Saturday, February 6, 2010

No Dumb Questions

“There is no such thing as a dumb question,” Mr. Stockman told our geometry class. “Ask me anything.” A lot of math teachers say this but they don’t mean it. They never want you to take them literally. I tried it. I asked Mr. Stockman, “How do you spell hypotenuse?” He said that was a really dumb question.

When I was a college student, I got a volunteer internship with the Santa Barbara County Probation Department. I was assigned to drive around in a county car and try to find these probationers who had “temporarily disappeared.” One day I went looking for this guy who was a heroin addict. He was supposed to be on a methadone maintenance program and going to drug abuse counseling sessions, and he wasn’t going to those. So I found him in this rundown apartment in a sketchy neighborhood. He looked terrible. I introduced myself and said I was a student intern with the Probation Department. I asked him how he was doing and he said, “Man, I am really depressed.” So I looked at this poor man—he was unemployed, strung out, really sick, all alone, and about to be taken back to jail—and I blurted out the following brilliant interrogatory: “Why are you depressed?” He looked straight back at me—I appeared to be about fourteen years old—and said, “What are you majoring in?”

A couple of years ago I was explaining to a young research assistant what it was like to run statistics on a computer back in the late 1970s. In those days, you went to the Yale Computer Center, which was housed in an elegant neoclassical building with a rotunda entrance on Whitney Avenue. Inside the YCC you waited to use a big machine that punched little rectangular holes in paper cards. You always screwed up a few cards, so you had to re-punch and replace those in the deck in exactly the right order. Then you would stack up your cards and carry them over to another big machine called the Card Reader, which performed the same basic function as a Hungarian fortune teller. The Card Reader rifled through your cards and “read” the inner meaning in the pattern of holes while you stood there and watched. The Card Reader’s interpretation was then transmitted into the bowels of something called the Mainframe. The Mainframe was massive. You had no idea how it worked. For all you knew, there was a small team of dissident Soviet mathematicians inside there working with slide rules—it was that big. Anyway, you gave the Mainframe a couple of hours and then walked over and inquired at a service desk on the other side of the building, where a guy in a white shirt and tie and pocket-protector handed you a printout the size of the Sunday New York Times. Almost all of it was Error Messages. The next step was to go over and stand in line to speak to another fellow named Dave who was schooled in the arts of Error Message Divination. Usually Dave pointed out that you had forgotten to punch a semicolon on one of your cards. Dave knew very well which card it was, but he wasn’t about to tell you. That was something you had to figure out for yourself. When Dave said this, you would drop your whole deck of cards on the floor of the YCC where they would scatter in a wide radius and mix with the dropped cards of other graduate students. That’s when the real research started. Those were the days.

My research assistant stared at me, wide-eyed. I was suddenly reminded that she was born during the latter years of the Reagan administration. “Could I ask you something?” she said.

“Of course,” I replied. “Ask me anything.”

“Why didn’t you just use Excel?”

* * *

So I had this cool dream the other night where I was wearing a tuxedo up on a big stage, and I was hosting the global awards for Best Health Care in the World.

“Good evening, ladies and gentlemen. It is my distinct honor and privilege tonight to announce the winners in several categories for Best Health Care in the World.

· In the category of Lowest Rate of Preventable Deaths, the winner is France! . . . and the consolation prize for 14th place goes to USA!

· In the category of Longest Life Expectancy, at 77 years for women and 72 for men, the winner is Japan! . . . and the consolation prize for 24th place goes to USA!

· In the category of Fairness . . . Responsiveness . . . and Overall Health Care System Performance, the winner again is France, closely edging out Italy! . . . and the consolation prize for 72nd place goes to USA!

· Finally, ladies and gentlemen, we’ve saved the most important award for last. In the category of Most Expensive Health Care in the World, measured by the highest percentage of gross domestic product spent on health care on the planet . . . topping out at 17.3% of GDP, a whopping 2.5 trillion dollars spent on health care in 2009 and growing at 5.7% . . . the winner is . . . USA!! USA!! We’re Number 1!! No other country comes close! Come on up here, USA, and receive your award . . .”

“Thank you very much, Jeff, and thank you ladies and gentlemen. First, I'd like to point out that we do have the greatest cutting-edge medical care in the world . . . Just ask any Saudi billionaire with a rare form of cancer! Ha ha! But anyway, I’d like to accept this award on behalf of our nation’s insurance companies, pharmaceutical companies, HMOs, our wonderful political system, the lobbyists, and most importantly, Jeff, those 46 million uninsured Americans who really made this possible. If those folks weren’t willing to go without basic health care and then show up and wait for hours in our hospital emergency rooms, I wouldn’t be standing here today. It’s a great accomplishment. And we’re not stopping there! As we speak, we’re seeing to it that 14,000 Americans lose their health insurance every day! Just in the last three years, our nation’s great insurance companies have held the line against 12 million Americans with preexisting conditions and made sure they didn’t get coverage! Looking to the future, there’s a report by the Robert Wood Johnson Foundation that says by 2019 we’ll have 66 million uninsured people in America. People will be spending 40% to 60% more on health care than they are now, and businesses will see their health care costs double—from $429.8 billion in 2009 to $885.1 billion in 2019. Employer spending on health insurance premiums will increase 72 percent. Spending on government insurance programs could double and the amount of uncompensated care in the health system will go through the roof. These are amazing numbers, Jeff. No other country comes close to us on this. We’re Number 1!! USA!!"

“Thanks, USA, and congratulations! Before you sit down, could I ask you one question?”

“Sure, ask me anything.”

“Do you think Congress is going to pass health care reform legislation this year?”

* * *

A girl I knew in high school forwarded an e-mail urging everyone to send an avalanche of messages to Congress to defeat the Democrats’ scheme for a government takeover of the American health care system. The e-mail was from Ralph Reed, the conservative political activist and former head of the Christian Coalition. Reed warned that passage of President Obama’s far-reaching “socialist agenda” would be “the end of America as the ‘Land of the Free’.”

Ralph Reed is a smart fellow with a PhD in American history from Emory, so let me ask you something: Does he really believe this?

I replied to my former classmate and said I supported health care reform. She sent back a three-screener with a lot of material explaining the basics of the Free Market System and some commentary by Republican Congressman Tom Price of Georgia, who is an expert on health care, being an orthopedic surgeon by training.

Doctor Congressman Price was sounding the alarm about the evils of the Democrats’ proposed health care legislation. He cited specific examples, like: “This bill, on Page 733, empowers the Washington bureaucracy to deny lifesaving patient care if it costs too much.” Whoa. That sounded pretty bad. So I downloaded the thing and looked up page 733 and it said the bill would authorize a Center for Comparative Effectiveness Research. The purpose was “to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.” I read it again, looking for the part about denying lifesaving care to patients. I just couldn't find it, and so I gave up on that and went back to the other stuff from Doctor Congressman Price, like: “This bill – on page 301 – will force Americans to purchase the health coverage that Washington picks, not that you select for yourselves.” Whoa again. So I looked up page 301 in the bill and it says people get to pick their own coverage. It says you can keep your current employment-based insurance plan, other grandfathered health insurance coverage, a qualified health benefits plan, Medicare, Medicaid, Tricare for people the Armed Forces, etc.

What am I missing?

Yesterday I read an article about the national Tea Party convention in Nashville. These people are really mad at Obama. For a fee of $100,000 The Sarah is coming to speak and inspire and channel their rage to take back the country from the Socialist in Chief. But even The Sarah may have a hard time topping the opening screed by Tom Tancredo. The former Congressman said President Obama was a “committed Socialist ideologue” who was elected only because “we do not have a civics, literacy test before people can vote.

Come to think of it, when I went to vote last year at the New Hope Fire Station, nobody made me pass a civics and literacy test at all! Maybe that’s a good thing . . . I think I could have passed the reading test. I’m pretty sure I could have answered the question about the 15th Amendment to the Constitution of 1870 and the Voting Rights Act of 1965. But what if they’d asked me to explain the Senate rules that allow one Republican Senator to place a “blanket hold” on 70 Presidential nominees awaiting Senate confirmation so that he can get federal money to build a Counterterrorism center in Alabama?

Now that’s a really hard question. I have no idea what the answer is. I'm just a professor. Remember the professor on Gilligan's Island? He figured out how to make a radio from a coconut, but he had no clue how to fix a hole in a boat. Somebody has to crack this. I wonder if any of those dissident Soviet mathematicians with the slide rules are still around.

* * *


Anonymous said...

I sure hope I'm not the research assistant you're referring to. I was born in the NIXON administration, thank you very much. If you really think I'm that young, I suppose I should be flattered. Besides, I wouldn't have suggested Excel. I would have suggested SPlus.

Anonymous said...

We had a lexis terminal the size of a baby grand piano and some funny little westlaw stations that looked kind of like kaypros in a nook in the library. We were so past cards my friend.

Anonymous said...

Yes I remember this, I was wonking away there 75-76 completing my analysis of employee choice of the Yale Health Plan versus whatever otherwise normal choice people had at that time. Sometimes the mainframe would go “down” and all would be lost. I hated that building but I am sure I had no appreciation of the architecture. And I remember the Lawn Club in the back, used to walk through there on my way home to 591 Orange Street right next to that little convenience store.

Anonymous said...

VERY FUNNY re Excel! I remember vividly watching some grad student senior to me in about 1971 put his IBM cards into the machine and the machine suddenly spewing the cards forth until they rained down on all of us. It was the only copy of his PhD data. I can still see the look on his face.