Jim Miller on Politics

Americans Pay More For Health Care Than Britons:  And we get more.

Patients who have major surgery in Britain are four times more likely to die than those in America, according to a major new study.

The comparison of care, which reveals a sevenfold difference in mortality rates in one set of patients, concludes that hospital waiting lists, a shortage of specialists and competition for intensive care beds are to blame.

  Here are some details:

A team from University College London (UCL) and a team from Columbia University in New York jointly studied the medical fortunes of more than 1,000 patients at the Mount Sinai Hospital in Manhattan and compared them with nearly 1,100 patients who had undergone the same sort of major surgery at the Queen Alexandra Hospital in Portsmouth.

The results, which surprised even the researchers, showed that 2.5 per cent of the American patients died in hospital after major surgery, compared with just under 10 per cent of British patients.  They found that there was a sevenfold difference in mortality rates when a subgroup of patients - the most seriously ill - were compared.

If these results are typical, they suggest that thousands of patients die every year after surgery in Britain who would survive in the United States.

My Apologies  for the lack of posts this weekend.  I was a little under the weather for a couple of days, and just didn't feel up to it.

Evaluating Teachers Is Harder  than most people think.   With kindergarden kids, we might try to evaluate a teacher with tests at the beginning and end of their school year.  That won't always work because the teachers may not be able to control much of what happens in their classroom.  They may not be able to choose the materials or exclude disruptive students who destroy the learning experience for others in the class.  At the other end, college professors are often evaluated by student opinion surveys, but that has its own problems, because it was not clear just what is being measured by those surveys.  (The charge that professors with high teaching evaluations at American research universities are hurt by that is, I am sure, baseless, since the ethical standards are so high in those institutions.)

I was reminded of the evaluation problem by this light Hal Varian column.   (Which I am discussing too late for it to be a free read.  Sorry about that.)   Varian recounts a small study which found that "good-looking professors got significantly higher teaching scores".  (Similar results have been found in other fields, by the way.)

By itself, this study doesn't tell us anything very useful.  Perhaps the students are shallow.  Perhaps they find it easier to pay attention to good looking professors.  Perhaps the good looking professors are, in fact, better teachers, for reasons we don't understand.  But it did remind me of a more significant study, which I saw in Science, about 30 years ago.

The study, and it is the only one of its type that I have seen, was a serious attempt to measure the validity of the student evaluations.  As I recall, a large university had a number of calculus sections that were given sample problems at the beginning of the term and told they would be tested on them at the end, so the goals were clear.  The students filled out the usual instructor evaluation at the end of the course.  Their evaluations were negatively correlated with how much they learned.  In other words, the less they learned, the better they liked their section leaders.  The relationship was not a strong one, but it did meet the usual statistical tests of significance.

What are we to make of all this?  First, there is the obvious point from these two studies, that student evaluations may be as inappropriate from college students as they are from kindergarten kids.  (They may be appropriate in those rare cases where the student is paying the entire cost of the tuition and sees the course as a consumer good, rather than training for a career.)  Reform of our universities must begin with some measurement of what they are doing, but student evaluations may be useless even as part of the measurement.

Second, there is a larger point with much wider application.  If college students find it hard to judge how good an instructor is (or judge the instructor on qualities other than how much they learn), the same is almost certainly true for all those supervisors in all those bureaucracies who fill out similar evaluations, regularly, on their employees.  I don't see a simple solution for this problem, since performance is so hard to measure in many jobs.  Even in sports, with all the data available to coaches and a simple measure of success, coaches regularly err in their evaluations of players.  Perhaps the most we can say is that this gives us one more reason to be suspicious of bureaucratic solutions to problems.  (Oh, and a bit of advice: If, like so many people, you have to fill out these evaluations, it would be sensible to put these thoughts aside while you are doing the chore.)

Who Is Trying to Block Progress for Black Students in Florida?   Our most influential civil rights organization, the NAACP.   The NAACP is suing to stop the use of a standardized test as a requirement for graduation.   They are bringing the lawsuit in spite of the evidence that the test, and other requirements for accountability, have already led to gains in school performance by black kids.

In 1998, for example, 58 percent of Florida's black fourth-graders scored at the lowest rung of the statewide reading exam, while this year only 40 percent did.  By comparison, among whites, this year 15 percent scored that low, compared to 18 percent five years previously.

Why is the NAACP doing this?  Politics.

In fact, the NAACP, in Florida and nationally, has viewed Gov. Jeb Bush and his presidential brother as political enemies whose professed intention to "leave no child behind" in their education policies is empty rhetoric, regardless of the evidence.

No one is asking that the venerable civil-rights group abandon its historic relationship with the Democratic Party.

But the NAACP might want at least to consider whether it is letting its political relationships obscure the best interests of black America.

Welfare reform has done much to improve the lives of poor Americans, many of them black.   Educational reform can do even more.  That the NAACP opposed the first, and is now opposing the second, shows how the organization has degenerated into a faction of the Democratic party, with a reactionary attachment to failed policies

Update:  And their allies in the Democratic party are blocking progress for blacks students, too, like Senator Mary Landrieu of Louisiana.  (The schools in Washington, D. C. are so terrible—in spite of very high spending—that some who oppose vouchers in general favor them there.)

Remember the Patty Murray Theory of Terrorism?  She thinks people become terrorists because we don't provide them day care centers, schools, and hospitals.  Indian officials have arrested 10 suspects in a series of terror bombings around the port city of Bombay.  Were these men deprived of day care centers, schools, and hospitals?  Apparently not.

The Indian Express newspaper this week profiled 10 men who had been detained or arrested for their alleged involvement in blasts across India's western financial hub since last December.

About 70 people have been killed in the bombings, with 52 of the deaths coming from lunchtime twin car-bomb explosions on August 25.

According to the paper, all 10 men were university graduates, with some having degrees in forensic science, medicine, business management or computer software.

Somehow I don't think more day care centers would have made a difference for these fanatics.  And I am almost certain that evidence like this will not change Senator Murray's thinking.

Asia Supports Bush:  Columnist Tom Plate is not a big supporter of President Bush, so what he has to say about the view from Singapore is striking.  Plate begins with his usual criticism, which he attributes to Asians.

Among many government officials, leading academics and others, Tokyo and Hong Kong—not to mention this clean-as-a-whistle, well-run island city-state—there is increasing agreement that future world geopolitics will be framed by the terror counter-offensive of nations and civilizations that value stability and modernity.  Leading that charge is the United States, of course, but doubts grow daily about Washington's wisdom and vision.

"But this is a war that the world must not lose," observes a widely respected senior Southeast Asian official.  "For if the United States fails or walks away from the terrorist challenge, they'll go for us all even worse."

The worry is that the Bush administration is widely—though not openly—viewed as heavy on the hubris and light on the nuance.  It believes it has the answer to almost everything and doesn't want to listen to different views.

Note that Plate's quotation does not support his argument; the official is saying that he is worried about American strength and staying power, not lack of nuance.

That our commitment is their main worry becomes clear in what they have to say about the alternatives to President Bush.

Yet, for all the criticisms of the current Republican administration, it is also widely thought here that if the Democrats regain the White House, the prospects for a sustained anti-terror effort and ultimate stability in Iraq evaporate.  Fairly or not, many in Asia feel the world overall is probably better off with the Bush administration re-elected—while at the same time wishing the Bush people would lower their stratospherically high self-esteem.

Our Asian friends back Bush and think the Democratic candidates are hopeless in the war on terror.  You won't hear that from Peter Jennings or the BBC.

What Kind of Iraqis  are still fighting for Saddam?   Criminals being paid for their dirty work, like Abbas Sayih Dayikh, who blew himself up with his home made bomb.  (Three others died, who may have been innocent.  If they were, that's unfortunate.)

A known criminal, suspected guerrilla and most likely both, Dayikh lived on the fringes of Baghdad's underworld, where residents say U.S. officials and their Iraqi allies are unprepared and ill-equipped to face resistance that has persisted for months.

The Iraqis who knew him don't consider him a martyr or a hero of the resistance.

As residents recall, Dayikh was the neighborhood ne'er-do-well.  He brawled a lot, stabbing a neighbor in the shoulder two months ago.  Even his family acknowledges he drank to excess.  And he was notorious for brandishing his AK-47 assault rifle around the neighborhood, a gaggle of boxy, three-story apartments built in 1973 to house workers of a nearby state-owned factory.

"He was a dirty, filthy person," said Mohammed Salim, a relative of one of the victims.   "You could smell his filthiness a long way away."

Dayikh and others like him do have supporters, notably the American cartoonist, and disgrace to the human race, Ted Rall.   (Here's the correct link to the entire Rall column, if you can stand it.)   Rall's support for men like Dayikh who are both criminals and fascists has not stopped newspapers like this one, which you may have heard of, from publishing his cartoons.

The City Is Seething  with anti-Americanism and hatred for Bush.  Political leaders are denouncing President Bush with increasing ferocity.  Disorder and crime are increasing.   Deaths in the war reached 195, by the latest count.   Radical clerics continue their campaign against the American forces.  The history of violence in the area make many wonder whether it is wise to keep American forces there.   Despite all this, I think that we should not withdraw our forces from the "Seattle Triangle".  In my view, it would be an error to yield to violence and threats of violence.

(Some explanations:  I assume you already know that Seattle Congressman Jim McDermott is not entirely fond of President Bush, and that he is not unique in his attitudes.   As of May, the latest month for which data is available, the crime rate was up by more than 10 per cent in Seattle over the same five months in 2002.   Deaths from drug overdoses in King County, which includes Seattle and most of its suburbs, jumped from 153 in 2001 to 195 in 2002, the latest year for which statistics are available.   The Church Council of Greater Seattle fully deserves the adjective, "radical", though not necessarily the noun "clerics", since their adherence to religious beliefs is, to say the least, weak.  Their support for anti-American causes and leaders, in contrast, is strong.  (Here's an angry, but, as far as I know, accurate, description of the help they gave to Castro, for example.)   Seattle has an extensive history of violence, including a general strike after World War I, and, more recently, the WTO and Mardi Gras riots.)

I did not make this comparison just to be cute, but to bring some perspective and to make a point about the focus of our journalists.  Our losses in Iraq are small by historical standards.  As I described here, we lost 2000 Marines just to capture the small island of Peleliu during World War II.   That's about seven times as many as we have lost, to date, in the entire Iraq campaign, including accidental deaths.  The number of combat deaths is about the same as the number of deaths from drug overdoses during 2002 in King County, which has a population of about 1.7 million.

The number of deaths by drug overdoses, 195 in 2002, almost makes my second point by itself.   Though, as I said, this is about the same as the number of combat deaths in Iraq (and sharply higher in 2002 than 2001), the deaths do not seem to concern many people.  Rarely do these deaths make the front pages of the newspapers.  There are few, if any, protests over the rising toll.  Most of all, almost no one seems to think that any public official might bear some responsibility for the deaths.  Why not? Perhaps the answer can be found in this list: Seattle mayor Greg Nickels (Democrat), Seattle city council (all Democrats), King County executive Ron Sims (Democrat), King County Council (Democratic majority), and Governor Gary Locke (Democrat).  (Though the Republicans control one house of the state legislature, the Democrats control the other.)  Are journalists, who are overwhelmingly Democrats, reluctant to blame Democratic officials for their failures on crime and drugs?  I don't see how to avoid that conclusion.

Cruz Bustamante: Evil Or Stupid?  I have not said anything about Bustamante's membership in that fascist organization, MEChA, because others, notably bloggers like "Tacitus" and Stefan Sharkansky, and talk show host Lowell Ponte, were saying what needed to be said.  MEChA is an organization with an evil ideology and Bustamante's youthful membership requires an explanation, a renunciation, and an apology.  We are unlikely, it would seem, to get a full explanation from Bustamante, and so others have been speculating on why he joined this organization.  As far as I can tell, there are two main hypotheses:  First, Bustamante agreed with the organization's evil goals and may do so, to some extent, even now.  Second, Bustamante was too stupid to realize what MEChA was all about.  Daniel Weintraub of the Sacramento Bee come close to endorsing the "stupid" theory in this post.   And he finds support for that idea in the programs that Bustamante and California's Latino caucus even now back, programs "that are destructive to their own people and to greater California".

Ethnic preferences gave a handful of favored Latinos a leg up into the universities while our public high schools were allowed to graduate (or see drop out) hundreds of thousands of functionally illiterate Latino kids.  Bilingual education doomed young Latino children to second-class status by preventing them from learning English.  But ballot measures to rein in both practices were opposed by every elected Latino Democrat in state office, including Bustamante, and not just opposed but condemned as somehow hateful.

Neither explanation is encouraging.  A person who has done evil can repent and reform, but there is no sign that Bustamante has done so.  Stupidity, on the other hand, is incurable.

James Carroll  is a leftwing columnist writing from Boston.  He thinks the liberation of Iraq was a "terrible mistake".   Jonathan Freedland is a leftwing columnist writing from London.  He thinks that the occupation of Iraq is going "badly wrong".   Ken Joseph is an Assyrian Christian minister with extensive experience and contacts in Iraq.  He has just come back from another visit to Baghdad.  He thinks that the liberation has made the "regular people", those without ties to Saddam, "much better off".   And he suggests, in his mild ministerial way, that journalists have not given us an entirely accurate picture:

I have been shocked at the difference between the Baghdad I found on my return and all the bad news from the city.

Despite the recent bombings, Baghdad looks dramatically different.  The stores are full of supplies.  The streets are crowded with people and cars.  The buses are working and police are on the streets, directing traffic.

At night the streets are full of pedestrians, many families with children.  I am at a loss to reconcile what we see on the ground with what is being reported.

Who is right?  Ken Joseph is closer to the scene and far better informed than Carroll or Freedland.  He is also, as his recent history shows, more open minded.  He changed his mind on the liberation of Iraq after he visited there before the war.   I am sure that Carroll and Freedland have changed their minds when confronted with new data—but can not think of a single example for either man.  And the numbers are on Joseph's side.  Take this one, for example.  If Iraq were getting worse, would not Iraqis be fleeing?  In fact, even though they are far freer to travel, applications for political asylum from Iraqis are sharply down since the liberation.  (Carroll and Freedland each give us a clue to why they err on Iraq, projecting on Bush their own faults.  Carroll thinks that the Bush administration suffers from hubris and hallucination, and Freedland thinks that "ideology is surely the chief culprit".  As self diagnoses, these are hard to fault.)

Israel And Sudan:  This disgusting piece, published in an Egyptian government newspaper, accuses Americans of being, literally, cannibals.  If you read the article, you will see that the author accuses us of crimes in the Sudan (and Liberia!).  His diatribe reminded me that I have long wanted to pose some questions to Muslims, and one in particular to Egyptian Muslims.

Egypt, with a population of about 65 million, is the largest Arab country.  It has land borders with three nations, Libya to the west, Sudan to the south, and Israel to the northeast.  It has had clashes with all three of these nations, being unhappy with Colonel Qaddafi in Libya and the radical Islamists now ruling Sudan.  Two of the nations, Israel and Sudan, have had years long internal conflicts.  The conflict in Israel has cost a few thousand lives.  On the Palestinian side, the dead are mostly combatants, and on the Israeli side, mostly civilians.  The conflict could be ended by the Palestinians at any time.

In Sudan, the most common estimate that I have seen is that 2 million lives have been lost in the civil war there, as the Muslim northerners have attacked the Christian and pagan southerners.  The war has been brutal and has been accompanied by a revival of slave taking by some Muslims.  The southerners can not, by themselves, end this conflict.

Egyptians are passionate about the conflict in Israel, but nearly indifferent to the conflict in the Sudan, where the losses are one thousand times as high.  Why?  The only answer I have been able to come up with is this: Egyptian Muslims see themselves as part of a "super tribe" of Muslims and do not care what happens to non-Muslims, if they are attacked by Muslims.  The claims made, over and over, about their adherence to universal values, rather than tribal values, are false.  And the attacks they make on Israel and the United States in the name of those universal values are fraudulent.  Is there is another explanation for the Egyptian indifference to the two million dead, the torture, and the slavery on their southern border?

Routine Anti-Americanism, Example 11:  This example is from a newspaper that usually is friendly to the United States, the Telegraph.   Adam Nicolson meanders through some descriptions of St. Petersburg, which has recovered both its original name (from Leningrad and, even earlier, Petrograd) and some of its gaiety.   But he is shocked to see that President Putin is putting up a building he thinks is tasteless, in an American style.  He concludes with this bit of moral obtuseness:

For all the sense of rupture and cruelty in Russia, of a hole three generations wide stretching across the bulk of the 20th century; for the tragedy of the biggest country in the world so damaged that it now has an economy no bigger than Holland's; for all the knowledge of the brutalities of absolutism, that the empress whose playthings these were had at least acquiesced in the murder of her own husband and had then rewarded the man responsible with the gift of a thousand serfs; for all the strangeness of Russia, wouldn't the greatest tragedy of all be the drowning of this unique spirit and sensibility under the kind of coarse-grained, marble-and-gold-tap materialism which is the worst side of America's gift to the world?

In a word, no.  Some pretty buildings do not make up for the thousands of serfs who died to build St. Petersburg or the hundreds of thousands who died during Stalin's rule in what was then Leningrad .  Not unless you have truly warped values.   Finally, though this should be obvious, it apparently is not.  The United States can be blamed fairly for many things, but President Putin's taste in architecture is not one of them.

Euroskeptics  will not be surprised that the new currency has not brought prosperity to Europe, that it has, in fact, slowed growth there.

Growth in euroland since the euro's introduction four-and-a-half years ago has been dismal; yet the euro was supposed to enhance growth by lowering interest rates and stimulating investment - something achieved in only a few countries.

So the UK and Sweden are right in questioning whether it will deliver better growth.   Indeed, there is every reason to believe the contrary - that it will lead to slower growth and higher unemployment.

Of course, the euro alone is not to be blamed for slow growth.  The weak global economy, including moribund America, is part of the problem.  But a good monetary system should protect an economy.

Nor are the reasons for this a mystery.  The euro forces a common interest rate, as well as a common currency on nations that have very different economies.  

Supporters of the euro point to the success of the US, with its single currency.  But America's institutional structure differs markedly from Europe's.  Labour mobility is an important part of the adjustment mechanism in the US.

Or, in English: In the United States, workers move to the jobs, which is much harder to do in Europe.

The place this mostly sensible argument against the euro was published is a bit of a surprise; it's the Guardian.

  (Since it's the Guardian, there are the requisite digs against the Bush administration, "moribund America" and "mounting evidence of America's economic mismanagement".  Actually, as Professor Stiglitz must know, the United States has been growing faster and has a lower unemployment rate than the two largest economies using the euro, Germany and France.   If, like me, you are picky, you will notice that Professor Stiglitz can not be bothered to give us even a single piece of that "mounting evidence".  And, though this point will never, ever appear in the Guardian, one of the reasons that growth is slower in the United States than it ought to be, is the slow growth in euroland.)

Voters Are Right To Be Skeptical  about what politicians say, though most modern politicians tell fewer outright lies than you would think.  (They are more likely to deceive by telling part truths.)  In the past, politicians could get away with more, as you can see in this story from Bob Dole's Great Political Wit.

The brilliant rogue Huey P. Long rarely let the truth get in the way of a good stump speech.   Campaigning in heavily Catholic southern Louisiana, Long invariably began each speech by declaring, "When I was a boy, I would get up at six o'clock in the morning on Sunday, and I would hitch our old horse to the buggy and I would take my Catholic grandparents to Mass.   I would bring them home, and at ten o'clock I would hitch the old horse up again, and I would take my Baptist grandparents to church."

Not surprisingly, such evidence of youthful piety had a profound effect on Long's audiences.   One night a local political boss who had gone out of his way to remind the candidate about the preponderance of Catholic voters in southern Louisiana expressed admiration for Long's devout conduct, "Why, Huey, you've been holding out on us," he added teasingly.  I didn't know you had a Catholic grandparent."

"Don't be a damn fool," replied Huey.  "We didn't even have a horse."

(And I can't help but add that Bill Clinton's long time political adviser, James Carville, comes from Louisiana and a family of Huey Long supporters.  Though not as bold a liar as Huey Long, Carville has shown throughout his career a certain, shall we say, flexibility, toward the truth.)

Polls Aren't Good Guides  to election winners this early, as I explained in this post.  You can see one of the reasons that they aren't in these interviews with Iowa voters.  Mark Ohrt is probably typical:

And with the first voting in the presidential race less than four months away, Mr. Ohrt is not certain where to turn.

"There are too many candidates out there," he said, grilling steaks at a softball tournament in this small city a 45-minute drive northeast of Des Moines.  "I wait till they get weeded out.  Everybody who thinks about running is running.  And whether they're saying what we want to hear or whether they're saying what they mean, heck, I don't know, either."

Given this ignorance, polls don't mean much since most voters don't have enough information to make up their minds yet.

And the history of nomination races shows that being a front runner at this stage doesn't mean much in the Democratic party.  

Let Clinton serve as a reminder how dramatically things can change as the race for the Democratic presidential election kicks up another couple of notches after Labor Day.   Democrats, much more than Republicans, have an uncanny knack for turning early underdogs into presidential nominees.

"Any candidate at this point would rather be in Howard Dean's position or maybe Joe Lieberman's, but so much can change," said Frank Newport, editor in chief of the Gallup Poll.  "History tells us that whoever is leading in the polls now has little relationship to the probability that they'll get the nomination.... Any of the candidates on the list right now conceivably could win their party nomination."

(If the reporter had gone back farther, he would have found that the Republicans also have seen many early front runners defeated, though that has not happened recently.  The first Republican president, Abraham Lincoln, was a dark horse candidate and trailed the favorite on the first vote at the 1860 Republican convention.  In 1944, Wendell Wilkie was about as big a dark horse as any candidate ever nominated.  And one can find many other examples between 1860 and 1944.) If you are wondering how Howard Dean, now said to be the front runner, might lose, John Fund explains here.   I should add that I am not sure that Fund is right when he says that Dean supporters are secretly pining for Hillary Clinton.

Worth Reading:  Bernard Lewis is always worth reading, and his opinion column in last Friday's Wall Street Journal gives some timely advice.  Everything considered, we are doing better than expected in Afghanistan and worse than expected in Iraq.

The main difference is that in Afghanistan there is an Afghan government, while in Iraq there is an American administration, and the cry of "American imperialism" is being repeated on many sides.   Even the most cursory examination will reveal that this charge is ludicrously inept.  America has neither the desire nor the skill nor--perhaps most important--the need to play an imperial role in Iraq.  But the accusation--and its resonant echoes in the Western and even in the American media--serve a very useful purpose for those whose complaints and purposes against America are in reality quite different.

Given the diagnosis, the solution is obvious:

What then should we do in Iraq?  Clearly the imperial role is impossible, blocked equally by moral and psychological constraints, and by international and more especially domestic political calculations.  An inept, indecisive imperialism is the worst of all options, with the possible exception of subjecting Iraq to the tangled but ferocious politics of the U.N.   The best course surely is the one that is working in Afghanistan--to hand over, as soon as possible, to a genuine Iraqi government.  In Iraq as in Afghanistan, a period of discreet support would be necessary, but the task would probably be easier in Iraq.  Here again care must be taken.   Premature democratization--holding elections and transferring power, in a country which has had no experience of such things for decades, can only lead to disaster, as in Algeria.  Democracy is the best and therefore the most difficult of all forms of government.  The Iraqis certainly have the capacity to develop democratic institutions, but they must do so in their own way, at their own pace.  This can only be done by an Iraqi government.

Part of this must be the training of Iraqi police.  I have been encouraged to hear that this has already begun on a large scale, with one source saying that we were training 50,000 recruits and another 60,000 recruits.

(By way of contrast, just two days later, New York Times columnist Thomas Friedman called for increasing UN involvement.   UN solutions have become, for a certain kind of commentator, the equivalent of the doctor's "take two aspirin and call me in the morning", a way to avoid thinking about the problem for the moment.  Sometimes the United Nations can be useful, but it is less of a panacea than aspirin, and far more likely to do damage.  Mark Steyn explains here, though Friedman will not pay any attention, why putting the UN in charge of Iraq is a bad idea.)