Some people have too much disposable income

There is a beautiful beach on Grace Bay on the island of Providenciales in Turks and Caicos, British West Indies.

If you want to visit Grace Bay next Christmas and stay in the oceanfront penthouse of the newest resort, you can do so for a mere $120,000. (That's $10,000 per night room charge plus $2000 per night for tax and service charges, all for the minimum required stay of ten nights.)

But lest you think it's not worth the price, your $120,000 does include continental breakfasts.

By way of comparison, in lieu of staying in the penthouse, you could buy any of the following:

• One three-bedroom house in Schenectady, or
  
• Six new 2005 Ford Mustang deluxe coupes, or
  
• 1212 new 512-MB iPod shuffles, or
• 167 new Dell Inspiron 6000 notebook computers, or
  
• 2.6 median incomes in 2003 for a New Mexico family of four.
  

Columbia University whitewash

You call this a whitewash?

Picture: Norman Rockwell


Now this is a whitewash, Ivy League style.

A-Rod for Bush

A reason to like A-Rod--he supports our president:

Contributor:
RODRIGUEZ, ALEXANDER E MR.
STOCKTON, CA 95208
NEW YORK YANKEES/THIRD BASEMAN

Candidate:
BUSH, GEORGE W (R)
President
BUSH-CHENEY '04 (PRIMARY) INC

Amount:
$2,000

Date:
08/12/03

(Not sure why this record has A-Rod working as a Yankess third baseman in August of '03, though.)

Biased academia

I don't know why I continue to be surprised at the level of the leftward tilt in academia. From today's New York Sun:

For those who need some kind of backup for what they know in their gut about colleges, feature a major new academic study showing that 72% of those teaching at American universities and colleges identify themselves as liberal and only 15% identify themselves as conservative. A dispatch by Howard Kurtz, on Page One of today's New York Sun, has the particulars. At the most elite schools, according to the study, the breakdown on the faculty is 87% liberal and 15% conservative. Mr. Kurtz points out that that is far out of step with the general population, which identifies as roughly 33% conservative and 18% liberal.

Positive signs from a poll of Iraqis

In a post entitled "Even In Najaf, Iraqis Reject Theocracy," PowerLine examines recent Iraqi poll results. The conclusion:

This is just one more item in a rapidly-expanding body of evidence that the overwhelming majority of Iraqis reject fanaticism and sectarian conflict.

Is Derek Jeter blocking Ari Fleischer from reaching his professional goals?

Fleischer's response to an interviewer asking what he wanted to do growing up:

I wanted to be shortstop for the Yankees. I still do, I haven’t given up that one yet.

Cutting spending

The Heritage Foundation's Brian M. Riedl proposes "The Five-Step Solution: Cutting the Budget Deficit in Half by 2009 While Extending the Tax Cuts and Rebuilding Iraq and Afghanistan":

1. Freezing non-defense discretion­ary spending through 2009,
2. Capping farm subsidies for wealthy farmers,
3. Reducing the Medicaid growth rate to 5 percent,
4. Replacing the Medicare drug bene­fit with the drug card, and
5. Reducing entitlement spending by 3 per­cent by targeting waste, fraud, and abuse.

Sounds good to me.

(Link via Andrew Sullivan.)

General Odom dissents

William Odom, lt gen, U.S. Army, retired, is a man whose point of view on international military affairs I have long respected.

I briefly encountered him in graduate school a decade and a half ago and found him so personable and approachable as to belie his stature as a serious scholar and practitioner of international diplomacy. I can recall a piece he wrote in the early 1990s making a compelling case for what has now become conventional wisdom--that President Reagan was responsible for the downfall of the Soviet Union.

Yet throughout 2004 Odom was a repeated and harsh critic of the invasion of Iraq. Following are some representative excerpts from Odom's work last year:

• A May 2004 interview with the Council on Foreign Relations:

  It was not in our interest to enter Iraq in the first place. It was, however, in the interest of Osama bin Laden for us to destroy a secular Arab leader; it was very much in the interest of the Iranians...

• A piece in the summer 2004 National Interest starts with this:

  The United States should begin a strategic withdrawal from Iraq now because it was never in the interest of the United States to invade that country in the first place. The mood in the United States before the war, created by the Bush Administration and supported by both parties in Congress, made a serious public discussion of the prudence of the invasion impossible. One year later, however, such an examination is difficult to avoid because the president and his aides assured us that the Iraqis themselves would greet U.S. forces as liberators and form a liberal democratic regime friendly to the United States in a very short time—months, not years. Clearly that has not happened and will not happen soon not in years or even decades.

  And it ends with this:

  Our military investment in Iraq is what economists call a “sunk cost.” We cannot retrieve it by investing more there, no matter how much. Thus, to say that we cannot afford to fail is a costly illusion. We ensured failure when we decided to invade. Our choices now are to get out of Iraq early, regroup with our allies, and try to stabilize the region, or to continue down the present path in Iraq and risk the dissolution of the American-led international order.

• A fall 2004 Constitutional Democracy Colloquium in Dissent ends thusly:

  How do we escape this awful predicament? Useful first steps would be to remove the barriers in front of the White House and the Capitol, encourage public confidence instead of hysteria about terrorism, rescind the Patriot Act, and withdraw U.S. forces from Iraq so more effort can be directed against al Qaeda.

He was consistent and firm in his criticism of US policy.

I have not read anything Odom has written on the topic since the elections in Iraq. I would like to see whether his thinking has changed.

Playgirl plays politics

• Press release, March 8:

  PLAYGIRL Editor-in-Chief Outs Herself as Republican!

• Drudge, March 21:

  'PLAYGIRL' EDITOR FIRED AFTER OUTING SELF AS REPUBLICAN

• Betsy's Page, March 21:

  I guess liberals don't really mean what they say about hiring more women as editors and writers. If a woman is a Republican, they are not interested in hiring her.

  Indeed.

Castro: What me, a plunderer?

Fidel Castro comments on being included on the Forbes rich list:

"Once again, they have committed the infamy of speaking about Castro's fortune, placing me almost above the queen of England," Castro said in a speech to top officials of Cuba's ruling Communist Party, military and police.

"Do they think I am (former Zairian President) Mobutu (Sese Seko) or one of the many millionaires, those thieves and plunderers...?"

Well, yeah.

(Via Instapundit.)

P.J. O'Rourke on mass transit

P.J. O'Rourke looks at the new transportation bill as only he can:

We don't want minimum-wage workers driving BMW X-5s. That's unfair. They're already poor, and now they're enemies of the environment?

And he throws in a bit of wonkery:

There are just two problems with mass transit. Nobody uses it, and it costs like hell. Only 4% of Americans take public transportation to work. Even in cities they don't do it. Less than 25% of commuters in the New York metropolitan area use public transportation. Elsewhere it's far less--9.5% in San Francisco-Oakland-San Jose, 1.8% in Dallas-Fort Worth. As for total travel in urban parts of America--all the comings and goings for work, school, shopping, etc.--1.7 % of those trips are made on mass transit.

Then there is the cost, which is--obviously--$52 billion. Less obviously, there's all the money spent locally keeping local mass transit systems operating. The Heritage Foundation says, "There isn't a single light rail transit system in America in which fares paid by the passengers cover the cost of their own rides." Heritage cites the Minneapolis "Hiawatha" light rail line, soon to be completed with $107 million from the transportation bill. Heritage estimates that the total expense for each ride on the Hiawatha will be $19. Commuting to work will cost $8,550 a year. If the commuter is earning minimum wage, this leaves about $1,000 a year for food, shelter and clothing. Or, if the city picks up the tab, it could have leased a BMW X-5 SUV for the commuter at about the same price.

America's daring

Victor Davis Hanson:

America's daring, not its support for the familiar — but ultimately unstable and corrupt — status quo, explains why less than three years after September 11, the Middle East is a world away from where it was on the first day of the war. And that is a very good thing indeed.

(Hat tip: Brian J. Dunn.)

John Kerry SF-180 clock

You might notice the new John Kerry SF-180 clock on the top of the right column of this blog. (Hey, it's never too soon to prepare for 2008.) To get one for your web page, visit PoliPundit. (Hat tip: Mickey Kaus.)

By way of background, the SF-180 is a form which, if Kerry were to sign it, would make his military records available for public perusal. For further context, here are two recent media appearances where Kerry discussed signing the form:

• Here is an excerpt from the transcript of John Kerry's January 30 appearance on NBC News' Meet the Press" [ellipses in original]:

  MR. RUSSERT: Many people who've been criticizing you have said: Senator, if you would just do one thing and that is sign Form 180, which would allow historians and journalists complete access to all your military records. Thus far, you have gotten the records, released them through your campaign. They say you should not be the filter. Sign Form 180 and let the historians...
  
  SEN. KERRY: I'd be happy to put the records out. We put all the records out that I had been sent by the military. Then at the last moment, they sent some more stuff, which had some things that weren't even relevant to the record. So when we get--I'm going to sit down with them and make sure that they are clear and I am clear as to what is in the record and what isn't in the record and we'll put it out. I have no problem with that.
  
  MR. RUSSERT: Would you sign Form 180?
  
  SEN. KERRY: But everything, Tim...
  
  MR. RUSSERT: Would you sign Form 180?
  
  SEN. KERRY: Yes, I will.

• Here is NewsMax's February 7 transcript of Kerry's appearance on the "Imus in the Morning" radio show [ellipses in original]:

  IMUS: You also told ["Meet the Press" host] Tim [Russert] that you would sign Form 180 releasing all of your military records. Have you done that?
  
  KERRY: Yeah. We're gonna do that. Absolutely, I will. But listen, I also think ...
  
  IMUS: When are you going to do that?
  
  KERRY: As soon as I get, as required by the military, precisely ...
  
  IMUS: Why don't you do it today?
  
  KERRY; Because I have a stack of different material they sent me. Every time they send me something I want to know what they sent me. I'll get it done. ...
  
  IMUS: By noon today?
  
  KERRY: No. But shortly.
  
  [Kerry continues by suggesting that those who have challenged him should release their records as well.]

(MSNBC link via PoliPunidit; NewsMax link via Freeper Kaslin.)

Condi's style

Betsy Newmark sums up an LA Times article on Condoleezza Rice's first weeks as Secretary of State:

Condi has hit the ground running and the Powell holdouts are upset.

Some of the article's themes:

• Rice can be a skillful fence mender.
• Rice can be a blunt and effective critic of unacceptable policies abroad.
• Rice's style is a marked contrast from that of Colin Powell whose words were more "nuanced" and who stressed public harmony.
• Rice and President Bush are in strong agreement on the issues.
• Powell loyalists think this is a problem:

  And some former department officials said it would be harmful if the new similarity in thinking between top State and White House officials meant that Bush heard fewer opinions on complex foreign policy issues in internal meetings, as he did when Powell was secretary.

Is it not appropriate that Bush surround himself with thoughtful advisors who share his views on major world issues?

TV competition

Heh: An ABC producer is apprehended by Atlanta police when he tries to disrupt an NBC broadcast.

Shocker: media harder on Bush than Kerry during election

Reuters reports,

U.S. media coverage of last year's election was three times more likely to be negative toward President Bush than Democratic challenger John Kerry, according to a study released Monday.

The annual report by a press watchdog that is affiliated with Columbia University Graduate School of Journalism said that 36 percent of stories about Bush were negative compared to 12 percent about Kerry, a Massachusetts senator.

Only 20 percent were positive toward Bush compared to 30 percent of stories about Kerry that were positive, according to the report by the Project for Excellence in Journalism.

The study looked at 16 newspapers of varying size across the country, four nightly newscasts, three network morning news shows, nine cable programs and nine Web sites through the course of 2004.

(Via Taranto.)

A great champion retires: "We are in a position to checkmate tyranny"

Garry Kasparov, the greatest chess player of my generation--perhaps of any generation--today announced his retirement. In a column entitled "The Great Game," Kasparov wrote more on the state of the world than on his own career:

This is a time for ambition. Victory in Ukraine and the reshaping of the Middle East are only the latest symbols of how democracy is dominant in the world today economically, militarily, and morally. We must leverage this ascendancy to set a global agenda and end the era of complacency and concession that is embodied by the United Nations. In politics as in chess, or in the military or in business, when you have the advantage you must press it quickly -- or lose it. For the first time in history, we are in a position to checkmate tyranny. Momentum is largely on the side of democracy.

...I am excited by this new strategic battle, to be played out on a larger board. At the same time, I realize that this is no game, but a very real struggle for the future of my country. I am preparing for the fight of my life. When I look at my eight-year-old son, I know the stakes of this battle could not be higher...

My retirement from chess... is about opposing our authoritarian regime and bringing positive change. There are millions like me in Russia who want a free press, rule of law and fair elections. My new job is to fight for those people and to fight for those things.

That's a retirement speech. (Well, okay, a retirement column. But the point stands.)

An America hater finds it hard to kick the habit

In June 2004, at the time of the handover in Iraq, columnist Yasmin Alibhai-Brown publicly struggled with her anti-American hatred. She wrote in the London Evening Standard (as quoted by Norman Geras),

The past months have been challenging for us in the anti-war camp. I am ashamed to admit that there have been times when I wanted more chaos, more shocks, more disorder to teach our side a lesson. On Monday I found myself again hoping that this handover proves a failure because it has been orchestrated by the Americans. The decent people of Iraq need optimism now, not my distasteful ill-wishes for the only hope they have for a future.

Alibhai-Brown is back at it again, this time with a column in the Independent entitled This domino theory is a dangerous delusion. (The link, which comes via The Daily Ablution, is free but may expire within a day; The Daily Ablution also gives a permanent link to the article, but unfortunately it costs money.) This time, however, Alhibai Brown does not profess that recent events have been challenging to the anti-war folks; nor does she admit to rooting against freedom in Iraq. Rather, she writes with strong doses of bitterness and sarcasm:

So now we know, or should know, say the patriotic acolytes who supported the Blair and Bush crusade, who excused, covered up, denied the blatant lies. This war on Iraq has apparently heralded the light of freedom and a surge of democratic will. Tyranny and state oppression will soon be defunct in the old lands of Abraham and beyond.

Those of us who still won't dance in the streets with pride and joy that we "liberated" Iraq are now asked to admit, concede, agree or reluctantly surrender to the view that out of this war is emerging a brave new world. Blair calls it "the ripple effect" and, like Bush, he is now even more confirmed in his belief that he is one of the two chosen new world prophets, who suffers for the good he has been called upon to do.

So we must thank him and bow to his wisdom and tactics. For it is because we bombed the hell out of Iraq (just don't ask how many civilian casualties there have been as a result of our actions) that the multitudes in Lebanon have started up a clamour for a more independent and democratic nation. They must have said to each other in the hookah cafés, "Great guys, Bush and Blair. See, Allah smiles on Iraqis. We are so unlucky that they never came here with their big weapons. Poor us, we must do it for ourselves."

The Daily Ablution's Scott Burgess, a regular critic of the left-wing bias of the British press, picks apart Alhibai Brown's recent effort here.

"But what are the Democrats thinking"

George Will thinks that some folks are on the wrong side of the Social Security debate:

Republicans of the "starve the beast" inclination -- those who aim to slow government's activism by reducing government's revenue -- might relish the thought of Social Security's rendezvous with 2011. At that tipping point, the Social Security surplus begins to shrink.

Today the government is partially funded by that surplus of Social Security tax revenue over outlays.... But between 2011 and 2016, Social Security outlays will exceed revenue by $32 billion, and the sums will rapidly increase during the cascading retirements of baby boomers. These sums must result in increased borrowing, or cuts of other government activities, or both.

"Starve the beast" Republicans can live with this. But what are Democrats thinking?

(Hat tip: Andrew Sullivan.)

"Bolton’s deeper sin is to believe that democracy matters"

Andrew Sullivan on the nomination of John Bolton:

Bolton’s real sin is to see the UN for what it is: an assembly of representatives of all world governments — some of which are democratic, some autocratic, and some of which are outright kleptomaniac, genocidal dictators.

This body can sometimes be effective in limited ways, but more often it defends the international status quo and sustains corruption.

Bolton’s deeper sin is to believe that democracy matters, that democratic regimes are more easily dealt with than non-democratic regimes and that institutions — such as the UN — that make no distinction between them have a serious credibility problem.

"No qualms about calling America the best hope of liberty"

Not every academic disdains the Bush Doctrine. The following is from the Publishers Weekly review of John Lewis Gaddis's Surprise, Security, and the American Experience:

The post–September 11 strategy of the Bush administration is often described as a radical departure from U.S. policy. Gaddis, one of America's leading scholars of foreign policy and international relations, provocatively demonstrates that, to the contrary, the principles of preemption, unilateralism and hegemony go back to the earliest days of the republic. Gaddis resurrects the 18th-century idea of an "empire of liberty": whether as a universal principle or in an American context, liberty could flourish only in an empire that provided safety. The British burning of Washington in 1814 highlighted American vulnerability to certain forms of surprise attack. In consequence, Gaddis recounts, John Quincy Adams developed a strategy of seeking control over the North American continent with minimal coercion, but through preemptive action where necessary. The attack on Pearl Harbor extended the concept to global dimensions, eventually expanding the U.S. sphere of influence exponentially. The events of September 11 extended the concept of preemptive action even at the expense of sovereignty when terrorism is involved. Gaddis describes this latest expansion of American power in response to surprise attack as a volatile mixture of prudence and arrogance. But instead of the usual caveats, he recommends the U.S. continue on an interventionist course, and he has no qualms about calling America the best hope of liberty in the eyes of most of the earth's inhabitants. The ability to question all values that is liberty's essence depends, he finds, on defending certain values—unilaterally and preemptively when necessary, but not randomly. This compact, provocative history of an idea-in-action has the potential to alter the U.S.'s collective self-image.

Need a wedding dress?

Beautiful dress, beautiful model:


(And the dress is for sale. More pics here.)

Annan courts Hezbollah

AP headline: "U.N. Must Accept Hezbollah, Annan Says."

Annan's rationale is a textbook example of a politically correct, ethically bankrupt concept of moral equivalence:

Annan said the world needs to accept that in every society different groups may hold different views.

Let's compare Annan's views on known terror groups with those of President Bush, as expressed in an excerpt from his recent address at the National Defense University at Fort McNair:

Like an earlier generation, America is pursuing a clear strategy with our allies to achieve victory. Our immediate strategy is to eliminate terrorist threats abroad, so we do not have to face them here at home. The theory here is straightforward: terrorists are less likely to endanger our security if they are worried about their own security. When terrorists spend their days struggling to avoid death or capture, they are less capable of arming and training to commit new attacks. We will keep the terrorists on the run, until they have nowhere left to hide.

The difference between Bush's sentiments and Annan's is telling. It is telling of the leadership each man provides; but more important, it is telling of the effectiveness of the two entities they lead. While Bush's US continues its emergence as the global leader in the defense of freedom and opposition to terror, Annan's UN slouches toward irrelevance.

Update: In related news, see "Kofi Annan Takes Credit for Iraq Vote."

Technical problems

Blogger, the website I use to write this blog, was having technical difficulties today. As such I was unable to post several times when I wanted, and one item posted several times (since corrected).

Sorry about that. I guess I get what I pay for with Blogger (a free service).

The next Democratic candidate

As various commentators have noted, it's been a long time since any Democrat who was not a southern governor was elected president. (Yes, the early 60s were a long time ago.)

In particular, liberal northeastern Democratic nominees have not fared well against Republicans for president.

So, will the Democrats heed history and choose a southern Governor? I suspect Phil Bredesen or Mark Warner.

In a piece called "The Next Bubba" in the Wall Street Journal last month, Glenn Reynolds proposed that Tennessee Governor Phil Bredesen should be given serious consideration, especially given his ability to reach across party lines. In fact, Reynolds sees Bredesen's biggest obstacle to be fellow Democrats:

Gov. Bredesen's success at reaching out to the opposition is undeniable. He's probably the most popular governor in Tennessee history, and there are even people around the state who call themselves "Republicans for Bredesen" and plan on backing him, across party lines, if he runs for president in 2008. His biggest problems, though, may come from within his own party.

George Will has suggested Virginia Governor Mark Warner. (Get an early start on your bumper stickers here.) Will points out Warner's willingness occasionally to break with Democratic orthodoxy, something Warner laments that John Kerry was unwilling to do.

In May 2004, I made the (not very original) prognostication that Hillary Clinton would get the Democratic nod in 2008. (At the same time, I correctly predicted W's re-election and wrote that Hillary would win the presidency in '08. Let's hope the former prediction proves more accurate than the latter.) In a recent article in the Sunday Times of London, Andrew Sullivan claims that the nomination is Hillary's to lose. He is particularly impressed with her repositioning as a centrist hawk who is gaining popularity in her adopted state of New York. Perhaps just as importantly, her disapproval numbers have decreased substantively:

Talk to Democrats in the capital city and you’ll find an astonishing consensus that the Democratic nomination in 2008 is now Hillary’s to lose.

How on earth did this come about? The answer is, I think, that Senator Clinton has finally escaped one of the critical drags on her national reputation. What many people disliked about her was what they perceived as her unreconstructed liberal politics and her use of her marriage to gain and wield political power.

But in 2005 Senator Clinton has recast herself in the public mind as a centrist and she has won election in her own right. That changes everything. Or perhaps more accurately it changes a lot.

Stay tuned.

Dan Rather's retirement: a cartoon round-up

Slate has a round-up of cartoons about Dan Rather's retirement here, here, here, here, here and here.

Another Donnie Brasco

AP:

An undercover FBI agent posing as a wiseguy infiltrated the Gambino organized crime family for two years with an act so convincing he was considered for membership, authorities said today.

"Had we left him out on the street much longer, the Gambino family ranks would actually have increased by one," Pasquale D'Amuro, head of the FBI's New York office, said at a Manhattan news conference announcing more than 30 arrests in a racketeering investigation.

Empirical evidence on school choice

Andrew Coulson of The Gantelope has assembled "A Quick Guide to the Scholarly Literature on School Choice."

He concludes that the empirical evidence favors school choice, but that the opponents of choice are doing a better job getting the word out:

During a recent round of visits with print journalists, I spoke to a newspaper editor who told me that she receives between five and ten times as many press releases attacking school choice as she receives in support of it. In particular, she is regularly apprised of studies published or funded by teachers unions, but was largely unaware of any research that might reflect favorably on parental choice and competition among schools.

In reality, the vast majority of sound empirical studies comparing competitive education markets to state-run school monopolies give the edge to markets. A few find no significant differences, and only the tiniest percentage find any sort of advantage to the state-run schools. The consensus of the valid empirical research is clear: Competitive markets of minimally regulated nongovernment schools regularly outperform state school monopolies. They do this, moreover, both at the level of individual student effects and broader social outcomes.

Canada's Paul Martin (who?) and Syria's Bashar al-Assad

Mark Steyn writes about the pressure on Syria's Bashar al-Assad in the "new Middle East." Canada's prime minister does not come out looking too good:

It's one thing for Bush to demand Syria gets out of Lebanon, but what's with Crown Prince Abdullah piling on? Not to mention Jacques Chirac, hitherto every dictator's best friend...

OK, that's enough Domino theory. The point is Assad is suddenly the loneliest guy in the room. He's the eye doctor whose eye no one wants to catch. The only world leader who didn't get the memo was Paul Martin. Who? Well, OK, he's not exactly a world leader, but he is prime minister of Canada, and asked the other day about the withdrawal of Syrian troops from Lebanon he replied thus: "It's clear if the Syrians are in Lebanon, it's because peace has to be maintained." I'm sure Assad is grateful for the endorsement. That and a dime'll get you a cup of coffee in Winnipeg.

Kensico Dam: masculine icon

Driving north on the Bronx River Parkway in Westchester County, New York, a driver comes upon a most dramatic sight, the view of Kensico Dam across the 98-acre Kensico Dam Plaza. The dam has loomed over Valhalla for the past 88 years. It is a most impressive sight indeed.

Here are some views:

Photo: NYC Dept of Environmental Protection


Photo: Westchester County Dept of Parks, Recreation and Conservation

Beautiful, no? Or perhaps I should say handsome. It seems the authorities have recently been determined to stress the masculinity of the dam. And indeed, with that much grey-brown stone rising out of the land to great heights, I suppose it is a fairly masculine edifice.

How have the authorities chosen to emphasize the male nature of the dam?

As a driver approaches the dam from the south, he comes across a large lighted sign proclaiming,

TESTTES

Forgiving the signmakers their mild misspelling, can there be any firmer announcement of the masculinity of the dam?

Here is a photo I snapped of the sign the evening of March 6:

Photo: David M

(Note the green sign just to the right of the TESTTES sign. Its second line reads, "Kensico Plaza.")

Here is a slightly enlarged shot of the TESTTES sign:


Photo: David M

Removes any doubt as to the gender of the dam, no?

Physicians push back against public quality reporting

Physicians are pushing back against the trend toward public reporting of quality measures. This comes from the current issue of JAMA (Journal of the American Medical Association):

The Unintended Consequences of Publicly Reporting Quality Information
Rachel M. Werner, MD, PhD; David A. Asch, MD, MBA

JAMA. 2005;293:1239-1244.

Health care report cards publicly report information about physician, hospital, and health plan quality in an attempt to improve that quality. Reporting quality information publicly is presumed to motivate quality improvement through 2 main mechanisms. First, public quality information allows patients, referring physicians, and health care purchasers to preferentially select high-quality physicians. Second, public report cards may motivate physicians to compete on quality and, by providing feedback and by identifying areas for quality improvement initiatives, help physicians to do so. Despite these plausible mechanisms of quality improvement, the value of publicly reporting quality information is largely undemonstrated and public reporting may have unintended and negative consequences on health care. These unintended consequences include causing physicians to avoid sick patients in an attempt to improve their quality ranking, encouraging physicians to achieve "target rates" for health care interventions even when it may be inappropriate among some patients, and discounting patient preferences and clinical judgment. Public reporting of quality information promotes a spirit of openness that may be valuable for enhancing trust of the health professions, but its ability to improve health remains undemonstrated, and public reporting may inadvertently reduce, rather than improve, quality. Given these limitations, it may be necessary to reassess the role of public quality reporting in quality improvement.

For what it is worth, I think the trend toward public reporting of quality data is a good one. It begins to take medical care out of its black box.

The trick is to measure the right statistics in the right way. For example, the motivation (cited above) for physicians to avoid sick patients should disappear if the data are appropriately risk adjusted. It will take years--or decades--of refinement before we have a fully robust measurement system; but that is not sufficient reason to shy away from measurement and reporting altogether.

Price controls: the government catches on

Headline, Pharmaceutical Business Strategies magazine:

U.S. government finds that nations' pharma price controls hinder innovation

Is the entire NHL for sale?

According to today's Toronto Star the NHL may be for sale:

A powerful Wall Street buyout firm and an upstart sports advisory company have made a dramatic joint proposal to buy all of the NHL's 30 teams for as much as $3.5 billion (U.S.).

Bain Capital Partners LLC and Game Plan International, both based in Boston, tabled the offer in a 30-minute presentation to NHL owners on Tuesday in New York, three sources told the Toronto Star.

The companies were invited to make their pitch by NHL commissioner Gary Bettman.

"That I was being a bigot never occurred to me"

Self-proclaimed 9/11 Republican Cinnamon Stillwell opines on her own one-time anti-Republican bigotry:

I wrote off all Republicans as ignorant, intolerant yahoos. It didn't matter that I knew none personally; it was simply de rigueur to look down on such people. The fact that I was being a bigot never occurred to me, because I was certain that I inhabited the moral high ground.

See related posts here and here.

(Hat tip: Newmark's Door.)

Inside blogging

Just for the heck of it, I googled (lefty blogger) Oliver Willis, and the first hits are all mockeries of Willis, some of them quite amusing.

First on the list is INDC Journal's Glimpse Into Oliver Willis's Future.

The Google results are here.

What Became of the CIA?

OpinionJournal reprints Gabriel Schoenfeld's piece from the March issue of Commentary. Schoenfeld's conclusion:

In this war, intelligence is the most important front--which means that fixing the CIA or, if it cannot be fixed, replacing it with something different and better, remains the government's most pressing task. Unfortunately, grafting a new layer of bureaucracy on top of what exists, as Congress has just done, does not even begin to grapple with the real weaknesses of the present system.

This just in: Major gathering places are potential terror targets

Memo to the New York television news crews: Places where lots of people gather in major cities are potential terrorism targets.

Walked into Grand Central Station (or Grand Central Terminal as it is officially known) today around 3 p.m. and had to weave through news trucks from TV channels 2, 4 and 7--the local New York affiliates of CBS, NBC and ABC respectively. Just inside the station entrance was another news crew from, I believe, Univision channel 41 (a Spanish language NY station).

What was all the excitement about?

Apparently a Madrid bombing suspect had sketches on his hard drive of Grand Central Station. And apparently the authorities have known about the sketches for months.

And so the local TV news has a scoop that Grand Central Station is a potential terrorism target. Is it possible that the New York TV news crews were the only ones who did not already know this?

Or have we already forgotten that there are people out there whose goal is to murder as many Americans as they can, however they can?

Q & A with David M

What’s your family situation?
I am a husband to my wife and a dad to my three young kids.

Where do you live?
In the suburbs of New York.

Have you always lived in the New York area?
No. I have lived in (alphabetically) France, Japan, the Netherlands, Switzerland and the U.S.; but mostly the U.S. I’ve lived or spent substantive time in Alabama, Arkansas, Connecticut, Georgia, New Jersey, New York, Tennessee and Wisconsin; but mostly New York. My roots for the past several generations are in New York and Tennessee. Before that, mostly Germany with some England and a bit of Ireland for good measure.

That’s a lot of countries. How are your language skills?
My English is practically fluent.

Are you a fourth generation Jewish American Republican?
Yes, I am a fourth generation Jewish American Republican. What an odd question.

What do you do for a living?
I run a small management consulting business for healthcare organizations. I also analyze healthcare organizations for investors.

What about sports?
My sports career peaked in high school. Or perhaps it was when I captained my class to a third-grade newcombe team victory.

What are your musical abilities?
I cannot carry a tune. But that does not stop me from trying. One score and seven years ago I gave the sax a shot. Wasn’t very successful. In recent years I’ve listened to a lot of Raffi. And I help out a music education non-profit, but not as much as I should.

I can whistle by cupping my two hands into a ball and blowing in through the thumbs. I cannot whistle by sticking two fingers into the sides of my mouth. Nor can I raise one eyebrow at a time.

Do you have any hidden talents?
I am adept at flipping a canoe upside-down onto my shoulders.

Anything else you like doing?
Trying to solve cryptic crossword puzzles. At times I’ll zero in on a random word I see in a newspaper and try in my head to come up with a creative cryptic definition for the word.

Why do you blog?
I’ve given various people various reasons, each of which I suppose has some element of truth:

• Procrastination
• Therapy for the writer, since there are no readers
• An outlet for my ranting so that my wife doesn’t need to suffer through it
• Vanity
• At times I’ve got something interesting to say.

Have you ever picked up packages in the Wanegan at gabbercom?
Yes. Indeed, I have. What an odd question, again.

Who were the first bloggers you started reading regularly?
Andrew Sullivan, Glenn Reynolds, Mindles Dreck.

A writer at the Nashville Scene's Pith in the Wind has linked via his name to this blog. Is he you?
No. But he tells me he is a regular reader.

Do you know him?
Know him? I've had lunch with him.

Anything else we should know about you?
If you have any questions, e-mail me. Any e-mail sent to this address will be assumed to be for publication unless you specify otherwise.

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Note: This Q & A entry was written in late 2004 (despite its date stamp) and is occasionally updated without notice.

To return to David M’s main blog, click here.