The knife

The death of an 18-year old girl from voluntary breast surgery explains the timing of this post, but is only tangentially related to its point. In the coming days, there will likely be a huge fuss about plastic surgery in the media, with people screaming on all sides in what passes for debate in that venue. Some, like this article, will make mention of an American Society of Plastic Surgeons report (pdf) claiming that the number of breast augmentations in 2007 increased 64% over the number in 2000. Some will claim this as a sign of the decline of Western Civilization. They may be right, but not in the way that they think.

In the past five years, health insurance providers have gained more and more control over the business of health in the United States. This has made them very profitable, as this comparison of four large, publicly held health insurers—Humana (HUM), CIGNA Corporation (CI), United Health Group Inc. (UNH) and Aetna Inc. (AET)—with the S&P 500 index from 2003 to 2007 shows (for the color blind, the S&P line is the one on the bottom):

Stock comparison
Image and data from Google Finance

In the process, they have essentially gained control of the pricing of nearly every procedure that they cover. They, not the doctor, set how much the doctor charges. I will have more to say about this later but, briefly, the result of this has been to cause a toxic environment with at least two major consequences: 1) in most cases, neither the person consuming health care nor the person providing it have any input or influence on what the care costs (this basically turns the invisible hand into a middle finger) and 2) doctors are now, essentially, indentured servants to insurance companies.

As a direct result of the latter development, doctors in private practice are now forced to make one of three choices: either close their practice down now, continue practicing until forced to close by bankruptcy, or find some way of making money that doesn’t involve dealing with insurance companies. A great many doctors have been choosing the third path by exploiting a loophole of sorts: insurance companies usually don’t cover voluntary surgery. Voluntary surgery, like breast augmentation.

It should, therefore, come as no surprise that plastic surgery is on the rise. There are now huge numbers of doctors motivated to get people to pay for it, so that the doctors themselves can, you know, house themselves and eat. This makes it cheaper, easier to get, and gives plastic surgery the perception that it is now routine (which, sadly, it is becoming). Ever heard of labial plastic surgery, where women have their genital “lips” reduced? You will, as millions of OB/GYNs discover they can’t actually survive by doing things like delivering children into the world.

As I said, I will have more to say on this later. For now, keep in mind when watching all these idiots on television that the rise in plastic surgery has real economic causes.

…and the rest

Quick: how many people died in Nazi concentration camps? Most people (at least in the States) will reflexively answer “six million”, if they can answer at all. If you are one of them, you are way off the mark. While six million Jews may have been killed, the total number of people killed is upwards of 9.5 million. Put another way, for every dozen Jews murdered in the camps, seven non-Jews in the camps were also exterminated.

Ironically, the zeal that intends (correctly) to ensure that no one ever forgets the 6 million Jews killed in the Holocaust has essentially caused the 3.5 million non-Jews killed in the same camps to be largely forgotten by the collective consciousness. (Not to mention the up to eight million other civilian deaths at Nazi hands outside the camps. Or the 20 million Stalin killed, for that matter.) I know the argument is that the Holocaust (used here to mean specifically the deliberate extermination of Jews) is deserving of special attention, because its very deliberateness screams out as being “more horrible” or “more evil” than other civilian death. Maybe that’s true. But if you view that same argument from the other end, it is essentially saying that the other 3.5 million premeditated camp murders are somehow “more acceptable”, and that just seems stupid at best and inexcusably vile at worst.

Of the many memorials to this insanity, many use the word “Holocaust” the same way I did above: to mean specifically the Nazi “final solution” against the Jews and only the Jews. The New England Holocaust Memorial, for example, counts only the Jews: “Six million numbers are etched in glass in an orderly pattern, suggesting the infamous tattooed numbers and ghostly ledgers of the Nazi bureaucracy. Evocative and rich in metaphor, the six towers recall the six main death camps, the six million Jews who died, or a menorah of memorial candles.” Some memorials might have a special room, wall or plaque to mention the “others” that also died. A few, like the United States Holocaust Memorial Museum are more inclusive of the other victims and fighting genocide in general, but these seem to be the exception, not the rule.

So, whatever else you might think of the proceedings, it was interesting to see Austria light 80,000 candles last week “one in memory of each of the Austrian Jews and others who perished”. It was good to see victims of all genetic backgrounds included, even though Chancellor Alfred Gusenbauer focussed his speech on wrongs done to “our Jewish fellow citizens”. The 3.5 million might finally be graduating from no mention at all to at least rate a first-season Gillian’s Island-like “and the rest”.

Here’s hoping they get their own credit sooner than later.

Growing up, sort of

The general reaction to the Eliot Spitzer “scandal” strikes me as an interesting stop along a fairly recent road toward a (sort of) more mature public treatment of sex. It wasn’t that long ago (say, a century or so) that nearly all of the public would have laid the blame for the whole scandal solely at the feet of the prostitute. Only recently has the “scarlet letter” mentality shifted to force men to bear the weight of their transgressions. Some parts of the world still stone prostitutes and adulteresses.

So, it seems encouraging to me that virtually no one has been trying to lay blame at the feet of the prostitute in this case or claiming that, somehow, Spitzer was somehow powerless to resist her feminine wiles. In fact, it seems that she has become something of a hero, with lots of people buying her music.

It seems like a good sign that the U.S. is starting to grow up a little bit, sticking a toe out from under the smothering history of Puritanical idiocy that has shaped so much of the region’s politics for centuries.

Of course, a nation that really had a mature attitude toward sex (and loves the free market as much as the U.S. claims to) wouldn’t be so bent out of shape about prostitution in the first place, so we still have a long ways to go.

Fair warning

Some (probably most) of you who read this blog do so because we’re personal friends. True as that may be, please consider this fair warning: if you call me up and tell me you have a likely dead woman with you on a beach, and would I please bring my boat to dump her in the ocean in the middle of the night, I’m going to give you the finger and call an ambulance.

That is all.

Now I care. Slightly.

Care-O-MeterNow that samaBlog has provided a primer to most of the candidates, I am upgrading my Care-O-Meter for the 2008 U.S. Presidential race from “nonexistent” to “slight”.

I now care a little bit about the election. I didn’t yesterday. I didn’t last week. And I sure has hell didn’t care two years ago when all this election coverage started. There is no purpose to debates 18 months before the election, damn it!

States, your disgusting race to have the first primary does nothing but make me hate you and your vanity. Stop it.

XM, there is no need for an entire freaking channel covering this election, particularly this far away from the actual election. Stop it.

CNN, there is a reason that a Google search for “election coverage” brings up the page for your 2004 coverage long before showing a link to your 2008 coverage.

There is a reason that the Economist’s current “Week in Politics” only mentions the US election as its second to last item, and even then with a note that the process “got under way” this week.

There is a reason these elections only happen every four years. I look forward to when this one is over, so that the next one can start a day after the inauguration.

I’ll alter the bait

Seeing samaBlog tackle an office pool of 2008 predictions from the New York Times, I thought I’d do the same. The only thing is, I think many of the choices suck. So I’m going to answer free-form. Also, I’ll not repeat the questions or choices, so you’ll need to follow along in one of the links above:

  1. The SEC does not allow me to answer this question.
  2. No Country for Old Men
  3. Portions of either the DCMA or the Patriot Act are un-Constitutional. Preferably both.
  4. Tree of Smoke.
  5. The World Without Us.
  6. …services offering media without access control financially crush those that require DRM, and find that “old media” sales (CDs, DVDs) for such “open” titles actually increase as well.
  7. …the 50 trillion dollar shortfall that will fiscally destroy America pretty soon will continue to be unmentioned.
  8. Pervez Musharraf.
  9. Cuba.
  10. …hell freezes over.
  11. …whichever of them happens last. I might even care by then.
  12. …slightly higher than it is now. Also, October and November will be bloody, as the insurgency attempts to influence the U.S. Presidential election.
  13. …roughly equivalent to shuffling deck chairs on the Titantic, as it will be something other than the only one that actually matters (see answer #7).
  14. …something very loud but, ultimately, not important that skews the results of one or more party’s nominations. In the actual election, the standard advantages of height, hair and the “beer factor” will turn out to not play a role.
  15. Hillary Clinton-Robert “Bob” Kerrey
  16. …almost certainly a pair for whom I will not vote.
  17. “Anyone but Bush”. This theme will likely be just as disastrous as the soccer-mom “I just think it’s time for a change” theme that brought Bush to power was. Alternately, the winning theme may be the real lesson learned in the 2000 election: “I can rig election results better than you”.
  18. …something other than the only thing that actually matters (see answer #7).
  19. …the consequences of a 50 trillion dollar shortfall that no one has done anything to fix.

Merry economic war

You don’t have to look very far to find dire warnings about Chinese goods these days. For several months, the focus has been on toys with lead paint in them. Before that, however, there were beads containing GHB, toothpaste containing diethylene glycol, and poisonous petfood. If you think back to this same time last year, I don’t remember any such thing being so prevalently in the news, even though it is difficult to imagine that these goods went from being perfectly safe to the deadly poisons the news harps about in twelve months. It’s possible that these stories have reached the mass consciousness organically, feeding on each other to dominate mind space. Maybe they are sort of a fad, where the U.S. media (ever hungry for stories to scare the crap out of you) finds they consistently sell better when China is trying to kill everyone. Yet, when you think about the fairly rapid rise of these stories, the broad range of their repetition, and the staying power they seem to have, I wonder if there isn’t something a bit more to it. I’m wondering if it’s an American attack in an economic war between China and the United States.

Honestly, I hope it is. It should be. In the first place, there is some reason to believe that China has been conducting large scale industrial espionage against the U.S. for some time. More troubling, China has been accumulating a vast reserve of U.S. dollars for years. The quantity of this horde seems far in excess of Chinas needs, and opens the possibility of China using this reserve to intentionally manipulate American economic policy for its own benefit, largely through a kind of economic blackmail. In August, coincidentally close to when the poison goods stories kicked into high gear, a number of Chinese officials began hinting they they would do exactly that if negotiations didn’t go their way. As early as 2002, China was also the second largest holder of U.S. bonds, which likewise frightened people, although some called China a scapegoat (Communism was just a Red herring).

This year saw another new development as well. Long content to let others come to it, China began seriously reaching out into the world. They recently bought a large chunk of Morgan Stanley, have a large and growing influence in Africa, and will be hosting the Olympic Games in less than a year. A few months ago, an author being interviewed on NPR (I can’t remember who, sorry) made the observation that, when you look at most of written history, the economic dominance of China has been the “natural state of the world”, with recent centuries being the fluke.

In October, both Japan and China started selling U.S. bonds for the first time. This is troubling because it can have cascading effects, since, in economics, perception of reality often causes a belief in that reality, which can easily cause that reality to occur. Laurence Kotlikoff, in his book The Coming Generational Storm, warns that the logical conclusion of present US economic policy is an inevitable collapse which, most likely, will be forced on us by just such an event, where the collective market suddenly stops believing in U.S. creditworthiness.

So, many punches come at America, but few were going the other direction, at least until the “China is trying to kill us” furor began. As a weapon, I’m not sure how effective it is, though. There have been some costly recalls, but these tend to hurt American companies as well (just ask Mattel). Other than an object lesson to companies to (unrealisticly) seek other partners, that doesn’t seem to do much good. As propaganda designed to rouse “don’t buy China” sentiment, catered to mess with Christmas sales as much as possible, it succeeds a bit better, but to what end? As a negotiation ploy? If that’s the plan, it doesn’t seem to be working.

Talks with China recently failed to accomplish much. According to that story, chief negotiator Henry Paulson thinks that:

The biggest issue we have with China right now is economic nationalism, the problem of its domestic industries welcoming competition. In China, what you find is that you’ve got an increasingly powerful domestic industry that is a strong lobby.

Trying to penetrate the Chinese market is an extremely old tale. So far, there seems to be little the U.S. can do to accomplish it. Here’s hoping we’re actually trying.

Update: not surprising.