Archive for April, 2016

The Trump Preference Cascade is moving.

Saturday, April 30th, 2016

rally

Earlier in the year, I predicted that a preference cascade is forming around Trump.

“This illustrates, in a mild way, the reason why totalitarian regimes collapse so suddenly. (Click here for a more complex analysis of this and related
issues). Such regimes have little legitimacy, but they spend a lot of effort making sure that citizens don’t realize the extent to which their fellow-citizens dislike the regime. If the secret police and the censors are doing their job, 99% of the populace can hate the regime and be ready to revolt against it – but no revolt will occur because no one realizes that everyone else feels the same way.

We are in a similar period right now. No one wants to put a Trump bumper sticker on their car because it seems an invitation to vandalism.

Siva is accused of slashing the tires of a Ford Focus and pouring yogurt into the car’s open sunroof while it was parked at a Gig Harbor Fred Meyer.

Police say Siva told them he attacked the vehicle because of the Trump sticker on the rear bumper. Siva allegedly told police he considered the sticker a “hate symbol” and vandalizing the car “improved the community.”

The victim of the crime is considered to be at fault because his bumper sticker was a “hate symbol.”

Rioters at the Trump rally in Costa Mesa California this week felt the same way. They showed their anger in obvious ways.

Protest organizers in Southern California said the anti-Trump demonstrations spread through word of mouth and involved mostly young people, including many high school and college students. They brought with them Mexican flags, which were once discouraged at immigrant rights rallies for fear they would be regarded as un-American.

The demonstrations outside the Pacific Amphitheatre in Costa Mesa on Thursday night blocked traffic and caused tense moments. Some protesters performed screeching burnouts in their cars or did doughnuts at intersections. Others kicked at and punched approaching vehicles, shouting expletives. Ranchera and hip-hop music was blasted throughout the streets. At least 17 people were arrested, and both a Trump supporter and a teenage anti-Trump protester were hurt.

No mention of payment but many of us believe these “demonstrations” are being funded.

What is particularly interesting to me is who is attending these rallies ?

I would like to have attended but I worked that day and was heading home when I heard about it. It was too late and I am not up to that much excitement at my age, anyway. What were the people waiting in line to attend like ?

As noted, the most interesting part of the rally proved the demographics: it was probably 60% women. Lots of minorities as well, plenty of people holding “Latinos for Trump” signs. It was a good mix of African-American, Asian, White, and Hispanic–everybody got along well. Over the loudspeaker, we kept hearing somebody saying over and over that if we saw protestors in the crowd, please do not touch them or say anything to them, just alert security by yelling “Trump! Trump! Trump!” Initially, I thought this was ridiculous, but it worked. Random protestors would get in with the rally crowd and start yelling, and folks would shout, “Trump! Trump! Trump!” The very efficient security personnel would escort the protestors out. No violence.

Doesn’t this sound like the Tea party rallies in 2010 ?

The national polls now show closer numbers and Rasmussen has them tied. Given what I believe is a Bradley Effect, in which people being polled may conceal their real choice to avoid being labeled bigoted by a pollster, I think we might be looking at a Trump landslide. I have wondered if he would implode at some point but I don’t see it.

I really hope the GOP Convention is not attacked by rioters and I do worry about assassination attempts but we will see how this goes on.

Planning another vacation.

Sunday, April 24th, 2016

After our bad experience last year with Europe, we have decided to stay in north America this summer. In June, we plan a trip to Chicago, partly to review family history.

In September, I am planning a bit more adventure in Denali National Park.

I have been there before and we had a family trip 20 years ago with all my kids. We rented a motorhome.

kids alaska copy

This worked well and we spent almost two weeks with time in Denali Park and in the towns of Seward and Valdez.

Kids in Alaska

My youngest was 13 and the other three were all adults. My older daughter had just taken her bar exams in Washington State.

We drove from Anchorage to Palmer where there was a nice RV park with water and power at each site. There we parked for a couple of days and did a couple of local tours.

Camper dinner

The dinners were prepared in the motorhome and we would often be having dinner at 10 PM or later because the sun did not set until 1 AM at that time of year. It was easy to forget how late it was but we weren’t getting up early anyway.

Claire Alaska

The kids got to walk on glaciers. My younger daughter, Claire, is wearing my wool shirt for the glacier jaunt. She had to sleep in the folded down dinette and her brother got her up early every morning so everyone could have breakfast.

Bears

The kids got to see few bears and the rest stops had big warning signs to never take food with you out of the bus.

This year we are going to do something different.

denali-backcountry-lodge

We are going to fly to Anchorage and take a Princess tour that includes a bus to Denali Park and a three day stay at the Backcountry Lodge in the park. It is 50 miles into the park and surrounded by wilderness. The lodge is not roughing it.

BN-DBL-River-View

It is located on a creek that flows past and there is a lake nearby. There are day tours for those more energetic.

Anyway, I have made reservations for early September which is after most of the tourist season. I’m looking forward to it. I tried to interest our English friends in coming over to go with us but they have other things to do.

Denali_Backcountry_Lodge4

I can’t think of a much better way to spend a week. After the lodge, we will go back to Anchorage and then to one of my favorite places, Homer Spit.

homer spit

It doesn’t get much better then this although the hotels are a bit basic. Some of the kids who work on fishing boats just camp on the beach. They got out for days at a time and no one bothers their stuff.

tents

Life is good. Some of these kids can make $50,000 in a summer with no expenses.

Why Importing Foreign Doctors may not fix the shortage.

Sunday, April 17th, 2016

MoS2 Template Master

The coming doctor shortage that I have previously written about might be dealt with as Canada did with theirs some years ago, by importing foreign medical graduates. Britain has adopted a similar plan as thousands of younger doctors plan to leave Britain.

How is the plan to import foreign doctors working out ?

Not very well.

Nearly three-quarters of doctors struck off the medical register in Britain are foreign, according to shocking figures uncovered in a Mail on Sunday investigation.
Medics who trained overseas have been banned from practising for a series of shocking blunders and misdemeanours.
Cases include an Indian GP who ran an immigration scam from his surgery, a Ghanaian neurosurgeon who pretended he had removed a patient’s brain tumour, and a Malaysian doctor who used 007-style watches to secretly film intimate examinations with his female patients.

First of all, foreign medical schools are often limited in real experience and students often graduate with nothing beyond classroom lectures.

This was the case with Mexican medical schools, like that in Guadalajara where many American students attended. A program was devised to provide them with a year of clinical training before they could be licensed.

The revelations come just a week after it emerged health bosses want to lure 400 trainee GPs here from India, to help ease short-staffing in the NHS.
Last night Julie Manning, chief executive of think-tank 2020 Health, said: ‘The NHS has thrived on many international doctors coming to work in the UK – but the public needs reassuring they are all truly fit to practise in the first place.’

Of course, the foreign doctors have their defenders.

Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin, admitted ‘there is a problem’ with the high strike-off rate among foreign doctors. But he claimed racism played a part.

We have a similar problem with affirmative action medical graduates but the figures are not available about their rates of license revocation. For example, the The Alan Bakke case went to the US Supreme Court, which eventually ruled in his favor. By the time the court ruled, years had gone by and Bakke eventually did gradate from medical school and has practiced quietly ever since.

However, a black student admitted by the program that denied Bakke a place was subsequently prosecuted for gross negligence and his license removed. Affirmative Action has been vigorously defended.

An admissions process that allows for ethnicity and other special characteristics to be used heavily in admission decisions yields powerful effects on the diversity of the student population and shows no evidence of diluting the quality of the graduates.

However, the conclusion does not match the findings in the study.

Regular admission students had higher scores on Parts I and II of the National Board of Medical Examiners examination, and special consideration students were more likely to repeat the examination to receive a passing grade.

The article goes on to explain that There was no difference in completion of residency training or evaluation of performance by residency directors.

A friend of mine was the Chairman of the Department of Surgery at a UC medical school who decided to fire a black female resident for incompetence. He was advised by the UC system and the other department heads that he would lose a lawsuit if she filed one. She did, in fact, file such a lawsuit alleging racial prejudice (of course). The department chair was able to successfully defend his decision but the fact that no one else was willing to try explains the finding that There was no difference in completion of residency training or evaluation of performance by residency directors.

I have had the experience of being a Surgery Department Chair in a community hospital confronted with the application of a known incompetent surgeon. The same factors apply to those known to be dishonest. A request for a letter of reference from the department in which the applicant trained usually results in a response that states, “The applicant completed the residency from X date to Y date.” No other information is provided and a further request is usually answered by “The matter is in litigation,” or words to that effect. This applies to all such applicants but affirmative action individuals are almost impossible to find negative information on even if the “grapevine” has provided warnings.

The general concern can be found, but details are thin on the ground.

A quick scan of the documents reveals that white students applying to medical school with a GPA in the 3.40-3.59 range and with an MCAT score in the 21-23 range (a below-average score on a test with a maximal score of 45) had an 11.5% acceptance rate (total of 1,500 applicants meeting these criteria). Meanwhile, a review of minority students (black, Latino, and Native American) with the same GPA and MCAT range had a 42.6% acceptance rate (total of 745 applicants meeting these criteria). Thus, as a minority student with a GPA and MCAT in the aforementioned ranges, you are more than 30% more likely to gain acceptance to a medical school.

There are other sources of the facts, but they don’t appear in mainstream publications. Social Justice keeps most of these concerns underground.

A friend of mine, who is Cuban born and an immigrant as a child, applied to UC, San Francisco medical school. This was in the 1970s. Affirmative Action was well underway. He waited several weeks, then months, to hear if he had been accepted. Finally, he drove to San Francisco and asked someone in the Admissions Office what had happened to his application. He was told that it was in the “Hispanic Applicant Committee.” Having no idea what criteria such a committee might be using to determine who should be admitted, he asked if his application could just be considered as a “white” applicant. This was done and he received a letter approving his admission a few days later.

The pressure is now on medical education to provide the hundreds of thousands of new doctors this society believes it needs. Productivity of the present graduates is well below that of my generation. Some of that is the disappearance of fee-for-service practice which motivates work ethic. Some of it is a result of the 60% female medical school classes.

The female doctor population is acknowledged to work less.

Today, however, increasing numbers of doctors — mostly women — decide to work part time or leave the profession. Since 2005 the part-time physician workforce has expanded by 62 percent, according to recent survey data from the American Medical Group Association, with nearly 4 in 10 female doctors between the ages of 35 and 44 reporting in 2010 that they worked part time.

This was the reason why medical school admissions committees “discriminated” against female applicants in the 1960s when I was a medical student. They were concerned, even then, about a doctor shortage and assumed women would stop working to have children or practice part-time.

They were absolutely correct.

Canada is finding some productivity issues and even some explanation.

a fee for service model, and its inherent encouragement of increased productivity through increased volume of patients, a significant shift away from this single model is taking hold.

This, of course, will not deter the Social Justice types as more doctors with less productivity is somehow more efficient than paying doctors more to encourage higher work loads. Socialism is the aim, productivity will have to take care of itself.

In the meantime, PHYSICIANS WHO DID not attend medical schools in the United States or Canada, referred to as “international medical graduates (IMGs)”, play an integral role in the U.S. health care system. Such physicians now represent approximately 25 percent of practicing doctors nationwide.

It’s going to increase.

Sailing

Saturday, April 9th, 2016

I’m tired of politics again and here is a bit more on sailing.

My first Sailboat that I owned was an Ericson 28 that looked just like this one.

ericson_29_photo

It was just right for our small family and we spent many days at Catalina. Mike Jr went with us but the others were still small.

Than, in 1975, I bought a bigger boat, a Yankee 38.

2094-C2 Yankee 38 sailing2

Here is the Yankee on the day we had open house.

Yankee38

The Yankee had a very nice interior and I began to get involved in racing. The boat was a classic design by Sparkman and Stephens but the IOR had changed the world of racing sailboats and the design was never very successful. Still, it was bulletproof and I had a lot to learn. We sailed it to Mexico several times,including one experience with a small Mexican hurricane. In 1978, I was ready for something with more potential and bought an aluminum boat designed by Doug Peterson, who had designed a world One Ton champion boat named Ganbare, Japanese for “Good Luck.” The boat I bought was built in San Diego by Carl Eichenlaub who had been building wooden race boats for years. He had recently gone to aluminum and this boat was owned by the same man I had bought the Yankee 38 from.

Peterson35

That was the Peterson 35 that I owned in 1977 to 1979. I was a very good light air boat and needed new sails that I could not afford at the time due to a divorce. It also rolled a lot in heavy air downwind so I did not want to take it in long races. Eventually, it ended up in San Francisco and did well in a single handed Transpac with a new owner.

After this boat was sold, I bought a J 24 for local racing until I recovered financially.

J24

It looked a bit like that one but Orange and I named it “Cheap Trick.”

J24

This is it racing off Dana Point taken through a telephoto lens.

J24-2

There it is rounding the windward mark and setting a spinnaker. Eventually, I recovered financially and was still interested in racing.

The next boat was a Scott Kaufman design that was built by Dennis Choate who I had known for years.

CatalinaLaborDayRace

It was light for the time and fast and very strong. We tested the strength with a windy Transpac. I would have been better advised to keep the Yankee and stay with cruising but the divorce was based a bit on issues of professional satisfaction and racing provided some ego gratification I needed.

Here we are motoring out to the start of the 1981 Transpac.

Transpac

The start and most of the race was recorded on a movie I made. I still watch it once in a while.

That is a clip from a longer movie I made. It is a spinnaker change 1000 miles offshore.

hawaii

Here we are turning into the slip in Ala Wai Harbor after the finish. Next to our slip is the schooner Spike Africa, which had raced in a schooner race and carried our cruising gear for the trip home. We unloaded the racing sails to Spike Africa and the delivery crew used only cruising gear to go home.

The crew looks like they have been up all night because they have been. It’s about 6:30 AM. We finished at 6:10, nine minutes later than we needed to win the whole thing.

hawaii 1

We had won second place in fleet and only missed first overall by 9 minutes.

trophy

That pretty much ended my racing career.

Eventually, another divorce led to another boat sale and I ended, several years later, with a nice cruising boat, a Cal 34.

family

This was nice for Catalina and I had finally given up on races, about two boats later than I should have. Still, if they offered to give me back the money, I probably would decline the offer. I had a lot of fun and some great experiences.

Cal 35

Claire and the kids liked the boat. It was big enough for the family.

Claire Cal 34

I had a 13 foot Whaler and the older kids could even go to Avalon although I worried when they went after dark. I had a mooring at the Isthmus and later at Emerald Bay. I should have stopped there. I replaced the Atomic 4 engine but balked at spending the money to put a new diesel in the boat for about $10,000. That was a mistake.

Eventually, the kids grew up and nobody was into boats just then. I sold it when I should have kept it and replaced the engine with a diesel.

My next adventure was a few years later and very, very expensive. I decided to buy a Cal 40 and restore it. Boy was that expensive !

After the whole project was finished, we had a few nice trips to Catalina.

conquest

The LA Yacht Club is the one I had been member of since 1977 and they have a nice facility at Howland’s Landing on Catalina.

Howlands view

There is a nice barbecue pit and tables plus a shower. The view is good and it is a pleasant mooring spot except on big holidays when it gets crowded. I eventually had my own mooring around the corner in Emerald Cove.

Howlands Memorial Day

I finally figured out that I was not up to handling the Cal 40 by myself and should have stayed with the smaller boat. I sold it in 2010 and now my only boat is a Lido 14 on Lake Mission Viejo. I will probably get some use of it this summer. No Catalina trips, though.

lido 14

It looks like this one but is light blue.

Feminism and Victimhood Culture.

Friday, April 8th, 2016

We are living an age when any reference to women runs the risk of violating the “victimhood” rights of feminist women.

What is “Victimhood?” It was explained by two sociologists in 2014.

We’re beginning a second transition of moral cultures. The first major transition happened in the 18th and 19th centuries when most Western societies moved away from cultures of honor (where people must earn honor and must therefore avenge insults on their own) to cultures of dignity in which people are assumed to have dignity and don’t need to earn it. They foreswear violence, turn to courts or administrative bodies to respond to major transgressions, and for minor transgressions they either ignore them or attempt to resolve them by social means. There’s no more dueling.

The “Honor Culture” requires that one avenge insults to preserve honor. The law and third parties are avoided and this culture is typical of areas where law and authority is mostly absent. A classic example is the American West in the Age of the Frontier. As law and authority became available, the culture gradually changed to one of The Culture of Dignity in which people are assumed to have dignity and don’t need to earn it. They foreswear violence, turn to courts or administrative bodies to respond to major transgressions, and for minor transgressions they either ignore them or attempt to resolve them by social means. There’s no more dueling. Lawyers have made this culture ubiquitous, even in war.

Now, we have a new phenomenon.

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Government: the things we do together.

Wednesday, April 6th, 2016

cal

Barack Obama is fond of describing government this way.

As President Obama said the other day, those who start businesses succeed because of their individual initiative – their drive, hard work, and creativity. But there are critical actions we must take to support businesses and encourage new ones – that means we need the best infrastructure, a good education system, and affordable, domestic sources of clean energy. Those are investments we make not as individuals, but as Americans, and our nation benefits from them.

That was a reaction to Romney’s criticism of his silly comment.

I prefer the quote attributed to Washington.

“Government is not reason, it is not eloquence,—it is force! Like fire, it is a dangerous servant, and a fearful master; never for a moment should it be left to irresponsible action.”

Now, we see a new imposition.

The Department of Labor says its so-called fiduciary rule will make financial advisers act in the best interests of clients. What Labor doesn’t say is that the rule carries such enormous potential legal liability and demands such a high standard of care that many advisers will shun non-affluent accounts. Middle-income investors may be forced to look elsewhere for financial advice even as Team Obama is enabling a raft of new government-run competitors for retirement savings. This is no coincidence.

Labor’s new rule will start biting in January as the President is leaving office. Under the rule, financial firms advising workers moving money out of company 401(k) plans into Individual Retirement Accounts will have to follow the new higher standards. But Labor has already proposed waivers from the federal Erisa law so new state-run retirement plans don’t have the same regulatory burden as private employers do.

State run retirement plans. What could go wrong ? Well, we saw one version in Cyprus in 2013.

European leaders reached an agreement with Cyprus early on Monday morning that closes down the island’s second-largest bank and inflicts huge losses on wealthy savers.

Those with deposits of less than €100,000 (£85,000) will be spared, but those with more than €100,000 – many of them Russian – will lose billions of euros under draconian terms aimed at preventing the Mediterranean tax haven becoming the first country forced out of the single currency.

The deal is expected to wreak lasting damage on the Cypriot economy, which has grown reliant on offshore banking and Russian money. Analysts said Cyprus could see its economy contract by 10% or more in the years ahead.

Well, those Russian oligarchs deserved it. Maybe American companies attempting “inversion” deserve it too.

CEOs have learned to keep mum in the Obama era, lest their companies be punished like J.P. Morgan after Jamie Dimon criticized some parts of Dodd-Frank. So it’s worth noting the candid reaction after a new Treasury rule scuttled the merger between Pfizer Inc. and Allergan PLC.

The companies ended their $150 billion tie-up after Treasury Secretary Jack Lew issued new rules that made it harder for companies like Pfizer to move to Ireland to legally lower their taxes. Pfizer will have to pay Allergan a breakup fee of $150 million, though Allergan shares are still down more than $10 billion since the Treasury ambush.

I am not a slavish advocate of corporate tax avoidance but we are in an era of confiscation.

“If the rules can be changed arbitrarily and applied retroactively, how can any U.S. company engage in the long-term investment planning necessary to compete,” Mr. Read writes. “The new ‘rules’ show that there are no set rules. Political dogma is the only rule.”

He’s right, as every CEO we know will admit privately. This politicization has spread across most of the economy during the Obama years, as regulators rewrite longstanding interpretations of longstanding laws in order to achieve the policy goals they can’t or won’t negotiate with Congress. Telecoms, consumer finance, for-profit education, carbon energy, auto lending, auto-fuel economy, truck emissions, home mortgages, health care and so much more.

Now, they want everypne to “invest” in state run “retirement programs.” CalPERS has not distinguished itself, except perhaps in corruption.

After spending years dogged by unpaid debts, California labor leader Charles Valdes filed for bankruptcy in the 1990s—twice. At the same time, he held one of the most influential positions in the American financial system: chair of the investment committee for the California Public Employees’ Retirement System, or CalPERS, the nation’s largest pension fund for government workers. Valdes left the board in 2010 and now faces scrutiny for accepting gifts from another former board member, Alfred Villalobos—who, the state alleges, spent tens of thousands of dollars trying to influence how the fund invested its assets. Questioned by investigators about his dealings with Villalobos, Valdes invoked the Fifth Amendment 126 times.

Well, it is California where Hispanics, especially illegals, run the state.

Last month the board of California’s new “Secure Choice” retirement plan wrote to state legislators about their “exciting win” in Washington. They reported that employers enrolling workers in the new government-run plan “would have no liability or fiduciary duty for the plan.” Score! The California bureaucrats added that “we have been given the green light to auto-enroll workers into an Individual Retirement Account (IRA).”

What could go wrong ?

The Doctor Shortage, discovered once more.

Friday, April 1st, 2016

33 - Lister

I have previously written posts about a coming doctor shortage.

They assume that primary care will be delivered by nurse practitioners and physician assistants. They are probably correct as we see with the new Wal Mart primary care clinics.

The company has opened five primary care locations in South Carolina and Texas, and plans to open a sixth clinic in Palestine, Tex., on Friday and another six by the end of the year. The clinics, it says, can offer a broader range of services, like chronic disease management, than the 100 or so acute care clinics leased by hospital operators at Walmarts across the country. Unlike CVS or Walgreens, which also offer some similar services, or Costco, which offers eye care, Walmart is marketing itself as a primary medical provider.

This is all well and good. What happens when a patient comes in with a serious condition ?

The health policy “experts” have been concerned to train “lesser licensed practitioners” and have pretty much ignored primary care MDs except to burden them with clumsy electronic medical record systems that take up time and make life miserable.

I repeatedly ask medical students if they would choose a career in primary care if it would completely erase their student loan debt. A few hands go up, but not many. In fact, for a while now, the federal government has dedicated millions of dollars to repaying loans for students who choose primary care. Yet residency match numbers show that the percentage of students choosing primary care is not increasing. Though loan forgiveness is a step in the right direction, medical students realize that by choosing a more lucrative specialty, they can pay off their loans just fine.

I proposed years ago, a health reform that resembled that of France where medical school is free. It could be arranged that service in primary care, low income clinics would give credit against student loans. Nothing happened. Except physician income has declined. And tuition has increased.

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