A beautifully told story with colorful characters out of epic tradition, a tight and complex plot, and solid pacing. -- Booklist, starred review of On the Razor's Edge

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Saturday, January 7, 2017

Fake News I

The topic of "Fake News" being much in the news lately, TOF thought he would much amuse himself by noting occasional sightings of the species here and there in the wild. Not being a frequenter of many of the places where these things are said to dwell -- indeed, he has never heard of many of them -- he is forced to rely upon his own sources and upon logical and rational analysis to identify them.

One of the most common kinds of false news is the press conference, or "photo op." These are dutifully reported by the Usual Suspects with faces among the straightest seen in all humanity, and often in the gravest tones. The media serves merely as bulletin boards for the press releases of the special interest groups holding the press conference. Recently, for example, the Democratic Party was shocked, shocked we tell you, to learn that the Republican Party intended to follow through on its promise to dismantle the Affordable [sic] Care Act. The skyrocketing insurance costs in premiums and deductibles consequent to this act was one of the factors leading to the narrow defeat of its perceived heir and champion, Mrs. Clinton, in the recent election, although this has not been much mentioned. So the Democrats in Congress held a photo op announcing their intention to oppose this opposition. So far, so good. This is the normal procedure -- sic et non -- pioneered in the medieval world.

This was their opposition:
One immediately senses the overall ineptness that led the Party to its losses of Congressional seats, state legislatures, governorships, and now the presidency itself. Their sound-bite fails on two levels: the visceral and the rational.

On the visceral level, the casual TV viewer on the evening news -- and this is most viewers -- is left with only the vague impression of Democratic leadership gathered around a poorly-designed sign reading "Make America Sick Again." This is a heck of a motto with which to associate one's party. It is only in the fine print that one sees that they blame the Republicans for doing this; but who reads the fine print in a 15-second sound bite on the evening news? As an ad slogan even a neophyte on Madison Ave. could come up with something ten times better.

On the rational level, the ad's failure is worse. People do not get sick because they lack health insurance. They get sick because they contract diseases or suffer injuries. The lack of insurance affects the ability to pay for the care, but that is a different problem.  In fact, a major reason why many people had foregone insurance in the past was that, being young and healthy, they saw no need for the expense. That did not account for all of the uninsured, but it was a big chunk of them. Nor is it true that Americans were especially sick before the Obama administration determined to subsidize the insurance industry.

 But the News has been sent. The Republicans want "to make America sick again," even if the signage was inept at making the point. Since Republicans do not actually want to do this, the photo op counts as Fake News.


In a discussion of the kerfuffle on another board, a correspondent had this to say:
The alternative to a regulated medical system is either to assume that you can make good health-care choices and bargains on your own, or to assume that your doctors will give you the best and cheapest care out of the goodness of their hearts.
Let's say that we've eliminated the bureaucracy and you come down with typhoid fever, because in the land of the free, no-one is organizing a vaccination program.
You can buy a medical text (although without collective agreement about things like the meaning of words you can't read or speak, but leaving that to the side.) but it'll take a while to determine what you're suffering from, because there are hundreds of possible diseases, and making an accurate diagnosis and determining a valid course of treatment requires years of training.

So you've got to trust doctors because human society is based on specialization. Some people build cars, others cut hair, others spend a decade and a half becoming doctors.
Or rather, they spend a decade and a half becoming doctors because the government doesn't allow them to practice medicine until they've put in that time. Without regulations anyone can hang up a sign and claim to be a doctor; and as they might be better at advertising than they are at medicine, they would rope in lots of patients, while delivering ineffective care.
It's hard to know where to begin with this. The netizen, a Mr. Eichenauer, must be very young since he evidently does not remember America as it was a mere eight years ago, before the ACA. He does not realize that vaccines were being developed by private industry long ago and programs of vaccination were being implemented even in the 19th century. Nor was it the government that declared how doctors might become doctors. Unique in the world, the Latin West had established medical schools, medical standards, medical societies, and medical practices in the middle ages, all without government tutelage. Now, it might be argued that the science of medicine had a ways to go. It still does. But that is a different pair of boots. Why he thinks that government bureaucrats would be any wiser at making medical decisions than doctors is a mystery; and how the ACA is to accomplish this is an even bigger one. It is only a law regarding the payment for insurance.


  1. I'm not sure that your statement, "The skyrocketing insurance costs in premiums and deductibles consequent to this act was one of the factors leading to the narrow defeat of its perceived heir and champion, Mrs. Clinton, in the recent election, although this has not been much mentioned," is quite right. I believe I have read that the Congressional Budget Office has estimated that the increases under the ACA were less than would have been the case without it.

    1. I love it when the green eyeshades report as if it were fact what their models say would have happened in an alternate universe. I think this should count as another species of fake news. Besides which, folks who have seen their deductibles soar from around one kilobuck to four kilobucks are not likely to remain staunch defenders when told that they might otherwise have soared to five. They only know what they have actually seen.

      I also think that the outputs of models is a third species of fake news, but we don't know where the figures on insurance coverage have come from: projections from computer models or actual nose-counts. I do know that figures on illegal immigration come from computer models not from tallying actual bodies. One year, the number of illegals from Ireland was reported as a negative number!

    2. One must assume the ends are known, because decisions are made, in the modern world, by choosing between ends. The Pragmatists, starting with Pierce, want to make the ends justify the means, so they habitually assume they know the outcomes and are deciding on them. A Pragmatist of the John Dewey species would be lost at sea if one were to demand moral decisions be made on principles, because, practically, the ends are unknown in any but very trivial cases. This is a Forbidden Thought.

      Thus, the "Trolley Problem" is used as an example of moral decision making: a fantastic set of assumptions where all the crucial pieces are assumed to be known with certainty so that only the ends - 1 guy dies or 5 guys die - is considered relevant.

      A real example of a moral decision might be: You promised to love, honor, serve and be faithful to your wife, but this morning you found out you didn't like her anymore. What do you do?

      No ends in sight. But that sort of question wouldn't be very popular, less so the answer. So we assume, instead, that we know the ends *for sure* so that we can be Good People and chose Wonderful Healthcare for Everybody at Very Little Cost (WHEVLC, let's say). And then make up whatever numbers and stories we need to help us feel good about it. In such a moral world, those who don't like the ACA don't want WHEVLC = what evil, evil people! The idea that there's a difference between choosing ACA and getting WHEVLC cannot be entertained.

  2. My brain faltered after Mr. Eichenaur's first paragraph. The false equivalencies and false dichotomy fried my synapses.

    Even allowing for the false dichotomy, there's an explicit doubt proposed by the writer that one can make sound judgments regarding one's health and another that doctors function without altruism or concern for their patients.

    Thus, it is a false dichotomy built on two false propositions, establishing it as a doubly false fallacy.

    I know that it is unfair to use myself as example (being a former MIT pre-med molecular biology student who spent nearly a quarter-of-a-century helping research scientists untangle chromatographic analyses), but I have frequently diagnosed myself that has induced a skeptical response from my attending physicians only to be confirmed by those physicians after tests; however, I believe that an ordinarily intelligent person attentive to one's own body for a decent portion of one's life may have superior insight into one's medical condition with the benefit of access to reputable online resources.

    Mr. Eichenaur is a snob who distrusts the Common Man.


  3. Another interesting assumption that this Eichenauer makes is that our current licensed set of doctors deliver 'effective' care. Opiod addiction seems less than effective care to me. Giving young people hormones and mutilating them in order to alleviate their 'symptoms' also seems counterproductive to caring for them as well. These sorts of things seem like the major function of doctors for people aged 2-50 to me, but I don't have any cool stats like TOF to reinforce my observations.

  4. There is a proper state involvement in medicine, but it's just putting teeth in the decisions of the private medical association. When the doctors get together and declare one of their number incompetent and unqualified, and therefore no longer numbered among the doctors, the state charges the one so expelled with "practicing medicine without a license" if they try to keep acting as one.

  5. I'd have to say these guys have nailed it:

  6. This comment has been removed by a blog administrator.


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