Wednesday, December 26, 2007

Trio of health care articles

(1) Hospitals Look to Nuclear Tool to Fight Cancer

There is a new nuclear arms race under way — in hospitals.

In Loma Linda Medical Center's fixed beam treatment room, where brain and eye tumors are treated, a machine is readied for a patient. The patient's head will be immobilized by the mask at left.

Medical centers are rushing to turn nuclear particle accelerators, formerly used only for exotic physics research, into the latest weapons against cancer.

Some experts say the push reflects the best and worst of the nation’s market-based health care system, which tends to pursue the latest, most expensive treatments — without much evidence of improved health — even as soaring costs add to the nation’s economic burden.

(2) Finding Alzheimer’s Before a Mind Fails

Ms. Kerley is part of an ambitious new scientific effort to find ways to detect Alzheimer’s disease at the earliest possible moment. Although the disease may seem like a calamity that strikes suddenly in old age, scientists now think it begins long before the mind fails.

“Alzheimer’s disease may be a chronic condition in which changes begin in midlife or even earlier,” said Dr. John C. Morris, director of the Alzheimer’s Disease Research Center at Washington University in St. Louis, where Ms. Kerley volunteers for studies.

But currently, the diagnosis is not made until symptoms develop, and by then it may already be too late to rescue the brain. Drugs now in use temporarily ease symptoms for some, but cannot halt the underlying disease.

Many scientists believe the best hope of progress, maybe the only hope, lies in detecting the disease early and devising treatments to stop it before brain damage becomes extensive. Better still, they would like to intervene even sooner, by identifying risk factors and treating people preventively — the same strategy that has markedly lowered death rates from heart disease, stroke and some cancers.

So far, Alzheimer’s has been unyielding. But research now under way may start answering major questions about when the disease begins and how best to fight it.

(3) Medicare Private Plan Abuses

Heavily subsidized private Medicare plans are continuing to prey on elderly Americans despite state, federal and industry efforts to stop them. It is yet another reason to rein in these operations by eliminating their unjustified subsidies.

These plans are a financial drag on Medicare as the government pays them about 12 percent more, on average, than the same services would cost in the traditional Medicare program. All too often, the private plans are an ethical horror as well. . . .
[U]nscrupulous insurance agents have tricked people into dropping traditional Medicare coverage and enrolling instead in private plans that do not meet their needs. Agents typically receive $350 to $600 for each patient they enroll in a private plan. Some try to boost sales by pretending to be Medicare officials, forging signatures or hiding the fact that a patient’s doctor will not be part of the private plan. Others barge into homes and use high-pressure tactics to push poor, semiliterate people into a private plan.

Monday, October 15, 2007

Colbert's NY Times Op-ed

I Am an Op-Ed Columnist (And So Can You!)

I’d like to thank Maureen Dowd for permitting/begging me to write her column today. As I type this, she’s watching from an overstuffed divan, petting her prize Abyssinian and sipping a Dirty Cosmotinijito. Which reminds me: Before I get started, I have to take care of one other bit of business:

Bad things are happening in countries you shouldn’t have to think about. It’s all George Bush’s fault, the vice president is Satan, and God is gay.

There. Now I’ve written Frank Rich’s column too.
And it goes on. Genius. And also, before ending this post, Colbert's fantastic Fresh Air interview from last week:
Colbert Builds 'Report' with Viewers, Readers

Wednesday, September 26, 2007

Happy Birthday Google!

The one website most responsible for the explosion of growth for the Internet over the last decade turns 9 today. They "do no evil", advocate for openness and transparency on the Internet, push for an interpretation of IP law that will allow for improved development and greater exploitation of future Internet tools and information aggregation, and continue to innovate, pushing their competitors to improve.

I remember the first time I used Google. I'd been a Yahoo! search user, but always felt that limited and frustrated when I attempted to search for something. At my dot-com job one day I became frustrated when unable to find an answer to a simple coding question. My co-worker, a skilled programmer by day and drummer by night, saw what I was doing and said "Worst!" - his catch phrase. "Man, why are you using Yahoo? Try Google. I just heard about it for a buddy, and I ain't goin' back."

I entered w-w-w-.-g-o-o-g-l-e-.-c-o-m into my fancy, new, IE-whoopin' Netscape browser. The logo, a search box, and a plain white background appeared on my screen. I typed in the same search I'd tried earlier. Google returned a plain, clean list of results. I clicked on the first one and had my answer. Game over.

Sure, people have concerns about the data they collect from users, but so long as they stick with their Mission, we'll all be alright. And Google will continue to improve. My birthday was yesterday. C's birthday is Sunday. Good to know that we're bookends to the endless repository of information named Google. Happy Birthday!

Tuesday, September 25, 2007

MF Doom: Don't look behind The Mask?


MF Doom is one of my favorite rappers. His beats are sick. His rhymes are clear, clever, intelligent. He raps with style and technique. He speaks on real life with wit, charm and a smirk. He always references comic books, cartoons and events from our (apparently) similar childhoods. I can relate.

Being such a big fan, I was disappointed when I couldn't make it to his mid-August shows in SF. And then I heard that he didn't show. Instead, an impostor donned the mask, lip-synced over two tracks, and took off. Worse, a friend in LA said he'd done it there the week before. Then reports started to stream in from more Doom-less dates.

Disappointed, I started searching the Intertron for news. The best report was from the Village Voice, which summarized everything I'd been able to learn via The Oracle.

"The first thing out of my mouth to my buddy was, 'Wow, that doesn't even look like him,' " says concertgoer Dan Schwab, a buyer for Adidas who flew down from Portland, Oregon, with his girlfriend to see the show. "He looked way skinnier—at least 30 or 40 pounds lighter than the guy I've seen before. The guy who was up onstage was just walking back and forth, doing a little bit of the 'rapper hands' action and giving high-fives."

Though unverified accounts of "fake" Doom shows have been swirling for a couple years, the critically beloved rapper usually does justice to his brilliant studio catalog in concert. Schwab, for one, says Doom's performance on the same stage two years earlier was one of the best he'd seen.

But this guy was a joke.

"I went up to the sound guy about two songs deep and said, 'No one can hear Doom's mic.' He looked at me and said straight-up, 'I know. His mic's not on, and that's not MF Doom.'"

No fun at all, and seemingly a slap in the face to fans and concert goers. But should fans have seen this coming? I mean, this is the same guy who "once said he planned to release an album called Impostor". Is Doom providing commentary on the state of the music industry, or on fandom, or on rapper as act as opposed to rapper as person?
In 2005, he even employed a double for a pair of photo shoots.

"He'd been calling our editor saying he wasn't feeling good and wasn't going to make it, but for the shoot he sent his hype man [Big Benn Kling-on] in the Doom mask," reports Scratch art director R. Scott Wells, referring to his magazine's story on The Mouse and the Mask, a full-length collaboration between Doom and the producer Danger Mouse. "The photographer didn't know any better, so he just went ahead and shot him. When we got the film back, we knew it wasn't Doom. Benn's a much bigger guy."

"I spoke to Doom, and he tried to tell me something to the effect of: It was a new persona he was experimenting with," says Jerry L. Barrow, who was Scratch's editor at the time. "He had some sort of justification for it, but to me it was really unprofessional." (The pictures were scrapped, and the magazine made light of the situation by running Photoshopped pictures of figures like Jessica Simpson and Saddam Hussein wearing the infamous mask.)

. . .

Doom appears to have performed the same stunt at Elemental Magazine, which he confirmed in a letter to the publication in late 2005. . . . [Doom] noted that several different actors, from Adam West to George Clooney, have played Batman. His note concludes, "In the world of hip-hop music on-the-other hand things might be considered even stranger although not at all unusual. When you have artists 'playing' themselves, pun intended while having someone else more qualified to write the story (beats and or rhymes). To each is owns, after all its just entertainment right?"

Even a 2003 NPR piece seems to foreshadow Doom's Wizard of Oz act:
Remember, even MF Doom, metal mask and all, is a created character. . . . According to the story that Doom tells, Viktor Vaughn is a scientist and a rapper who's traveling the cosmos looking for the best places to practice his art.

I'm left hoping that The Villain is pulling an Andy Kaufman. Based on the depth and genius of his body of work, I'd bet he's laughing at us, with us, and giving someone the metal finger right now. Hopefully he'll start performing again in the near future... in person this time. For now, I'll stick with Madvillainy and MM...Food?, and stay far away from his shows.

Monday, September 24, 2007

JD = no guarantee

According to an excellent report by the Wall Street Journal, law school graduates who are not in the top 10% of their class at all but the elite schools are having an increasingly difficult time finding work. Work that is found (outside of the big firms, of course) offers starting salaries more modest than in the past.

Evidence of a squeezed market among the majority of private lawyers in the U.S., who work as sole practitioners or at small firms, is growing. A survey of about 650 Chicago lawyers published in the 2005 book "Urban Lawyers" found that between 1975 and 1995 the inflation-adjusted average income of the top 25% of earners, generally big-firm lawyers, grew by 22% -- while income for the other 75% actually dropped.

To which I say cry me a river. The vast majority of law school graduates are still going to find quality work and earn a more-than-comfortable salary. What really caught my eye were these paragraphs:

[D]ebate is intensifying among law-school academics over the integrity of law schools' marketing campaigns. Defenders argue that the legal profession always has been openly and proudly a meritocracy: Top entrance-exam scores help win admittance to top schools where top students win jobs at top firms. Even the system that is used to issue law-school grades -- a curve that pits student against student -- reflects the law profession's competitiveness. . . . [The Dean of second-tier Loyola Law School] says it is problematic that big firms only interview the top of the class, "but that's the nature of the employment market; it's never been different."

. . .

"Prospective students need solid comparative data on employment outcomes, [but] very few law schools provide such data," adds Andrew Morriss, a law professor at the University of Illinois who has studied the market for new lawyers.

Students entering law school have little way of knowing how tight a job market they might face. The only employment data that many prospective students see comes from school-promoted surveys that provide a far-from-complete portrait of graduate experiences. Tulane University, for example, reports to U.S. News & World Report magazine, which publishes widely watched annual law-school rankings, that its law-school graduates entering the job market in 2005 had a median salary of $135,000. But that is based on a survey that only 24% of that year's graduates completed, and those who did so likely represent the cream of the class, a Tulane official concedes.

It often feels that my school has forgetten that Law School is a professional school. It's an investment, and our goal, as students, is to be prepared for and to land a job after we graduate. As an example, On Campus Interviews (OCI) are taking place right now, and the application process began in early August. Unbeknown to the majority of students, however, was the fact that our Office of Career Planning (OCP) is not as we left it in the Spring. Our entire staff (of 3, for 750 students) resigned, was released, or is on sabbatical. Upon returning this Fall, we found one new OCP attorney, with her Director not arriving until mid-September, long after OCI applications were due.

I'm sure there's an interesting back story here, and while we do seem to have upgraded our OCP staff, leaving students high and dry for OCI was a horrible means to that end. Some students at my school have lost out on interviews, quality internships, and possibly even jobs because Career Planning has not been enough of a priority for our administration. I can only hope that the positive reports I've heard and the positive acts I've seen from the newly hired staff marks a change in attitude at my law school.

For a larger discussion on the WSJ piece, see the WSJ Law Blog »

Free speech

Speaking of higher education, this sign was held up amidst the protesters opposing Iranian President Mahmoud Ahmadinejad's visit to Columbia University today. Iran's President is in NYC to address the U.N., an international body whose mission is to work for peace and is committed to improving the lot of the world's poor by 2015. What's more, Ahmadinejad is the President and spokesman of a government whose greatest opposition has come, in recent years, from student protests. These protests were stopped by violence in 1999. What better way to push for openness and debate in Iran, for discussion and protest by students, than to lead by example?

Meanwhile, Stanford students are rightly up in arms over the conservative Hoover Institutes's appointment of Donald Rumsfeld as a visiting fellow. While Ahmadinejad is visiting for a couple of days, speaking at the UN and giving a speech to a major University, Rumsfeld is suddenly a part of the Stanford faculty. The Hoover Institute may be independently funded and therefore free to appoint whomever they want, but students and alumni need not be happy about it. The Stanford Daily has published some lovely sarcastic commentary.

(Update: A transcript of the President of Columbia's introductory, speech as well as the Q&A with Iran's President, is now available.)

On the myth of academic meritocracy

Jerome Karabel in his NY Times op-ed The New College Try:

The paucity of students from poor and working-class backgrounds at the nation’s selective colleges should be a national scandal. Yet the problem resides not so much in discrimination in the admissions process . . . as in the definition of merit used by the elite colleges. For by the conventional definition, which relies heavily on scores on the SAT, the privileged are the meritorious; of all students nationwide who score more than 1300 on the SAT, two-thirds come from the top socioeconomic quartile and just 3 percent from the bottom quartile.

Only a vigorous policy of class-based affirmative action that accounts for the huge class differences in educational opportunity has a chance of altering this pattern. This change should be accompanied by a fundamental re-examination of the very meaning of “merit.”

Is resilience in the face of deprivation a form of achievement? Should universities expect — and even demand — higher levels of achievement from applicants who have enjoyed every social and educational advantage? Does the emphasis on outstanding extracurricular accomplishments privilege already privileged students who have the time, the resources and the opportunities to display such accomplishments?

This field is Karabell's area of expertise. Says Slate, of his book The Chosen:
Karabel's ultimate goal in deconstructing merit is not, however, to vindicate affirmative action but to expose the hollowness of the central American myth of equal opportunity. The selection process at elite universities is widely understood as the outward symbol, and in many ways the foundation, of our society's distribution of opportunities and rewards. It thus "legitimates the established order as one that rewards ability and hard work over the prerogatives of birth." But the truth, Karabel argues, is very nearly the opposite: Social mobility is diminishing, privilege is increasingly reproducing itself, and the system of higher education has become the chief means whereby well-situated parents pass on the "cultural capital" indispensable to success. "Merit" is always a political tool, always "bears the imprint of the distribution of power in the larger society." When merit was defined according to character attributes associated with the upper class, that imprint was plain for all to see, and to attack, but now that elite universities reward academic skills theoretically attainable by all, but in practice concentrated among the children of the well-to-do and the well-educated, the mark of power is, like the admissions process itself, "veiled." And it is precisely this appearance of equal opportunity that makes current-day admissions systems so effective a legitimating device.

In his 2005 New Yorker article Getting In, Malcom Gladwell cites to The Chosen and expounds on how admissions directors at elite schools are primarily concerned, long term, with creating and maintaining a brand:
Social scientists distinguish between what are known as treatment effects and selection effects. The Marine Corps, for instance, is largely a treatment-effect institution. It doesn't have an enormous admissions office grading applicants along four separate dimensions of toughness and intelligence. It's confident that the experience of undergoing Marine Corps basic training will turn you into a formidable soldier. A modeling agency, by contrast, is a selection-effect institution. You don't become beautiful by signing up with an agency. You get signed up by an agency because you're beautiful.

At the heart of the American obsession with the Ivy League is the belief that schools like Harvard provide the social and intellectual equivalent of Marine Corps basic training—that being taught by all those brilliant professors and meeting all those other motivated students and getting a degree with that powerful name on it will confer advantages that no local state university can provide. Fuelling the treatment-effect idea are studies showing that if you take two students with the same S.A.T. scores and grades, one of whom goes to a school like Harvard and one of whom goes to a less selective college, the Ivy Leaguer will make far more money ten or twenty years down the road.

The extraordinary emphasis the Ivy League places on admissions policies, though, makes it seem more like a modeling agency than like the Marine Corps[.]
Ivy League admissions directors are in the luxury-brand-management business, and "The Chosen," in the end, is a testament to just how well the brand managers in Cambridge, New Haven, and Princeton have done their job in the past seventy-five years. . . . No good brand manager would sacrifice reputation for short-term gain. The admissions directors at Harvard have always, similarly, been diligent about rewarding the children of graduates, or, as they are quaintly called, "legacies." . . . Karabel calls the practice [of legacy admissions] "unmeritocratic at best and profoundly corrupt at worst," but rewarding customer loyalty is what luxury brands do. Harvard wants good graduates, and part of their definition of a good graduate is someone who is a generous and loyal alumnus. And if you want generous and loyal alumni you have to reward them.

Regarding law schools, Gladwell notes:
Most élite law schools, to cite another example, follow a best-students model. That's why they rely so heavily on the L.S.A.T. Yet there's no reason to believe that a person's L.S.A.T. scores have much relation to how good a lawyer he will be. In a recent research project funded by the Law School Admission Council, the Berkeley researchers Sheldon Zedeck and Marjorie Shultz identified twenty-six "competencies" that they think effective lawyering demands—among them practical judgment, passion and engagement, legal-research skills, questioning and interviewing skills, negotiation skills, stress management, and so on—and the L.S.A.T. picks up only a handful of them. A law school that wants to select the best possible lawyers has to use a very different admissions process from a law school that wants to select the best possible law students. And wouldn't we prefer that at least some law schools try to select good lawyers instead of good law students?

This search for good lawyers, furthermore, is necessarily going to be subjective, because things like passion and engagement can't be measured as precisely as academic proficiency. Subjectivity in the admissions process is not just an occasion for discrimination; it is also, in better times, the only means available for giving us the social outcome we want.

And discrimination is what I see every day when I look around at law school. My school clings to our tenuous position as one of the top-100 law schools in the nation. At the same time, we're also one of the most diverse law schools in the nation. While I commend our administration for being more inclusive than administrations at peer institutions, I still feel, everyday, that I'm surrounded by the wealthy and the privileged.

Most of my classmates have parents who, at minimum, have college educations, if not advanced degrees. A huge percentage - if not a majority then close to it - have parents who are lawyers and/or doctors. On balance, all of my classmates work hard, but very few know just how lucky they are, just how few get the opportunity to attend law school, how few would even deign to consider college an option for them. Even fewer of my classmates can imagine or would dare try to place themselves in the shoes of someone who has lived their whole life without the safety nets, the time, the opportunity, the support, the balance, the lack of stress that they, themselves have enjoyed.

Meritocracy is preached from start to finish in law school. "Work hard and you'll succeed" is the mantra. By inference, those who don't succeed fail because they're not working hard enough. If only the school/teachers/students/profession would recognize that mantra is only true in a protected space, on a balanced field. All too often, for the vast majority, hard work alone isn't enough.