The Obama Plan – Part I

We’re starting to hear about how Obama intends to implement healthcare in this country.

President Barack Obama says he’s open to requiring all Americans to buy health insurance, as long as the plan provides a “hardship waiver” to exempt poor people from having to pay.

Obama opposed such an individual mandate during his campaign, but Congress increasingly is moving to embrace the idea.

In providing the first real details on how he wants to reshape the nation’s health care system, the president urged Congress on Wednesday toward a sweeping overhaul that would allow Americans to buy into a government insurance plan.

Obama outlined his goals in a letter to Sens. Edward Kennedy, D-Mass., and Max Baucus, D-Mont., chairmen of the two committees writing health care bills. It followed a meeting he held Tuesday with members of their committees, and amounted to a road map to keep Congress aligned with his goals.

The letter published at whitehouse.gov, lays out some basic ideas, but it seems as though Obama is willing to have congress work out the specifics.

Let’s go through his recommendations and talk about the implications.
Continue reading “The Obama Plan – Part I”

Know Privacy Report: Google Web Bugs on 88% of Websites

I’m very proud of the Know Privacy team, a group of three students who performed a broad analysis of online privacy issues for their master’s project at UC Berkeley’s School of Information. The study is featured today on the New York Times Bits blog. Several findings are notable:

They found: “From our analysis, it is apparent that Google is the dominant player in the tracking market. Among the top 100 websites this project focused on, Google Analytics appeared on 81 of them. When combined with the other trackers it operates, such as DoubleClick, Google can track 92 of the top 100 websites. Furthermore, a Google-operated tracker appeared on 348,059 of 393,829 distinct domains tracked by Ghostery in March 2009 (over 88%).”

Also, under the Bush administration, the Federal Trade Commission has framed privacy as one of “consumer harms.” That is, they claimed (without any evidence), that consumers really cared about privacy issues that caused harm. However, in an analysis of the FTC’s own consumer complaint data, the group found that American consumers were most frequently complaining about a lack of control over personal information.

The team investigated web site affiliate sharing too. The public policy debate around information sale generally is limited to third parties. There is a growing consensus, driven by international privacy rules, that companies should not sell personal information to third parties without affirmative consent from consumers. However, affiliate networks are very large, and US privacy law generally does not allow consumers to restrict the flow of personal information among affiliated companies. In looking at the top websites, the average had almost 300 affiliates. Newscorp, the company that owns myspace, has 1,500 affiliates. Identifying affiliates was very difficult: “We sent each company a request via email or an online web form for a list of each affiliate they may share data with. We received 14 replies, but none included the lists we asked for.”

Finally, it’s worth checking out the team’s findings on third party tracking: “…36 of the [top 50] websites affirmatively acknowledged the presence of third-party tracking. However, each of these policies also stated that the data collection practices of these third parties were outside the coverage of the privacy policy. This appears to be a critical loophole in privacy protection on the Internet.” Regulators should rethink this practice. Websites claim that they do not sell personal information to third parties, but then they allow third parties to follow you on their site. This seems to me to be outside consumers’ expectations.

Oprah is a crank

PZ brings to my attention this article in Newsweek which sums up Oprah’s views on health, and one sadly must come to the conclusion that Oprah is a crank. Based on our definition of crankery, one of the critical aspects is the incompetence of an individual in judging sources of information. How else can you describe her dismissal of legitimate medical opinion for the pseudoscience of celebrities like Suzanne Somers or Jenny McCarthy?

That was apparently good enough for Oprah. “Many people write Suzanne off as a quackadoo,” she said. “But she just might be a pioneer.” Oprah acknowledged that Somers’s claims “have been met with relentless criticism” from doctors. Several times during the show she gave physicians an opportunity to dispute what Somers was saying. But it wasn’t quite a fair fight. The doctors who raised these concerns were seated down in the audience and had to wait to be called on. Somers sat onstage next to Oprah, who defended her from attack. “Suzanne swears by bioidenticals and refuses to keep quiet. She’ll take on anyone, including any doctor who questions her.”

That would be a lot of doctors. Outside Oprah’s world, there isn’t a raging debate about replacing hormones. Somers “is simply repackaging the old, discredited idea that menopause is some kind of hormone-deficiency disease, and that restoring them will bring back youth,” says Dr. Nanette Santoro, director of reproductive endocrinology at Albert Einstein College of Medicine. Older women aren’t missing hormones. They just don’t need as much once they get past their childbearing years. Unless a woman has significant discomfort from hot flashes–and most women don’t–there is little reason to prescribe them. Most women never use them. Hormone therapy can increase a woman’s risk of heart attacks, strokes, blood clots and cancer. And despite Somers’s claim that her specially made, non-FDA-approved bioidenticals are “natural” and safer, they are actually synthetic, just like conventional hormones and FDA-approved bioidenticals from pharmacies–and there are no conclusive clinical studies showing they are less risky. That’s why endocrinologists advise that women take the smallest dose that alleviates symptoms, and use them only as long as they’re needed.

This is where things get tricky. Because the truth is, some of what Oprah promotes isn’t good, and a lot of the advice her guests dispense on the show is just bad. The Suzanne Somers episode wasn’t an oddball occurrence. This kind of thing happens again and again on Oprah. Some of the many experts who cross her stage offer interesting and useful information (props to you, Dr. Oz). Others gush nonsense. Oprah, who holds up her guests as prophets, can’t seem to tell the difference. She has the power to summon the most learned authorities on any subject; who would refuse her? Instead, all too often Oprah winds up putting herself and her trusting audience in the hands of celebrity authors and pop-science artists pitching wonder cures and miracle treatments that are questionable or flat-out wrong, and sometimes dangerous.

But back on the Oprah show, McCarthy’s charges went virtually unchallenged. Oprah praised McCarthy’s bravery and plugged her book, but did not invite a physician or scientist to explain to her audience the many studies that contradict the vaccines-autism link. Instead, Oprah read a brief statement from the Centers for Disease Control saying there was no science to prove a connection and that the government was continuing to study the problem. But McCarthy got the last word. “My science is named Evan, and he’s at home. That’s my science.” Oprah might say that McCarthy was just sharing her first-person story and that Oprah wasn’t endorsing her point of view. But by the end of the show, the take-away message for any mother with young kids was pretty clear: be afraid.

Dangerous is right. One wonders why the CDC doesn’t have a public health authority devoted to studying the spread of quackery at the hands of celebrities and promoters of woo such as Oprah. It’s disappointing though, she’s clearly an intelligent person and has the potential to do so much good, but instead chooses to follow the advice of any celebrity at hand who will tell her and her audience what they want to hear.

What’s worse is that while seeking advice from quacks who promote this wishful thinking, at the same time she reinforces that most fundamental aspect of medical woo. When you are sick it isn’t because human bodies are fragile, or they wear out, or are attacked by bacteria and viruses, instead it’s your fault. Sickness isn’t an accident. It’s your failure. You failed to take supplements, or you failed to protect yourself, or you are weak-minded, or you failed spiritually. Of course there are things that we can do to protect ourselves and stay healthy, I wouldn’t suggest some form of health fatalism. But medical quackery takes a healthy attitude of self-protection to an extreme of self-flagellation. It promotes the idea that there is always a way of staying healthy, (take this vitamin!) when in reality sickness and death comes to us all no matter how hard we wish it were otherwise. This wishful thinking and self-doubt is, of course, what is exploited to sell quack remedies.

Oprah fails her audience, not only in her incompetence in judging medical expertise, but also for complicity in this most insidious aspect of quackery, that of blaming the victim.
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What’s sad is that this actually works

The onion, as always, nails it:

Oh, No! It’s Making Well-Reasoned Arguments Backed With Facts! Run!

I…I think it’s finally over. Our reactionary emotional response seems to have stopped it dead in its tracks. If I’m right, all we have to do now is smugly reiterate our half-formed thesis and–oh, no! For the love of God, no! It’s thoughtfully mulling things over!

Run! Run! It’s making reasonable, fact-based arguments!

Quickly! Hide behind self-righteousness! The ad hominem rejoinders–ready the ad hominem rejoinders! Watch out! Dodge the issue at hand! Question its character and keep moving haphazardly from one flawed point to the next!

All together now! Put every bit of secondhand conjecture into it you’ve got!

All is lost. We don’t stand a chance against its relentless onslaught of exhaustive research and immaculate rhetoric. We may as well lie down and–Christ, how it pains me to say it–admit that it’s right. My friends, I would like to take these last few moments of stubborn close-mindedness to say that it’s been an honor to dig myself into this hole with you.

Unless…wait, of course! Why didn’t we think of it before? Volume! Sheer volume! It’s so simple. Quickly now, we don’t have much time! Don’t let it get a word in edgewise! Derisively cut it off mid-sentence! Now, launch the sophomoric personal attacks! Louder, yes, that’s it, louder! Be repetitive, juvenile, and obstinate! It’s working! It’s working!

We’ve done it! It’s walking away and shaking its head in disgust! Huzzah! Finally–defeated with a single three-minute volley of irrelevant, off-topic shouting!

Ironic, really, isn’t it?

Thanks lbcapps