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Monday, November 29, 2010

Rebutting Ravitch

Witney Tilson of Democrats for Education Reform has a great post on why the new teacher union darling, Diane Ravitch, is all wrong. Once upon a time Ravitch was in favor of school choice, technology, teacher evaluations but she's backing away fast with harsh criticism that only the teacher unions seem to support.

Tilson writes,

In my opinion, most of what she is currently saying and writing is completely wrong-headed, based on shoddy and one-sided research and analysis, yet because of her sterling resume and the fact that she was once a reformer, her views are quite influential and thus she is one of the greatest obstacles to the reforms our schools so desperately need.

My goal is to expose her for what I believe she is: a thinly disguised shill for the teachers’ unions, advancing their agenda of entrenching the unacceptable status quo that’s working very well for the adults, but screwing millions of children, especially the most disadvantaged ones.
Read Witney Tilson's article "Rebutting Ravitch" here.
Read more on Ravitch by Jay P. Greene and Stuart Buck.

Friday, November 19, 2010

Marxist mumbo jumbo in a video game

Assassin's Creed: Brotherhood, awesome graphics, engaging story, lame hidden conspiracy theories

The political left is upset that you can assassinate Fidel Castro in a new shoot-em up military style action game, but apparently the political right now has  a reason to be mad. A new game called Assassin's Creed: Brotherhood paints several prominent Republicans as members of the evil and manipulative Templars - an ancient organization bent on world domination.

Some of the comments that are allegedly seen in the video game are so over to top, it seems like a hoax. Especially the ideas that capitalism will destroy democracy, or that expanding free speech so citizens can band together and use their resources to influence others (yes, I'm talking about Citizens United). Think about it, Citizens United was a non-profit organization of private citizens who pooled their money together to make a movie criticizing Hilary Clinton. Previous law prevented these organizations from making political speech near an election.

 Assassin's Creed takes the player back and forth in time between our modern era and the ancient times to uncover a thousand-year-old conspiracy theory to rule the world.

Capitalism and trade can destroy many things like racism, sexism, and tribalism, but democracy? No...

Think about this further. What period in world history has the most rapid expansion of democracy and rising standards of living in human history? Answer: the period with THE MOST capitalism!

Despite encapsulating some of the most famous assassinations in ancient history and rolling it into an engaging storyline, the game developers seem to forget the wonderful role capitalism played in stabilizing government, improving human rights and increasing our standard of living.

Besides, what part of,

"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances"

does Congress, the left-wing and the Assassin's Creed game producers not understand?

In an otherwise good (though not scientifically sound) action franchise, this is an extremely lame conspiracy theory.

Wednesday, November 17, 2010

Tax credits improve public schools

 Florida parents, students and community leaders march on the Florida state capitol in support of the state's tuition-tax-credit program.

Cassandra Hart and David Figlio recently found that Florida's "Step Up for Students" corporate tuition tax-credit program improved the quality of public schools. Florida's program allows corporations to make donations to non-profit scholarship organizations who in turn create scholarships for low-income children to attend any public or private school of their parent's choice. Corporations receive a dollar-for-dollar tax credit on taxes owed to the state (up to a specified limit). The Florida state legislature recently passed an expansion of the program that increases the scholarship amount and the corporate donation limit. Interestingly half of the Black Caucus within the Democratic Party voted in favor of expanding the program.

The closer the public school is to their private school competitor, the more the public school improved. Hart and Figlio also found stronger affects for public schools facing large changes in Title 1 funding (federal funding for low-income students). Schools threatened with losing low-income students to private schools through the scholarship program (and thus Title 1 funding on top of a portion of the state per-pupil funding) " tend to improve disproportionately" after the program begins.

Finally the researchers found that the effects grow stronger over time, perhaps due to increased parental knowledge about the problem which in turn creates greater competitive pressure on the public schools to improve.

While the researchers note that the effects may be smaller in rural districts and states, they conclude, "our results indicate that private school competition, brought about by the creation of scholarships for students from low-income families, is likely to have positive effects on the performance of traditional public schools."

Monday, November 15, 2010

The Marshall Plan

Ghost hunting is based on anecdotal evidence and mumbo jumbo, not science or empirical evidence...

Vegas Sun staffer Marshall Allen isn't happy I've been critical of his article which concluded that profits were part of the problem with the quality of hospital care in southern Nevada. In fact, after I presented evidence that contradicted one the three main "problems" claimed by the article, Allen suggested I was putting my "ignorance on display." Sigh.

 Marshall Allen reponds,

Patrick - You possess ignorance in abundance and seem proud to put it on display. I would dismiss your wild allegations, but you're questioning my integrity.

You accuse me of jumping to conclusions, but do so yourself. Let me assure you that I am the one who has been driving this project, based entirely on more than 170 interviews with health care experts and insiders and years of in-depth reporting about health care in Nevada. The health care sources have been directing this work, not my higher-ups. I do not get any type of mandates from above.

I write about health care from a patient-centered perspective, and that's been the foundation of this entire series. Hospital care in Las Vegas has become a joke -- "Where do you go for good health care in Las Vegas?" "The airport." -- and that's not acceptable to anyone with a conscience. So I've been exploring the reasons for this.

The story does not say that nonprofit medicine is better than for-profit medicine. But the quest for profits does relate to short-staffing of nurses and non-academic medicine, which has a direct effect on patient care. The story also points out that Las Vegas is missing an academic medical center, there is not effective oversight, and that hospitals often do not learn from their own mistakes. Those issues combine to help explain our substandard hospital care here.

If you really care to understand these issues, including how the Sun operates, then please call me at 259-2330. I enjoy being informed by by people with all types of points of view. I would be interested in hearing what you've been doing to improve the quality of health care here.
I responded back, this time asking how they reached their conclusion (I'll post Marshall's response when/if it comes).
Marshall Allen,

Anecdotal evidence about preventable problems are not sufficient to conclude that profits are being put in front of patients. No amount of interviews will be sufficient to prove that -- you need solid empirical evidence; which you don't have.

Lets look at one of your unsupported statements,
"The corporate push for profits sometimes trumps patient care and can create an environment where best practices give way to risky shortcuts. Nevada and Clark County have the highest concentration of for-profit hospitals of any state or urban county in the nation."

How did you justify making this claim?

Lets take a look at the data from Health and Human Services.
1) There is not a statistically significant difference in mortality or readmission rates for the problems tracked by HHS between southern Nevada's hospitals and the national average.

2) There is no evidence to suggest that for-profits are statistically different than the non profit and government hospitals in southern Nevada
3) Patient satisfaction surveys conduced by HHS at southern Nevada hospitals suggest people are actually happier with the for-profit Hospital service than UMC.

Furthermore, your most damning evidence was against UMC (southern Nevada's government run hospital), not the for-profits. I'm seriously confused as to how or why you'd even suggest profits are the problem.

Now, I'm not questioning your integrity (but suggesting someone is ignorant after they provide evidence that you are wrong does say something about you) I do question the intentions of the Las Vegas Sun's management.
So why is anecdotal evidence so bad if it is human interest stories that puts a real face to real problems? Anecdotal evidence is worthless to the scientific community because it doesn't paint a broad picture of reality itself. One issue may turn out minor or even rarely occur, but to the people who experience those problems it can be a big deal - it is natural to think this.

But in order for Allen to prove that for-profit hospitals put profits before people he has to show a systematic failure of for-profit hospitals in Nevada. And not just systematic failure of for-profits, the failure has to be statistically different than the outcomes at other hospitals in Nevada AND the rest of the nation. This is why you need good quantitative data - its not sexy but it does get you closer to the truth.

Think about this another way - Marshall Allen thinks 170 interviews with insiders is sufficient to prove the point (though provides no evidence beyond "I did 170 interviews.") With who, what did they say? What was their proof? Most of the interviews turn out to be more anecdotal evidence and do not further us in our quest to prove that profit seeking hospitals provide lower quality care.

This is about as good as interviewing 170 people about ghosts or aliens to determine whether or not ghosts and aliens exist. We know ghosts don't exist because the alleged ghost hunters use fallacious scientific methods and misuse scientific tools in ways that aren't proven to do anything. This isn't intended to diminish the suffering of patients in Nevada's hospitals who are, in fact, experiencing problems that could have been avoided, but it is intended to help demonstrate why one person's experience, as traumatic as it might be, may not explain what is going on in the world at large.

I see anecdotes

Besides, I found patient surveys at HHS that contradicted Allen's claims - every single for-profit hospital in southern Nevada was more responsive to patient needs than the government run UMC. Additionally, patients at for-profits were also more likely to recommend the hospital to others than patients at UMC. The HHS patient survey, I bet, is far less likely to be subjected to selection bias as Mr. Allen's interviews (investigative journalism's biggest bounty comes from disgruntled employees and in this case, patients, wanting to tell their stories in public. This means you are likely to get a concentration of personal but negative stories that may, or may not, accurately represent the typical experience. This may be effective at highlighting specific problems but in no way, shape, or form, should be used to draw broad conclusions like assuming hospitals are putting profits before patients).

Allen wants us to believe the anecdotal evidence is good enough, but if it is good enough for you, then you might as well believe the world ends in 2012, that aliens travel thousands of light years to make crop circles and probe an anus or two, or that Jupiter will spontaneously combust and turn into a star when a human space probe crashes into it sometime in 2014 (which won't matter because you died in 2012).

2012 - based on hysteria, mumbo jumbo, revisionist history and yes, anecdotal evidence.

Real hard science and real numbers can prove those anecdotal pieces of misinformation wrong just as the empirical evidence I found proved that at least one of Marshall's theories (profits are a problem) was wrong.

Finally, Mr. Allen seems more concerned with the idea that I've besmirched his integrity because I suggested that political bias was used to fill in the blank - that is, create a narrative that was intuitive to his political or ideological understanding of how the world works - than the fact that he has little to no evidence to support his claims. Without calling him names, suggesting he was unprofessional, or poorly trained, this was actually the nicest thing I could have said.

These aliens had to call an emergency meeting because too much anecdotal evidence was "proving" alien abductions are real.

It is easy, and natural, for us to backfill stories with our own personal biases. Its not that Mr. Allen is a scientifically untrained and unethical moron, its that he has a certain understanding of the private sector and profits that influences his way of thinking. The real problem isn't that he theorized that for-profit hospitals put profits before people, the problem is that he substituted his personal bias and theories for actual hard evidence. It is easy enough to do and it doesn't mean he's not intelligent or lacks ethics. But it may mean he didn't think too hard about the problem at hand, or was too easily swayed by the anecdotal stories of pain or loss that could have been prevented.

After reviewing the article and weighing the available empirical evidence available online at the Health and Human Services website, it appears Mr. Allen's reliance on anecdotes gets him in the usual sort of trouble. That is, he's guilty of the usual logical fallacies such as confirmation bias, non causa pro causa, and post hoc ergo propter hoc.

Again, this doesn't necessarily mean he's stupid or unethical (I doubt he is either) but it does mean he has made an error in reasoning.  But that said, the ethical thing to do would be to run a correction in the next issue of the Las Vegas Sun or at least point out all the available evidence that suggest profit seeking behavior is not likely reducing the quality of healthcare in Nevada.

Waiting for Superman - Chinese anime style

HT: Jay P. Greene

Sunday, November 14, 2010

Mortality rates in southern Nevada hospitals

The Las Vegas Sun’s recent spat of articles on the quality of health care uses anecdotes to make a case that for-profit care in Nevada is insufficient and deadly. However, the Las Vegas Sun fails to provide enough evidence to make the case. I covered this and patient satisfaction in southern Nevada hospitals in this blog post.

In the chart above, I have bolded the data from the U.S. average, non-profit and for-profit hospitals that beat the UMC mortality rates. As you can see, there is no clear case to be made that profits are being put before patients.

According to mortality rate data from the U.S. Department of Health and Human Services, southern Nevada’s hospitals are not statistically any different from the U.S. national average. Even comparing the private for-profit, non-profit and government run hospitals in southern Nevada does not show that for-profit hospitals are dangerous uncaring institutions. In fact, all private hospitals in southern Nevada have lower mortality rates for heart attacks and all but two have lower mortality rates for pneumonia. The results are more mixed for heart failure.

The conclusion we can make from the data available is that for-profit hospitals are not statistically better or worse than non-profit rivals. The Sun simply jumped to an unsupported conclusion because of an ideological bias toward socialized medicine.

Southern Nevada has great private hospitals

It is not uncommon for the Las Vegas Sun to editorialize in its own news articles, especially within the headlines, or reach a conclusion without enough evidence or supporting facts. The Sun is an agenda driven organization and this is more apparent thanks to the recent article, “Why we suffer: Substandard hospital care has roots in a culture of seeking profits, shunning best practices, turning away from problems.”

Without much in the way of substance, or evidence, the agenda driven "Fox News" of Nevada’s left-wing attempts to link profit seeking with substandard hospitals (note, the Greenspun's own several private for-profit organizations). The only thing the Sun is able to prove is that for-profit hospitals in Nevada make a profit. It is not even clear that southern Nevada's for-profit hospitals make a statistically significant larger profit than private for-profit hospitals elsewhere. Overall, the Sun fails to provide enough information to reach the conclusion that hospitals are putting profits ahead of patients.

Data from the U.S. Department of Health and Human Services finds that between the national average and the private for-profit and non-profit Hospitals in southern Nevada there are no statistically significant differences in death rates for heart attacks, heart failure, and pneumonia. The same is true for readmission of patients for those three problems.

Additionally, private non-profit and for-profit hospitals in southern Nevada consistently beat the government run UMC in the patient satisfaction survey. While the non-profit Catholic affiliated St. Rose Dominican Hospitals are the best for responding immediately to patient needs, controlling the patient’s pain, and receiving high recommendation marks from patients, UMC does worse than all the for-profit Hospitals the Sun attempts to malign.

Hospitals, regardless of status, have their issues and can improve, but profit seeking isn’t the culprit. The culprit is almost always going to be government interference either through costly paperwork driven regulations, uncompetitive paperwork driven government health insurance or the government created uncompetitive paperwork driven semi-private health insurance system.

As Dr. Peter Pronovost, a medical director at Johns Hopkins University stated, medicine must be patient driven – more government regulations, more government health care, more government restrictions, and more government driven paperwork (all policies the for-profit Greenspun empire supports) will not get hospitals to focus on patients.

Expect more anti-capitalist politically driven “news” from the Las Vegas Sun, but if you want unbiased facts you can double check the government data yourself at

Wednesday, November 10, 2010

Happy Birthday US Marine Corps

The Marine Corp turns 235 today, Happy Birthday.

"So they've got us surrounded, good! Now we can fire in any direction, those bastards won't get away this time!" - Chester Puller, USMC

"Some people spend an entire lifetime wondering if they made a difference in the world. But, the Marines don't have that problem." - Ronald Reagan, President of the United States

Joel Klein retires

Joel Klein was put in charge of New York City public schools by Mayor Bloomberg. After becoming chancellor in 2003 Klein went to work upending the failed status quo, closing bad schools, expanding charter schools, grading schools A-F, increasing standards, and giving principals greater autonomy in exchange for accountability.

Despite the constant wails and attacks from the teacher union, the results were impressive. Dr. Jay P. Greene of the University of Arkansas writes,

In 2003, when Klein became chancellor, only 21 percent of the city's fourth-grade students were proficient in math, trailing the national average of 31 percent. By 2009, 35 percent of Gotham's students were proficient at math, nearly catching the national average of 38 percent. New York City's 14-percentage-point gain was twice as large as the 7-point gain nationwide.

The improvement in fourth-grade reading was similarly strong. Between 2003 and 2009 the percentage of the city's fourth graders who were proficient at reading jumped from 22 percent to 29 percent. That 7-point gain far outstripped the national improvement, up just 2 points from 30 percent to 32 percent.

The performance of New York City's eighth graders was less dramatic: Proficiency in the math NAEP rose from 20 percent to 26 percent, tracking the US rise from 27 percent to 33 percent. In reading, city eighth graders remained statistically unchanged, mirroring the national rate.

The large gains in fourth-grade performance and more modest improvements among eighth graders didn't win over Klein's fierce critics. The vitriol with which they denounced him was severe, even by New York standards.

Read more at the New York Post.

Saturday, November 6, 2010

A Memorial Tribute

Some brilliance from my friends over at - I love you guys (and gals).

Friday, November 5, 2010

Die and save taxpayers money

Well news from the Rand Corporation about the National Health Service (socialized medicine from across the pond) suggests that while elderly Americans are sicker than their British counterparts, we actually live longer. So much for universal health care.

In spite of both higher prevalence and incidence of disease in America, death rates among Americans were about the same in the younger ages in this period of life and actually lower at older ages compared to the English.

Researchers say there are two possible explanations why death rates are higher for English after age 65 as compared to Americans. One is that the illnesses studied result in higher mortality in England than in the United States. The second is that the English are diagnosed at a later stage in the disease process than Americans.

"Both of these explanations imply that there is higher-quality medical care in the United States than in England, at least in the sense that these chronic illnesses are less likely to cause death among people living in the United States," Smith said.

Read more at Reason
Read more at Science Daily

Thursday, November 4, 2010

Happy Meal ban

San Francisco bans toys in fast foods - unless the meals get healthier. This is just stupid. Government shouldn't have a right to tell parent's how to raise their children. Parents can learn to say NO, and if they don't, it isn't your business to do anything about it.

We can expect more stupid behavior from big government as they continue to erode responsibility from the American ethos.

Everything is on the table; so look at everything

Nevada state agencies want an $8.3 billion budget, but this would require a 59 percent tax increase - larger than the last two tax hikes combined. Such a large tax increase would make the recession in Nevada virtually permanent.

Senate Majority Leader Steven Horsford has made it clear he wants at least $1.5 billion in tax increases - sill the largest tax hike in state history. Such a tax increase will only serve to sustain our bloated spending at 2007-09 biennium levels (and about 2009-11 as well).

So what can we do? If history is any guide, be warned, tax increases are coming and I wouldn’t be surprised if it was $1 billion to $1.5 billion. But can Republicans, lead by Brian Sandoval, stick together long enough to get major concessions out of Democrats?

Democrats claim that everything is on the table, but what they really mean is that they want a tax increase, fund sweeps and accounting gimmicks to sustain our bloated government spending.

Republicans should take them to task over this claim – like calling for privatization of state services, spending limits, pension reform and more. In other words, seriously look at everything on the table before going to tax hikes.

Republicans should hold out and stick with the no tax mantra until Democrats can agree to the following:

  1. Roll back the state’s budget to a previous year – 2007 at latest but 2003 would be “best” (and this still keeps the Kenny Guinn tax hikes). Nevada actually increased spending at the beginning of the recession and barely made a dent in the budget afterward. Basic support per pupil even went up.
  2. Spending limits – limit total state government spending growth to population plus inflation. This will prevent or lessen the damage from future spending bubbles that lead to this mess in the first place.
  3. Pension reform – Create defined contribution plan for government workers rather than our unsustainable defined pension plan. This will reduce an already massive unfunded liability; estimated at $9 billion but is likely much more.
  4. Eliminate health insurance subsidies for retired government workers – this is already a $4 billion unfunded liability.
  5. Competitive sourcing – require state agencies to bid against the private sector to provide state services including landscaping, auto repair, HVAC repair, and even social services, health and welfare.
  6. Priority based budgeting – Nevada’s baseline budgeting results in our staee agencies treating tax dollars like an entitlement. Priority based budgeting forces government to look at available revenue first, and assign it based on priorities and agencies ability to meet goals set by legislature.
  7. Transparency – put the entire check book online in a searchable database. Let the people see if you’ve really cut to the bone or not.
  8. Government worker union reform – A) negotiations are subject to open meeting laws B) binding arbitration is outlawed C) government workers can no longer be protected by seniority or tenure (this means the worst employees, rather than the youngest or cheapest, can be fired).
  9. Education reform – A) statewide school empowerment and decentralization B) statewide open enrollment C) charter school institute (to regulate, oversee, and approve new charter schools) D) teacher evaluations and school grades E) end social promotion in early grades F) PARENTAL CHOICE – Republicans don’t have the votes but at the very least, Republicans can capture the moral high ground and call for scholarships for special needs and low income students.
  10. Sell non-essential state assets like Forestry Nurseries – seriously, why is the state growing plants when the private sector already operates several plant nurseries? Force local governments to sell their non-essential assets like golf courses, tennis courts, and gun ranges. Think about this for a second - the government is threatening to cut "essential" services while they still provide luxury perks like these. Sell the assets and sweep some of those funds.
  11. Freeze new public school construction (allow only new charter schools because their capital cost is paid for by the private sector). Why do this? CCSD was building new schools during the middle of a recession while they were losing students. Sweep some surplus funds from school districts. CCSD, for example, is sitting on $900 million – take $100-200 million before raising taxes.
  12. Look into leasing state highways. Indiana made $3.85 billion on a 40 year lease for a 157 mile long highway. Nevada could make at least that much for I-80 and I-15. The money could be used to prop up government spending to avoid making real cuts, refill our rainy day fund, and provide a tax rebate. We could even lower Nevada’s notoriously high gas tax since highway maintenance will now be done by the companies operating the highways.

Once all of that is complete, and there is still a budget shortfall, then look at raising taxes. But seriously, take a look at EVERYTHING on the table and don’t let Democrats (or the Las Vegas Sun editorial board) get away with empty rhetoric.

Tuesday, November 2, 2010

I worked hard for this title

Call Me Senator from RightChange on Vimeo.

A short from director David Zucker.

What is a libertarian?

Because government is clearly inefficient, wasteful and incompetent and providing basic services, I believe libertarianism will become the future of both the Democrat and Republican parties. Libertarians stand for limited government - in our homes and in our pocket books. This includes free market capitalism and a defense of private property.

The future debate, I believe, will be on how much we should limit our government and how to manage collective externalities. For example, As I see it, it will be a debate as to whether welfare should be eliminated or privately managed (rather than managed by government).

In the video above Nobel Prize winning economist Milton Friedman talks about libertarianism. This should clear up some misconceptions that have floated around the media (especially in the Las Vegas Sun).

Looking forward to divided government

My dad sent me a financial report from LPL Financial regarding market performance under particular party control. They find that the market tends to be strongest when the government is divided between Republicans and Democrats.

Makes sense - divided government means the government is fighting with itself rather than creating new laws and messing up everyone's livelihoods.


Monday, November 1, 2010

High speed make believe

Supporters of high speed rail are passionate about the project, but they are "imagining benefits that don't exist and ignoring costs that do," says Washington Post columnist Robert J. Samuelson.

The same is also true in Nevada. Desert Express (a train proposal now backed by Senator Harry Reid), for example has underestimated its costs and overestimated its ridership (3 times as much as the high speed line between Washington D.C. and Boston).

It is even fanciful to claim high speed rail is more energy efficient than automobiles - for one they're assuming lofty ridership numbers on trains compared to automobiles that never increase in fuel efficiency.

In 2005, the high speed rail authority in Florida released an environmental impact study which recommended "no build" as the optimal solution for the environment. In other words, not building a high speed rail and continuing with automobiles and highways created the best scenario for a clean environment. Automobiles also improve fuel efficiency faster than trains AND train tracks have to be ripped up every 30-40 years creating massive environmental externalities once again. If a clean environment is your goal, there are smarter and cheaper solutions.

High speed rail is expensive - it won't be able to pay back the loans and bonds let alone cover the operation costs. Although the fare may be artificially low, you're going to have to pay large subsidies to keep it afloat. Subsidies for highways amount to less than a penny per passenger mile while airports cost about 13 cents per passenger mile. Amtrak, by comparison requires 56 cents per passenger miles - four times as much as flying. Are we supposed to believe that high speed and mag-lev trains are going to be cheaper than moderate speed rail transit? Give me a break.

High speed rail is ineffective - too few people will ride it to make any impact on automobiles.  In fact, bus service between Washington D.C. and Boston carries 3 times as many passengers as Amtrak's Acela Express.

High speed rail is inconvenient - the tracks don't go where you want to go, you have to go where the train has to go, this makes automobiles a superior choice for convenience.

High speed rail isn't very high speed - The nations only high speed line, Acela Express, averages 79 mph. In fact, most of Obama's high speed network is just moderate speed trains - top speed of 110-120mph and averages of 80 to 90mph. A true high speed network would cost about 10 times more than Obama's plan making it cost prohibitive for just a few extra mph gain. In many cases rail transit is slower than auto travel. In pretty much all cases, rail transit is slower than air travel.

As Robert J. Samuelson concludes, "[t]he absurdity is apparent. High-speed rail would subsidize a tiny group of travelers and do little else."