radiologist instead of a surgeon.  Thus the surgeons earn nothing when they make the correct referral to a radiologist.

A couple of months ago, I had a similar experience with my dermatologist.  After noticing a discoloration on my shiny dome of a head, I visited my dermatologist to check for sun cancer.  In the past, my internist Marnie Ross took care of such an inspection, and she routinely froze several spots every year.  But Marnie retired, even though she was only 40-years-old, because, she said, insurance companies had made her practice not financially rewarding.  I suspect that her husband’s medical practice and their two small kids might have played a role, too.  Regardless, Marnie was gone from my life and my new internist, Kevin Horton, preferred to avoid doing the work of dermatologists.  So I have started seeing a dermatologist annually. 

You may have read that dermatology is one of the most lucrative branches of medicine, and that is surprising to me.  The work of a dermatologist appears uncomplicated and the working conditions seem relatively favorable.  Of course, the principle of supply and demand sometimes leads to distortions in the marketplace and that appears to be happening here.

My recent trip to my dermatologist revealed two reasons that dermatology could be so lucrative.  The first reason is that I didn’t see the dermatologist, but instead saw a physician’s assistant.  This concept of leveraging less skilled employees has been applied by lawyers for decades.  Senior lawyers who billed by the hour couldn’t make enough money ($1 million a year) even though they increased their hourly rate to amounts ($500 an hour) that made clients gag.  Their solution was to hire several junior lawyers at $50 an hour and supervise their work that was billed to clients at $200 an hour.  Voila – senior lawyers could make $1 million a year.

Doctors have caught on.  Physicians’ assistants do the same work and charge the same price, yet they are paid only a fraction of what the doctor makes.  My dermatologist’s physicians’ assistant inspected my sun spots, and instead of freezing them, she decided to take a couple of biopsies.  After determining that one of them was basil-cell carcinoma, she scheduled me to come back to have it cut out. I asked why they cut instead of freeze and was told that cutting is a doctor’s decision.  That was a little confusing since I hadn’t seen the doctor.

A week later, I saw the dermatologist, who cut out the sun spot.  A couple of weeks after the surgery, I returned to have half the stitches removed by the physician’s assistant, and a few days later the remaining stitches were removed.  And finally, in early March I will return to the dermatologist for a final inspection.  In sum, the sun spot that my previous internist would have frozen during my annual physical was treated with two visits to the dermatologist and three to the physician’s assistant; one surgery and two biopsies. 

Although I don’t know what this treatment cost, it is probably a good example why medical care in America can consume one-seventh of our GDP.  Physicians have too many conflicts of interest to be in exclusive charge of managing our medical care.  The insurance companies need to be more involved so that care can be effectively and efficiently managed.

February 18, 2011

Prescription ads with side-effect warnings

If you are like me, you may have wondered about (and been annoyed by) TV and print ads for prescription drugs that include lengthy warnings of possible side effects.  The warnings seem redundant because the use of prescription drugs is managed by medical professionals, and we should be able to rely on our doctor to go through the same information. 

Thinking as a defense lawyer, however, I saw the invisible hand of a creative plaintiffs’ lawyer.  I can imagine an individual using a friend’s prescription drug and then suffering a side effect.  Give this claim to a creative plaintiffs’ lawyer, and the next thing you have is a lawsuit against the drug manufacturer for failing to disclose this side effect to the public.  Although this suit may seem frivolous to you, I studied a plethora of cases in law school where victims recover even though they ridiculously misused the product.

To confirm my suspicion about drug warnings, I went to the internet.  There I learned that it was not creative plaintiffs’ lawyers who caused this snafu.  Rather it was the only thing less popular than plaintiffs’ lawyers – it was the federal government.

According to the FDA website, all ads for prescription drugs must present the benefits and risks of a prescription drug in a balanced fashion.  The requirements distinguish slightly between print and broadcast ads:

  • Print ads must include a brief summary about the drug that generally includes all the risks.
  • Broadcast ads must include the drug’s most important risks and either (a) all the risks, or (b) a variety of sources for viewers to find the drug’s related information.  Sources include ahealthcare provider, atoll-free telephone number, acurrent issue of a magazine that contains a print ad; or a website address.

This FDA regulation is another example of why the federal government has such a low approval rate.  Often a faceless, nameless bureaucrat makes an arbitrary decision that costs billions of dollars. 

However, according to an article in the NYTimes yesterday, the FDA places a value of $7.9 million on a human life when it considers the cost-effectiveness of its warnings.  If the drug warnings were subjected to that sort of analysis, that would provide some rational basis for the government’s position. 

My other pet peeve concerning warnings and disclaimers in broadcast ads – when they are speed-spoken.  As a lawyer, I can’t imagine a speed-spoke warning providing any benefit in litigation, although I know a marketing lawyer who has argued that a speed-speaking is better than nothing.  That is a subject for another day.

February 17, 2011

What’s a life worth?

There’s an old saying that you can’t put a price on a life. 

Although that is clearly true, sometimes you have to do it.  The best example of such a situation is a wrongful-death lawsuit, in which an individual who caused a death is required to pay damages to the deceased’s beneficiaries.  Because I worked with the insurance-claims department at USAA, I saw the evaluation of numerous wrongful-death claims.  

Wrongful-death lawsuits focus primarily on pecuniary damages – i.e., money that the deceased would have given to various beneficiaries over the course of his life.  Thus, the life of a high-earning individual with several dependents has a high wrongful-death value, whereas the life of a retired individual with no dependents has low wrongful-death value.  Of course, many wrongful-death statutes allow some consideration of subjective factors such as companionship, which tends to give every life some value.

Perhaps the most famous wrongful-death valuation was called The September 11th Victims Compensation Fund, through which Congress agreed to pay the survivors of those killed that day.  Congress developed the fund to avoid a plethora of lawsuits that would have probably bankrupted the involved airlines.  Attorney Kenneth Feinberg was given the task of valuing each life, and he ultimately spent $7 billion, with an average payout of $1.8 million.

The wrongful-death lawsuits that I saw when I worked in the insurance industry were invariably the result of negligence.  Thus, the damages were intended to compensate those who were injured, but not intended to punish or deter the defendant.  But that is not always true with respect to businesses.  Businesses sometimes could take safety steps that would reduce the danger of injury or death, but decline to take those steps because they believe the costs exceed the benefits.  When they are doing this, they are implicitly placing a value of human life.  Although they may not conduct a formal cost-benefit analysis, the principal cost would be the damages that potentially will be awarded in a wrongful-death suit.

With some businesses, however, the federal government takes discretion away from the business and instead performs its own cost-benefit analysis of various safety requirements.  A recent article in the NYTimes described some common applications of this type of cost-benefit analysis and reported that the Obama administration had significantly raised the valuation to almost $10 million.    

In explicably, the development of this new, higher valuation failed to include any consideration of wrongful-death settlements.  Although the 9/11 payments were considered exceptionally high because of the preponderance of high-salaried Wall Street types, those payments are still less than 25% of the new government valuation.  That means that government regulations will err on the side of safety, which will makes things more expensive and make America less competitive.

More change from Obama that we didn’t need.

Interestingly, both sides consider the objective cost-benefit analysis to be problematic and seem to prefer subjective lobbying of politicians and bureaucrats.

February 16, 2011

Computers vs. humans

A day after blogging about Singularity, I encountered an article in the NYTimes about computers vs. humans.  According to the article, the war concerning artificial intelligence and intelligence augmentation is accelerating and is being highlighted by an upcoming battle between a computer and the two best Jeopardy players.  This battle, in which the computers are generally picked to win, will reveal whether computers are capable of dealing with questions.  If they are, their capability for replacing humans is expanded immensely.  A contrarian opinion is provided by computer scientist John Seely Brown, who suggests that machines that are facile at answering questions only serve to obscure what remains fundamentally human – “The essence of being human involves asking questions, not answering them.”

I look forward to seeing who wins.

Bob Herbert re-evaluates Ronald Reagan

Filed under: Issues,Politics — Mike Kueber @ 5:38 am
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According to NYTimes’ Bob Herbert, Americans should cease lionizing Ronald Reagan.    Although Herbert concedes that Reagan did some commendable things:

  • But when all is said and done, it is the economic revolution that gained steam during the Reagan years and is still squeezing the life out of the middle class and the poor that is Reagan’s most significant legacy. A phony version of that legacy is relentlessly promoted by right-wingers who shamelessly pursue the interests of the very rich while invoking the Reagan brand to give the impression that they are in fact the champions of ordinary people.”

To support his thesis, Herbert cites Reagan’s erratic son, Ron, Jr.:

  • Reagan’s son, Ron, says in the film that he believes his father ‘was vulnerable to the idea that poor people were somehow poor because it was their fault.’ A clip is then shown of Ronald Reagan referring to, ‘The homeless who are homeless, you might say, by choice.’”

That is probably a good explanation of conservative vs. liberal policies.  As a conservative in America, I think most people are responsible for their poverty or homelessness or crime.  I don’t think America is responsible.  Although I accept that (a) people born into rough or difficult situations are more likely to end up poor, homeless, or in crime and (b) America should do more to afford opportunity to help the disadvantaged, I think we have to treat people as responsible for their situation.  Herbert and Ron, Jr. seem to think that is wacko, right-wing thinking.

November 2, 2010

Stimulus spending

Filed under: Economics,Issues,Politics — Mike Kueber @ 6:02 pm
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Yesterday’s NYTimes column by liberal economist Paul Krugman laments the fact that today’s election results are likely to repudiate the actions taken by Barack Obama for the past two years.  Krugman hates the current drumbeat for tightening our belts and deficit reduction.  If anything, Krugman thinks that Obama’s stimulus spending has been far too parsimonious.  http://www.nytimes.com/2010/11/01/opinion/01krugman.html?_r=1&hp.

In a nutshell, Krugman argues that, if some people tighten their belts, others will have to pick up the slack in order to avoid a double-dip recession.  Because businesses and good-credit consumers (and state governments) appear to be unwilling to pick up the slack, Krugman wants the federal government and bad-credit consumers to do the dirty, but necessary job of spending beyond their means:

But the moralizers will have none of it. They denounce deficit spending, declaring that you can’t solve debt problems with more debt. They denounce debt relief, calling it a reward for the undeserving.  And if you point out that their arguments don’t add up, they fly into a rage. Try to explain that when debtors spend less, the economy will be depressed unless somebody else spends more, and they call you a socialist. Try to explain why mortgage relief is better for America than foreclosing on homes that must be sold at a huge loss, and they start ranting like Mr. Santelli. No question about it: the moralizers are filled with a passionate intensity.  And those who should know better lack all conviction.”  (The famous W.B. Yeats quotation actually says the “worst” have passionate intensity and the “best” lack all conviction.  I rarely use this quote because it is so polarizing, but Krugman probably intends to polarize.)  

Krugman began his column with a quote from CNBC’s Rick Santelli – “How many of you people want to pay for your neighbor’s mortgage that has an extra bathroom and can’t pay their bills?”  According to Krugman, this “rant” is widely credited with giving birth to the Tea Party movement.

Getting back to today’s election, Krugman concludes with:

So the moralizers are winning. More and more voters, both here and in Europe, are convinced that what we need is not more stimulus but more punishment. Governments must tighten their belts; debtors must pay what they owe.  The irony is that in their determination to punish the undeserving, voters are punishing themselves: by rejecting fiscal stimulus and debt relief, they’re perpetuating high unemployment. They are, in effect, cutting off their own jobs to spite their neighbors.  But they don’t know that. And because they don’t, the slump will go on. 

Although the term “moralizer” means a person who thinks about or expresses moral judgments, I suspect Krugman is sneeringly suggesting that such people are hypocrites.  I try to avoid moralizing, especially about lifestyle issues, but I believe people, businesses, and governments generally should live within their means, even if that results in an economic downturn.  As I stated during my congressional campaign, I think a short-term stimulus by the federal government is appropriate in helping America recover from a recession, but not the long-term stimulus that Obama obtained and certainly not the humongous stimulus that Krugman is suggesting.

October 29, 2010

Campaign 2010 – Iraq and Afghanistan

Filed under: Issues,Politics — Mike Kueber @ 12:09 am
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Earlier in the week, Tom Brokaw contributed an Op-Ed piece to the NYTimes titled, “The Wars That America Forgot About.”  He complained about the paucity of campaign consideration of the wars in Iraq and Afghanistan despite the wars’ duration (nine years) and cost (5,000 lives and $1 trillion).  In Brokaw’s opinion, the dearth of discussion is due to the fact that few Americans are affected by the wars – i.e., the all-volunteer military is less than 1% of the population, and America’s non-military are not even asked to pay for the wars.       

Today, a headline in the NYTimes read, “In 2010 Campaign, War Is Rarely Mentioned.”  In the accompanying article, the author Helene Cooper concludes, however, that the absence of coverage is the fault of politicians.  She opines that politicians in both parties have strategically decided that discussion of the war would not be helpful to them.

I suggest that Brokaw and Cooper are conveniently overlooking a major, obvious cause for the lack of coverage.  No, it’s not the apathy of the American public, and, no, it’s not the fecklessness of politicians.  But rather, it is the political bias of the media.

Obama campaigned for president by promising to quickly end the bad war (Iraq) and to fully engage in the good war (Afghanistan).  Unfortunately for him, Bush ended the bad war before Obama had a chance to end it, and the good war deteriorated badly.  Because the media completely bought into the Obama presidency, they have no motivation to undermine him by adding Afghanistan to his pile of difficulties.  The media was downplaying the wars and bringing their correspondents home long before the 2010 campaign. 

So, Tom and Helene, when you wonder why the wars aren’t being covered, look to your brethren.

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