Posts tagged ‘risks’

The Media and Cancer Risks

The old saying goes, “where there is smoke, there’s fire.”  I think we all are at least subconciously suceptible to thinking this way vis a vis the cancer risks in the media.  We hear so much about these risks that, even if the claims seem absurd, we worry if there isn’t something there.  After all, if the media is concerned, surely the balance of evidence must be at least close – there is probably a small risk or increase in mortality.

Not so.  Take cell phones.  We have heard for decades concern about cancer risk from cell phones.  But they are not even close to dangerous, missing danger levels by something like 5 and a half orders of magnitude.

Cell phones do not cause cancer. They do not even theoretically cause cancer. Why? Because they simply do not produce the type of electromagnetic radiation that is capable of causing cancer. Michael Shermer explains, using basic physics:

…known carcinogens such as x-rays, gamma rays and UV rays have energies greater than 480 kilojoules per mole (kJ/mole), which is enough to break chemical bonds… A cell phone generates radiation of less than 0.001 kJ/mole. That is 480,000 times weaker than UV rays…

If the radiation from cell phones cannot break chemical bonds, then it is not possible for cell phones to cause cancer, no matter what the World Health Organization thinks. And just to put the “possible carcinogen” terminology into perspective, the WHO also considers coffee to be a possible carcinogen. Additionally, it appears that politics and ideology may have trumped science in the WHO’s controversial decision.

Public vs. Private

Folks on the Left prefer public institutions over private ones because they percieve them as more “fair.”  But the power of lawmaking and police and prisons allows public institutions to be far more abusive than private entities could ever be.  We spent months and years torturing ourselves about accounting abuses at Enron, but these are trivial compared the accounting shenanigans state institutions engage in every day.

Or consider this, from Europe, particularly the first bit

“In the event of default (i) any non-official bond holder is junior to all official creditors and (ii) the issuer reserves the right to change law as needed to negate any rights of the nonofficial bond holder.

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“We should not underestimate the damage these steps have inflicted on Europe’s €8.4 trillion sovereign bond markets. For example, the Italian government has issued bonds with a face value of over €1.6 trillion. The groups holding these bonds are banks, pension funds, insurance companies, and Italian households. These investors bought them as safe, low-return instruments that could be used to hedge liabilities and provide for future income needs. It was once hard to imagine these could ever be restructured or default.

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“Now, however, it is clear they are not safe. They have default risk, and their ultimate value is subject to the political constraint and subjective decisions by a collective of individuals in the Italian government and society, the ECB, the European Union, and the International Monetary Fund (IMF). An investor buying an Italian bond today needs to forecast an immediate, complex process that has been evolving in unpredictable ways. Investors naturally want a high return in order to bear these risks.

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“Investors must also weigh carefully the costs and benefits to them of official intervention. Each time official creditors provide loans or buy bonds, the nonofficial holders become more subordinated, because official creditors including the IMF, ECB, and now the European Union continue to claim preferential status.”

This is not to say that bondholders in private entities don’t get crammed down in a refinancing or bankruptcy.  But here we are talking about differential treatment of holders of the exact same class, even issue, of securities.

Fannie and Freddie: Worse Than We Thought

From Edward Pinto at the American

Fannie and Freddie entered into agreements accepting responsibility for misleading conduct discovered by the SEC, including:

1.    As of June 30, 2008, Freddie had $244 billion in subprime loans, while investors were told it had only $6 billion in subprime exposure.

a.    Freddie knew it was inadequately compensated for the risks it was taking. For example, it was taking on “subprime-like loans to help achieve [its] HUD goals” that were similar to private fixed-rate subprime, but the latter typically received “returns five to six times as great,” says the complaint.

b.    Freddie had concerns about risk layering on loans with an LTV >90% and a FICO <680. (Yet, in Freddie’s disclosures it only noted risk layering concerns on loans with an LTV >90% and a FICO <620. This is a major difference since only 10 percent of its loans fell into the LTV >90% and a FICO <620 category, while nearly half fell into the LTV >90% and a FICO <680 one.)

2.    As of June 30, 2008, Fannie had $641 billion in Alt-A loans (23 percent of its single-family loan guaranty portfolio), while investors were told it had less than half that amount ($306 billion, or 11 percent of its single-family loan guaranty portfolio).

3.    The SEC complaint disclosed that Freddie had a coding system to track “subprime,” “other-wise subprime,” and “subprime-like” loans in its loan guaranty portfolio even as it denied having any significant subprime exposure.

These suits are important because they demonstrate that Fannie and Freddie “told the world their subprime exposure was substantially smaller than it really was … and mislead the market about the amount of risk on the companies’ books,” said Robert Khuzami, director of the SEC’s Enforcement Division.

Dispatches from the Corporate State: A Study in Contrasts

It is interesting to study the contrast between the handling of the Toyota accelerator problems, which turned out to be pretty much all driver error, and the Chevy Volt fire issues.

In the case of the former, we had public hearings and government threats.  The government, without evidence at that point, demanded Toyota recall the vehicles and stop production.  Eventually, when the NHTSA determined that the panic and recall was in error and the issue was operator error and not with the car, the Obama Administration suppressed the results.

Now, Volts appear to have a fire problem with their batteries.  This time, the government is keeping things real quiet and, instead of exaggerating the safety issue, they are suppresing it

It now appears the fire hazard was first discovered back in June, when GM first heard about a fire in a Volt that occurred some three weeks after the vehicle had been crash tested.

Yet, almost five months went by before either GM or the US National Highway Traffic Safety Administration (NHTSA) told dealers and customers about the potential risks and urged them to drain the battery pack as soon as possible after an accident.

Part of the reason for delaying the disclosure was the “fragility of Volt sales” up until that point, according to Joan Claybrook, a former administrator at NHTSA.

Demagoguing a non-problem in the first case, covering up a real problem in the second.  Guess which one has a union that supported Obama’s election and which does not.  Guess which one Obama bought equity in with taxpayer money?

The True Cost of the Education Bubble

I hinted at it in my last post, but have addressed it in more depth in my column this week at Forbes.  A brief excerpt:

The theme from all these failures is distorted signals and corrupted communication.  People, no matter how savvy, cannot possibly research every nook and cranny of the economy before making an investment.  They make decisions, therefore, based on signals – prices, interest rates, perceived risks, and the profit history of other similar investments.  If these signals are artificially altered or corrupted, bad decisions that destroy wealth and growth will result.

Which brings me back to education.    I will tell you something almost every business owner knows:  We business owners may whine from time to time that banks won’t lend us money, but what really is in short support are great people.  Nothing has more long-term impact on an economy than amount and types of skills that are sought by future workers.  That is why everyone accepts as a truism that education is critical to economic health.

Unfortunately, there is good evidence that our education policies have already done long-term harm.   The signals we send to kids making their higher education plans have disconnected them from reality in a number of fundamental ways, causing them to make bad decisions for themselves and the broader economy.

Examples follow.  Read it all.

Politicians and Entrepeneurship

Don Boudreaux asks:

Here’s a quick question for anyone who takes seriously politicians’ pronouncements about what particular industries are “vital” or are “of the future” or are “crucial to meeting consumers’ needs”: Why do virtually none of these politicians, when they leave office, found their own non-political firms? Why do virtually none of these politicians, when they leave office, found their own non-political firms – firms that specialize neither in granting clients access to incumbent politicians nor in projects that depend upon getting subsidies or other favors from those same politicians?

This question occurred to me a few days ago upon hearing that former president Bill Clinton was off somewhere talking about something to some group concerned about some issue.  His career now is to make lots of money as a sort of high-brow social healer – to emit platitudes, attend state funerals, and (pardon my switch of imagery) be a show-pony for politically correct causes.  The post-Oval Office careers of every other recent president – to the extent that they haven’t simply retired to the golf course or the study – have been largely the same, with the groups and causes served by their attentions differing only as one former president’s political affiliations differ from those of another former president.

One guy comes to mind who had a sniff of the White House and then went on to run his own business:  George McGovern.  And though its just a small Inn that will never be even a blip on the economic radar screen, it has driven McGovern dangerously close to being a libertarian.  Actually, that might be a misnomer.  He probably is still a liberal, but from the days when liberals actually cared about individual freedom and saw aggregations of power in the government to be at least as scary as those in the private world.  Take this for example:

Under the guise of protecting us from ourselves, the right and the left are becoming ever more aggressive in regulating behavior. Much paternalist scrutiny has recently centered on personal economics…

Since leaving office I’ve written about public policy from a new perspective: outside looking in. I’ve come to realize that protecting freedom of choice in our everyday lives is essential to maintaining a healthy civil society.

Why do we think we are helping adult consumers by taking away their options? We don’t take away cars because we don’t like some people speeding. We allow state lotteries despite knowing some people are betting their grocery money. Everyone is exposed to economic risks of some kind. But we don’t operate mindlessly in trying to smooth out every theoretical wrinkle in life.

The nature of freedom of choice is that some people will misuse their responsibility and hurt themselves in the process. We should do our best to educate them, but without diminishing choice for everyone else.

The only other place I have heard this recently on the Left was, perhaps not coincidentally, from that other child of 60′s liberal politics, Jerry Brown

To the Members of the California State Senate:

I am returning Senate Bill 105 without my signature.

This measure would impose criminal penalties on a child under the age of 18 and his or her parents if the child skis or snowboards without a helmet.

While I appreciate the value of wearing a ski helmet, I am concerned about the continuing and seemingly inexorable transfer of authority from parents to the state. Not every human problem deserves a law.

I believe parents have the ability and responsibility to make good choices for their children.

Sincerely,
Edmund J. Brown

Postscript:  The answer to Don’s question is one of two.  Either a)  They are not up to it.  And/or b) There is a hell of a lot more wealth that can be captured through the exercise of government power than through private enterprise.

Additional Thoughts on Risk

SB7 has some good observations about risk:

I was listening to the WSJ radio podcast while getting some dinner ready, and one of their reporters said, in the context of discussing Fukushima, that some of the engineers at the plant “knew there was a risk” in the plant’s older design and could conceivably face charges for not doing something about said risk.

This kind of talk really grinds my gears.  In any engineering situation there is always some risk.  You can have less risk, or more risk, but risk is not something you either have or do not have.

I will go one step further.  This ex post facto witch hunt aimed at folks who discussed risks  (an pogrom that occurs in nearly every product liability lawsuit with fishing expeditions through company memos) is the WORST possible thing for consumers concerned about the safety of their products and environment.  Engineers have to feel free to express safety concerns within organizations no matter how hypothetical these suppositions may be.

Some concerns will turn out to be unfounded.  Some suggested risks will be deemed too small to economically overcome.  And some will turn out to be substantial and require action.  And sometimes well-intentioned people will make what is, in retrospect, the wrong trade-offs with risks.   These witch hunts only tend to suppress this very valuable and necessary internal dialog within organizations.  Nothing is going to turn the brains of engineers off faster than an incentive system that punishes them retroactively for well-intentioned discussions about risk.

Bank Regulation

This article by Mark Perry seems right to me — the lightest touch (and probably the most effective) approach to bank regulation is to return to a regime that puts its major emphasis on capital requirements.

We can talk all day about causes of the recent financial crisis, but in my mind the root cause was taking real property with a volatile underlying value (e.g. homes) and leveraging the absolute crap out of it.   In the initial transaction, home buyers were allowed to come to the table with less and less equity, until deals were being cut with more than 100% debt.  This stupidity was a true public-private partnership, as the government kicked off the party and encouraged its growth via various community development policies as well as policies atFannie and Freddie, but private originators as well as home buyers eagerly jumped into the fray.

This debt backed by property that was already too highly leveraged was thrown into portfolios that were themselves highly leveraged, and then further leveraged again through CDS’s and other derivatives.  And then the CDS’s were put into leveraged portfolios.  I would love to figure out the effective leverage in the AIG portfolio.  For ever $1 million in real property that secured the mortgages they insured, how much equity did they have?  A thousand bucks?  Less?

These investors felt protected by diversification that didn’t really exist.  The felt safe with AAA ratings from agencies who really didn’t understand the risks any better than anyone else did.  They relaxed assuming everything was watched by government regulators who were in way over their heads.  But more than anything, they felt protected by history.  The system of putting mortgage risks into tranches, such that the top tranches could only be affected by default rates consider then to be wildly improbable, had never to that point failed to deliver its promise.   Default rates had always stayed withing expected norms.

And this is the most dangerous risk — the risk that something will happen that has never happened before.  Default rates that seemed impossible suddenly became reality.  Tranches that were untouchable suddenly were losing large chunks of their value.  Sure, there were warning signs, but at the end of the day what happened was that events occurred that were worse than people had thought was the worst case scenario  (there is a whole body of interesting behavioral study on how humans tend to overestimate their understanding and underestimate the width of a probability distribution).

As new financial products are created and the economy evolves and the government pursues new forms of interventions in commerce, new failures can occur that have never happened before.  And never has there been invented a micro-regulatory approach that guards against new-type failures (they don’t even do a very good job against old-style failures).  Capital requirements are the one approach that guard against catastrophic failures even for unanticipated risks.

It can be argued that this will raise the cost of capital, at it is true interest rates at any one point of time would have to go up.  But one can argue that the low interest rates of the 2000′s greatly understated the true cost of capital, and that those additional costs were paid in a sort of balloon payment at the end of the decade.

I am still thinking this through — I don’t think any regular reader would be mistake me for someone who favors regulation in general, but I am coming around to some extent on the notion that banks are different.  I would ideally like to see a self-policing market where companies that choose to cut equity too fine just go bankrupt.  But the reality of the political-financial complex today is that this never happens — costs of large failures are socialized, and executives who made bad choices get fat gold parachutes and Treasury jobs.

Postscript:  I have arguments all the time about whether the financial melt down was mainly caused by government or private action.  Was it a public or private failure.?  My answer is yes.

One thing that those of us who promote private action over public can never repeat enough is this:  Our support for private action does not mean that private actors don’t screw up, that there are not bad outcomes, that people don’t make bad decisions, etc.  They do.  Lots of them.  When these constitute outright fraud, there should be prosecution.  For the rest of the cases, though, libertarians believe that in a free society there are automatic corrections and sources of accountability.

Make a bad product – people stop buying it.  Sign a union contract with wages that are too high – you go bankrupt.  Treat your workers shabbily – and the best of them go work for someone else.  Take on too much risk – you will fail and lose all your capital.

The problem with our financial sector is not that it is not regulated — it is the most regulated sector of the economy.   The problem is that, as always happens, there has been substantial regulatory capture.  There has been an implicit deal cut by large financial institutions – regulate me, but in return protect me.  In a sense, as is typical in a corporate state, large corporations and government have become partners.

As a result, many of the typical checks and balances on private action in a free economy have been disrupted.  In effect, certain institutions became too big to fail, and costs of failure and risk taking were socialized.

That is why the answer is not one or the other.  Certainly the massive failures were driven by the actions of private actors.  But they were driven in part by incentives put in place by the government, and their stupid behavior was not checked because traditional private avenues of accountability had been neutered by the government.    This is why the recent financial crisis will always remain a sort of political Rorschach test, where folks of wildly different political philosophies can all find justification for their position.

The Looming Failure of Obamacare, Part 3: Rent-Seeking

The third installment of my series on Obamacare is now up at Forbes.  An excerpt:

In the health care field, the Holy Grail of rent-seeking is to get one’s medical device, drug, or procedure added to state health insurance mandates.  Before Obamacare, health care insurance regulation had been a state function, and each state had written laws mandating that all health insurance policies written in the state must cover certain services.   By getting one’s particular service added to such a mandate, the service essentially becomes “free” to consumers in that state  (of course it’s not free — everyone pays in the form of higher premiums, but the marginal price for the service goes to zero).

Imagine you have a procedure — let’s use laser elimination of birthmarks as an example.   This procedures requires a series of treatments using a fairly expensive piece of equipment to produce results that are of enormous value to a few people with extensive birthmarks, and of smaller value to many other people with smaller birthmarks.  Business growth in such a field is typically good at first as those who most value the procedure pay for it.  But it can be hard to grow outside of a relatively small niche, as most potential customers may consider it to be an expensive elective cosmetic procedure that, given other uses for their money, they can do without.  What can an aspiring dermatologic surgeon do?  Run to the government!

In 1997, the University of Indiana conducted a study of the laser treatment of these birthmarks.  I don’t know who funded the study, but tellingly the study findings did not really touch on the efficacy of the treatment or its risks.  The study surveyed a number of dermatologic surgeons.  What was its primary finding?  ”Based on current health care policy guidelines, laser treatment of port-wine stains should be regarded, and covered, as a medical necessity by all insurance providers.”  In other words, the sole purpose of this research was to convince legislators to add this procedure to their state’s  insurance mandates.   To date, this procedure has been added to the must-carry list in only two states, but in those two states doctors no longer have to convince price-sensitive patients that this elective procedure is worth the cost – after all, its free!

As you can imagine, the cost of these mandates are staggering for those of us who pay the premiums.  State governments are requiring us to pay higher insurance rates in order to cover procedures we might never consider.   Four states have mandated coverage for naturopaths;  three for athletic trainers; one for oriental medicine; eleven for hair prosthesis; four for massage therapists; and three for pastoral counselors.  The state with the most such mandates is Rhode Island, with 70, a state which not coincidently also has the third highest insurance premiums in the country.

On a quasi-related note, John Goodman has thoughts on “government failure” (an analog to market failure) as it applied to health care.  It is a point that cannot be made too often.  Merely pointing out supposed imperfect outcomes from private action does not immediately justify government action — too often people take the default position that if an improved outcome can be imagined, the government can achieve it.  But does this ever happen?  In health care, the irony is that many of the supposed market failures we are “fixing” with Obamacare are in fact results of past ham-handed government action.

The Power to Say “Yes”

Bruce McQuain tells some stories of bureaucratic frustration in the Gulf, as local governors trying to protect their state from the spill fights against a myriad of mindless bureaucracies.

The governor said the problem is there’s still no single person giving a “yes” or “no.” While the Gulf Coast governors have developed plans with the Coast Guard’s command center in the Gulf, things begin to shift when other agencies start weighing in, like the Environmental Protection Agency and the U.S. Fish and Wildlife Service. “It’s like this huge committee down there,” Riley said, “and every decision that we try to implement, any one person on that committee has absolute veto power.”

I would state the problem differently.  In the Federal bureaucracy, seemingly everyone has the power to say “no,” and absolutely no one is willing to risk their career or even a minor bureaucratic sanction to over-rule when someone else in the room says “no.”  I have seen it a hundred times in my business — we will be close to doing something for the public, building a new shower building in a campground for example, and some government employee in the room will say that their sister’s gynecologist’s barber’s housekeeper once overheard a conversation in a bar that some guy who may have visited a university once said he had heard a rumor that there might have been a Native American settlement somewhere within 100 miles of that spot 10,000 years ago — and suddenly the work on the shower has to stop for 6 months while we all run around calling in archeologists and taking this concern seriously.

The problem  in a government discussion, particularly a multi-agency discussion, is that EVERYONE can say “no,” and worse, since their incentives are loaded towards risk avoidance (they get punished for violating procedure, but never punished for missing an opportunity), they have a tendency to say “no” a lot, in fact to say “no” by default.  In the Gulf you have a thousand federal employees from 20 agencies whose entire incentive system, whose entire career, whose every lesson from every bureaucratic battle in a sort of long-term aversion therapy, prompts them to say “no” by reflex.

What is missing is someone who can say “yes,” and make it stick against all the no’s.  That does not have to be Obama — but it probably does have to be someone very senior who knows (and who everyone else knows) is backed to the hilt by the President and has an incentive system where the only measure of success is more or less oil damage, and thus for whom aggrieved bureaucrats (even senior ones) and petty procedure are irrelevant.  It does not appear such a person has been appointed.

Postscript: By the way, I don’t want folks to fall into the trap of thinking that these government folks are necessarily bad people.  I think that is a mistake both conservatives and liberals make — conservatives vilify government employees, while liberals want to believe that government would work right if we just had the right people in it.   I work with a lot of very bright, very good people in government.  The problem is that their incentives and information are awful.  How would you behave if for 20 years your main feedback was to be criticized for violating minor procedures or trying new things?  How would you have any understanding of business if you grew up in the bizarro world of government budgeting and accounting?   This is the problem with government – not that it is full of bad stupid people, but it takes good smart people and incentivizes them do counter-productive things.

Update: Here is a great example, from Kevin Drum, who is a smart guy but can’t do anything but dither in a decision among multiple risks:

It’s pretty hard to take the other side of this argument [ie defending the Coast Guard's decision to hold up the GUlf cleanup barges for minor rules violations]. But I wonder. We are, after all, talking about barges that are sucking up oil, and the last time I checked oil was pretty damn flammable. Everyone wants the cleanup operation to proceed with breakneck speed, but that’s exactly when people get tired and sloppy. And I wonder what everyone would think of the Coast Guard’s ridiculous rules if they waived them and then some boat went up in a huge fireball because a spark caught somewhere and no one had a fire extinguisher handy?

I will say again – I have been in many rooms of bureaucrats, both federal and private, and they all think this way.  These rooms are full of Kevin Drum’s wondering out loud, “I don’t know, what happens if…”  This is such a common phrase in these meetings I wish I had a dollar for every time I heard it.  Then everyone in the room defers to this hypothetical risk.   Bureaucrats are always more worried about sins of commission  (e.g. knowingly allowing a barge to go out without enough fire extinguishers in violation of guidelines) than the sin of omission (e.g. delay will allow the spill to get worse).  Even when the omission is 100% certainty and the danger from the act of commission is vaguely hypothetical.  It takes a leader to say “send the damn barges out now.”

Something for Atlas Shrugged Readers

Do you remember the State Science Institute report on Rearden Metal?  If you were like me, you thought that this ridiculous report was an exaggeration, a literary device to make a point.  But as in so much of Atlas Shrugged, I am finding that it was no exaggeration at all.

Check out this real life example of “science.”  From the real state science folks at the Interagency Working Group on Climate Change and Health.

There are potential impacts on cancer both directly from climate change and indirectly from climate change mitigation strategies. Climate change will result in higher ambient temperatures that may
increase the transfer of volatile and semi-volatile compounds from water and wastewater into the atmosphere, and alter the distribution of contaminants to places more distant from the sources, changing subsequent human exposures. Climate change is also expected to increase heavy precipitation and flooding events, which may increase the chance of toxic contamination leaks from storage facilities or runoff into water from land containing toxic pollutants. Very little is
known about how such transfers will affect people’s exposure to these chemicals—some of which are known carcinogens—and its ultimate impact on incidence of cancer.  More research is needed to determine the likelihood of this type of contamination, the geographical areas and populations most likely to be impacted, and the health outcomes that could result.

Although the exact mechanisms of cancer in humans and animals are not completely understood for all cancers, factors in cancerdevelopment include pathogens, environmental contaminants, age, and genetics. Given the challenges of understanding the causes of cancer, the links between climate change and cancer are a mixture of fact and supposition, and research is needed to fill in the gaps in what we know.

One possible direct impact of climate change on cancer may be through increases in exposure to toxic chemicals that are known or suspected to cause cancer following heavy rainfall and by
increased volatilization of chemicals under conditions of increased temperature. In the case of heavy rainfall or flooding, there may be an increase in leaching of toxic chemicals and heavy metals
from storage sites and increased contamination of water with runoff containing persistent chemicals that are already in the environment. Marine animals, including mammals, also may suffer
direct effects of cancer linked to sustained or chronic exposure to chemical contaminants in the marine environment, and thereby serve as indicators of similar risks to humans.64 Climate impact
studies on such model cancer populations may provide added dimensions to our understanding of the human impacts.

Remember, the point of this all is not science, but funding.  This is basically a glossy budget presentation, probably cranked out by some grad students over some beers, tasked to come up with scary but marginally plausible links between health issues and climate change.   Obama has said that climate is really, really important to him.  He has frozen a lot of agency budgets, and told them new money is only for programs that supports his major initiatives, like climate change.  So, every agency says that their every problem is due to climate change, just as every agency under Bush said that they were critical to fighting terrorism.  This document is the NIH salvo to get climate change money, not actual science.

The Only Health Care Cost Control Idea the Democrats Have Ever Had

I think this article makes it clear that, no matter what the rhetoric, the only health care cost control idea Obama and the Democrats ever had was saying “no” to care.  Whatever one calls this (managed care, rationing, death panels) it is really not that much different from what insurance companies have been doing for years.  And it is areal irony that Democrats passed this legislation feeding off anger of voters with insurance companies saying “no”, when their plan really depends on the government saying “no” even more often  (or else there won’t be any cost savings).

The author argues that information is important for patients to make better decisions:

When patients are given information about potential benefits and risks, they seem to choose less invasive care, on average, than doctors do, according to early studies. Some people, of course, decide that aggressive care is right for them — like the cancer patient (and palliative care doctor) profiled in this newspaper a few days ago. They are willing to accept the risks and side effects that come with treatment. Many people, however, go the other way once they understand the trade-offs.

They decide the risk of incontinence and impotence isn’t worth the marginal chance of preventing prostate cancer. Or they choose cardiac drugs and lifestyle changes over stenting. Or they opt to skip the prenatal test to determine if their baby has Down syndrome. Or, in the toughest situation of all, they decide to leave an intensive care unit and enter a hospice.

I agree, but I would go further — information and incentives are important.  And the absolute most important bit of information when it comes to cost control is price, and patients under Obamacare have absolutely no incentive to give a sh*t about price even if they were informed of it.  Exactly the opposite of the incentives I have had since I took on a high-deductible health care policy several years ago.

Update: Brad Warbiany discusses the proposed IPAB and its powers to shape health care spending in the context of Congress as an addict trying to control its impulses.  However, I think Brad underestimates the power of the board to be captured.  What will result is rulings for more coverage of procedures with powerful lobbies, offset by less coverage of procedures with weaker lobbies, irrespective of the science.   Just look at the diseases the NIH and NSF gives grant money for — the grants have nothing to do with the science of where research could be most productive and everything to do with diseases that have large and powerful constituencies.

Update #2: Isn’t it interesting to see the NY Times, after arguing for months that Obamacare was not about rationing, is now admitting that rationing is the key to success.  It reminds me of this that I wrote a while back:

I have decided there is something that is very predictable about the media:  they usually are very sympathetic to legislation expanding government powers or spending when the legislation is being discussed in Congress.  Then, after the legislation is passed, and there is nothing that can be done to get rid of it, the media gets really insightful all of a sudden, running thoughtful pieces about the hidden problems and unintended consequences of the legislation.

Made Some Money on Intrade

A while back, Megan McArdle had what I thought was good advice – using betting as a way to hedge emotional risks.  For example, I was going to be really disappointed if the health care bill passed, so I bet that its passage would occur.  I am still unhappy, but I have some extra cash.

I have been buying on the dips for a while now.  I predicted way back last July that it was going to pass no matter what

It is totally clear to me that Obama and Pelosi will spend any amount of money to pass their key legislative initiatives.  In the case of Waxman-Markey, the marginal price per vote turned out to be about $3.5 billion.  But they didn’t even blink at paying this.  That is why I fear that some horrible form of health care “reform” may actually pass.  If it does, the marginal cost per vote may be higher, but I don’t think our leaders care.

SEC Climate Disclosures

From the SEC web site (via frequent contributor LK)

The Securities and Exchange Commission today voted to provide public companies with interpretive guidance on existing SEC disclosure requirements as they apply to business or legal developments relating to the issue of climate change.

I haven’t seen anyone explain the reason for this requirement, so I thought I would do so.  Companies know that no real investor is going to pay any attention to these climate disclosures, so to avoid any future action accusing them of not being forthcoming enough, companies are going to go overboard outlining potential risks far beyond what they think is likely.  These exaggerations will protect them from the SEC while at the same time having no effect on their stock price.  Then, alarmists will collate all of these and use them as evidence of the high cost of climate change, saying “see, look at what all these public companies are saying climte change will do to them.”  Lacking any evidence of harmful climate change in the actual climate or economy, this is one way to manufacture fake evidence.

By the way, here is the diclosure every oil company should put in their reports:

Notice:  Poplist politicians are very likely to demagogue this company for a wide-range of imagined crimes in an attempt to get re-elected, including crimes against the climate in various forms.   Politicians will attempt to preferentially saddle this company with new taxes and regulations given that this company is not liked by many voters (despite the fact that many of these voters freelydo business with this company).  Politicians will likely continue to try to sieze portions of this company’s earnings, despite the fact that those earnings are relatively low given the magnitude of the our investments and the amount of value we add.

Consider the Incentives

Consider the incentives for a bank trying to set the risk profile of its investments.  Should it go for higher returns at higher risk, or dial back the risk at a cost to near-term profits?  Now consider this decision in the context of two actions from the past year:

  • Large banks that took on too much risk are bailed out and management mostly preserved
  • Banks that eschewed higher profits by avoiding bad risks are now forced to pay for the bailout of those that went wild:

Obama administration officials and lawmakers are scrambling to find a way to funnel some of the financial industry’s record earnings back to the taxpayers who helped rescue the industry from looming disaster.The White House is considering a fee on banks and other financial companies

as one approach, with revenues earmarked to help recoup any losses from the government’s $700 billion bailout fund, a senior administration official said.

Some in Congress want to add a new tax on bonuses or assess a small fee on all stock transactions, which would hit large banking companies the hardest.

Note that there is no attempt here to only charge banks who received bailout money, but all banks will be charged equally.  To each according to his need, from each according to his ability.  This is moral hazard in spades.

Expect A LOT More of This With The New Federal Health Care Rules

Via the Dallas Morning News:

A last-minute change in the federal health care bill ditched a proposed 5 percent tax on cosmetic medical procedures and replaced it with a 10 percent tax on indoor tanning services.

Goodbye Botox tax. Hello tan tax.

This seems really random.  Why should either of these businesses foot a special, disproportionate share of my health care bill?  Well, things that seem random to most of us make perfect sense in Congress.

The tan tax popped up in the health care bill last weekend after powerful medical lobbies – including the American Academy of Dermatology Association, American Medical Association, American Society of Plastic Surgeons and Botox-maker Allergan – persuaded Congress to remove a tax on cosmetic medical procedures and replace it with a 10 percent surcharge on indoor tanning services.

Lobbyists are very good at punching political hot-buttons.  Since they couldn’t argue that botox is “for the children,” and since it is generally used by rich white people they could not place the race or class card, they played the only card they had:

“Since 90 percent of cosmetic surgery patients are women, this would have been a very discriminatory tax,” said White, who opposed the cosmetic surgery tax.

Technocrats want to believe, and perhaps honestly believe themselves, that care guidelines in the new Federal health care system will be science-based.  What possible basis do they have for thinking that?  We have 50 state laboratories, where states specify must-carry rules on procedures, and not a single one of these lists are science based – they are loaded with special interest handouts.   I even show in this post how special interests give money to academia to produce studies whose entire conclusion is that certain procedures (performed by the special interest group funding the study) need to be in the minimum coverage laws.   The very first time out, when confronted with a science-based care recommendation (that women not receive breast cancer screening until after 50), the Congress specifically overrode it in the bill under a firestorm of public outcry.

But maybe the dermatologist guys are really looking after us?  After all:

The American Academy of Dermatology warns of significant health risks caused by indoor tanning.

But, as it turns out, it only sees health risks in the use of ultra-violet light by practitioners who are not members of their trade group.  I have bolded the key passage that gives away the game.

Indoor tanning industry groups note that dermatologists use tanning equipment in their offices for cosmetic skin conditions, such as eczema and psoriasis, in phototherapy treatments that cost up to $100 per visit billed to health insurance companies. In contrast, indoor tanning salons cost as little as $6 to $20 per session.

The tan tax would exempt phototherapy services performed by a licensed medical professional.

“This is like Coke being allowed to lobby the government to tax Pepsi, but that Coke be allowed to sell the same product and not be taxed for it,” International Smart Tan Network Vice President Joseph Levy said in a statement. “It’s unbelievable.”

ACORN Relief Act

This was sent to me by a reader, something called the “Environmental Justice Small Grants Program.”  Over the last 20 years, socialists who realized their message wasn’t selling anymore remarketed themselves under the green “global warming” banner.  Coincidentally, all the exact same things socialists wanted 20 years ago are what we need to do to fight global warming.

It appears that ACORN may be getting a second life using this same strategy.  I can’t bear to read all this leftish public policy psychobabble in the document, but did note this early on:

The primary purposes of proposed projects should be to develop an understanding of environmental and public health issues and to identify ways to address these issues at the local level, and educate and empower the community. The long-term goals of the EJSG Program are to help build the capacity of the communities with environmental justice concerns and create self-sustaining, community-based partnerships that will continue to improve local environments in the future.

There is a well-established scientific consensus that climate change will cause disproportionate impacts upon vulnerable populations. [1] Thus, the program is adding emphasis this year on addressing the disproportionate impacts of climate change in communities with environmental justice concerns. The goal is to recognize the critical role of grassroots efforts in helping shape climate change strategies to avoid, lessen, or delay the risks and impacts associated with climate change. An overarching goal of including this emphasis is to help increase the number of underrepresented communities and ensure equitable green economic development in ways that build healthy sustainable communities.

This translates to “we have found a way to hand out government money to leftish groups like ACORN to do things that are impossible to measure and thus bear little accountability by calling it all “Green.”

By the way, the little footnote to prove the statement above is this:

[1]  As stated in the Technical Support Document for the Endangerment and Cause or Contribute Findings for Greenhouse Gases under Section 202(a) of the Clean Air Act (April 2009), “Within settlements experiencing climate change, certain parts of the population may be especially vulnerable; these include the poor, the elderly, those already in poor health, the disabled, those living alone, those with limited rights and power (such as recent immigrants with limited English skills), and/or indigenous populations dependent on one or a few resources. Thus, the potential impacts of climate change raise environmental justice issues.”

Given that cap-and-trade is almost certainly going to impose a very large regressive tax disproportionately on the poor, I wonder why no one ever discusses environmental-solution justice issues?  Maybe it really has nothing to do with the poor, but just with power.

Your Idea Sucks — Here’s Your Money

Having read this:

In his proposed budget for 2010, Chu wanted $480 million to start eight Energy Innovation Hubs, or “Bell Lablets,” as he called them, to stimulate research in areas ranging from solar energy to new materials for the electric grid. Each would receive $35 million to get started, and $25 million more in each of the following 4 years.

Last week Congress poured semi-cold water on the idea….Its skepticism was no surprise, having been included this summer in reports accompanying the spending bills in the House of Representatives and Senate (House, Senate versions). In August, Science reporter Jeffrey Mervis described how Chu admitted to a mediocre job of selling the idea and overcoming congressional concerns that the concept was poorly thought out and not well-coordinated with other energy research at the Department of Energy. House appropriators were particularly unkind to the idea, noting:

A new set of centers with overlapping research goals risks adding confusion and redundancy to the existing fleet of research and development initiatives

So since everyone agreed it was a bad idea, they killed it right? Ha ha, cute idea, actually voting and spending money based on efficacy. In fact, they gave Chu quite a bit

Conferees to the Energy and Water spending bill approved funding for three of the centers, two in energy efficiency and renewable energy and one in nuclear energy.

If they really make no sense, how about “zero”

Wherein Kevin Drum Discovers Different Individuals Have Different Preferences

From Kevin Drum today on health care:

But here’s the tidbit that caught my eye:

A fascinating series of pilot programs, including for prostate cancer, has shown that when patients have clinical information about treatments, they often choose a less invasive one. Some come to see that the risks and side effects of more invasive care are not worth the small — or nonexistent — benefits. “We want the thing that makes us better,” says Dr. Peter B. Bach, a pulmonary specialist at Memorial Sloan-Kettering Cancer Center, “not the thing that is niftier.”

When I read about healthcare, pretty much the only thing I hear is that everyone wants infinite amounts of it.  And they always want the latest and greatest stuff.

Not me.  My motto is, “That healthcare is best that cares the least.”  Or something like that.  Basically, I prefer to get the minimum reasonable amount of healthcare possible, and I have a strong preference for the simplest, oldest, best-known treatments.  I’m not exactly a fanatic about this, but generally speaking I think that most new treatments turn out not to be nearly as effective as we think, and the more time you spend around hospitals the better your chances of catastrophe.

Wow, that’s amazing!  Its almost as if we shouldn’t have one bureaucracy in Washington making health care decisions for everyone!  In fact, there are several things in here that tend to challenge leftish assumptions:

  1. Contrary to leftish assumptions, individuals do seem to be grown up enough to make health care tradeoffs for themselves
  2. Individuals seem to want to make different cost-benefit-treatment trade offs from each other, belying the notion there is some universal optimum that bureaucrats in Washington are capable of achieving
  3. Allowing individuals to actually shop and make price-benefit decisions in health care might actually reduce costs and improve satisfaction (though absolutely no one in DC seems to be proposing a plan along these lines)

Unfortunately, Drum seems to take none of these lessons from his own post.  Here is the conclusion he draws:

But maybe the difference is just information: I read an awful lot about this stuff, and it’s convinced me that there dangers to overtreatment just as there are dangers to undertreatment.  Leonhardt’s “fascinating series of pilot programs” suggests that with better information, more people might agree.

Creepily, he seems to conclude from all this that if we can just “educate” the public more, they will be more likely to accept the one-size-fits-all treatment constraints to be implemented by Washington.

PS: I am generally with Drum on doing the absolute minimum for run of the mill health problems I encounter.  If I have a cold, for example, I don’t start dosing myself with every over the counter drug I can find.  And our family tries very hard not to use antibiotics unless the condition is really serious.

But my sense is that my attitude will change a lot if the “C” word ever comes into play.  Cancers are much more solveable early than late, and my tendency would be to hit the crap out of it early with  as much of the arsenal as I could.  I don’t know what Drum’s personal medical history is, but my sense is that it is unwise to extrapolate linearly one’s treatment preferences from colds to cancer.

Mommy, Mommy, I’m Scared

Via the environmental blog Thin Green Line:

Check out this post on Bay Area Moms revealing that products with high fructose corn syrup contain mercury. Scary!

I have had some experience working with recreation on lakes that have mercury-contaminated fish  (not good for business) so I thought I would check out the articles.  Mommy Files blog here.  Advocacy group quoted here.  Actual study here.  Test results here.

This strikes me as being right at the focal point of where both the environmental and consumer protection movements went off the rails — the issue of relative risks.  In short, risks for things with scary names (mercury and radiation being two great examples) cannot seem to be processed rationally.  Everything is toxic, at some concentration.  The key is understanding concentration and relative risks, and not panicking when anyone yells “mercury” in a crowded grocery store.

Before I get into this more, it is a little hard to discuss because I can’t really find in the study or the advocacy press releases what forms the mercury take in the HFCS — it may be they just don’t know yet.  The form the mercury is in matters.  Most people would be surprised, but while pure liquid mercury is not good for you, but it isn’t particularly toxic when compared to other forms  (just ask Sir Isaac Newton, who used to drink the stuff).  Mercury vapor is really bad, as are certain chemical derivatives of mercury, such as the form often found in fish.

So here is some perspective on mercury concentrations, again remembering these standards often apply to specific chemical variants.  The US legal limit on fish is 1 part per million, or 1 ppm.    The legal US limit on mercury in water is 2 parts per billion, or 2 ppb.  One might think that means the mercury in water is more dangerous, but it is actually in a much less dangerous form (according to my imperfect understanding) than the mercury in fish.  However, it is assumed that one drinks more grams of water a day than grams of fish.  This does not entirely explain the 500-fold discrepancy — my guess is that this is also a matter of attention, as drinking water standards and contaminants get much more headline plan than for fish (again, in part due to a general inability, particularly in the media, to sort through relative risks).

So then we have HFCS.  The worst test value was apparently in Quaker Oatmeal to Go, which had a value of 350 parts per trillion (ppt).  In other words, the worst sample found anywhere had a mercury level nearly 6 times lower than the federal drinking water standard (2 ppb = 2000 ppt).   What this means is that you would have to eat 63 pounds of Quaker Oatmeal to Go a day to have the same mercury risk as drinking 5 liters of water at the federal standard each day.  And that is the worst product.  Only 17 of 55 products tested had any detectable mercury at all, and only 7 had concentrations over 100 ppt.

Don’t even get me started on fish.  8 ounces of fish at the federal standard would have the same mercury as 1,429 pounds of Quaker oatmeal.  The risks are not even in the same ballpark.  The oatmeal risk is three orders of magnitude lower than the fish risk.   I wonder how many of the moms who now quiver at giving their kids oatmeal still feed their kids lots of nutritious fish?

The right way to write this story is not “scary!”  The right way to write this story is “Hey, we found some mercury where we did not expect it, this bears further study, but right now the concentrations are so far lower than you would find in many other everyday foods you eat or drink that it’s not worth worrying about.  If you really want to protect your kids from mercury, stay away from fish.”

Postscript: I lament the passing of sugar in favor of HFCS.  So often food activists gloss over this issue, preferring to imply it is some kind of corporate conspiracy to give us worse food.  But in fact, the main blame for this shift lies entirely on Congress, which maintains absurdly high sugar tariffs and a continued blockade of Cuba that give us among the highest sugar prices in the world.  Faced with this reality, food manufacturers cleverly found an alternative.   I prefer good old sugar, and implore Congress to ditch corporate welfare for sugar manufacturers

Add GM, Ford, and Chrysler to this List

Via TJIC, who had a much better title, “poor credit risks remain poor credit risks, even after you give them a free pony

Recent data suggests that many borrowers who received help with mortgage modifications earlier this year tended to re-default on their payments, a top U.S. banking regulator said on Monday.

“The results, I confess, were somewhat surprising, and not in a good way,” said John Dugan, head of the U.S. Office of the Comptroller of the Currency, in prepared remarks for a U.S. housing forum.

“Put simply, it shows that over half of mortgage modifications seemed not to be working after six months,” he said.

You can absolutely, without a doubt, add the Big 3 to the list of folks who will be facing default once again just months after getting their first dollop of federal money.

Now They Tell Us

It’s fascinating that our local paper, after months of positive Obama coverage, manages to express its first printed criticism of Obama on … the day after the election.

With President-elect Barack Obama promising tougher government regulations on some sectors, including the financial markets, a handful of business leaders expressed concern Wednesday.

“The key thing is to not choke us to death with regulation,” said Ioanna Morfessis, an economic-development consultant and Greater Phoenix Economic Council founding member.

With the faltering of the financial markets and a massive federal bailout this fall, Obama and congressional Democrats, who expanded their majorities with an upset electorate, have called for more federal oversight on Wall Street. Obama also has called for more regulation in the energy and health-care sectors, and Democrats could more strictly enforce environmental rules….

Morfessis said before lunch Wednesday, she received phone calls from 11 entrepreneurs concerned there would be a “higher premium for taking risks or entering new markets.”

My Alternative to the Bailout

This is taken from and expanded from the end of this post.

Everyone involved in the bailout plan says, at least publicly, that they are not trying to bail out a bunch of Wall Street folks who lived high off the risk premium of these investments but now want to avoid the costs when the actual risks become clear.  They claim to be bailing out Wall Street and various large banks because they fear that a financial meltdown and liquidity crisis will starve main street businesses of cash, and create a deep economic slowdown.

OK, if this is the real policy goal — to maintain the ability of main street businesses to borrow — then here is my alternative proposal:

  1. Immediately increase the SBA loan gaurantee authority by $100 billion dollars.  That is enough for a million new small business loans of $100,000 each.
  2. Authorize treasury to spend up to X hundred billion to buy rated new issues of bonds and commercial paper of US non-financial companies.  Some limits should be applied – such as the feds cannot buy any more than 30% of a single issue and/or more than 10% of the entire outstanding debt of one company.

That’s the plan.  Here are the advantages:

  • The government is addressing the actual policy goal of keeping liquidity in main street business directly
  • The government is investing in success, in main street companies trying to grow, and not in failed banks and financial institutions
  • Moral hazard issues are avoided with financial institutions. 
  • The SBA loan guarantees cost nothing today.  In fact, they are cash positive in the short term due to loan guarantee payments by borrowers.  Of course, they risk future losses,  but such losses in the future are in part covered by the guarantee payments, and a future loss is cheaper than a loss today.
  • Investments in corporate bond issues are much easier to value, and are far less risky, than investments in illiquid mortgage securities.  The taxpayer is far less likely to take a beating on these purchases.
  • Banks may still fail, but the FDIC has an infrastructure and experience for handling this.  If necessary to calm people, the FDIC could make a public commitment to assisted mergers to maintain all depositors.
  • If there is some big financial meltdown, which I still doubt, there might be a need to inject some mortgage liquidity, but since the Feds now own Fannie and Freddie, the vehicle for doing so is easily available.

Update:  I was not clear — this is actually an alternative to by alternative.  My first, preferred alternative plan is "do nothing."

Thinking about Jeff Skilling

I was thinking a bit about Jeff Skilling (former Enron CEO) today.  What must he be thinking as a series of large firms that were supposedly far more stable than Enron go down one after the other to liquidity crises much like that of Enron?  Bear Stearns and Lehman, two firms that should have been rock solid, go down in the blink of an eye in a credit crunch, and all we hear from the media is how the firms fell victim to larger forces beyond their control.  At least at Enron they were up-front with the market about their taking on large risks.  Now, the government is running around in the background trying to match-make these failing companies and helping to save at least a squidge of shareholder equity.  The only thing the government did in the Enron collapse was hound Skilling and others into jail.   

Sure, Skilling may have made some overly optimistic statements about his company as he was trying to stave off the crunch, but no more so that the happy-face statements issuing from Bear or Lehman in their final days.  Executives who find themselves in a credit crunch are in a nearly impossible position.  The best way they can serve equity holders is to downplay or even bury bad news to head off the looming crisis of confidence.  But if they do so, they face presecution for making false statements about the company, ironically under laws meant to protect equity holders.

Phthalates and Cargo Cult Science

First it was breast implants, then thimerosal, and now it is phthalates.  Each have been attacked in turn by the junk-science / media / tort law complex.  Nobel Prize-winning chemist William Knowles wrote this week:

Lawmakers — representing the concern of parents influenced by certain
environmentalists — are calling for an outright ban of phthalates from
children’s toys because of the misguided belief that by exposing
children to toys made with these chemicals we are putting their health
at risk.

Phthalates have a long history of attacks by environmental groups
dating back more than 30 years. Even then babies were of prime
consideration. Few chemicals have undergone such extensive testing and
survived as being safe. In fact, diisononyl phthalate, the most
commonly used phthalate in children’s toys, has been subjected to more
than 200 tests….

Today, with no new scientific evidence, we are again challenging
phthalates as dangerous to babies and threatening to ban them. These
are products that have survived the toughest test of all, the test of
time. There is no evidence that babies or anyone else has ever been
harmed by them.

Eliminating phthalates from consumer products would be a true
challenge. Even more worrisome, however, is the notion that any
replacement would ever be able to pass the extreme scrutiny diisononyl
phthalate and other phthalates have.

There is nothing wrong with examining the products our children
come into contact with to be sure they pose no health risks. However,
in this case, it would be a great mistake to ban what has been proven
to be a benign product without some further scientific evidence.