Two doctors

Laura Esserman, shaking things up in a men’s world to improve the health and increase the happiness of her patients, and other people’s patients. Evidence-based medicine and courage.  Rockstar! You go, doc!

Patricia Horoho, [link corrected 29/IX] smoothing things out in a men’s world to improve the comfort of officers at the expense of her patients (students who aren’t officers yet). Evidence-suppressing management and craven servility.  Flack in scrubs costume, and not such a great officer come to think of it. Hang up your stethoscope, doc, and maybe park your stars in the kitchen junk drawer too.

“The black activists who helped launch the drug war”

My friend Jesse Singal has a nice piece over at the Science of Us about Michael Javen Fortner’s new book, Black Silent Majority: The Rockefeller Drug Laws and the Politics of Punishment. “Key to this story,” Jesse notes, “is the role of Harlem’s residents in forcefully advocating for a tougher, more punitive approach to the neighborhood’s ‘pushers’ and addicts.”

You should read Jesse’s piece, which includes some striking graphics.

There is a sad parallel to be drawn between criminal justice policy of the late 1960s and early 1970s and the respectability politics that blossomed fifteen years later around HIV and AIDS. David Dinkins, Benjamin Ward, Charles Rangel, and much of New York’s African-American political establishment opposed syringe exchange and other harm reduction policies ironically promoted by that noted liberal Ed Koch. That’s the world I entered early in my career when I researched these same public health issues.

This 1988 New York Times story, “Needle exchange angers many minorities,”captures one strain of the dispute:

More specifically, the needle exchange has been vehemently denounced by black and Hispanic city officials.

They, joined by many drug treatment specialists, contend that because the majority of the city’s addicts are black or Hispanic people, the needle program is misguided and insensitive. What is needed, many of them say, is more drug-prevention education and treatment centers in minority neighborhoods. So intense are the sentiments that City Councilman Hilton B. Clark of Harlem recently accused the New York City Health Commissioner, Dr. Stephen C. Joseph, of using the free needle program to conduct a genocidal campaign against black and Hispanic people.

Mr. Clark said that the needles, even if distributed for a limited period of six to nine months, will encourage drug use rather than contain AIDS.

Even the city’s Police Commissioner, Benjamin Ward, last week joined the debate. Some drug treatment experts suggest that debate illustrates more about the failure of the city’s black and Hispanic leadership to effectively combat AIDS in their communities than about the alleged insensitivity of City Hall to minorities.[...]

On a television call-in program Mr. Ward, who is black, called the exchange a ”bad idea” and said he opposed it as a law-enforcement official and as a black man.

”As a black person we have a particular sensitivity to doctors conducting experiments, and they too frequently seem to be conducted against blacks,” he said.

In a letter to Mayor Koch dated Oct. 27, the City Council’s Black and Hispanic Caucus said, ”It is beyond all human reason and common sense for the city to hand out needles to drug addicts at a time when our police officers and citizens have become casualties in the drug war.”

The current generation of African-American elected politicians is at the forefront of HIV prevention and treatment advocacy. In retrospect, Ward his allies were disastrously wrong. I wish we could go back and replay the initial poisonous reaction to essential public health interventions. But before we harshly condemn Ward and his colleagues ,we might consider the human consequences of the heroin epidemic in Harlem and similar communities, and consider our broader societal failure to address the widespread joblessness, addiction, and crime that beset minority communities long before AIDS came along.

Jesse concludes his piece with a simple point:

Lurking underneath Fortner’s intricate, careful parsing of the historical record, then, is a simple claim about human beings: If you live in a neighborhood where you feel like you, your family, and your possessions are perpetually at risk, it will harden your politics and your view of your neighbors. Fortner’s main goal is to remind readers that this isn’t just true of white people.


What is the Catalan for magic pony?

??Yesterday Catalonia held elections for the regional government. Since Madrid frustrated their hopes of an independence referendum, the tactic of the secessionists has been to try to turn every election from rat-catcher up into an independence plebiscite. From that perspective, yesterday was not a win. Pro-independence parties narrowly failed to get a majority of votes. They did together win a narrow majority of seats, and will continue to control the Generalitat. That does not look a basis for UDI.

The circumstances in the last few years could not have been more favourable to their cause: a disastrous boom-and-bust cycle in property, leading to bank rescues that doubled Spain’s national debt; mass unemployment from austerity dictated by Brussels and Berlin; and a governing party in Madrid mired in scandal. The economy has now started to improve, not dramatically but steadily, which should erode support.

The pedestrian Mariano Rajoy (no pigs, no bribes) has opposed the separatists by standing pat on the constitution. This has given him institutional wins through the Constitutional Court, but has done nothing to win Catalan hearts and minds. There has been no counterpart to Gordon Brown’s spirited defence of the Union in Scotland on emotional grounds: shared battlefields and war cemeteries, and the NHS. (Imagine an American politician defending US healthcare as a glorious achievement. On second thoughts …) Can you make such a case in Catalonia? Sure. Catalans died in 1714 and 1812 and 1936 in defence of a particular vision of Spain, not just Catalonia. Bringing up the Civil War is dangerous stuff of course, precisely because the memories are high voltage. If the stakes are the unity of your country, you have to take a few risks.

How serious is the independence project? I looked up the programme of Junts pel Si, the main separatist coalition in the election. Website, programme Continue Reading…

Impressive, though not-so-red-moon

But still. In honor of the occasion. From my front yard. 250mm lens, f5.6 at 1/3200 sec. Colors always wash out because I don’t know how to address color saturation in this type of photography.

1/3200 sec, f5.6

Sadly, my camera is way, way smarter than I am.

Gaming out the VW affair from the Oval Office

Imagine you were the President of the United States. (Sure, that’s daunting, but remember you’re more qualified for the job than about 90% of the people now running for it.)

You just found out that all the Volkswagen diesels sold in the U.S. over the past six years are in massive violation of pollution-control standards, and that the resulting excess emissions have caused, and will continued to cause, deaths and injuries. Apparently, in order to get those models past emissions certification without sacrificing mileage or performance, VW installed an elaborate software patch on the computer that runs the engine.

The program cleverly detects whether the car is being emissions-tested (apparently a testing machine isn’t much like an actual driver) and, if it is, turns on the emission controls. Once the test is done, the program notices that, too, and turns them back off. So the car-on-the-test-treadmill looks legal, but the car-on-the-road is grossly illegal.

GM, Ford, and Honda have all been caught before playing similar tricks; so had VW. There’s even a term of art for them: “defeat devices,” because they’re designed to defeat emissions tests. And Bosch - which supplied the code to VW, supposedly to be used only in testing rather than actual operations – also supplies several other automakers, so there may be other recent-model cars with the same problem.

Even after the cheating had been detected by some very clever engineers at West Virginia University, VW officials kept denying that there was anything amiss until the EPA threatened not to certify its 2016 models. Then the company changed its tune. (Note that if the people making those denials knew them to be false, they may have serious personal criminal liability; 18 U.S.C. 1001 (a) provides, in relevant part:

[W]hoever, in any matter within the jurisdiction of the executive, legislative, or judicial branch of the Government of the United States, knowingly and willfully (1) falsifies, conceals, or covers up by any trick, scheme, or device a material fact; (2) makes any materially false, fictitious, or fraudulent statement or representation; or (3) makes or uses any false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry shall be fined under this title, imprisoned not more than 5 years …or both.

In that situation, Mr. (or Madam) President,what should you be trying to accomplish, and how should you go about it?

I submit that your goals should be:

1. Getting the cars off the road – or fixed, if that turns out to be possible – sooner rather than later. The death rate is unknown, but a month’s delay will, more likely than not, kill at least one person.
2. Identifying whether there are similarly gimmicked non-VW cars on the road, and deal with them as well. Again, time is of the essence.
3. Ensure that justice is done with respect to VW as an enterprise and the VW officials who engaged in this conspiracy. Of course legal guilt or innocence remains to be determined in each case, but there’s no doubt there was a conspiracy to cheat the testing process; VW has now admitted what was done, though of course the company is trying to blame a “small group” of engineers. Doing justice is not merely a matter of revenge; this is your best opportunity in years to establish the principle that deliberately planned regulatory violations that cost lives can have drastic consequences for firms and individuals.
4. The decision whether VW stays in business is now up to you and people who work for you. There’s a case for corporate capital punishment. But there’s also a case for using the leverage this case gives the government to force VW to spend company money on environmental improvement. That needn’t involve VW’s own operations. To choose an example not quite at random: pollution from new cars – even faux clean diesels – is trivial compared to pollution from old cars. The problem with a systematic “cash for clunkers” program is that it encourages people to keep their clunkers rolling until a buyback comes alone. It’s also hard to get Congress to come up with the money. But a buyback paid for by VW as part of a settlement of the criminal and civil cases against it would – precisely because it was unpredictable and unlikely to be repeated – pose no such problem. Buying and scrapping a million old cars at $1000 a copy might be an excellent way of spending $1 billion that the Congress never has to appropriate, and it would almost certainly turn the whole event into a net plus from the perspective of morbidity and mortality, even given the inevitable fact that some of those cars would have been headed for the scrapheap anyway.

All of those purposes are served by promptly gathering information about who did what at VW and elsewhere. No doubt folks at EPA and at various universities are feverishly inventing tests to detect defeat devices, so it’s likely we’ll eventually learn about most of the schemes that have been put into practice recently at any substantial scale. That still leaves the problem of detecting older or smaller schemes, and the further problem of determining which individuals at the offending firms were responsible.

You could speed that process enormously by instructing the Justice Department to open a criminal investigation into conspiracies to install defeat devices.  Again, you’d need to be careful to make it clear that you weren’t imputing criminal liability to any specific individual or firm, but it would be well within your legitimate function to say, or have your Attorney General say, something like this:

On the facts as reported, it seems more than likely that criminal laws have been violated, and at least possible that they have been violated by more than one manufacturer, with regard to “defeat devices” designed to evade pollution controls. People have gotten sick and died, and others are getting sick and dying right now, because of the excess pollution that was deliberately and illegally emitted. These are not “regulatory violations” in the sense that someone forgot to file the right paperwork; this was a deliberate scheme to put toxins into the air we breathe and to conceal that fact.

Starting this week, Federal agents will be asking automobile manufacturers and their employees for information about defeat devices and other attempts to cheat the emissions-testing process. For now, those requests for information will be voluntary; no one is obliged to answer. But everyone involved should also know that making a false statement to a federal official in such a situation is a felony.

It also seems very likely that eventually one or more grand juries will be empaneled and subpoenas issued. Again of course, everyone involved has the right to assert the Constitutional privilege against self-incrimination and refuse to answer questions that might lead to his own prosecution. As in any such investigation, those who come forward early and make a clean breast of things are likely to wind up facing less serious consequences than those who wait to be called.

To facilitate the process, we have established a hotline, 1-800-DEFEAT-D. People who call that number have the option of giving their own names or remaining anonymous. Of course, those who think they may be facing personal criminal liability should consult an attorney first.

We need to find any other cars that have similar gimmicks and get them fixed, or off the road, as soon as possible. Every mile driven by any of those cars makes this country just that much less healthy to live in.

The truth is going to come out eventually. I appeal to anyone who can help it come out faster to call that hotline.


So far as I can tell, of the eleventeen people currently running for President, only Hillary Clinton has made a statement on the issue; hers was forceful but brief. There’s no sign of any legislative action.  The contrast with the phony Planned Parenthood scandal couldn’t be stronger.


“God, why have you foresaken me.”

Perhaps that’s what this boy was saying. Much about that figure indicates why I have warmer feelings for Pope Francis than I do for his former or his current boss.
Screen Shot 2015-09-26 at 1.20.38 PM

No big deal

“Tuez-les tous! Dieu reconnaîtra les siens.” Arnaud Amaury to his troops before the sack of Béziers, who were unclear on how to tell the difference between the Cathar heretics who needed extermination and good Christians.  Often rendered as “kill ‘em all; let God sort ‘em out!”

It is widely believed in Islam that anyone who dies on the Hajj goes directly to heaven; if so the 700 souls killed in the stampede in Mecca were actually spared years enduring our imperfect world and are now grateful for the short cut.

“…it seems to me that the more Christian a country is, the less likely it is to regard the death penalty as immoral. … I attribute that to the fact that, for the believing Christian, death is no big deal.” Antonin Scalia, 2002. [It is not clear whether the distinguished believing Christian justice was dissing the death of non-Christians, or of Christians, or all of these.]

A Man was hanged by the neck until he was dead.

“Whence do you come?” Saint Peter asked when the Man presented himself at the gate of Heaven.

“From California,” replied the applicant.

“Enter, my son, enter; you bring joyous tidings.”

When the Man had vanished inside, Saint Peter took his memorandum-tablet and made the following entry:

“February 16, 1893.  California occupied by the Christians.” Ambrose Bierce

Living on $2 per day

I recently had some work done. Just a tuck here, some stubble there. It's subtle, but I think it looks pretty good.

I recently had some work done. Just a tuck here, some stubble there. It’s subtle, but I think it looks pretty good.

Katheryn Edin and H. Luke Shaefer are attracting huge attention with their new book, $2.00 a Day: Living on almost nothing in America.

Writing about this book in the New York Times, William Julius Wilson concludes:

This essential book is a call to action, and one hopes it will accomplish what ­Michael Harrington’s “The Other America” achieved in the 1960s — arousing both the nation’s consciousness and conscience about the plight of a growing number of invisible citizens. The rise of such absolute poverty since the passage of welfare reform belies all the categorical talk about opportunity and the American dream.

Shaefer and I sat down for a long converation about the book at It was a special pleasure to speak with him, since he is a friend, co-author, and one of my very first doctoral students at the University of Chicago. Much more here.

Yeah, that’s Luke above.

Cities of Refuge

When I first met Paul Roemer a few years ago a few years ago he was promoting an idea he called “Charter cities.”

The basic idea is that, under contemporary economic conditions – in particular the astonishingly low cost of transporting freight by water – economic activity doesn’t require much in the way of natural or even human resources: just a piece of land with access to ocean transportation, a little basic urban planning, the rule of law, and the absence of intrusive and kleptocratic government.

Alas, those last two are sufficiently rare in the worst-off countries that hundreds of millions of people, deprived of industrial opportunity where they are, want to leave and go somewhere else. The problem is that “somewhere else” mostly doesn’t want to take them in.

Romer’s proposed solution flows directly from this analysis: find an empty space with the requisite transportation access, get the national government out of the way, and build a new city, attracting economic migrants from around the world. At first the charter city would be governed by an international board, with housing and industrial plant built by private actors and infrastructure and public-services financed by ground leases: in effect a Henry George single tax.

Continue Reading…

The moral universe of the corporate killers

Daniel Fisher – not otherwise known to me – writes for Forbes, covering “finance, the law, and how the two interact.” Naturally, given where he works, he hates plaintiffs’ lawyers, which is his right and privilege in this great and free country of ours. So his first reaction to the VW emissions-cheating scandal was to criticize - not VW – but a class-action law firm threatening to sue VW on behalf of consumers.

His point is that the buyers of the supposedly-clean-but-actually-filthy-dirty VW diesels weren’t in any direct sense harmed by VW’s fraud. By disabling pollution controls except when the car was being tested, VW managed to pack more performance and fuel economy into a car than it could have done while also actually meeting the emissions targets. So when VW issues a recall notice it will in effect be asking consumers to trade their existing car for one that performs worse and gets lower miles-per-gallon. So, he says, except for a few Marin County cranks, they’re mostly going to ignore the recall.

Therefore, the plaintiffs’ lawyers are being silly again.

Tort reform, tort reform, sis, boom, bah!

Now, I don’t know what it is you need to know to be a Certified Financial Analyst - that’s the credential Fisher claims – but apparently it isn’t logic or economics.

Continue Reading…