Wheat, Tares and Stage Six

I heard an interesting idea related to the parable of the Wheat and the Tares. I always took the wheat and the tares as referring to good or bad people. The idea I heard is that instead of people, wheat and tares represents the good and evil in each of us.

The part of the parable "Wilt thou then that we go and gather them up? But he said, Nay; lest while ye gather up the tares, ye root up also the wheat with them." makes more sense to me since it is harder to separate the good and evil in an individual than to separate good and evil people.

This also fits better with my last posting of striving for greater civility. Rather than identifying people or groups as "wheat or tares", we can identify the good in all people and ideas.

This also fits better with my recent reading on Lawrence Kohlberg's "Six Stages of Moral Development" and Fowler's "Six Stages of Faith". The early stages start with simple, idealistic definitions of right and wrong.

The sixth stage for both seems a bit hard to reach. For Kohlgerg, the sixth stage is based on universal ethical principles. For Fowler, the sixth stage is a universal inclusion of all beings.

I found this statement from Fowler particularly interesting:

[Person in the sixth stage] are "contagious" in the sense that they create zones of liberation from the social, political, economic and ideological shackles we place and endure on human futurity. Living with felt participation in a power that unifies and transforms the world, Universalizers are often experienced as subversive of the structures (including religious structures) by which we sustain our individual and corporate survival, security and significance. Many persons in this stage die at the hands of those whom they hope to change. Universalizers are often more honored and revered after death than during their lives. The rare persons who may be described by this stage have a special grace that makes them seem more lucid, more simple, and yet somehow more fully human than the rest of us.

Do you know any historical figures that fit this description?

V&V

As a software/system engineer, I can't help but compare the process I follow to provide a product vs. the process our legislatures follow. Maybe I just don't get political science. The process I use may seem a little dry, but even cool products like the iPod and cell phone were not produced by a continuous stream of pizza parties and happy hours (or backroom deals).

Intro

Verification and Validation or "V&V" is the process of making sure that a product does what it was asked to do (Verification) and meets its intended purpose (Validation). In other words, verification is "I did what you asked me to do" and validation is "I met your needs".

In developing software, the process before V&V includes coding (writing the software), compiling (the computer converts your software into a program it can run), and testing (Make sure the program doesn't crash and appears to do what it should). For example, let's write a program that provides health care for every American.

Coding and Compiling

Which of the following two code samples will compile?

Code Sample 1:
for (american=1, american<=NUMBER_OF_AMERICANS, american++) {
provide_healthcare(american)
}

Code Sample 2:
for (american=1; american<=NUMBER_OF_AMERICANS; american++) {
provide_healthcare(american);
}

The answer is Code Sample 2, since a "for" loop uses semi-colons instead of commas and the "provide_healthcare" statement is not terminated with a semi-colon.

I think that one of the main complaints about the healthcare bill is that we don't understand the language required. The legal system is like a big compiler that expects the language to follow very strict rules that your average American is not familiar with.

Testing

Even though the code in sample 2 compiles, it crashes when we run it. The reason is that the computer starts with "0" when for the first American. Here's the fix:

Code Sample 2 Fixed:
for (american=0; american < NUM_AMERICANS; american++) {
provide_healthcare(american);
}

This compiles and runs, but we have to test to make sure the function provide_healthcare does what it says and has no side effects. One problem with software is what is called a "memory leak". This is where the software uses resources and doesn't properly return the resource to the operating system when it's done with it. Eventually the result is that the computer will start getting slow and then eventually crash. For critical applications, this can be very dangerous and precautions need to be taken in advance to recover from a computer crash to avoid catastrophe.

The "memory leak" problem is a big fear for health care reform. This is one of the main problems with Medicare.

Take the word of the Engineer

Another alternative to the above process is to ask the engineer "Is this going to work?". The answer is typically "Yeah, sure". The reality is that relying on this answer is like playing Russian Roulette. Even if the engineer is experienced and answers with confidence "I stake my reputation on this!!!", taking his word is no replacement for a rigorous V&V process.

Back to health care, it doesn't matter who voted for it, what the polls say, what groups (AMA, AARP, etc.) support it; the question is "Will it improve the health of Americans?" A second question (that V&V doesn't address) is "what will it cost?".

How did we ever get anything done?

Last Thursday I got a text message from Jon at work:

"We'll merge in the morning. Be here around 9ish. See email".

We are currently working towards a deadline and we had to come in on our Friday off. I got home and checked my email. He needed my help with the "merge". Friday morning I pulled in the parking lot and I didn't see Jon's car. I was a little bugged until I read my email. It turns out Jon finished the merge about 2:00 am that morning. I quickly forgave Jon and was glad because I could start testing our software immediately. When Jon showed up around 10:30, I was surprised since I knew he had worked late.

Flashback to 1990

Whenever I needed to coordinate with someone at work (no instant messaging, email OR voice mail), I would call on the phone. Usually they weren't there, so the phone would roll over to the secretary. She would leave a note on their desk to call you. They would call back and usually miss you and then leave a note with your secretary that they were returning your call. Sometimes it took a week or two to get a simple answer.

The way I see it that with faster computers and better communication, we should be several times more efficient today than 20 years ago. I actually feel more efficient, I just don't remember how we got anything done that required people working together.

Flashback to 1986

I had a summer job as a research assistant. I was modifying a simple software program for my professor. It took 20 minutes to recompile the software after the smallest change. How did I ever get anything done?

Flashback to 1969

We landed a man on the moon. The computers they used had less computing power than my cell phone. How did they do that?

The Mental Health of California

I heard an interesting piece of news about California cutting benefits for the mentally ill. The news story argued that we should all contact the State government to tell them to not cut benefits. There are several syllogisms (logical appeals) that I would like to address.

Let's get my position out of the way on this:

P1. Society as a whole should provide support to families, individuals and institutions that care for the mentally ill.
P2. Charities, private businesses and individuals most likely do not meet all the needs of caring for the mentally ill.
P3. The only other significant source of support for meeting the needs of the mentally ill is the government.
C1. The government should use some of their tax revenues to help support meeting the needs of caring for the mentally ill that is not provided by other sources.

The first two premises (P1 and P2) I think are reasonable. P3 is only true insofar as I can't think of other sources of support. The conclusion (C1) is a valid logical appeal, but the truth of the premises need to be proven.

Here is the syllogism from the news story
P1. The government should provide support to families, individuals and institutions that care for the mentally ill.
P2. The government is cutting benefits for the mentally ill.
C1. You should contact the government to tell them that they should not cut benefits for the mentally ill.

I'm not enough of an expert, but my emotions agree with C2 while the fiscally responsible side is confused. These are unanswered questions:

Why is government cutting support for the mentally ill?
These are my premises:
P1. State revenues have dropped relative to financial obligations
P2. Support for the mentally ill does not have the priority (due to political and legal reasons) as other financial obligations (such as pensions, etc) do.
P3. Cutting funding for emotionally charged issues like mental health care is a political move to gain acceptance for increasing government budgets and is a distraction from the need to cut less critical expenditures in a time of declining state revenues.

An implied syllogism from the news story:

P1. State revenues have dropped relative to financial obligations.
P2. The people don't want the state to cut spending on critical programs like mental health care.
C1. Therefore, the State should spend more than it has or raise taxes.

This syllogism is not valid, since it does not address the total State budget and what other items could be cut. My version of this logical argument is:

P1. There are many families, individuals and institutions that operate at the margin of their budget that would be significantly overburdened by a reduction in mental health benefits.
P2. There are other means of cost cutting that would not cause undo burden on an individual. Examples (to name a few):

• Cutting the salary ($117,000) for wealthy members of the California State Assembly.
• Cutting the retirement benefits provided by California to wealthy recipients.
• Cutting the budget of other programs.
  

P3. There are other means of revenue generation. Examples:

• Wealthy Athletes, Hollywood stars, heirs/heiresses, etc.
• Using more of California's rich resources (untapped oil and natural gas).
  

P4. A general tax increase will put an unfair burden on some Californians.
C1. Therefore, we should look for specific areas of cost cutting and revenue generation instead of raising taxes in general to help meet the mental health needs in California.

A Memorial to Chelsea King

I was shaken to the core when I found out what happened to Chelsea King. I don't know her personally. The first I heard of her was an email at work last week saying she was missing. The place where they arrested her murderer was the same place my sons and I go mountain biking. I remember my young son falling behind and it is terrifying to think that a predator lurked in the same area. This atrocity is too close to home.

Chelsea is not much younger than my own daughter. I can't imagine the pain this loss is causing her family and friends. I found out yesterday that a coworker lives in Danielle Van Dam's neighborhood. My friend's daughter was in Danielle's class at school and she had come over for a birthday party about a year earlier. She is still scarred by Danielle's murder after 8 years.

To remember the true horror and reality of the crimes against these girls, I recommend that the next time you watch CSI Crime Scene Investigation, CSI New York, CSI Las Vegas, CSI Miama, Law & Order Criminal Intent, Law & Order Special Crimes Unit, Criminal Minds, Cold Case, Bones, Without a Trace, or any other crime drama or horror movie (of which there is a disturbing abundance) ---

Remember it is real and it is ugly!!!

P.S. If I just ruined watching these shows for you, then this posting served its purpose.

The Health Insurance Iceberg

The world is not run by those who are right. It is run by those who can convince others that they are right p 37

When you're debating something as big as health care reform, it seems that there are two sides that have each decided on a solution, and they simple report the numbers to convince others that they have the "right" solution.

Government Provided Health Care
For example, one solution is for a complete takeover of health care by the government. This side reports the high costs of medical insurance, excessive executive compensation, etc. The logic for government provided health care goes something like this:

1. Because of high costs, too many American's don't have health care.
2. It's the moral responsibility for a rich nation to assure all citizens have access to health care.
3. Therefore, the government should provide health insurance for all American's.

I've tried hard to come up with a valid syllogism to fit this argument. The form of a syllogism is:

All X is Y
All Y is Z
Therefore, all X is Z.

"All" can be replaced with "Some" or "No".
"is" can be replaced by "is not".

In order to be a valid argument, the premises need to be valid and the syllogism needs to be valid.

Valid Premises, Invalid Syllogism = Invalid Argument
Some health care is provided by the government
Smart people have health care
Therefore, smart people get their health care from the government.

In order for this to work, any value of X,Y and Z should work:
Some X is Y
Z is X
Therefore, Z is Y

To show how this is flawed, try:
Some lawyers are crooks.
Pres. Obama is a lawyer.
Therefore, Pres. Obama is a crook.

Another example (if you see no fallacy in the last example)
Some whites are racists.
Nancy Pelosi is white.
Therefore, Nancy Pelosi is a racist.

Valid Argument, Invalid Premise = Invalid Argument
Everyone deserves affordable health care.
Only the government can provide affordable health care (Invalid).
Therefore the government should provide health care for everyone.

Valid Argument, Valid Premise = Valid Argument
All health care for American's is _________
All _______ is health care provided by the government
Therefore, all health care for American's is provided by the government.

For those pushing government provided health care, a middle term is needed to make both premises valid. Good luck!

The Free Market Solution

For full disclosure, I am a proponent of the Free Market, but some of the arguments on this side are weak. For example, in response to the attack on health insurance companies, the health care reform opponents say that the we spend about $2.5 trillion ($2,500 billion) on health care in the U.S. each year and that the executive compensation ($10 million and up) is pennies. Also, the average profits for health insurance companies is only about 5%, which ends up being less than $20 billion per year (not even 1% total health care cost). Very compelling numbers! The Free Market wins! Or does it? (I think this is a fallacy of invalid contrast or misuse of statistics).

A closer look at the numbers (see table below) shows that the top 10 health insurance providers have total annual revenues of $253 Billion or 10% of all of our health care costs.

Company	Sym.	Mark.Capital. $Billion	P/E	Profits $Billion	Total Revenue $Billion	%profit
UnitedHealth Group	UNH	38.19	10.44	3.66	87.14	4.2%
WellPoint	WLP	27.47	6.26	4.39	61.24	7.2%
Aetna	AET	13	10.56	1.23	34.73	3.5%
Cigna	CI	9.37	7.25	1.29	18	7.0%
Health Net	HNT	2.4	5	0.48	15.71	3.1%
Coventry Health Care	CVH	3.38	14.1	0.24	13.9	1.7%
Humana	HUM	8.06	7.7	1.05	8.02	13.1%
Amerigroup	AGP	1.34	9.21	0.15	4.97	2.9%
Universal American	UAM	1.1	8.34	0.13	4.85	2.7%
Centene	CNC	0.77	9.47	0.08	4.1	2.0%
Total		105	88	13	253	5.0%

While these revenues represent exchanges for goods or services, none of these goods or services actually represent health care. For example, a policy that costs $8000 (rough estimate of annual cost of insurance), the amount breaks down as follows (If we assume that all U.S. health care is paid by claims against insurance - which it isn't).

$7200 Medical Claims paid out ($8000 minus 10% or $800 of insurance company revenues)
$760 Operating costs (buildings, utility bills, salaries, etc.)
$40 Profit of 5% on the $800

The opponents of government provided health care say that the $40 profit on a $8000 policy is nothing. The problem is that this is a flawed argument used to counter another flawed argument. Insurance profits are only the tip of the iceberg. The rest of the "insurance" iceberg is the $760 per person it costs to run the insurance company.

The flawed argument here is:
1. Insurance company profits and executive compensation are only 5% (True)
2. Insurance company profits are an even smaller percentage of total health care costs (True).
3. Therefore, insurance companies are not the problem with out of control health care costs.

This is either the fallacy of the excluded middle (total insurance costs) or of irrelevant contrast.

Why is Health Care so expensive?
My hypothesis is that government measures that attempt to improve health care has the unintended consequences of interfering with the free market feedback loop.

Here's where I expose my strong bias against publicly owned/traded companies.

Privately owned - focus on making customers happy by increasing quality of products and services while reducing prices/costs.

Publicly owned - focus is split between making customers happy and making stock holders happy. Increasing revenues is the only way to make stockholders happy.

Regulation on health care companies and another focus to both types of companies: how to satisfy government rules and regulations. For public companies, no amount of regulation is going to reduce the stockholders demand for growth. Limiting preexisting conditions, guarantees for uninsured, etc. all reduce revenue growth and therefore force premiums to go up.

Conclusion

Insurance companies are a larger contributor to rising health care costs than free market proponents will admit. The reason that insurance companies are a problem is due to government intervention and market growth demands that squeeze out the consumers needs.

The way to shrink the "iceberg" is to find ways to help private companies compete against the public companies. This will only work if many of the regulations that the government has imposed to "fix" health care are changed so that market forces can help melt the rest of the "iceberg".


Only the government thinks that cutting a foot of the bottom of a blanket and sewing to the top will make the blanket a foot longer.

Health Care Summit - The Onus is On Them

While trying to listen to the Health Care Summit today, I found myself cringing at the abuse of logic. (I just finish reading "Nonsense: Red Herrings, Straw Men and Sacred Cows: How We Abuse Logic in Our Everyday Language").

I only heard one person who actually seemed to attempt to address the issue while not pushing an agenda. That was Senator Tom Coburn who happens to be a medical doctor. I liked how tried focus on "why" health care cost so much and what we can do about it. His first proposal was to address Medicare fraud and abuse, which could save billions of dollars (The current cost of Medicare, etc. is about $440 billion with an estimated 10% of that being fraud, waste and abuse).

The response to Senator Coburn was:

Pres. Obama - "Every good idea that we've heard about reducing fraud and abuse in the Medicare and Medicaid system, we've adopted in our legislation... we want to eliminate fraud and abuse".

Rep. Steny Hoyer - "In our bill.. you'll be happy to see a very substantial investment in [cutting fraud, waste and abuse]".

So I say, Mr. President and distinguished members of Congress, if you are capable of "legislating" significant reduction of fraud, waste and abuse then you might gain my confidence that the rest of your legislation is more than "good ideas" and "investment [spending]". Until you gain my confidence, I am suspicious that any expansion of Government Health Care will be subject to the same fraud, waste and abuse of the old programs.

The onus is on you: reduce fraud in the programs you already manage before expanding them OR get out of the health care business altogether.