Financial Data & Prescription Records Use Limited

If you are a resident of California, rejoice, because the Supreme Court let stand a decision in the 9th Circuit finding that SB 1 (California’s Financial Information Privacy Act) was not preempted by the Fair Credit Reporting Act. In plain English, this means that California residents can opt-out of “affiliate sharing” among banks. Thus, if you have an account at Bank of America, you can ask the bank not to share information about your account with the company’s 2,000 affiliates! This sets the stage for other states to limit affiliate sharing, and in all likelihood, it means that some banks will simply stop affiliate sharing without direction from the consumer. Why is this important? Say that you are in charge of buying drinks for office parties, and that you regularly purchase large amounts of beer on your credit card for that purpose. Later, you apply for life insurance at Traveler’s. These entities are jointly owned, and they can make inferences from your purchase history information.

The Supreme Court also refused to review an important case from the 1st Circuit, involving the use of prescription records. In IMS Health, marketers challenged a prescription confidentiality law, which prohibited the sale of prescriber-identified prescription records. The 1st Circuit upheld the law, holding that it did not violate the free speech rights of prescription drug marketing companies. The 1st Circuit decision is important in particular because the court viewed the sale of records as mere conduct, rather than expression. If the sale of personal information is viewed in this way, marketing companies will have great difficulty framing privacy laws as restrictions on free speech. It also will mean that marketers will no longer see what drugs are prescribed on a per-physician basis in New Hampshire. Will this lower drug prices? Stay tuned!

Making A Business of Going Out of Business

In Adam Sandler’s 2008 masterpiece, You Don’t Mess with the Zohan, the actor is offered a job at an electronics store called “Going Out of Business.” This is a shady operation that constantly makes false claims about products and rips people off. Sandler was mocking a real phenomenon–the liquidation companies named “going out of business” or “total liquidation sale.” The Journal has a fun article on the issue today, focusing on a rug salesman who has settled down in Texas for a permanent going out of business sale. Barry Newman reports:

Many localities do have rules against such claims. New York City asks stores to get licenses for angst-inspired specials, from “fire sale” to “lost our lease.” Texas asks the same. But with blowouts on every corner, there’s been no burst in enforcement. Texas has issued 49 such licenses since 2001 — and prosecuted one used-car dealer in Austin.

What is Brain Wave Vibration?

Sounds like a more dangerous form of Scientology, according to the Chronicle’s Scavenger Blog:

…Lee’s yoga focuses on Brain Education, or as one official put it, “using your brain well.” Part of this training includes the head-shaking Brain Wave Vibration exercise…Participants take basic yoga classes and are reportedly encouraged to attend pricey workshops, retreats and healing sessions. The group also sells followers $4,000 healing turtles, $800 healing necklaces and $90 vibrating power brains, according to a Boston TV station.

Is Government Health Care Unconstitutional?

David Rivkin and Lee Casey consider this question in today’s Journal, explaining that the Supreme Court’s abortion jurisprudence limits the government’s power to unduly burden choices about healthcare:

It is, of course, difficult to imagine choices more “central to personal dignity and autonomy” than measures to be taken for the prevention and treatment of disease — measures that may be essential to preserve or extend life itself. Indeed, when the overwhelming moral issues that surround the abortion question are stripped away, what is left is a medical procedure determined to be “necessary” by an expectant mother and her physician.

If the government cannot proscribe — or even “unduly burden,” to use another of the Supreme Court’s analytical frameworks — access to abortion, how can it proscribe access to other medical procedures, including transplants, corrective or restorative surgeries, chemotherapy treatments, or a myriad of other health services that individuals may need or desire?

If only the right to privacy had so much influence in government decisionmaking!

I don’t even know where to start with Rivkin and Casey’s argument, except to say that privacy is not going to stop government-supported (or even government-dominated) healthcare. But it is fun to see the conservatives get all libertarian on you once they’re out of power. We’ll be hearing “privacy this” and “my rights that” a lot. Where were those rights during the warrantless wiretapping and FISA debates, by the way?

Iran Likes DPI Too

Christoper Rhoads and Loretta Chao report in today’s Journal:

…the Iranian government appears to be engaging in a practice often called deep packet inspection, which enables authorities to not only block communication but to monitor it to gather information about individuals, as well as alter it for disinformation purposes, according to these experts.

The monitoring capability was provided, at least in part, by a joint venture of Siemens AG, the German conglomerate, and Nokia Corp., the Finnish cellphone company, in the second half of 2008, Ben Roome, a spokesman for the joint venture, confirmed.

The article later clarifies that the actual creator of Iran’s deep packet inspection (DPI) technology is not certain. But I blog for a different point. A group of companies, including ISPs and new advertising firms have proposed DPI for advertising purposes. The idea is that if you were to allow your internet tracking to be analyzed and used for targeted advertising, this could offset the cost of providing internet access. The proposals have largely failed in the US, because of legal, privacy, and business problems with the plan.

The holy grail advertising technologies are the same types of tools that governments would like to use for norm setting, criminal enforcement, and terrorism prevention. It’s interesting to see how advertisers and governments are interested in similar technologies.

It Begins!

Obama’s honeymoon is over, and so is my intermittent blogging, because business groups have finally started their machines! Christopher Conkey reports in the Journal:

The U.S. Chamber of Commerce said it will spend $100 million in an effort to stem the “rapidly growing influence of government over private-sector activity,” in a major new move by the powerful business group to counter the Obama administration’s regulatory agenda.


Chamber president Thomas Donohue said his organization is launching its “Campaign for Free Enterprise” because an “avalanche of new rules, restrictions, mandates and taxes” could “seriously undermine the wealth and job-creating capacity of the nation.” Funds from the Chamber’s campaign will be largely spent on advertising and lobbying.

This is reminiscent of a similar campaign, started by the National Association of Manufacturers, to fight the New Deal. And smaller efforts are afoot as well. Frank Davies of the San Jose Merc reports that:

NetChoice, a group backed by AOL, Yahoo, eBay, Oracle and other online companies, launched a campaign Tuesday against proposed laws across the country that it says would harm e-commerce and consumers. The list is dubbed iAwful, a catchy acronym for Internet Advocates’ Watchlist for Ugly Laws.

The list, mostly state proposals, includes North Carolina bills to impose sales tax on digital downloads and on the resale of sports and concert tickets, and New York’s effort to tax job-seeking and résumé services.

Yes, choice, that’s what we want. Of course, state laws are a form of democratic choice. But they’re bad choices! Obviously NetChoice will make better ones.

Davies’ report continues: “States are hurting and looking for taxes from anywhere they can,” said Steve DelBianco, executive director of NetChoice. “We’re also seeing more business online, and a disruptive technology that kids understand better than many legislators, so it’s a perfect storm.”

Wait, I recognize that name. Steve DelBianco…isn’t that the same Steve DelBianco that works for the libertarian Association for Competitive Technology (ACT), where he is Vice President for Public Policy? And isn’t it interesting that NewChoice’s postal address is the same as ACT’s?

Holocaust Museum Shooter – Anti-semite and conspiracy theorist

Orac has already pointed out the disgusting hate behind the Holocaust museum shooter and his holocaust denial. Others around the internet, in particular Pat at Screw Loose Change have pointed out he was an example of crank magnetism. Not surprisingly, he was also a 9/11 truther (which as Pat says, “scratch a 9/11 truther and you get a holocaust denier”), loved Mel Gibson, and promoted conspiracies about how Obama isn’t a US citizen.

I am particularly interested in his anti-Federal Reserve craziness, which these days, especially among the Ron Paul crowd, I’ve noticed seems to be a stand-in or euphemism for “Jewish bankers”. I think it’s no surprise that Ron Paul is the Stormfront candidate, as his theories about the gold standard and federal reserve being the source of all evil are congruent with the classic jewish/banker/protocols conspiracies usually espoused by the extreme right wing and neo-nazis. Is this the mainstreaming of an anti-Jewish conspiracy theory? Or is it just another example of crank magnetism?

Finally, this is another example of the importance of understanding and working to correct the problem of the suspicious personality. This type of thinking isn’t just unscientific, historically bankrupt, irrational, and just plain crazy, it also leads to extremism as it feeds into persecutory delusions, and as people become more disenfranchised due to their insane beliefs, it eventually will cause violence. This violence, evidenced by shootings loosely directed at liberals and gays like at the Knoxville Unitarian Church, is likely being ratcheted up by the increasingly unhinged conspiracy-mongering coming from the right. Liberals are being described as destroying America, major right-wing media moguls like Andrew Breitbart are spreading conspiracies about the liberal intent to destroy the country, Glenn Beck is spouting off total gibberish about how his country is being destroyed by liberals, etc. This is only going to get worse and the paranoid conspiracy-mongering from the right is stoking the flames.

The psychology of crankery

ResearchBlogging.orgOur recent discussions of HIV/AIDS denial and in particular Seth Kalichman’s book “Denying AIDS” has got me thinking more about the psychology of those who are susceptible to pseudoscientific belief. It’s an interesting topic, and Kalichman studies it briefly in his book mentioning the “suspicious minds”:

At its very core, denialism is deeply embedded in a sense of mistrust. Most obviously, we see suspicion in denialist conspiracy theories. Most conspiracy theories grow out of suspicions about corruptions in government, industry, science, and medicine, all working together in some grand sinister plot. Psychologically, suspicion is the central feature of paranoid personality, and it is not overreaching to say that some denialists demonstrate this extreme. Suspicious thinking can be understood as a filter through which the world is interpreted, where attention is driven towards those ideas and isolated anecdotes that confirm one’s preconceived notions of wrong doing. Suspicious thinkers are predisposed to see themselves as special or to hold some special knowledge.
Psychotherapist David Shpairo in his classic book Neurotic Styles describes the suspicious thinker. Just as wee see in denialism, suspiciousness is not easily penetrated by facts or evidence that counter individuals’ preconceived worldview. Just as Shapiro describes in the suspicious personality, the denialist selectively attends to information that bolsters his or her own beliefs. Denialists exhibit suspicious thinking when they manipulate objective reality to fit within their beliefs. It is true that all people are prone to fit the world into their sense of reality, but the suspicious person distorts reality and does so with an uncommon rigidity. The parallel between the suspicious personality style and denialism is really quite compelling. As described by Shapiro:

A suspicious person is a person who has something on his mind. He looks at the world with fixed and preoccupying expectation, and he searches repetitively, and only, for confirmation of it. He will not be persuaded to abandon his suspicion of some plan of action based on it. On the contrary, he will pay no attention to rational arguments except to find in them some aspect or feature that actually confirms his original view. Anyone who tries to influence or persuade a suspicious person will not only fail, but also, unless he is sensible enough to abandon his efforts early will, himself, become an object of the original suspicious idea.

The rhetoric of denialism clearly reveals a deeply suspicious character. In denialism, the science of AIDS is deconstructed to examine evidence taken out of context by non-scientists. The evidence is assimilated into one’s beliefs that HIV does not cause AIDS, that HIV tests are invalid, that the science is corrupt, and aimed to profit Big Pharma.

The insights offered by Shapiro are that denialists are not “lying” in the way that most anti-denialists portray them. The cognitive style of the denialist represents a warped sense of reality for sure, explaining why arguing or debating with a denialist gets you nowhere. But the denialist is not the evil plotter they are often portrayed as. Rather denialists are trapped in their denialism.

Psychologically, certain people seem predisposed to suspicious thinking and it seems this may be true of denialism as well. I submit that dienialism stems from a conspiracy-theory-prone personality style. We see this in people who appear predisposed to suspiciousness, and these people are vulnerable to anti-establishment propaganda. We know that suspicious people view themselves as the target of wrongdoing and hold persecutory ideas.

I agree that this certainly represents a portion of denialists, but not all. I think others, for example creationists and global warming denialists, tend to have a different motivation and style, due to ideological extremism that warps their worldview. Ideological and paranoid denialism can co-exist within denialist camps, or even within an individual, but there are areas where the overlap is incomplete. Still, the issue of the suspicious personality style is important.

We all know this person. If you don’t, maybe you know Dale Gribble (AKA Rusty Shackleford).


I just know Mike Judge has met the suspicious personality style and encapsulated the extreme of this personality in this character. Dale inevitably sees every event as tied to some bizarre government/alien conspiracy, and inevitably the other men in the alley ignore his interjections or Hank simply says, “that’s asinine”. Hank is a wise man. To argue with a Dale would only make you look like the fool.

Some anti-denialists sites have recently brought to my attention a growing body of work trying to understand how people become conspiracy theorists. Two papers in particular are of interest, the first Unanswered Questions: A Preliminary Investigation of
Personality and Individual Difference Predictors of 9/11 Conspiracist Beliefs
[1] is an interesting study because it provides some explanation for crank magnetism.

Continue reading “The psychology of crankery”

Changing medical school requirements for scientific medicine

Science has an editorial today discussing a topic near and dear to me, what medical schools should require from undergraduates before admission.

Since I was a bit non-traditional as an undergraduate premed (I was a physics major), I am happy to see that they’ve ignored calls to overload undergraduate education with a bunch of pre-professional courses that prevent people from being anything but biology majors.

How should preparation for medical study be assessed? Medical schools generally determine scientific readiness for admission by course requirements and scores on the MCAT, which mainly reflects the traditional content of those courses. In contrast, medical schools have long evaluated readiness for medical practice in terms of competency–specific learned abilities that can be put into practice–rather than by mandating standard courses and curricula for all medical schools. The report recommends that scientific readiness for medical school entry be assessed similarly: The current list of required premedical school courses should be replaced with required science competencies. Instead of a nationwide requirement that premedical undergraduates take specific chemistry classes, for example, a required competency might be described as being “able to apply knowledge of the chemistry of carbon compounds to biochemical reactions.” The report suggests competencies for premedical and medical school science education, recognizing that there may be multiple routes to gaining a competency. An integrated approach to both undergraduate and medical education may help both to innovate.

The editorial discusses this report from the American Association of Medical Colleges and the Howard Hughes Medical Institute that suggests what should medical students arrive at medical school knowing. For years, I’ve thought the premedical requirements were absurd. You are required to have a year of physics, a year of calculus, a year of organic and a year of inorganic/analytic chemistry (at least when I went through). While I benefited from having a basic science background before arriving at medical school, I have to say, the only things I’ve retained from organic chemistry class of any importance are that like dissolves like, and hot solvent is great for cleaning. I still can not think of anything valuable I learned from inorganic chemistry that I didn’t get in high school like computing basic stoichiometry or making solutions. Physics? Maybe it was more useful (and for me it was interesting in fun), but mostly as a course of study in rigorous scientific thinking, statistics, error analysis, etc. Calculus? Totally worthless for medicine. Even the biology courses tend to be exceedingly general (which I think is good). You know what’s been most useful? Knowing how to write. Knowing how to research for a paper, whether it’s on history or quantum mechanics. Knowing how to think and teach yourself about subjects rather than just memorize them. That’s what college should do, and that’s what medical schools should select for, rather than those who memorized the most facts in premed science requirements. And the MCAT? Don’t get me started. The smartest people I know did the worst on that test, and some of the most useless do well, because it doesn’t test reasoning or anything useful, just memorization of all that worthless junk in all those premed classes.

The report acknowledges this, and emphasizes a different skill set and set of “competencies” for premed requirements, rather than some rote knowledge on subjects you’ll never use again in your life. This made my heart swell and brought a tear to my eye.

The fact is, the first year of medical school is a great deal of catch-up for many students, even chemistry and biology majors, because the majority of what we learn in college is irrelevant to medicine, and that’s a good thing. College should not be treated as a pre-professional school that merely exists to give you specific knowledge to get you ready to be a doctor. There is great value in young people coming to medical school with a diversity of experiences and knowledge. If you like chemistry? Great! By all means, take 3 years of organic chemistry if that’s what you like, but we shouldn’t pretend it will ever be used again for medical school. I’m still angry about the hours of life I wasted in organic chemistry class, never to be used again, when I could have been learning about something I really cared about, or exploring more of the liberal arts classes at my university.

This is why it’s good that experts in medical school have begun to acknowledge that premed requirements do nothing useful to prepare one for medical school, but only really serve as a barrier to the unmotivated by virtue of being a giant pain in the ass. One could easily imagine a 1 year, or 1 semester course containing all the basic science required for medical school (which should be administered pass/fail). It’s more important that people arrive at medical school knowing how to think, knowing how to evaluate the scientific literature, having knowledge of the world and hopefully having a higher level of maturity. The physiology, pharmacology, anatomy – all of it is available in the basic science years of medical school. There is very little specific knowledge one needs at the start.

I’m glad to see there is talk of finally breaking from the stodgy and pointless premed requirements that generations of medical student hopefuls have had to suffer through (despite some, like Jules Dienstag, defending the premed torture as a “necessary gauntlet”. Let’s just hope they implement some of these changes, save premeds years of excessive study of irrelevant subjects, and maybe, if we’re lucky, burn the MCAT for the useless test that it is.