Anecdotal Evidence on Health Care

June 26, 2009
Posted by Jay Livingston

Opponents of government involvement in health care seem to have two strategies. One is name-calling – “socialism” and “European-style” are two of their favorites. The other is to repeat anecdotes to illustrate the horrors that people in Europe and Canada have suffered – delayed treatment, denial of treatment, and so on. There’s a third strategy – spending huge amounts of money in lobbying legislators directly – but that’s less visible.

The Obama Administration has asked Americans for their own stories about their experiences with the insurance industry. Stories have poured in by the thousands. You can read them here, read them and weep.

Some people report on their experiences with socialized European-style health care, and the US does not come off on the plus side (here, for example). Others compare experiences with private insurance against public plans in this country Again, the private system comes off as inferior.
I’ve blogged before (here and here) about the utter hollowness of the claims that socialized health care will mean that “bureaucrats” rather than doctors will be making decisions. In fact, the bureaucrats are already doing that. And a few of them have contributed their stories to the Obama website. Here’s one from Barbara in Barbara, Deer Island, FL
I worked for United Health Care in small group customer service. If a company was more than 5 days late in their monthly payments, United would "terminate" their coverage. When they were terminated the group administrator from the "termed" company would call me to reinstate their coverage. I would take their phone number, go to my supervisor's office and get a computer disk showing all small groups "loss ratios." If the company I was working with was in the high risk ratio, I was not to reinstate their coverage. This meant people in the hospital or scheduled for surgery would never nave coverage with any company because of pre-existing conditions if their coverage was less than 90 days. Sometimes a new group misses payments in the first few months before they get on a payment schedule. This is how United Would "weed out" the high claims group. Their actions were not illegal, but were IMMORAL!
That term “loss ratio” refers to the ratio of premiums that the insurance company pays out. When your insurance company pays a claim to your doctor or hospital, that’s a loss.

Barbara’s story was amplified recently in Congress. Wendell Potter, a former executive at Cigna, testified before the Commerce Committee.

"They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment."
(Potter’s full testimony, thanks to Ezra Klein, is here.)

Selling (Out) Public Transport

June 26, 2009
Posted by Jay Livingston

Even in my early morning stupor, I couldn’t help noticing the new turnstiles at Penn Station. Where once spotless chrome gleamed, proclaiming the subway’s purity, now speaks the crass voice of commerce: There’s a sale at H&M waiting for you upstairs when you leave the station. You can get something for as little as five bucks. Cheap.

It’s not so different from the ads on the walls, I thought. Besides, it might help to keep the fare from going up too much. At least the MTA isn’t selling naming rights to the subway the way the Port Authority nearly sold the George Washington Bridge to Geico (see my old blog entry here.)

That was then. Yesterday, the MTA announced that the Atlantic Ave. Station in Brooklyn will henceforth also be known as the Barclay’s Bank station. The station is a major hub, with transfers available from at least four different subway lines. For a large British bank, the $200,000 a year is pocket change. Talk about cheap.

Oh well, at least they didn’t sell the name for my station.

Taylorized Eating

June 24, 2009
Posted by Jay Livingston

The 1954 musical The Pajama Game makes fun of “scientific management” and efficiency experts. The comic foil in the show is Hinesy, the time-study man. (See my post of last December on Taylorism.)

In the song “Think of the Time I Save,” Hinesy tells the female workers in the pajama factory of how his personal life is devoted to saving time. He even eats so as to maximize efficiency. The song includes this verse:

At breakfast time, I grab a bowl.
And in the bowl I drop an egg,
And add some juice.
A poor excuse for what I crave.

And then I add some oatmeal too,

And it comes out tasting just like glue,

But think of the time I save.

Parody, right? Could never happen, right? Maybe not, but as Mike at Pragmatic Realists Idealists reports, one fast food chain, BBQ Chicken, is coming close.

Twenty-five Is Not a Random Number

June 21, 2009
Posted by Jay Livingston

Political scientists Bernd Beber and Alexandra Scacco have a simple test for electoral fraud in the Iranian election. Here are the results from Qom
  • Ahmadinejad . . . . .422,457
  • Karroubi . . . . . . . . . . 2,314
  • Mousavi. . . . . . . . . .148,467
  • Rezaee. . . . . . . . . . . . 16,297
Which digits are the important ones? The left-most ones, of course – Ahmadinejad’s roughly 420,000 to Mousavi’s 148,000.

But Beber and Scacco were interested in the right-most digits, the ones that we might throw out and round to zero. Here’s why:

When people try to make up numbers that appear to be random, they show certain preferences. Try it yourself. Think of any random number from 0 to 100. I’ll wait. Got your number? O.K. Chances are it’s an odd number that does not end in 5. More than likely, it does end in 7.*

In an honest vote count, about 10% of the final digits should be fives, and 10% should be sevens. If five is underrepresented, and if seven is overrepresented, someone is trying to make up numbers and have them seem random.

Beber and Scacco looked at the 116 results (four candidates x 29 provinces) and . . .
The numbers look suspicious. We find too many 7s and not enough 5s in the last digit. We expect each digit (0, 1, 2, and so on) to appear at the end of 10 percent of the vote counts. But in Iran's provincial results, the digit 7 appears 17 percent of the time, and only 4 percent of the results end in the number 5. Two such departures from the average – a spike of 17 percent or more in one digit and a drop to 4 percent or less in another – are extremely unlikely. Fewer than four in a hundred non-fraudulent elections would produce such numbers.

In a second test, Beber and Scacco also looked at the last two digits.
Psychologists have also found that humans have trouble generating non-adjacent digits (such as 64 or 17, as opposed to 23) as frequently as one would expect in a sequence of random numbers.
Sure enough, the totals had fewer non-adjacent pairs than would be expected, especially in the province totals for Ahmadinejad. The two tests provide a fairly persuasive case for what most people think anyway – that the vote totals reported by the Iranian government were fabricated.

Beber and Scacco report their research in the Washington Post here.

*Street magician David Blaine uses this same tendency in one of his mind reading tricks. A lot of people pick 37.

Hat tip to Joshua Tucker at The Monkey Cage, which has links to the electoral data.