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   <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/fredmoolten//13982</id>
   <updated>		2009-11-22T16:10:56Z			2009-11-22T15:59:30Z							2009-11-22T15:44:09Z	2009-11-22T15:38:01Z	2009-11-22T15:34:27Z	2009-11-22T15:32:07Z	2009-11-22T15:26:11Z	2009-11-22T15:25:58Z	2009-11-22T15:23:28Z	2009-11-22T15:21:13Z		2009-11-22T15:12:42Z	2009-11-22T15:11:05Z	2009-11-22T15:11:03Z	2009-11-22T15:11:03Z	2009-11-22T15:10:24Z	2009-11-22T15:07:12Z	2009-11-22T15:05:57Z	2009-11-22T15:04:08Z	2009-11-22T15:04:08Z</updated>
   
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            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/donal_fagan//398.302630-comment:3676971</id>
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		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-20T04:01:55Z</published>
			   <updated>2009-11-20T04:01:55Z</updated>
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		        <![CDATA[<p><i>If the validity of your theory depends on believing that a human can flip a coin in exactly the same way twice,</i></p>

<p>What theory?  No-one can flip a coin exactly the same way twice, but I'm not exactly sure what point you're trying to make.  In any case, I did point out that when viewed in retrospect, the probability of any specified outcome is always exactly zero or exactly one.  I don't know that it takes much theorizing to arrive at that conclusion.</p>

<p>Of course, if you believe in multiverses, one outcome in our universe might be met by an opposite outcome for the same event in one of the other universes.</p>]]>
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		    <title>Fred Moolten Commented on Harry Reid, and What Happened to the Public Option by Robert Reich</title>
		        
			<published>2009-11-20T03:05:56Z</published>
			   <updated>2009-11-20T03:05:56Z</updated>
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		        <![CDATA[<p>The Senate bill public option ("community" option in the Senate version) has some features that are better than the House version.  A potential disadvantage is the opt-out provision, but ultimately, most states will be unlikely to opt out. At this point, no-one knows how many subscribers would eventually choose it.  The number might be a few million in the early years, but there is lattitude for it to increase into the many tens of millions after that.</p>

<p>Even so, artappraiser is correct in pointing out that a public option is a fairly minor component of reform, and that the Senate bill, like the House bill that has already passed, should be judged on its other components as well.  Some are excellent, and others are only tiny steps in the right direction.  All in all, I found the Senate bill an important step forward, undeserving of the term "incremental", if that term is meant to connote only a very small advance.  This would be a major advance if it passes, but of course, getting it passed will be a challenge.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-20T02:51:46Z</published>
			   <updated>2009-11-20T02:51:46Z</updated>
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		        <![CDATA[<p>Probably not, Erica, because treatment of mammographically diagnosed breast cancers hasn't changed or improved discernibly.  It's the treatment of clinically apparent cancers that has improved.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-20T02:49:03Z</published>
			   <updated>2009-11-20T02:49:03Z</updated>
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		        <![CDATA[<p>The cost to insurers of covering mammograms in a fraction of the 40-49 year old age group, when spread across the entire subscriber base, is likely to be minimal - perhaps $10/year per subscriber.  It's the radiologists who have a large stake in this, because mammography is lucrative for them.  I don't doubt the sincerity of most of them, but I'm merely pointing out that the insurance industry probably cares little which way this goes.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-20T02:44:06Z</published>
			   <updated>2009-11-20T02:44:06Z</updated>
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		        <![CDATA[<p>Ramona - The evidence indicates that mammography starting at age 50 saves lives.  The results are not dramatic, but more than sufficient to justify the screening (e.g., about 1300 women screened for 10 years to avert one breast cancer death).</p>

<p>Unfortunately, there is no evidence that mammography before age 50 saves lives.  There is no evidence for a net benefit of screening in the 40-49 age group.  This has been known for some time, but too many advocacy groups resisted acting on it, and so it has been up to the latest Task Force to bring it to attention again.</p>

<p>In Europe, screening routinely starts after age 50, because the political forces play less of a dominant role.</p>

<p>If the new recommendations are implemented, as I believe they should be, women will still be able to choose screening if they wish, but will no longer be made to feel guilty if they refrain.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-19T19:02:28Z</published>
			   <updated>2009-11-19T19:02:28Z</updated>
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		        <![CDATA[<p>The corporate/conservative/Republican constituencies are the ones denouncing any change from current routine mammography for women age 40-49.  The change, within the realm of healthcare experts, is being celebrated by many from the liberal side, which has been aware for a while of the lack of evidence that mammography in this age group is beneficial.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-19T18:59:10Z</published>
			   <updated>2009-11-19T18:59:10Z</updated>
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		        <![CDATA[<p>I should add that the health industry is among those promoting political resistance to a change in guidelines, because mammograms are a big money maker. The insurers probably have little to gain or lose from the change.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-19T18:56:25Z</published>
			   <updated>2009-11-19T18:56:25Z</updated>
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		        <![CDATA[<p>No.  The Task Force has been operating independently for some time, and the recent announcement simply related to its ability to assess the evidence and reach conclusions.  However, as I mentioned above, this is not the first time that a rational analysis of data has shown screening to exhibit a net benefit only starting at about age 50.  The previous recommendations met so much political resistance that they were dropped.  The current guidelines are also meeting intense resistance, with attempts to politicize them, but there may be a greater effort afoot these days to base guidelines on evidence than previously.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-19T18:49:48Z</published>
			   <updated>2009-11-19T18:49:48Z</updated>
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		        <![CDATA[<p>Yes, the impetus to eliminate PSA screenig for cancer has grown substantially, and it is now likely that routine PSA testing is on its way out.  Mammography is likely to retain an important role, unlike prostate cancer screening, because it is known to have modest life-saving potential in women age 50 and older, whereas the evidence that prostate cancer screening is of benefit in more than a rare subgroup of men is very meager.</p>

<p>In that sense, the push to eliminate prostate cancer screening has preceded the present push to limit the age group for mammography.  However, it has been known for some time that screening below age 50 had little or no known benefit, but previous attempts to put this knowledge into a change in policy met political opposition from radiologists and various other advocacy groups in the U.S.  In Europe, screening is routinely limited to women age 50 and above.<br />
</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-19T18:43:46Z</published>
			   <updated>2009-11-19T18:43:46Z</updated>
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		        <![CDATA[<p>There is no evidence it has saved lives - see the linked cite in my post.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-19T16:41:01Z</published>
			   <updated>2009-11-19T16:41:01Z</updated>
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		        <![CDATA[<p>Erica - Yes, BC treatment has advanced over the past 13 years, and there has consequently been a modest increase in long term survival among a small subset of women with BC. In a smaller number of cases, this probably includes an increase in cure rate.  The changes do not mainly involve the management of small cancers found at mammography, but rather women with more advanced cancers.  It probably has little relevance, therefore, to cancers detected by mammography and cured while small, but rather relates more to cancers that progress despite mammography or appear clinically in the absence of mammography. Even so, it's possible that on occasion, mammography has contributed to the better prognosis.  If so, its contribution has probably been minor.</p>

<p>How these changes would affect younger women is unclear.  As you point out, their cancers tend to be more aggressive and faster growing, and therefore more likely to progress despite mammography.</p>

<p>At this point, the new guidelines seem best matched to the evidence, which indicates that screening benefits start to become a net positive around age 50, but which also leave enough uncertainty to justify the decision of individual women in the 40-49 age group to have mammograms, and the decision of others to forego them.</p>]]>
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		    <title>Fred Moolten Commented on How Much Does This Senate Health Care bill Save Me? by coonsey</title>
		        
			<published>2009-11-19T03:28:04Z</published>
			   <updated>2009-11-19T03:28:04Z</updated>
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		        <![CDATA[<p>If you want to try to figure some of this out for yourself, here is a link to the proposed Senate bill -</p>

<p><a href="http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf" rel="nofollow">http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf</a></p>

<p>I think it will be hard even for the government, much less the average subscriber of insurance today, to estimate which way his or her premiums will change compared with an unreformed system.  Forces tending to reduce premiums will be measures designed to increase healthcare efficiency overall (e.g., bundled payment mechanisms to providers), as well as government subidies to subscribers who qualify but are currently paying all premium expenses themselves.  On the other hand, premium costs may go up for some current subscribers at the point where insurance plans are required to meet higher standards for the nature of benefits they offer.  Taxes on high end "premium" insurance plans might conceivably be passed on to subscribers of lesser plans, although the extent of this is likely to be small.</p>

<p>Healthy low-risk subscribers in the individual market may see cost increases because insurers can no longer exclude high risk individuals and may therefore raise premiums to cover their extra medical costs. On the other hand, the inclusion of a public option (a "community" option in the Senate version) should reduce costs for subscribers in that market.</p>

<p>Overall, the system is likely to see a cost reduction compared with costs in the absence of reform, but the effect on different individuals will vary in either direction.</p>]]>
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		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-19T03:14:22Z</published>
			   <updated>2009-11-19T03:14:22Z</updated>
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		        <![CDATA[<p>correction - probability the play would <i>succeed</i> is known to be zero in retrospect, not <i>fail</i>.</p>]]>
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		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-19T02:01:30Z</published>
			   <updated>2009-11-19T02:01:30Z</updated>
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		        <![CDATA[<p>There is no evidence for net benefit before the age of 50.  However, the panel did not state that mammograms should not be done in that age bracket, but only that they should be chosen by women based on their individual circumstances rather than recommended as a routine procedure.</p>]]>
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		    <title>Fred Moolten Commented on HAVE A GREAT THANKSGIVING! GOD MIGHTILY BLESS YOU! by Leo Emmanuel Lochard</title>
		        
			<published>2009-11-19T01:56:47Z</published>
			   <updated>2009-11-19T01:56:47Z</updated>
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		        <![CDATA[<p>Uh oh, I'm beginning to feel "the tugs of entropy".  Gotta go.</p>]]>
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		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-19T00:37:04Z</published>
			   <updated>2009-11-19T00:37:04Z</updated>
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		        <![CDATA[<p>Sorry for the "get over it" remark, by the way.  I enjoy this topic because of the many different perspectives that have merit.</p>]]>
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		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-19T00:21:53Z</published>
			   <updated>2009-11-19T00:21:53Z</updated>
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		        <![CDATA[<p>The gist of my argument is this.  No matter how far back in time you trace it (again discounting quantum effects that can be effectively ignored at the macroscopic level and within the human timeframe), the outcome was always determined.  You say the computer didn't know how high the coin was tossed, but that is incorrect, because given enough information, including for example the energy content in the tosser's arm muscle, it could have predicted with 100 percent probability exactly how high the coin would be tossed.</p>

<p>At the time the decision was made, no human had all the relevant information, and so for any human, the probability might have been anywhere greater than zero and less than one, but that is because <i>proability is a function of available information and not an inherent property of an event</i>.  Retrospectively, we have total information about the play (assuming no vast media conspiracy to deceive us) and so the probability it would fail is now known to be exactly zero.  Same play, different probabilities retrospectively and prospectively because prospectively our information was necessarily incomplete and retrospectively it's complete.</p>

<p>In theory, one could go back to the beginnings of the universe and ask whether the outcome of the Patriots/Colts game was determined at that time.  It wasn't, but that was because quantum uncertainties would have had 13 billion years in which to operate, and that's enough time not only to affect the results of a 4th down play, but the existence of planet Earth.</p>

<p>Games of chance don't refute these principles, because incomplete information is always guaranteed.  As long as all contestants are equally ignorant, the games are fair, and equally "chancy".</p>

<p>Wasn't Belichick once implicated in something called "spygate"?</p>]]>
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		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-19T00:03:08Z</published>
			   <updated>2009-11-19T00:03:08Z</updated>
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		        <![CDATA[<p>That's true.  Incidentally, I like the main thrust of your post, and my apologies for diverting it into a discussion of probability theory.  It's just that I find the latter fascinating because every time I think I understand the meaning of probability, it slips through my fingers.</p>]]>
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		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-18T22:33:46Z</published>
			   <updated>2009-11-18T22:33:46Z</updated>
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		        <![CDATA[<p>Hi Donal - I wasn't really trying to start a debate, but just indulging in observations about the nature of probability, because it's a concept I find tantalizingly elusive.  Retrospective probabilities are always exactly one or zero, so we now know the probability the play would succeed is zero.  At the time, the probability depended on the state of knowledge of Belichick or other observers.  Outside of quantum effects, which would have had no discernible impact at the level of football play, complete knowledge even before the play would have shown it to have zero probability of success, but it was reasonable for humans, who never have complete knowledge, to arrive at some other probability value valid for their actual level of knowledge.</p>]]>
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		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-18T22:03:47Z</published>
			   <updated>2009-11-18T22:03:47Z</updated>
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		        <![CDATA[<p>Lulu - get over it.  The "almost" zero was zero for practical purposes, and the word was inserted simply as a nod in the direction of quantum indeterminacy, which, however, would have had no impact in the context of the football game, even if it affected the wave functions describing individual electrons in the football.</p>

<p>Seriously, my only real point (outside of my confessed ignorance of insider football) is that complete knowledge at the time of Belichick's decision would have told him it was inevitably destined to fail, and that the incomplete knowledge he had probably should have told him it was likely to fail.</p>]]>
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            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/fredmoolten//13982.302704-comment:3674778</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/talk/blogs/fredmoolten/2009/11/mammography-probably-yes-but-p.php#c3674778" />
		
		    <title>Fred Moolten Commented on Mammography?  Probably yes, but perhaps not for every age group. by Fred Moolten</title>
		        
			<published>2009-11-18T21:49:48Z</published>
			   <updated>2009-11-18T21:49:48Z</updated>
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		        <![CDATA[<p>To amplify the points in my post above, I should mention a number of considerations.  A reduction in disease-specific mortality without a corresponding reduction in all-cause mortality can reflect (a) errors in disease diagnosis, (b) offsetting increases in mortality from the effects of screening (e.g., radiation, stress, unnecessary surgery, etc.), or (c) the diluting out of small disease-specific mortality reductions by other causes of death to the point where they are too small for statistical detection.  The effects in the 50-69 year age bracket appear to be substantial enough to outweigh any of these other factors, at least as far as mortality if concerned.  Women must still make choices regarding quality of life issues related to screening and the anxiety it may provoke.  That may be an inadequate reason to refrain from mammography starting at age 50, but a rational decision to refrain from screening at an earlier age.</p>]]>
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            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/donal_fagan//398.302630-comment:3674656</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/talk/blogs/donal_fagan/2009/11/going-for-it.php#c3674656" />
		
		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-18T20:59:53Z</published>
			   <updated>2009-11-18T20:59:53Z</updated>
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		        <![CDATA[<p>Well, Lulu, I will stick with my plea of ignorance about football tactics, but I'm correct about the zero probability that Belichick's gamble would work.  That requires an understanding of the meaning of probability as a concept, and an acceptance of my disclaimer that quantum effects preclude zero or 100 percent probabilities, because at the macroscopic level, these effects average out, and so we can come close to absolute determinism.</p>

<p>Briefly, probability is not an intrinsic attribute of an event, but rather a reflection of our information about that event.  If we flip a random coin of ordinary nature, the probability of a heads is 0.5 if we know nothing else about the coin.  However, a computer observing the same coin toss, but armed with knowledge about the coin's center of gravity, its weight, the height of the toss, the initial position, the speed of coin rotation, the wind speed, the slope of the terrain and its elasticity, as well as other important variables, will announce a probability closer to either one or zero, and with total knowledge, would come very close to one or zero.  Same coin, different probabilities for us and the computer.  Which is correct?  They both are, because each is based on a different level of information.</p>

<p>If Belichick had been privy to all relevant information, and the omniscience to process it, he would have known that his decision had a zero (almost) probability of success. </p>]]>
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			<entry>
            <id>tag:tpmcafe.talkingpointsmemo.com,2009://14.302559-comment:3674617</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/2009/11/18/is_islam_uniquely_violent/#c3674617" />
		
		    <title>Fred Moolten Commented on Is Islam Uniquely Violent?  by M.J. Rosenberg</title>
		        
			<published>2009-11-18T20:40:22Z</published>
			   <updated>2009-11-18T20:40:22Z</updated>
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		        <![CDATA[<p>One should not conflate "conflict" with "extremism", because imparting a religious element to an embattled group favors the emergencence of extremist elements.  More than any other force in human psychology, religion, in its most perverted forms, grants license to humans to inflict the most terrible cruelties on other members of their species that conscience would forbid if motivated only by economic or nationalistic goals.  No abomination, however horrible, is to be eschewed, but instead must be embraced with fervor if it is carried out in the service of God's divine mission.</p>

<p>Although cynical leaders will exploit this principle for political gain, their followers are often genuine in their acceptance of faith as a justification for expressing demonic instincts that they would otherwise repress, and in a non-religious ambience, often do.</p>]]>
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            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/david_seaton//1840.302671-comment:3674466</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/talk/blogs/david_seaton/2009/11/an-interesting-take-on-the-shi.php#c3674466" />
		
		    <title>Fred Moolten Commented on An interesting take on the sheikh by David Seaton</title>
		        
			<published>2009-11-18T19:23:50Z</published>
			   <updated>2009-11-18T19:23:50Z</updated>
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		        <![CDATA[<p>I agree pretty much, although there's always an outside possibility of a surprise.  Attorney General Holder considered all of the legal pitfalls before making his decision, consulted multiple legal experts, and is confident the pitfalls pose little threat to a conviction that stands up legally and in public opinion, and which does not rely on tainted evidence.  The comparisons with wartime tactics of attacks on enemy combatants overseas will have little resonance with the mainstream public, however much they might appeal to various partisan groups.</p>

<p>There is no absolute certainty, but Holder will probably be proved astute for making the choice he made.</p>]]>
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			<entry>
            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/donal_fagan//398.302630-comment:3674437</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/talk/blogs/donal_fagan/2009/11/going-for-it.php#c3674437" />
		
		    <title>Fred Moolten Commented on Going For It, updated by Donal</title>
		        
			<published>2009-11-18T19:10:40Z</published>
			   <updated>2009-11-18T19:10:40Z</updated>
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		        <![CDATA[<p>I'm going to have fun analyzing Belichick's decision, which I think was bone-headed, based on my almost total lack of expertise about football strategy.</p>

<p>First, for some physics.  The laws of quantum indeterminancy are more or less averaged out at the macroscopic level at which we operate.  This means that for practical purposes on the football field, we live in a deterministic universe.  Belichick's decision was wrong at the time it was made, and this conclusion is not altered by the fact that we only learned about its outcome later.  If, in fact, he or any other human, had access to all relevant knowledge at the time (which way the wind was blowing, the amount of sweat on the football, the entire history of decisions made by the opposing coach, etc.), he would have known the "gamble" had zero probability of paying off, and would have probably chosen to punt instead (although he might have also seen that as an inevitable failure, in which case he knew the game was lost).</p>

<p>In any case, here's my inexpert take on why it was a bad gamble, and can be summarized by the number 2, taken twice - 2 minutes to play, and 2 yards to go.  Because the Colts were 6 points behind with 2 minutes left, they would certainly gamble if pushed.  That meant ignoring all alternatives Patriot strategies and gambling that the Patriots would attempt to gain 2 yards via a short pass.  This was not inevitable, but likely, because a run had a poorer chance to gain 2 yards, and a long pass is always a gamble for the offense.  By focusing almost exclusively on stopping a short pass, the Colts greatly inmproved their chances of success, and that is what happened.</p>

<p>Note that this would have been different if the situation had been fourth down and inches, where a run was a strong possibility.  It would also have been different if the situation had arisen in the third quarter, where failure to guard against a long pass might have turned a 6 point deficit into a 13 point one.</p>

<p>Anyway, that's my take on what happened to the Belichick, and as the saying goes, "you can't argue with failure".</p>

<p>If anyone wants to prove me wrong, I forewarn them that I intend to plead ignorance.</p>]]>
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			<entry>
            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/coonsey//1805.302459-comment:3674148</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/talk/blogs/coonsey/2009/11/how-about-catastrophic-coverag.php#c3674148" />
		
		    <title>Fred Moolten Commented on How About Catastrophic Coverage for ages 21-45 with a $5000 Deductible by coonsey</title>
		        
			<published>2009-11-18T16:29:51Z</published>
			   <updated>2009-11-18T16:29:51Z</updated>
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		        <![CDATA[<p>Congress now appears likely to pass reform legislation that will make sure that the large majority of Americans have health insurance capable of covering all essential medical services rather than merely catastrophic illnesses (for details, see my comment above).  This should significantly reduce the burden of illness and death experienced by Americans who are currently uninsured or underinsured - indeed, up to 45,000 excess deaths annually are attributable to lack of insurance.</p>

<p>We are the only major industrialized democracy that fails to provide comprehensive coverage for all members of society.  Our outcomes are worse than all the others</p>

<p><a href="http://www.infoplease.com/world/statistics/infant-mortality-life-expectancy.html" rel="nofollow">http://www.infoplease.com/world/statistics/infant-mortality-life-expectancy.html</a></p>

<p>despite the fact that our costs are much higher</p>

<p><a href="http://economix.blogs.nytimes.com/2009/07/08/us-health-spending-breaks-from-the-pack/" rel="nofollow">http://economix.blogs.nytimes.com/2009/07/08/us-health-spending-breaks-from-the-pack/</a></p>

<p>These disparities remain striking even when alleged discrepancies in the criteria used for comparison are adjusted.  In fact, compared with any one nation, our poor showing might be attributable to factors other than our healthcare deficiencies, but our low rank in comparison with all the others is compelling evidence that the types of reform now likely to pass are overdue.</p>]]>
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			<entry>
            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/coonsey//1805.302459-comment:3673698</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/talk/blogs/coonsey/2009/11/how-about-catastrophic-coverag.php#c3673698" />
		
		    <title>Fred Moolten Commented on How About Catastrophic Coverage for ages 21-45 with a $5000 Deductible by coonsey</title>
		        
			<published>2009-11-18T04:14:31Z</published>
			   <updated>2009-11-18T04:14:31Z</updated>
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		        <![CDATA[<p>The bills wending their way through Congress have analyzed this issue and quantified the extent to which insurers should cover medical services.  The House Bill, HR3962, addresses this in some detail.  It specifies a set of essential medical services, which if not covered adequately, would leave subscribers vulnerable to serious illness or death under most ordinary circumstances.  The services include hospitalization, physician visits, laboratory tests, medications, and a variety of other important components of medical care.  In the case of many serious illnesses, the initial expenses involve far less than $5,000, but are still high enough to impede patients from seeking adequate or timely care if not covered by insurance.</p>

<p>The quantitation has resulted in the provision in HR3962 of a tiered system comprising basic, enhanced, and premium plans, all of which cover all of the above services, but to a different extent.  The basic plan has an "actuarial value" of 70 percent, meaning that for the average patient, the insurer would pay 70 percent of expenses and the subscriber the remaining 30 percent.  The other tiers pay higher percentages. Based on past behaviors, the 70 percent minimum is judged to be the minimum value required to adequately protect the health of most subscribers.</p>

<p>A plan with an actuarial value of 70 percent might vary in terms of subscriber cost sharing - in some cases, it would emphasize co-pays or co-insurance, and in others, more of the burden would be placed on deductibles, but even in the latter case, the deductibles would be far less than $5,000.  Such a high deductible leads to actuarial values known to be far too low to be of substantial benefit to more than a minority of subscribers.</p>

<p>I expect that something like HR3962 will eventually pass.  Although as I said earlier, even a high deductible plan, if mandated, would make the uninsured a bit safer, it would not go nearly far enough, and I don't think such a plan has much chance of being part of the final deliberations in Congress.</p>]]>
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            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/m_paul//8940.302277-comment:3673646</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/talk/blogs/m_paul/2009/11/stupaks-wedge-god-what-an-abor.php#c3673646" />
		
		    <title><![CDATA[Fred Moolten Commented on STUPAK&apos;S WEDGE, GOD WHAT AN ABORTION by M.Paul]]></title>
		        
			<published>2009-11-18T03:16:44Z</published>
			   <updated>2009-11-18T03:16:44Z</updated>
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		        <![CDATA[<p>Why did you address that comment to me?</p>]]>
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            <id>tag:tpmcafe.talkingpointsmemo.com,2009:/talk/blogs/m_paul//8940.302277-comment:3673534</id>
		    <link rel="alternate" type="text/html" href="http://tpmcafe.talkingpointsmemo.com/talk/blogs/m_paul/2009/11/stupaks-wedge-god-what-an-abor.php#c3673534" />
		
		    <title><![CDATA[Fred Moolten Commented on STUPAK&apos;S WEDGE, GOD WHAT AN ABORTION by M.Paul]]></title>
		        
			<published>2009-11-18T01:46:36Z</published>
			   <updated>2009-11-18T01:46:36Z</updated>
		    <content type="html" xml:lang="en-us" xml:base="">
		        <![CDATA[<p>Your interpretation of the Stupak amendment is incorrect.  It does not merely prohibit subsidization of abortion, but prohibits women from purchasing an insurance policy covering abortion even it they pay for the policy with their own money.  That is unconscionable.</p>

<p>Fortunately, that provision will probably be greatly moderated or eliminated in the final bill, although it will be important to keep up the pressure to make sure that happens.</p>]]>
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