Friday, August 22, 2008

Why a Blog?

I decided to try to maintain a blog, to set down perceptions of the day's events, some personal, some political, or commercial. I used to write a lot as a public policy analyst with my own consulting firm. Now I ruminate less frequently, except for a weekly "liberal" column in our local Concord newspaper.
So, this is a beginning at a new form of open diary. I plan no specific agenda, but rather I will try to speak to issues that interest me, and hopefully others.
Three issues spark my interest this morning.
1. Vaccination rates for measles are down marginally, and the measles rate is up marginally, mainly due to parents who refuse to vaccinate their kids due to (largely unfounded) issues about links between autism and the measles vaccine. It's unfortunate, because eventually some kids will die. That's the way it is with measles. Most kids just get sick. Some require hospitalization, and some die. So parents are rolling the dice with their children's lives at stake. But for people unwilling to look at the evidence, that's their decision. Too bad their kids don't get a shot at the decision.
2. Hospital Death Rates are now being published by Medicare. That seems a good thing, except it's more complicated than the simple statistics indicate. One might assume that the higher the death rate associated with a hospital, the worse its care. That assumption is often wrong. Higher death rates might reveal hospitals that treat disproportionately high percentages of very elderly, or even very sick elderly patients. Sometimes people leave the hospital ok and then die within 30 days--they count. It's just one more indicator that for every complex issue there are generally one or two really simple answers that are wrong. Like the measles vaccination issue, it is always useful to look more deeply, and ask more questions before subscribing to particular points of view. Thinking, however difficult, remains useful.
3. Fat people seem to abound in the South. The day's Charlotte Observer reports the percentages of obese people in each state, and the South dominates. Life style and food preferences (high fat, fried foods) would account for the differences. But there's also an element, call it the George Bush Syndrome, that you can keep doing demonstrably harmful things forever and there will never be a bill to pay. Unfortunately, the bill always comes due.
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