Wednesday, 9 January 2013

07:53 – Barbara’s dad is still in the hospital. The news isn’t good, exactly, but it’s about the best that could be expected. Barbara’s hoping he’ll be released tomorrow or Friday and can go home. She and her sister are resigned to the fact that their dad’s congestive heart failure is chronic, and it’s likely that he’ll have repeat episodes every month or two indefinitely.

This episode hasn’t been much easier for Barbara and her sister than previous ones. The one bright point is that they don’t have to worry about their mom now that she’s in the retirement village rather than by herself at home. They’re trying to keep their mom away from the hospital as much as possible, particularly because of the nasty flu strain that’s going around. At her age and with her long-standing lung problems, a hospital is a very dangerous place for their mom to be. The retirement village staff is keeping a close eye on their mom, which is one less thing for Barbara and Frances to worry about.


10:01 – Yesterday while I was out with Colin, I ran into Paula, who lives across the street, walking her dog, Max. Max is almost 15 years old and on his last legs, literally.

Paula asked about Barbara’s dad. She went through the same thing with her dad a few years ago, and now she’s going through it with Max. Now, as then, she feels completely helpless to stop the downward slide, which of course she is. Paula is enraged about aging and death, and the fact that no one can do anything about it. I agree with her. Something needs to be done.

Biologically, of course, senescence and death are just a part of life. The old have to die to make room for the younger generations. Or do they? Some organisms are immortal for all intents and purposes. Individual examples of these organisms do not senesce, nor die from natural causes. Lazarus Long has real analogs in the natural world.

Scientifically, there’s no reason why normal human lifespans couldn’t be nearer a millennium than a century, or even ten or a hundred millennia. Nor is there any reason why humans couldn’t spend the vast majority of that extended lifespan in their prime rather than becoming increasingly decrepit as they age.

The real reason that so little work is being done on this has nothing to do with the science. It’s purely a matter of politics. Unless everyone can have it, no one can have it. And, unfortunately, even if we already knew how to extend lifespans by an order or orders of magnitude, the only people who would have access would be exactly the ones that shouldn’t: politicians. Meet the new boss, the same as the old boss, literally.

Even if we can’t (yet) arbitrarily extend human lifespans, there’s another alternative. While work continues on genetic engineering, we can at least clone those humans whose genomes are worth preserving. And if politics prevents that for the time being, we can at least collect and preserve DNA specimens from our geniuses in all fields. We do it now for plant seeds; there’s no reason we shouldn’t do it for humans. Eventually, although it may be centuries before it happens, we can use that DNA as seed material to create artificial human genomes that preserve all of the good things and eliminate all of the bad. As a matter of fact, I think I may start collecting cheek swab DNA samples from my genius friends.


11:24 – Hmmm. I’m running low on glass bottles (I still have plenty of plastic ones), so I just ordered a case of 10 mL amber glass bottles and seven cases of 30 mL amber glass bottles. At checkout, I was given a choice of one of two shipping methods. Next-day air cost $816.20. UPS ground cost $0.00. I dithered for all of a nanosecond before choosing the free shipping option.

40 thoughts on “Wednesday, 9 January 2013”

  1. From the article OFD cites:

    ”The key to understanding this sector is to note that the government partners with industry to reimburse costs with little systematic oversight and control,” Sachs says. ”Pharmaceutical firms set sky-high prices protected by patent rights; Medicare [for the aged] and Medicaid [for the poor] and private insurers reimburse doctors and hospitals on a cost-plus basis; and the American Medical Association restricts the supply of new doctors through the control of placements at medical schools.

    Actually this is the most inaccurate part of the article in question. At least for Medicaid, primary care doctor’s aren’t even paid cost. Medicare pays more than Medicaid, but for the most part pays only 80% of what commercial insurance pays a doctor for the same service. (Actually, it’s worse than that. Medicare allows 80% of what most commercial insurance pays, and pays only 80% of what they allow, thereby requiring the patient or secondary insurance to pay the other 20%.)

    As to US Medical schools limiting the supply of doctors, that’s also not true. Of all the medical appointments I have taken my mother to, only one was with a doctor who went to US medical school. That was with a podiatrist. The practice my mother visits most frequently has her alternate between seeing a doctor and a nurse practitioner. All the other doctors my mother has seen went to medical school outside the US.

  2. “Nor is there any reason why humans couldn’t spend the vast majority of that extended lifespan in their prime rather than becoming increasingly decrepit as they age.”

    I kinda wonder if people would get sick of living by about 100, even if they we’re in their “prime”. If everyone you knew at 20 was still around it might be okay, but if there isn’t enough longevity to go round even fit 100 year olds might want to check out just from loneliness and boredom. And even if their bodies function well it might not be possible to stop their minds decaying.

  3. Wow! I knew Australia was having a heat wave, but I had no idea how bad it was.

  4. Absolutely right. Reminds me of the classic novel “Methusalah’s Children”, in which long-lived people are hunted down for no other reason than jealousy.

    Really, even barring scientific progress, there is every reason to suppose that Heinlein’s proposal would work: simple breeding. I know of an experiment with the classic fruit flies, where a very few generations of selective breeding tripled the average lifespan.

    But, indeed, not everyone would “have it”, and human nature would take its course.

    On a totally different topic: good luck to everyone in Oz. The fires sound pretty horrific.

  5. “Absolutely right. Reminds me of the classic novel “Methusalah’s Children”, in which long-lived people are hunted down for no other reason than jealousy.”

    Also, Hot Sleep, by Orson Scott Card. The rich can afford to “hot sleep” and stop aging. Wake up once a century or so to see what’s going on. Did I mention the rich.

  6. More police thuggery:

    http://www.twincities.com/localnews/ci_22333563/little-canada-man-videotaped-sheriffs-deputies-and-got

    Using the health care law to just go up and take a camera. What the frick! The health care law.

    Now Biden is flapping his jaws about Obummer using executive order to stop gun violence. “As the president said, if you’re actions result in only saving one life, they’re worth taking. But I’m convinced we can affect the well-being of millions of Americans and take thousands of people out of harm’s way if we act responsibly.” There is so much wrong with that. Why not make cars that can only go 10mph and are surrounded by 5 feet of foam rubber? Outlaw ciggies. Saving one life by taking away 100’s of millions of peoples freedom is never right.

  7. Too many of today’s U.S. robocops apparently believe they can do anything they want, and once they’ve done it, even if blatantly illegal, their bosses back them up or “lose” or destroy evidence, and then the local gummint authorities back THEM up, too.

    And O’Bummer and the wack job VP will find out just what a big mistake they made if they go ahead with any kind of ‘executive order’ or other high-handed attempt to seize citizens’ lawful firearms, all half a billion to a billion of them. Besides the example from MrAtoz, it’s doctors who are killing and crippling more people, by far, than firearms in this country. When one sees stuff like this, one really does begin to wonder just how it is so convenient after several mass-murder incidents like we’ve had recently. With many facts not made public, witnesses disappearing, evidence being ‘lost,’ etc.

  8. I read something many years ago and I don’t, unfortunately, have the source to cite anymore, but it said if humans didn’t die of old age that the longest anyone would probably lived was into their 300s. Your chances of either being in a fatal accident, being murdered, contracting a fatal disease, etc. reach almost 100% by then. So, if old age doesn’t get you then by the time you entered your 4th century you would have almost certainly succumbed to some other cause of death. It’s not enough that you don’t age.

  9. That assumes facts not in evidence, and it also assumes that accident/murder rates will remain the same.

    As to diseases, our scientists will eventually conquer all of them. Bacteria, protists, and viruses just aren’t that smart. Right now, we go after them indirectly with antibiotics and antivirals, which allows the microorganisms to evolve resistance. Eventually, and we’re starting to see this already, we’ll go after them with genetically-engineered hunter/killer microorganisms tailored to attack specific pathogens and only them. Those viruses will track down every single pathogenic microorganism, kill it, and then die off themselves for lack of prey/hosts.

  10. ” Your chances of either being in a fatal accident, being murdered, contracting a fatal disease, [or pissing off SteveF], etc. reach almost 100% by then.”

    There, fixed that for ya.

  11. “I dithered for all of a nanosecond before choosing the free shipping option.”

    It took you that long? You’re obviously slowing down.

    “Getting old is hell” ™

  12. From OFD’s article:

    “which notes that the previous record high was 50.7°C (123°F), recorded in 1960 at Oodnadatta Airport in the southern part of Australia — right around where the new shades of hot are showing up today.”

    Oodnadatta is in South Australia, but it’s not in southern Australia. It’s in the far north of SA:

    http://en.wikipedia.org/wiki/Oodnadatta

    I wouldn’t care to live there; it’s a long way from the beach and I’m sure petrol and groceries cost a ton.

    We had a pretty severe drought, lasting around a decade, that ended 2-3 years ago. I’m hoping it’s not back. The reservoirs around Canberra are 95% full, but that can change quickly. In the last drought the local water authority raised prices to encourage efficiency. When the drought broke and there was less demand for water (for watering gardens, showering and staying hydrated) they put up prices *again* to try and clay back the money they were losing by selling less water.

    I can smell smoke in the air sometimes from the bushfires nearby but at least it’s not as bad as this:

    http://en.wikipedia.org/wiki/2003_Canberra_bushfires

  13. MrAtoz wrote:

    “Also, Hot Sleep, by Orson Scott Card. The rich can afford to “hot sleep” and stop aging. Wake up once a century or so to see what’s going on. Did I mention the rich.”

    In Iain M. Banks’ Culture novels people can be stored, and revived later on. The usual practice seemed to be to make a copy of their “mind state” and genetic code. The inert body would be displaced into the centre of the local sun, and at some later stage, perhaps when the storee’s revival conditions were met, a new body was grown for them from scratch and their mind re-implanted.

    In The Culture people routinely lived for hundreds of years. In Look to Windward an old chap who was still in reasonably good condition, but 400 years old, had grown tired of life and chose to autoeuthanase. His friends gathered, he said farewell, and died of his own will. A Displacement Drone teleported him into the centre of the system’s sun, where the photons created by the destruction of his body would shine down on his Orbital a million years later.

  14. OFD wrote:

    ” Your chances of either being in a fatal accident, being murdered, contracting a fatal disease, [or pissing off SteveF], etc. reach almost 100% by then.”

    I ain’t afraid of SteveF. He’s there and I’m here, and I’m sure his wife wouldn’t let him out of the house long enough to track me down.

  15. Oh sure, go ahead and scoff at SteveF when you’re, what, twelve-thousand miles away. I have to worry because he’s just down the road here.

    On a somewhat related topic; Mrs. OFD doesn’t like Ann Coulter and I have it on good authority from fellow paleoconservatives who’ve known her personally for years, that she is a real bitch on wheels sometimes and nasty to other people. However, she fairly regularly gets things right, as she does in this column, and she pisses off all the right people, so I cut her some slack:

    http://www.humanevents.com/2013/01/09/coulter-doing-the-research-the-new-york-times-wont-do/

  16. Ann Coulter is famous for being a bitch, and that doesn’t surprise me the least. Most people think smart, tough women are.

  17. Nice article Dave, but I wouldn’t recommend posting that link in Jerry Coyne’s or PZ Myers’ blogs.

  18. Just Googled her. She’s pretty cute.

    (Okay, is she beautiful, pretty or attractive? Or two, or all three?)

  19. She’s underfed and I would be happy to buy her a triple steakburger with bacon, extra cheese, and sure, we’ll throw in veggies: lettuce, tomato and mushrooms. Supersize the fries and chase it down with a Friendly’s mocha Fribble. Then we’ll go out drinking and see who can stand up longest on German and English ales. Once she’s out, I’ll pack her up and ship her down to you in Oz…be prepared, though, for major hassles…

  20. Oh sure, go ahead and scoff at SteveF when you’re, what, twelve-thousand miles away. I have to worry because he’s just down the road here.

    OFD, I was about to roll my eyes and go “sheesh”, but before I got even one word into my rebuttal, I got a story idea: What is the bogieman afraid of? And for a nice, contemporary, distopian twist, the bogiemen are masked police assault teams. Yes, it’s coming together…

    Besides, hadn’t we already determined that you’re like my cool, older brother? What are you worried about? Sheesh.

  21. Arglebargle. Bodged the closing tag. I can never show my face in public again.

  22. I wouldn’t wear a mask, and those I see coming at me masked are asking for beaucoups trouble, whatever their alleged allegiance. Ordinarily, though, I think masks are funny. I also like maniacal clowns. And my two favorite comic strips are Red Meat and Lulu Eightball, so one can see what a warped sense of humor I have.

    37 here in the howling wilderness of northern Vermont, on the shores of Lake Champlain, with the eldritch wind screeching and twigs snapping against our sorry-ass old windows. And I will toss and turn tonight as I ponder how it is that my workplace is hiring two more Linux sys admins at our location and one more at our other team’s site down in lovely East Fishkill. Yes, that is a real name for a real town. We can’t laugh much up here, though; not with Hardwick and Ticklenaked Pond.

    http://www.redmeat.com

    http://citypaper.com/news/comics/lulu

  23. “Once she’s out, I’ll pack her up and ship her down to you in Oz…be prepared, though, for major hassles…”

    Ann C or Princess?

  24. “And I will toss and turn tonight as I ponder how it is that my workplace is hiring two more Linux sys admins at our location and one more at our other team’s site down in lovely East Fishkill.”

    I thought they were sacking people, not hiring.

  25. Krugmann complaining about “austerity”, when there isn’t any to be found. In Europe, as in the US, “austerity” consists primarily of cuts in the spending the politicos would like to do. What he doesn’t understand is simply this: Economic growth requires production; the government consumes, but does not produce.

    Granted, there are a few exceptions to that rule (nationalized companies, perhaps some infrastructure work), but not many. The government as a whole is a massive net consumer.

    The other thing that he blithely fails to address is: lacking “austerity” (such as it is), where is all of the money supposed to come from? The only option would be to print money, which will ultimately be reflected in inflation, which is nothing more than a huge hidden tax on private savings and investments.

  26. “I thought they were sacking people, not hiring.”

    They’re sacking regular, permanent employees and hiring contractors, temps and part-timers and finagling various retirement and buy-out packages for lifers. The corporate goal in this country is to have as few employees as possible and pay them peanuts and not have *any* benefits for them. While the top dawgs make out like bandits, per usual, and then bail out after they’ve gutted the firm and left it an empty shell. We’ve heard scuttlebutt that the organization where I work plans to cut its American work force by 90%, to around 10k, leaving mainly just the top honchos at the corporate HQ.

    This is more evidence of what Robert has been discussing here from time to time.

  27. I wholeheartedly endorse Krugman’s view that austerity in the face of recession is EXACTLY the 180° opposite of what should happen. Apparently, Europe needs better spectacles and some proper respect for data, because data is not lacking. This calling for even more austerity when it is perfectly obvious that the current austerity is devastating the EU is the same as calling for the outlawing of guns because criminals use them and certifiable loonies go on shooting rampages in places where they know there will be no resistance. Outlawing guns hurts that part of the population at large which wants to protect itself and is perfectly capable of doing so.

    As to Brad’s question of where should the money come from? It should come from reserves built up during the good years. But the fact that politicians are crooks and have no intention of building reserves during good times, does not mean massive suffering should be inflicted on the rest of society because of the repeated failure of politicians to represent the people, their wishes and best interests.

    There is now even more to the story of the US housing bubble and subsequent banking fiasco, though. Data now reveals that the housing bubble was caused almost exclusively by people refinancing their houses at lower interest rates to get borrowed cash from the increased equity in their houses, which they then spent. As inflation and the bubble drove housing prices ever higher, borrowers kept going back to the well to get even more cash to spend—a true bubble. Canada almost completely escaped this, because they have regulations which forbid lenders from selling loans. If a bank loaned money to a homeowner, that bank is required to keep that loan in their portfolio, so there is none of that crazed frenzy of constant refinancing, which made money for lots of people in the chain as the loan was passed around, until it all collapsed. But will US regulators get smart and prohibit the selling of loans like our Canadian cousins? Not on your life!

    Krugman clearly describes how the economies of nations are not equivalent to households. This is something that common people (and Europeans especially) apparently cannot understand. It was one of the first things taught in my Econ 101 class.

  28. While I am on economics, afraid I have to take exception to DAveB’s anecdotal information about foreign-trained doctors in his area somehow proving that there is no doctor shortage.

    Over the last decade, Dean Baker has pointed out several studies that contradict claims by The Washington Post and New York Times that there is nothing wrong with the US healthcare system that needs fixing. As Baker puts it: when doctors are paid three to five times what the highest paid doctors outside the US make, there is both isolationist trade barrier control over the US system, and not enough competition within the system (not enough doctors). The same is true for lawyers in the US.

    It is a plain fact that both the medical associations and Bar associations in most states control how many doctors and lawyers will be permitted to be educated in their state during any one school year. I have not seen figures past 2009, but in Indiana, while higher education has increased enrollment since the Great Recession began, both the medical school and law school at Indiana University saw declines, not rises, in their student enrollment during the period when the recession took hold.

    Dave lives in an area where there has long been a highly educated immigrant population, because of the nearby university, which has actively encouraged foreign student populations. But over here in the eastern part of the state, no such immigrant doctors exist. I just checked the websites of the main clinics for doctors serving the public in New Castle and Muncie, and none of the practicing doctors listed their medical training as coming from outside the US. Most got theirs from Indiana University, or were residents at one of the IU hospitals, coming from other US medical schools. Even those doctors with foreign-sounding names were educated at US medical schools.

    That article noted by OFDave is right on the money. Furthermore, allowing any industry to regulate itself is certain to degrade the product IMO while increasing costs, and I include my own industry of broadcasting. Putting limits on how many doctors and lawyers will be educated, is a Socialist/Communist concept, not a free market one. But yet, we embrace that commie concept here and now, and nobody but Baker and Greg Mankiw call for stopping that. And Uwe Reinhardt:

    http://economix.blogs.nytimes.com/2012/08/17/health-care-reform-and-the-doctor-shortage/

    http://econospeak.blogspot.com/2012/08/the-baker-mankiw-solution-to-impending.html

  29. While I am on economics, afraid I have to take exception to DAveB’s anecdotal information about foreign-trained doctors in his area somehow proving that there is no doctor shortage.

    Oops, I should have been clearer. I wasn’t saying there isn’t a doctor shortage. I was trying to say that to some extent number of physicians is now outside the control of medical schools. If there is a single chokepoint, it’s the number of residencies, which I seem to recall are paid for by Medicare.

    I will stipulate that there is a primary care physician shortage. I think the cause of this has more to do with basic economics. Insurance doesn’t pay primary care physicians any more than it pays nurse practitioners. Medical school requires a lot more time and money than nursing school, even if we are talking about including both undergraduate and graduate nursing school. I think anyone going to medical school should either become plan on becoming a specialist, or rethink medical school.

    In our current healthcare system we think of doctors as a monolithic block. There is a drastic difference between how primary care physicians and specialists are paid. Observing my family’s medical bills, I’ve noted our insurance pays $60 per primary care visit and pay $4000 or $5000 for a days work for highly specialized surgeons.

    Specialists may be overpaid, but I’d argue that if anything primary care physicians are underpaid. I think the underpayment of primary care physicians is the primary cause of a primary care physician shortage. Before we realize it, I think we’ll see the primary care physician become a thing of the past, replaced by the nurse practitioner.

  30. Let’s face it: nurse practitioners can do a whole lot of what primary care doctors used to do, and instead of always focusing on money, money, money, which I fully understand is a wonderful part of our supposed capitalist system, common sense once in a while would be good, too.

    “Putting limits on how many doctors and lawyers will be educated, is a Socialist/Communist concept, not a free market one.”

    Exactly, and it also reminds me of the feudal guild system. Let the markets decide, but also let’s use whatever vestiges of common sense and reason are left among contemporary homo sapiens sapiens.

  31. Chuck wrote:

    “Krugman clearly describes how the economies of nations are not equivalent to households. This is something that common people (and Europeans especially) apparently cannot understand. It was one of the first things taught in my Econ 101 class.”

    What about the trillion dollar platinum coin? I don’t really have an ideological commitment either way but it seems to me that Krugman doesn’t recognise that increasing deficits have to stop eventually. One of the problems with the US Government is that it doesn’t salt enough away during good times to make up for deficit spending in bad times. I’m sure that liberals have some sort of magic that allows this to happen but I don’t see it.

  32. Dave B wrote:

    “Specialists may be overpaid, but I’d argue that if anything primary care physicians are underpaid.”

    A friend of the family is a young female doctor who says she gets AU$1000 for two hours work on Saturdays. I think she’s just a GP, or perhaps a registrar in one of the hospitals in Adelaide. But $500 per hour? I know that’s just loose change to Bill Gates and Warren Buffet, but I think it’s not bad for a girl only five years out of med school.

    As to the supply of doctors, we had/have a shortage here, to the extent that many doctors had closed their books – i.e. stopped accepting new patients into their practices. Part of the problem is that the government controls the purse strings and doesn’t want too many, which it fears would lead to overservicing and hence drive up costs.

  33. Not to worry, OFD has the solution:

    More nurses and fewer doctors.

    A bounty on lawyers and politicians and financial industry types.

    Bonuses for firefighters and fewer cops.

    Huge bonuses for STEM graduates who become teachers and professors.

    A gigantic bonus for hired assassins like SteveF and assassination marketing professionals like myself.

  34. I’m not high on nurses taking over for doctors. In Germany, nurses are secretaries; they do not administer shots, they do not do tests or take blood pressure (if they do take blood pressure, the doctor does it again when s/he comes in); nurses do put lids on urine samples and they do prep the patient for things like EKG’s. They do NOT administer the EKG’s. They do not put casts on people; doctors do.

    I NEVER had a German doctor give me a shot or draw blood that broke a blood vessel or bled under the skin. That happens about 90% of the time here in the US, where doctors never give shots and only nurses do. All this throwing work on nurses, instead of doctors, is just insuring that you will have less trained care than you pay for. Already I pay many multiples of what I paid for healthcare in Germany—and I get a discount from my particular hospital practice because my income is lower now than it used to be. You want to throw your money at a system that substitutes nurses for what doctors should do (and do do in Europe), count me out; I want education and experience for the significant money I throw at healthcare here.

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