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Wednesday, November 30, 2005

1918 & Today

A review of the 1918 influenza virus compared to H5N1.
A team at the CDC recreated the 1918 virus and tested it in mice for pathogenicity. Compared with contemporary human flu viruses, the 1918 virus produced nearly 40,000 times more viral particles in lung tissue. It caused severe bronchiolitis and alveolitis, pulmonary edema, and alveolar hemorrhage — just as it had in human lungs in 1918

The 1918 virus contains several amino acid changes that also are present in the current highly pathogenic H5N1 avian virus that has killed humans in the past 8 years.

I'd like to see the models of what an easily transmittable H5N1 would do in the industrialized world. I'm certainly completely off the track here, but how bad would the 1918 epidemic be with today's public health knowledge and treatment options?

Of course there's a great deal more of the world to be concerned about other than America and Western Europe.

AIDS Tax

A think tank in South Africa is proposing an AIDS tax to help combat the 11% infection rate in the country. A survey proposes that upwards of half of South Africa's affluent would be willing to pay a tax to go towards helping stem the epidemic.

Tuesday, November 29, 2005

Others Get Paid To Say This Stuff?

I have this gut feeling. It's deep. It is not that USC will lose on Saturday to cross town rival UCLA. It is more like it might happen, but not quite. Inexplicable as it may be, the feeling really is that if we're going to lose its going to be to UCLA (no offense to Texas).

I've had it for weeks; since that night USC beat Notre Dame. My vision didn't include a scare with Fresno St. but here we are having not pulled a Penn St. or LSU.

But to hear others speculate on it, against a team that needed a 21 point rally in the last 8 minutes to beat un-bowl bound Stanford. Who lost to Arizona. Arizona. Arrrrrrrizonnnnnna. Who can't even spell defense. Well, those type of claims are only legit when they come from members of the USC family.

I'm just rambling. However, my plea to sports writers, if there's no storyline don't fabricate one.

*EDIT*
USC 66, UCLA 19 (2 touchdowns in garbage time)

Prediction: USC 45, Texas 28

*EDIT EDIT*
ESPN's SportsCenter just had NCAA 06 simulate the Rose Bowl with decidely dissimiliar results to my simulation but very close to my prediction.

USC 45, Texas 27

I Will Never Stop...

...marveling at the human body.

The kidneys, like just about everything else in the body, really are incredible.
It is incomprehensible how something as really complex and yet eloquent as this could evolve. That's not to say it's fun to flip endlessly through histology slides of them...

Monday, November 28, 2005

That's Gotta Hurt

Pretty funny.

Need a good doctor? Certainly for this problem...

Put The Pieces Together

It is always fun when, in the same day, you study the abdominal venous system, learn about the consequences of portal hypertension, and then stumble across a recent article like this. Or maybe I'm just a dork.

Beta blockers help prevent hemorrhage from existing esophageal varices but don't apparently provide a means to limit esophageal varices, for those at risk, in the first place.

I'm still not quite sure why bleeding from these things is so difficult to stop.

All Their Chips On 14 Black

On Merck's reorganization:
[M]any observers have questioned the industry’s over-reliance on a small number of blockbuster cures to keep the money rolling in. In common with most other drug giants, Merck has seen its earnings fall over the past couple of years as the patents expired on its leading drug and the flow of new medicines from its research-and-development pipeline dried up, highlighting the drawbacks of concentrating too much effort on a limited range of cures.
and
Making cost savings now in anticipation of fewer blockbusters and falling profits in the future is sensible. Making plans for fighting or settling legal cases that could break Merck is a much tougher call. By taking a knife to the company, Mr Clark [Merck CEO] has made his mark. But he may yet be remembered as the man who brought an American giant to its knees.

Can I Learn This in a Book?

Cleaning out cadaveric bowel isn't high on the list of medical school rigths of passage and now I know why.

Big Bad Pharm

Huge greedy profit margins are forcing Merck to fire 11% of its workforce.

Not that Merck didn't screw up with Vioxx, but it SHOULD be difficult (more difficult) in a court of law to prove causality between the drug and ill consequences. I'm being pessimistic, but the payouts Merck makes are going to come in numbers that defy the statistics on the probability of adverse effects from taking Vioxx.

Sunday, November 27, 2005

BCS Update for Week 6

Upsets

Nevada (AP: NR Coach: NR Computer: NR) over Fresno St. (AP: 16 Coach: 16 Computer: NR)

Current Standings

AP: 192 + 14 = 206
Coach: 197 + 14 = 211
Computer: 190 + 0 = 190

Only one upset, of course it practically crushes any chance of the human polls beating the computers for the season. Is it possible for the AP poll to catch the computers? Well it depends on how the polls following Saturday's games play out.

To even have a shot, here's the games where the difference between the computer rankings is greater than for the AP polls...

Goal: +16

South Florida over West Virginia +2
Georgia over LSU +6
Florida St. over Virginia Tech +1
Colorado over Texas +1
Total: +10

And that wouldn't be enough as the polls sit from last week.

So, what have we learned here? That the computers, even without using margin of victory which they claim would make them even MORE accurate, is a better judge of a team's strength and predictor of games than the human polls.

Overweight and Healthy

Think back to the report that revised the deaths attributable to obesity downward.

With apparently faulty information the government took action, lowered the BMI at which people are 'fat,' and

Seven years ago, 35 million Americans became overweight literally overnight.

America suddenly became fatter when the federal government changed the definition of overweight, based on a calculation called body mass index.

The question, addressed in the Chicago Sun Times article quoted above, becomes should so much stress be placed on lowering people's weight as a preventitive health measure?
[N]utritionist Paul Ernsberger of Case Western Reserve University thinks the overweight threshold is too low.

He notes that a recent study by the Centers for Disease Control and Prevention found that people who had with a BMI between 25 and 30 did not experience any increased risk in mortality. If anything, they had a slightly lower chance of dying.

Ernsberger thinks the overweight cutoff should be raised to 30.

The current cutoff of 25 "sets up people for failure. The goal may be admirable, but is not realistic," he said.

Ernsberger and other critics say researchers have a vested interest in expanding the number of people defined as overweight by setting a low BMI cutoff. The worse the problem appears, the more funding they will receive from the weight-loss industry and government.

*EDIT*

Right on cue, and thanks to Kevin, MD, The UK's NHS is going to refuse some more elective surgeries, such as knee and hip replacements, to obese people. A Scotsman article sheds light on what it believes is the last PC discrimination, against those with 'self inflicted' health problems.

Give A Mouse A Cookie...

This post was more specific at one time, criticizing a civil suit against a healthcare provider who gave discounts to the insured. However, it is a fine lead into the culture of victimhood and entitlement that surrounds worsening disrespect and annoyance of patients and pundits for the healthcare system.

Advances in technique, knowledge, and technology means I wouldn't trust a better outcome, if I had a medical condition, at ANY point in the past compared to today. That is across the board, even the indigent.

So what are these complaints or these or these? We can do EVEN better? Certainly if not a word was written in criticism healthcare tomorrow would be better than it is today. Make no mistake, I'm not taking offense at criticism and debate. These are fine tools. However, much of the growing aggitation amongst bloggers, pundits, and columnists over costs and services in healthcare seem to be rooted in a sense of entitlement. An entitlement to what? Perfection? A "reasonable" cost for healthcare? The advances of tomorrow, today? Many of these scathing op eds are too venomous to be taken as legitimate efforts to prompt action or shed light on the situation. They're the whines of dissappointed expectations, as if once you get a taste of how fast healthcare has improved over the past century suddenly you want more...You Give A Mouse A Cookie And He'll Want A Glass of Milk.

Help make healthcare even better, because it can be, but every once in a while, please, for the love of God, sit back and marvel how really incredible it is that such and such a drug or such and such a surgery. Marvel that, despite the inequality you denounce, since Shaman's provided healthcare as a community service, there has not been more parity in healthcare access between rich and poor.

Saturday, November 26, 2005

Median Wages & Healthcare

From an interesting article about the median wage as a metric of growth and productivity:

So why have median wages been stagnating even though productivity began increasing in the 1990s? Two reasons: increasing labour supply, and increasing costs for benefits. While median wages have stagnated, total compensation hasn't. In essence, workers have been consuming all of their income increases as health care.

Note my complete lack of training on this, and many other, subjects. However, the article seems to make some assumptions, and maybe these are classic macroeconomic things, that I have trouble with. There's an assumption that increased production necessarily lead to increased median wages for growth.

This may be symantical but shouldn't the view be more of from the other direction? Income inequality but the belief in the possibility of wage increases are necessary for increases in productivity. I guess my concern is why this post even seems to entertain the idea that decreasing income disparities has inherent benefits.

Making the country as a whole poorer in order to reduce income inequality doesn't sound to me like a good idea. I realize that many liberal commentators claim that they can do this without sacrificing growth. But I don't see how.

This post seems to imply IF you could reduce the inequality without making the country poorer it would be worth it. That doesn't seem clear to me. I'm not exactly sure of the correlation between income inequality and productivity, and I'm sure there's disagreement over this amongst economists, but there seems to be a point in which income disparity is so great it actually decreases productivity.

Maybe all this anger against healthcare costs is one representation of a decreasing belief in the American Dream; in one's ability, through increased productivity to better one's income. Why would this be? I'm just throwing stuff out there but people may respond better to increases in actual wage, which has failed to keep up with productivity increases apparently, rather than total compensation, including increases in healthcare spending on employees.

If this is the case then is there an argument that reducing healthcare costs --> leads to decreased spending on non-income compensation --> leads to an increase in median wages --> leads to increased productivity and better economic growth?

Even if that is the case I don't think government has a place trying to enforce it. This may be the eventual direction the market leads healthcare, the fear is it will be such a slow reaction that the economy and people's health will suffer through the transition, but it is still not the place of government to engage in over regulation...such efforts have ways of backfiring.

But more deeply, I don't see either of these metrics [GDP & Median Wage] as a very good guide to policy, because I don't believe that there is very much the government can do to influence them, for good or ill.

Economics of P2P

A study of the economic depression of file sharing music by a Harvard PhD student finds that illegal sharing harms sales of music of the most popular musicians but increases exposure and sales for less successful artists.
File sharing is reducing the probability that any act is able to sell millions of records, and if the success of the mega-star artists is what drives the investment in new acts, it might reduce the incentive to invest in new talent. This is, at its heart, an empirical question which is left to future work.
H/T to Slashdot

Bacterial Camera

UCSF and UT scientists have published a report in Nature on how they've engineered a colony of e. coli bacteria to act as film, so that images appear on it. That is just weird.

Painful Peace

Too much politics and college football and not enough medicine.

In any case, Power Line has led me to an interesting take on Sharon's decision to leave the Likud party. Basically the Telegraph opinion piece claims Sharon's efforts mimics every independence effort in the Western world. Israel is still struggling for her independence, in the same vein, as say the United States did.

As I've praised Sharon's decisions in the past, all with the seeming effort to give peace a chance, I praise this one, to turn his back on the establishment, as well.

Environmental Health

In China right now 100 tons of benzene compounds in the drinking water of its fourth largest city, Harbin, is causing a mini-crisis. Here is NPR's report on the crisis as well.

I truly don't want to focus on public health in my practice. I think I need to do something procedure based. But, public and enviornmental healthcare research and policy, such as this epidemiology fellowship at the CDC, seems really really interesting.

Rethink a Racist World

A new study refutes previous studies and claims healthcare disparity has no cause in racism or race bias.

I want to believe this. It seems like the 'logical' thing. Obviously disparity has much to do with socioeconomic status and indeed geographic location. It is easy to imagine this is enough to explain the problems between black and white healthcare access levels. However the two previous studies I have actually read seem to have pretty infallible methodology...not that I have any training whatsoever in evaluating research design.

Rose Bowl Sim

I let NCAA 06 have a shot at simulating the Rose Bowl after I tweaked the ratings of both USC and Texas.

You can watch it.

I'm not real pleased with the A.I. involved. Texas stuffs Reggie but Leinart and Dwayne Jarrett go off and Jarrett ends with a couple touchdowns and just around 150 yards recieving.

In any case Vince has a terrible day, throwing three interceptions, the last one with just under two minutes to play. USC picks up one first down, but Texas uses all three of its timeouts and a tough situation arises:

There's a minute ten left, you're in the lead, it is third and long, you're just on your side of the field, and the other team has no timeouts left. Do you throw for the first down or run the ball knowing you'll probably be stopped short and the other team will get the ball back with about 50 seconds left?

For me the fact that Texas needed a touchdown to win (USC was up by 5) means I run the ball and try to waste the clock. The game had Matt Leinart try to throw for it, and he was picked off. The ball was returned to USC's 35 setting up Vince Youngs game winning touchdown throw with 3 seconds on the clock. They went for the 2 pointer and failed (as if USC was going to get within field goal range in 3 seconds).

Texas 27, USC 26

42 Points

Should USC be worried about giving up 42 points and the apparent discrepancies between our defense and Texas'?

Probably not, we're still doing very well in perhaps Carrol's most stressed defensive statistical category -- turnover margin. The fact we lead the nation in interceptions with this patch work secondary in pretty incredible.

Here's some comparative figures, and these are all BEFORE Texas' terrible statistical game against A & M.

Total Offense
USC -- #1 -- 571 ypg
Texas -- #2 -- 528 ypg

Scoring Offense
USC -- #2 -- 48.55 ppg
Texas -- #1 -- 50.10 ppg

Total Defense
USC -- #43 -- 351 ypg
Texas -- #6 --278 ypg

Scoring Defense
USC -- #33 -- 31.9 ppg
Texas -- #5 -- 14.3 ppg

Turnover margin
USC -- #1 -- +1.91/game (Also, #1 in total interceptions)
Texas -- #42 -- +.3/game

The statistics deserve to be put into context however. Let's look at the offensive statistics of the opponents of both Texas and USC.

Opponents Total Offense
Arizona St. #3 -- 518 ypg
Texas Tech #4 -- 511 ypg
Washington St. #9 -- 489 ypg
Notre Dame #10 -- 472 ypg
Hawaii #11 -- 468 ypg
Oregon #15 -- 449 ypg
Texas A & M #16 -- 447 ypg
UCLA #17 -- 444 ypg
California #29 -- 424 ypg
Missouri #30 -- 423 ypg
Fresno St. #35 -- 412 ypg
Ohio St. #38 -- 405 ypg
UL - Lafayette #55 -- 383 ypg
Colorado #56 -- 380 ypg
Arkansas #61 -- 372 ypg
Washington #72 -- 358 ypg
Arizona #77 -- 348 ypg
Oklahoma St. #82 -- 343 ypg

Oklahoma #88 -- 334 ypg
Rice #90 -- 331 ypg
Baylor #97 -- 318 ypg

Stanford #98 -- 314 ypg
Kansas #103 -- 304 ypg

USC faced 6 Top 20 offenses. Texas faced 2 Top 20 offenses. USC's opponents average 422 ypg. Texas' opponents average 351 ypg!

The Pac 10 is an offensive powerhouse. Beyond Texas, the Big 12 couldn't find offense with the help of an electrified offense finding machine. A better measure is the difference between the two teams total defense and the average opponent offense. USC held their opponents 71 yards under their average. Texas held their opponents 73 yards under their average. Pretty close. Throw in USC's domination in forcing turnovers (although obviously the Pac 10, throwing the ball more, is more likely to turn it over than the Big 12) and I'll take our defense versus Texas' any day of the week.


Tuesday, November 22, 2005

Take It To The Street...

From Medrants:

Of course this comes off SFgate.com but it certainly makes sense, "decriminalize marijuana and tax the heck out of it."

Sounds good to me.

Mandatory Health Insurance

The AMA recently looked at backing proposals for all to carry at least catastrophic health insurance. The idea is to broaden quality of care and perhaps more importantly relieve some of the burden of public health funding. The finances of most community hospitals, I imagine, are not in the happiest of shape and government spending on healthcare is certainly rising.

First, let me make it clear, to anyone who it isn't obvious to that this is based in a far different philosophical model than required auto collision insurance. It is more in line with say, personal seat belt laws, which are completely out of line with the idea of individual responsibility and liberty.

There are two points to be made.

First, the move is unenforceable.

One need look no further than the example of auto insurance to see some of the pitfalls that can accompany individual mandates, said Donald Franklin, MD, a nephrologist and Tennessee delegate.

"We believe the intent [of the resolution] is satisfactory, but requiring a form of health insurance coverage probably sets a bad precedent," he said. "Even though automobile insurance and driver coverage may be mandated in many states, we all know friends, family, acquaintances who have had the instance of an automobile accident where the opposing driver is not covered by insurance."

Check out statistics on uninsured motorists. In the past 10 years some states have suffered uninsured rates, despite the requirement for auto insurance, in the one-third range.

Second is a slippery slope argument in which this sort of law is another step in government interference in healthcare.

[S]aid psychiatrist Richard Warner, MD, a delegate from Kansas. "A federal government that is going to mandate health insurance is also going to regulate that health insurance," he said.

Attempts at upping health insurance coverage are all based in noble sentiments but that sentimentality is their fault as well.

Sunday, November 20, 2005

The Myth of Precedents

Slate has some really fallacious and just down right malicious columnists, at least it seems there intent can't be anything but sometimes, but in this piece they shed light on the growing "dance," as they call it, that is a Supreme Court nomination hearing.

[S]enators pretend, maybe even to themselves, that they really care about precedents and privacy in the abstract.
This is a well written, thoughtful piece going over the political realities of abortion and the court system.

Week 5 of the BCS

Upsets

Georgia Tech (AP: NR Coach: NR Computer: ??) over Miami (AP: 3 Coach: 3 Computer: 5)
  • I think Georgia Tech may have a top 25 computer average but because it isn't in the top 25 of the BCS, it is difficult to figure out what GT's computer average actually is
Auburn (AP: 11 Coach: 12 Computer: 17) over Alabama (AP: 8 Coach: 8 Computer: 9)

Clemson (AP: NR Coach: NR Computer: NR) over South Carolina (AP: 19 Coach: 21 Computer: 25)

UAB (AP: NR Coach: NR Computer: NR) over UTEP (AP: 24 Coach: 25 Computer: NR)

Current Standings

AP: 145 + (27 + 3 + 11 + 6) = 192
Coach: 152 + (27 + 4 + 9 + 5) = 197
Computer: 152 + (25* + 8 + 5 + 0) = 190

The computers regain the lead.

Friday, November 18, 2005

HIV Rates Drop

Some progress. In one of the highest risk groups - African Americans - a new study of the statistics shows the new infection rate has dropped about 5% a year over the past four years.

Even outside of the United States the AIDS epidemic update has at least some good news associated with it involving steady or decreased prevalence by percentage. Of course, as these third world regions of the world grow it means more people infected, even if the percentage of the population carrying it decreases.

On the other end, the percentage of HIV infections that are women is increasing. This is tragic but shouldn't be a surprise seeing as just by the nature of heterosexual intercourse women are at a much higher risk of having HIV transmitted to them from a partner than they are of transmitting it to a heterosexual male. As well, a lack of female autonomy in many third world countries puts women at increased risk.

Monday, November 14, 2005

External Heart

Pretty incredible story coming out of India concerning a girl born with her heart and part of her great vessels outside her chest wall.

Sunday, November 13, 2005

BCS Week 4

Upsets

LSU (AP: 5 Coach: 5 Computer: 13) over Alabama (AP: 3 Coach: 3 Computer: 4)

Auburn (AP: 15 Coach: 17 Computer: NR) over Georgia (AP: 9 Coach: 9 Computer: 12)

South Carolina (AP: NR Coach: NR Computer: NR) over Florida (AP: 12 Coach: 12 Computer: 17)

Clemson (AP: NR Coach: NR Computer: NR) over Florida St. (AP: 17 Coach: 16 Computer: 24)

Iowa (AP: NR Coach: NR Computer: NR) over Wisconsin (AP: 19 Coach: 19 Computer: 9)

Virginia (AP: NR Coach: NR Computer: NR) over Georgia Tech (AP: 24 Coach: 24 Computer: 22)

Current Upset Standings

AP: 88 + (2 + 6 + 18 + 13 + 11 + 6) = 145
Coach: 93 + (2 + 8 + 18 + 14 + 11 + 6) = 152
Computer: 77 + (9 + 18 + 13 + 6 + 21 + 8) = 152

Well, for the first time a human poll is better than the computers. Crushing underestimations of LSU and Auburn, and a misplaced love for Wisconsin hurt the BCS computers significantly. Through the season so far the computers are no better than the human polls at predicting upsets and indeed the media writers are the best of all.

Tuesday, November 08, 2005

Flying Spaghetti Monster

I believe in intelligent design. It's not dressed up creationism, it is the acceptance of what science has shown but a belief in God as a creator. However, the idea it should be taught in schools is even beyond me.

All that to lead into this, Church of the Flying Spaghetti Monster. It is pretty funny.

Here We Go Defense, Here We Go!



Are arguments to limit the "right" of suit hypocritical and out of line of my general Libertarian views?

Here's the deal, the person who brought this up, I imagine...I really am just putting words in her mouth, is probably for universal healthcare. So, she removes her opposition to physicians setting their own prices (that means busting up price fixing insurance rings and a HUGE increase in the cost of healthcare)...and I'll argue for the freedom to sue anyone whenever they want.

But really, she raises a good point against me. The best solution, that may allow me to keep some dignity, may be health courts. Get the innumerous frivolous cases out quickly, and thus lower physician and insurance defense fees, and still allow the maintenance of a patient's right to suit. The "right" to a jury trial is really just one the Constitutions' attempts at protection of a more universal right, one to impartiality and justice. I think that can certainly be maintained in sort of bureaucratic health courts manned by knowledgeable judges.

Sunday, November 06, 2005

Alito and HIV

Ah, finally Alito's nomination comes into contact with a healthcare issue. Attacks on Alito seem to be particularly dragging up writing and opinions concerning private discrimination. I've heard complaints about opinions on affirmative action, mandated maternity lead, and now an opinion he wrote while serving in the DOJ during Reagan's term, which claimed that people with HIV were not protected by the American's With Disabilities Act from firing.

Private discrimination may be morally appalling but where's the right to work? Where's the right to sit at the counter? There's a far better argument for the rights of a business owner in his leeway to act. Get out of Dodge; liberals want to argue against conservatives mandating "morality" by, and just an example, denying gay marriages. However, limiting private discrimination is the same dance.

www.lp.org

Week 3 of the BCS

UPSETS

North Carolina (AP: NR Coach: NR Computer: NR) over Boston College (AP: 19 Coach: 19 Computer: 20)

NC State (AP: NR Coach: NR Computer: NR) over Florida St. (AP: 9 Coach: 8 Computer: 14)

Arizona (AP: NR Coach: NR Computer: NR) over UCLA (AP: 7 Coach: 7 Computer: 6)

Miami (AP: 5 Coach: 5 Computer: 10) over Virginia Tech (AP: 3 Coach: 3 Computer: 2)

Current Upset Standings

AP: 31 + (11+ 21 + 23 + 2) = 88
Coach: 35 + (11 + 22 + 23 + 2) = 93
Computer: 19 + (10 + 16 + 24 + 8) = 77

Saturday, November 05, 2005

Immigration Troubles In France

I'm not going to try to say I have any concept of the grievances, apparently mainly among France's African immigrant population, that are driving these massive riots...but France has had a recent history of growing agitation between its homegrown citizens and a growing immigrant population.

With massive racial undertones amongst these riots it is difficult to take some of old Europe's past criticisms of America's own immigration and integration history with any sort of seriousness.

Low Income = Poor Outcomes

I'm not even sure why this study was undertaken. I have a lot to learn concerning research, no doubt, but I just don't see the benefits of this study. Maybe the article is misrepresenting the intention of the study but the headline reads, "Higher Death Rate for Low Income HIV Patients".

From the article:
Prior research has shown that HIV-infected patients from a low socioeconomic background, as well as racial and ethnic minorities, receive fewer health services, including treatment with Highly Active Antiretroviral Therapy (HAART). The researchers examined whether these patients also had higher mortality rates than others.

How can this be a surprise to anyone? It might be; there might be a lot of misrepresentation about the level of care the poor actually recieve. But if this is an attempt at increasing public awareness it is a poor one (as probably anything published in The Journal of Health Care for the Poor and Underserved is) and if it was an actual attempt to determine whether the poor truly have poorer outcomes then it was a wasted effort.

There's probably a good finding for higher mortality and morbidity for lower socioeconomic status across virtually all health afflictions. Well not all...but very many, especially chronic ones. I don't need a study to say that.

Friday, November 04, 2005

Property Rights Reaffirmed

Good news from Congress. Not sure how often you can say that. I know I love federalism and hate Washington's power of the purse but at least an evil is being to put to good use in this case...not that I don't trust most local governments to restrict themselves.

Thursday, November 03, 2005

Best Conference

This blog is turning into a college football clearinghouse...no wonder I never do any studying...

The Big East is not being included in this competition for obvious reseasons. The idea is to compare the ACC, Big Ten, Big 12, Pac 10, & SEC. I'm looking for interconference play (along with any games against Notre Dame). The score is the winning percentage of the teams the conference beat minus the LOSING percentage of the teams the conference lost to.

At current the best conferences are:

1. ACC -- .375
2. Big 12 -- .323
3. SEC -- .210
4. Big 10 -- .118
5. Pac 10 -- .091
* That is what happens when one of your teams loses to Purdue. Take away that loss and the Pac 10 jumps the SEC and Big 10. But alas the Pac 10 is clearly the worst of the major conferences (I dare not see if they're actually weaker than the Big East). As well, the ACC and Big 12 are, at current, in a class by themselves...and the SEC is overrated.

ACC

Major Opponent Beaten
Texas A & M 5 - 3
Colorado 6 - 2
Auburn 6 - 2
Winning %: .708

Major Opponent Lost To
Vandy 4 - 4
Nebraska 5 - 3
Wisconsin 8 - 1
Losing %: .333

Major Opponents Pending
Florida (v. Florida St.)
S. Carolina (v. Clemson)
Georgia (v. Georgia Tech)

Conference Strength Score: (.708 - .333) = .375
Major Interconference Record: 3 - 3

Big 12

Major Opponent Beaten
Iowa 5 - 3
Wake Forest 4 - 5
Ohio St. 6 - 2
Winning %: .600

Major Opponent Lost To
Miami 6 - 1
UCLA 8 - 0
Clemson 4 - 4
Losing %: .277

Conference Strength Score: (.600 - .277) = .323
Major Interconference Record: 3 - 3

Big 10

Major Opponent Beaten
North Carolina 3 - 4
Notre Dame 5 - 2
Kentucky 2 - 5
Arizona 2 - 6
Winning %: .413

Major Opponent Lost To
Texas 8 - 0
Notre Dame (x2) 5 - 2
Arizona St. 4 - 4
Iowa St. 5 - 3
California 6 - 2
Losing %: .295

Conference Strength Score: (.413 - .295) = .118 (or .120 if Notre Dame isn't counted twice as a loss)
Major Interconference Record: 4 - 6

Pac 10

Major Opponent Beaten
Oklahoma 5 - 3
Arkansas 2 - 5
Notre Dame 5 - 2
Illinois 2 - 6
Northwestern 5 - 3
Winning %: .500

Major Opponent Lost To
LSU 6 - 1
Purdue 2 - 6
Notre Dame 5 - 2
Losing %: .409

Major Opponents Pending
Notre Dame (v. Stanford)

Conference Strength Score: (.500 - .409) = .091
Major Interconference Record: 5 - 3

SEC

Major Opponent Beaten
Wake Forest 4 - 5
Arizona St. 4 - 4
Winning %: .470

Major Opponent Lost To
Indiana 4 - 4
Georgia Tech 5 - 2
USC 8 - 0
Losing %: .260

Major Opponents Pending
Georgia Tech (v. Georgia)
Florida St. (v. Florida)
South Carolina (v. Clemson)
Notre Dame (v. Tennessee)

Conference Strength Score: (.470 - . 260) = .210
Major Interconference Record: 2 - 3

Tuesday, November 01, 2005

Alito Is Right Choice

Alito is a good choice.

I was listening to NPR the other day and I heard Sen. Kennedy speak. He was ranting on Alito's rulings that saw limits on Congress' power to prevent private discrimination based on race and pregnancy (such as in requirements for maternity leave in the private business world).

What was appalling was not his rejections of Alito's opinions but the fact he seemed to be appealing to the lowest common denominator. His claims amounted to: Discrimination is bad; and Alito is for it!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

What? Is this man incapable of addressing this issue on a logical keel? Why does he want the public to be blind to the very real and important fact that a judge's rulings and his personal feelings are two different things?

I don't trust the grand middle of the American public to draw that distinction any more than Sen. Kennedy probably does, but shame on him for trying to foster that line of "reasoning" in an effort to fight support for Alito's nomination.

There are obvious very legitimate judicial arguments that the government doesn't have the right to limit private discrimination (arguments I believe in) but their debate, and the debate over Alito, needs to be on this sort of philosophical level...not the emotional, sloppy debate "heart on sleeve" democrats like Sen. Kennedy seem to want to sink to.

Concierge Fees

Kevin, M.D. and DB have spoken at length on this concept. Indeed, I took this link from DB's Medrants.

The idea for a general practitioner is that you see fewer patients but charge them a yearly subscription or "concierge" fee on top of your reimbursement for their office visit. Typically these extra fees (maybe a couple to several hundred dollars for the year) don't violate Medicare or private insurance contracts as long as you aren't charging for a service.

The individual patients then can be scheduled for hour long (or more) office visits and encouraged to contact the physician in his or her private life. Basically the patients are buying quality time with their physician. There's no over booking, there's no time spent in the waiting room, it can be very convenient.

It makes a lot of financial sense because most insurances have a fixed rate office visit reimbursement (and it ain't much) whether the physician needs to spend fifteen minutes or two hours with the patient. No wonder the last time you went in for a check up you spent two hours in the waiting room...the doctor has to book too many patients just to keep his staff's salaries on keel...