April 23rd, 2008

two medical screening articles, one dippy, one interesting

I'm sure their numbers are right, and I'll even stipulate without further investigation that their methods were no worse than average.

But come on. If you are a frail 80+ year old woman who no one is going to operate on anyway, and who already has a DNR, do you really need to be subjected to regular mammograms? This is just asinine.


They're just trying to drum up more business.

"This study suggests that mammography benefits may have no age limit and that women should consider being screened on a regular basis, even into their 80s and possibly 90s, depending on their current health status," study chief Dr. Brian D. Badgwell, MD, of the University of Texas M.D. Anderson Cancer Center said in a written statement.

Well, Dr. Badgwell, you go out and have some sensitive bit squished to a point where you'd just about rather die than continue. Regularly. As an 80 year old. And tell me that torture does any real good for anyone.

The other article(s) is about Ritalin and related stimulant drugs to treat ADHD and similar in children. As one might expect, stimulant drugs + heart problems = bad.


"Children should be screened for heart problems with an electrocardiogram before getting drugs like Ritalin to treat hyperactivity and attention-deficit disorder, the American Heart Association recommended Monday."

At least some of the coverage is doing a good job of pointing out the (in)obvious.

(1) Screening costs something (apparently $100 or so per ECG)
(2) False positives will create a cascade of more intrusive, expensive, possibly more dangerous tests that are emotionally extremely stressful for the patient and family.
(3) ECG screen may let enough cases through that screening ultimately has no net benefit.

No net benefit can happen several ways. The "cost" of the program may exceed the "value" of the patients saved. That's kind of yucky. But also, the added deaths due to additional unnecessary testing in the resulting false positive cascade (yes, virginia, people _do_ die from tests!) could conceivably equal or exceed the hypothetically avoided deaths from successful screening. And there's a chance this won't actually save anyone.

shopping for real estate?

RealtyTrac has a seven day free trial, but read the fine print carefully. It's $50/month to join, and they want your payment information up front and will cycle you through to joining unless you opt out within the seven days, and if you opt out any way _other_ than the website edit profile, you need to give five days warning (unless you do it by letter, in which case they want 10 days, which renders the 7 day trial kinda moot). Just so you know.

After some discussion, I signed up for the trial, largely because other web sources of similar information seem to be less good (in some cases, completely useless crap). Our calculation is that even paying a year should be damn easy to get back if it helps us determine the right time/property to buy and the right amount to offer. RealtyTrac is awesomely cool and a major time suck, altho I could wish that their search page was a little better. You can search by zip, city, county, but not list-of-towns, so I'm either stuck laboriously doing several searches per town, or sorting through a bunch of cities I don't want on a county search (and then doing a second search for Harvard, which is in Worcester, not Middlesex county). I also wish that you could sort finer on square footage.

They offer some loan and prior sale information, but it is freakishly tricky to decode. In some cases, you can just see the ATM behavior in action, but in others, the refis are scattered 2/decade at erratic amounts, some up, some down and it isn't always clear if these are replacement loans or additional loans in all cases. And I apparently am still sufficiently naive in the ways of real estate that I don't understand the various kinds of sale. But I will!

We expect we'll still get an agent at some point, but this should help us figure out which agents are shining us on.

Zillow.com, of course, is free. Where Zillow at the height of the bubble had prices that struck me as consistently 10%+ too high, now Zillow has prices that are, well, let's just say they knock more than 10% and/or $100K off of some of the houses we have been contemplating. Best of all, Zillow includes (usually) some past sales information and (as near as I can tell, always) a chart of past valuation for the home/area/etc. Which means you could, in principle, pick a date where you think we're going back to, and use that for valuation. Nominal/real dollar problem, not to mention there's the talk-the-lender-into-playing-along issue (assuming you can get the "owner" to agree), but still.

_Bad Money_ by Kevin Phillips

I apologize if I've already posted about this. I can't find a post about this, but when I typed in, it seemed to think it had seen that subject before. *shrug* Pregnancy brain. Anyway.

I bought this when I bought _Gusher of Lies_, and I had heard part of a Phillips interview on the Diane Rayne (probably spelled wrong) on N(H)PR. I've almost bought his previous books, but kept not, for a variety of reasons which I think I actually kind of understand now.

Phillips is erudite and cranky. Also, a little flippant. The basic thesis of this book is that when empires (previous examples: Spanish, Dutch and English) "financialize", that is, when their financial sector starts to be the biggest/most profitable part of their economy, it's The End (whether it's the beginning of the end, the middle of the end, or the end of the end is not entirely clear, and probably somewhat picky of a point anyway). He points out that the incoming administration is likely to face several major crises (global warming, peak oil, loss of global financial power) that are probably not addressable. He rallies evidence from the aforementioned empires to show how politics is not up to the task, and then describes the current situation in some detail (basically, all our national politicians are bought and sold by Wall Street to a substantial degree). He spends a lot of time on the housing bubble and its collapse, a little time on the tech bubble and its collapse, and a good chunk of time on Rubin/Paulsen/Greenspan (the latter, in particular, as a serial bubbler), and also speculates about what various administrations have done to prop up equity markets in recent decades. He also spends some time explaining why a variety of economic statistics are incredibly bankrupt at this point (hedonic adjustments for computers, for example).

While I think Phillips and I probably agree on, well, just about everything (unlike Bryce, the author of _Gusher of Lies_, who infuriated me repeatedly), this book was a bit of a slog to get through. And I'm a little uncertain how much I learned from it. In an ideal situation, this would have been a great Doom read, but it wasn't, probably because Phillips is a little flippant, and at no point does he suggest these problems are so severe We're All Gonna Die (altho, of course, we _are_, one way or another).

Neutral on this one. I think it's probably a good book.

musing on Doom

Having just read _Gusher of Lies_ and _Bad Money_, while avidly watching the housing market crumble, WTI head for the stars ($119.40 today) and Costco et al limit Big Bag o' Rice purchases, I find that I am curiously disappointed by the level of discourse surrounding the End of the World as We Know It.

On the one hand, we have people saying suburbia is done for and start growing your own food and maybe move out to a farm so you can be self-sufficient. Which is stupid; I've already been over why that is Stupid in the lead up to Y2K. If our society really is going to go through that level of chaotic drive off the cliff, any farm you could be self-sufficient on (and let me tell you, subsistence farming is not for the faint-hearted, or, realistically, the over-40) has decent odds of being overrun by gun-toting cannibals from one of the particularly silly horror movies being touted currently. We'd _really_ better hope things don't get to that point.

Post-whatever-the-most-recent-disaster-in-your-area-was, or, absent that, post-Katrina, we're all supposed to have enough food, water, lighting, etc. to get us through a 2-3 day lapse in services, so there's a pretty solid argument for doing something between that and, say, the Mormon 1 year stockpile.

And that's all fun enough, but if what we're really talking about is every third family being foreclosed on, no one being able to afford gas (even if they could find it to buy), and desperately trying to figure out how to cook whatever kind of food is currently available and cheap enough to buy with whatever fuel you can manage to scrounge up, it seems like it might be worth talking about just what we can do to reduce our collective resource use in advance of that point, operating under the theory that if we were sufficiently frugal and clever we could, say, manage to avoid _getting_ to that point. And that part of the debate is utterly missing.

Sure, there are people who are talking about eating locally, and that's great. Garden. Farm stand. CSA. Whatever. Yup, we're all switching to commuter cars and trying to reduce trips because my god can you believe the gas prices. Whatever. Why aren't we seeing a more organized effort to do energy audits on homes and businesses? People all want to talk about solar panels and wind turbines and installing "geothermal" (one of those heat-pump/well systems), which is lovely and all, and of course everyone has already switched their lightbulbs. And there are a few cities/counties around the country putting together RideShare websites to help people find people to carpool with. But in the middle of all these random statistics about what percentage of energy goes into lighting, and how LED lights can reduce that by some significant amount, I don't see anyone putting together a package (I know; Al Gore had the list of things in _An Inconvenient Truth_, and I distinctly remember R. getting pissy about the wrap-hot-water-tank-in-insulation saying that was a terrible idea with modern, insulated hot-water-tanks) for NOT JUST INDIVIDUALS but the country as a whole or at least regions to adopt.

Like, you know, a platform. It could start with get the hell out of Iraq, and work its way from there. And it should supply specific numbers. We use X amount right now on gas. We make these changes, we can use X/Y instead. We use A on heating/cooling costs. We make these changes, we can use A/B instead. We use C to grow food. We make these changes, we can use C/D instead. Etc. With a total at the end, and a goal of cutting our total energy use by some substantial factor within 5 years (cutting it in half would be the lowest interesting amount to me; I'd like to see it cut to one fifth. Not BY one fifth. To one fifth. Which would put us in spitting distance of energy independence).