Monday, May 26, 2008

Google Commemorates Memorial Day

Google generally makes special holiday modifications to their homepage logo. Here's Google's celebratory logo for Memorial Day:

What kind of statement are they making here? It seems that I'm far from the only one who's noticed the extent to which they honor the deaths of our nation's fallen warriors; the same dead who gave Google the ability to freely gather and disseminate information in a free society.

Google may be ignoring this day but at 10:30AM, my 5-year-old daughter, my wife, and I will be at the Los Angeles National Cemetery where we go every remember.

In case anyone wants to send a message to Google telling them how they feel about this, here's how. My message to them:

"One of the ways I'll be celebrating Memorial Day is by not accessing your website for a week.

"Maybe next year you'll consider the pernicious effect of your decision to pointedly ignore one the United States' most solemn days."


Tuesday, May 20, 2008

A Practical Suggestion for President Bush and Congress

I rarely write about non-medical issues but I have an important policy recommendation that I think will help the country.

Several days ago, the media lampooned President Bush for being "snubbed" by the Saudi's for refusing his request to significantly increase oil production. Bush's request was part of his plan to to ameliorate the problem of seriously rising oil prices. I wasn't there but I imagine that his plea was met with an admonition to "go pound sand".

Today, it was announced that the House of Representatives passed a bill allowing the U.S. to sue OPEC for their antitrust activity in arbitrarily limiting oil production. I may be wrong on this but I kind of doubt that the idea of being sued in an American federal court has the OPEC nations shaking in their boots right now.

So to these two Solomonesque solutions, I've decided to add one of my own: Let's have a bipartisan committee from Congress travel, along with the president, to India and China and ask them to stop buying so much oil. Most economists believe that their dramatically increased consumption (due to rising industrialization) is a principle reason for our current high prices at the pump.

Who could doubt that these two countries would willingly curtail their own drive for progress so that we Yanks can shave off a buck or two a gallon here in the states?

See? This policy stuff isn't so hard.

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Saturday, May 10, 2008

Those Crazy Politicians and University Endowments

The Wall Street Journal is reporting that Massachusetts is contemplating a 2.5% state tax on university endowments in excess of $1 billion per university (via Greg Mankiw's Blog). Now personally, I could care less about Harvard's financial concerns. It's hard to worry about a school with a $34 billion endowment. I'd be happy if my net worth was half that amount.

Here's an idea that would take some of the wind out of these legislative proponents' sails. Harvard could take 2% of their endowment each year and give it to their 19,000 undergraduates and graduate students. This is surely a fraction of the annual interest Harvard makes on its investments each year.

This would amount to over $35,000 per year per student and would essentially give them free tuition. Of course the B-school students would still have to cough up about $7,000 more per year but well...they're B-school students. They'll be able to pay that off after their first few weeks of gainful employment.

Massachusetts would have an awfully hard time taxing such "good" citizens as the Harvard administrators for providing a world class education for free.

I don't know. 2.5% going to taxes vs. 2.0% going to their own students? Seems like a no brainer to me. Maybe the legislature is threatening the universities with this tax just to achieve this end. Either way, it seems like an abuse of their authority to me.

More on my thinking about government meddling in the affairs of private universities (non profit organizations) here.


Friday, May 09, 2008

The EMTALA and Inintended Consequences

Edwin Leap wrote a revealing post about one of my personal pet peeves: the EMTALA laws (h/t KevinMD). Read the whole thing.

The EMTALA (Emergency Medical and Active Labor Act) mandates that essentially all patients must be seen regardless of ability to pay. Admittedly, this federal law states that people can be sent away without treatment after they've been properly evaluated. However, the penalties for being wrong are so severe that few hospitals are willing to take the chance. In effect, hospitals see and treat almost all E.R. patients even if they know that they won't be payed for doing so.

People will of course argue that some patients might die after having been mistriaged to home. Unfortunately, it is the nature of things that this is so. Triage nurses will always make mistakes on occasion and as sure as the sun rises in the east, some patients or their families will pay a tragic price.

Inevitably, such cases will become front page headlines, but rare as they may be, the victims will be "named" and therefore worthy of our sympathy and compassion. Consider though, that in California alone, at least 65 E.D.'s have closed in the last decade. Unreimbursed care is at the root of most or all of these closures.

How many more patients will die, however, because of a lack of nearby or conveniently located E.D.'s? Moreover, these patients will not be named but will instead be mere statistics in some as-yet-unperformed observational study.

Again, read Leap's article for more reasons why the EMTALA is a bad idea (as it's currently written).

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