Jon Stewart Don't Know Squat About Data

This past Wednesday (Mar 27, 2013), the Daily Show included a segment on the backlogs within the VA and found the cause to be

• The reliance on paper to transfer medical records between the DoD and the VA

So far, so good. Good investigative reporting. If they had only left it at that and allowed viewers to form their own conclusions...

Instead, John Stewart made a joke about validating his preconceived ideas concerning Republican responsibility. He played a clip of a Republican member of the Defense Appropriations committe comparing AHLTA (the DoD healthcare information system) and VistA (the VA's Healthcare Information umbrella) to Play Station and X-Box which, though both can use the same TV, cannot talk to one another. AND THEN Mr.Stewart suggested that the parent of the household, if he/she wanted to minimize contention and confusion, could impose a single solution on the household. A photo of President Obama was displayed during this, clearly indicating that all the blame could be laid at the President's feet.

Nothing could be further from the truth. The VA has been assembling the components of VistA since 1987 and it was fully formed by the late 1990s. AHLTA was introduced amidst much fanfare at the beginning of 2004. The birthing process for AHLTA overlapped the adolescence and maturation of VistA, indicating a conscious decision (pre-2004) by the DoD to ignore the VA's efforts.

This entire mess is too complex in its origins and effects to discuss in a single blog entry so I'll content myself with one last piece of exculpatory evidence on behalf of anyone who has assumed elected office since 2004. The only way to move information from AHLTA to VistA is

1. Generate paper from AHLTA
2. Send the paper to the VA
3. Enter the information from the paper into VistA

This is also the reason why the DoD can't simply replace AHLTA with VistA.

There is a lot more to be said on this subject but, among other things, it seems clear that this is but one (albeit very painful) example of the inability of our health care "system" to adopt anything approaching a standardized view of the enterprise. Interoperability is something to be wished for but which cannot exist in an environment in which healthcare systems vendors are the X-Box, the Play Station, and Wii.

Violence and Firearms

A statistic led me to this point.  In reporting on the NRA's response to the Newtown tragedy, the networks reported that the organization has 4 million members.  I was struck by the small number and how disproportionate was their influence.

In a nation of 300 million people, how does 1.3% of that population get to control the debate on the regulation of firearms manufacture, sales and ownership?

Some background on my perspective: I have owned several firearms--as many as three shotguns, two rifles, two handguns and an air rifle at one time.  I enjoy hunting, target shooting and taking care of the weapons.  I do not own or possess any firearms currently.  In the interests of full disclosure, I should also say that I have been a member of the NRA.

Now that those cards are on the table, my opinion of the NRA is that it is an extremist organization.  When I was a member, I was sent messages and asked to pass them along to my elected representatives and/or network media figures.  The language in these messages was, to my mind, extreme and I could not, in good conscience, do as requested by Wayne Lapierre or Charlton Heston.

So how does the NRA wield so much influence?  It's mainly because their voice is the well-orchestrated one.  A voice for something always drowns out the voice against.  They have consistently made the issue about the Constitution and for a right cited in the Second Amendment.  The opposition, such as the Brady Campaign to Prevent Gun Violence, is portrayed as being against the "right" cited in the Second Amendment.

This much is obvious, right?  It's also obvious that the voice that is heard is easily interpreted as the majority.  The NRA is very good at whipping up a frenzy of fearful indignation amongst the membership.  They can generate 4 million (I don't imagine there were too many others like me) emails, letters and phone calls, frequently to multiple targets.  The Brady Campaign can't do this nearly as well.

As we saw in Mr. Lapierre's most recent statements, it is easy to sow seeds of confusion and generate several tangential debates while all the while adamantly holding the flag of the Second Amendment high and calling on loyal Americans to rally to its defense.

In fact, there is no justification for high-capacity magazines and high rate-of-fire except as a thrill for certain kinds of enthusiasts.  (There must be another term for an enthusiastic extremist--or maybe enthusiastic is redundant.)  You can get quite a thrill from cocaine or meth, too, but those thrills are illegal.  I have been in the woods during deer season and heard a single weapon discharge 10,15,or more rounds in the space of a few seconds.  It made me profoundly uneasy as I sat there with my single-shot rifle.  Thrills for a few are not sufficient justification for the level of danger presented.

The Second Amendment could be satisfied with a muzzle loading black powder weapon.  Let's shrug off the "right to keep and bear arms" as the central issue and stay focused on issues more central to the public welfare.

Grace

Grace is the slender but unbreakable thread upon which we are all suspended.  If you happen to be a Christian (as I am) you should know this already.  Other faiths may share this dependence in some way.  Buddhists, for example practice to become at one with life, accepting everything as part of the journey, believing that it is possible to transcend the journey.

I'm sure that Buddhists would express this differently and I won't even attempt a similar expression for Islam or the other religions.

In my mind the most elegant expression of grace is the story (in John chapter 8) of the woman who was apprehended in adultery and brought to Jesus as a test.  Jesus had given the religious Jews the idea that he might not support the ancient Law.  They asked Jesus to condemn the woman according to the Law.  As you will recall, he agreed that she had violated the Law and suggested that whoever among them had not violated the Law should be the one to throw the first stone.

One by one they were shamed by this until none were left.  At this point Jesus asked the woman who was condemning her.  When she answered that there was no one, he said, "Neither do I condemn you."

That's grace.  He then sent her on her way, suggesting that she give up her life of sin.  It would be startling to find out that she had been stoned the very next week after being caught in adultery again.  I put myself in the shoes of this woman and think that if I had been required to confess in order to escape punishment, I would certainly have done so.  Then I would have begun resenting that coercion immediately.  That resentment would certainly have led me back to the sinful life.

It is critical to the concept of Grace that Jesus never asked the woman for anything.  No seed of resentment was planted.  I could walk away completely free and begin at that moment a new kind of life. 

If you believe that confession is a prerequisite to forgiveness, you're probably not a parent.  As a parent, I know that I can demand a confession and apology and I will probably get them.  I also know that an assurance of love and forgiveness will elicit truly sincere remorse including repentance.  Repentance in avoidance of punishment is cheap and unreliable.  Repentance in response to forgiveness (grace) can last the rest of one's life.

You are loved and your are forgiven.  Let your life be a response to that.

The Origin of Species (When is a theory not a theory?)

There are just a couple of things that continue to bother me when discussion turns to evolution. 

First, we're told that this theory explains how higher organisms (like us) gradually developed from much simpler organisms.  This is based on observations of certain small birds which are identical to other small birds except that their beaks are longer (or shaped differently).  We're told that the difference happened by accident (a mutation) and that this accident allowed the mutant bird to survive in a changing environment.  We're told that the mutation was passed on to offspring and that, over time, the birds showed a mating preference for others with the same beak so that after many generations, all descendants of the original mutant possessed the new beak.

This part is believable, though improbable.  The likelihood of a stable mutation that can be genetically transmitted to offspring is small.  The likelihood of the original mutant surviving to produce offspring is small.  The likelihood of the mutant successfully mating, given that differences are generally not accepted by prospective mates, is quite small.  The likelihood of sufficient mutants reaching adulthood and mating with one another to produce a stable breeding population is very small.  Entire breeding populations (known as flocks or herds or packs...are often wiped out completely by sickness, fire, storm, famine or any of a host of devices that nature keeps for such purposes.

As you may know, the probability of a series of things happening together is the product of their individual probabilities.  For example, let's say that the probability of a successful/useful mutation is one in a hundred (1%).  For many species in the wild, the probability of surviving to breeding age is one in three (33%).  Let's imagine that the probability of attracting a mate given that you are visibly different is one in five (20%).  Let's further assume that the probability of any specific individual becoming the basis of a stable breeding population is one in 100 (1%).  The actual probabilities may be much lower but these will do for this illustration.  There are many other conditions, each with it's own probability that might also come onto play but with only these few variables we calculate the probability of success at .01 x .33 x .20 x .01 = .0000066 or less than one in one hundred thousand.

By the way, at this point we have only succeeded in producing a new sub-species because we have assumed that the mutants have bred with non-mutants within the species.  One of the defining characteristics of a species is that interbreeding with another species is not possible or at least highly improbable.

Evolutionists deal with improbability through the use of time.  If enough time goes by, they say, virtually anything is likely to happen, regardless of its probability.   That's hard to argue with.  Hard to argue isn't quite the same as persuasive, though.

The point that is most difficult to accept is the mutation that produced sexual reproduction.  We go from a time in which all reproduction (in single-cell organisms) is via mitosis.  The cells simply split and become two identical cells.  Suddenly, everything changes.  We now need another individual in order to procreate.  This is not a mutation.  The difference can't be explained by evolutionary (meaning incrementally small changes over a long period of time) change.  It seems we are left with only a handful of choices.

• We need more complexity in the origins.  At least we need both sexual and asexual reproduction to be represented in the universe.
• If we insist on a single original lifeform, we need to change the basic building block of evolution from mutation to something else.
• We have to relegate evolution to a much smaller role.

Of course there are many other theories out there to explain the breadth and depth of the diversity of lifeforms on our planet.  They aren't getting enough attention because only one theory, evolution, has been granted the "scientific" seal.

It's not important to me to explain how we became what we are because the the real value comes in understanding how we will become what we should be.  It just raises my hackles when someone says that they have an explanation for Homo sapiens and it is evolution.

A Little Deeper

Let's take that last post a little deeper.  Here are some statements from candidates for leadership office that should automatically disqualify them.

• I'll create jobs
• On Day One I'll [anything]
• I'll ensure the security
• I'll deliver an ultimatum
• I'll undo everything the last guy did (except the parts I agree with)
• What's good for the economy is good for America
• What's good for business is good for the economy (therefore--the logic goes--what's good for business is good for America)

Statements like these are made for one purpose only and that purpose IS NOT accountability.  When the buck is being passed, this guy will ALWAYS make sure someone else is holding it.

Friends, what is good for the people of the nation (as a whole) is good for the nation.  Good for business or good for Undecided Voter have such a small probability of being good for the nation that, to the extent that the candidate is successful in doing these things, they actually do harm to the nation by diverting energy and resources from those efforts that really would be good for the nation.

We simply can't afford to have a leader who has his mind made up before anything happens.  Does anyone believe the world is a simple, easy to understand place?  Does anyone believe that our role in the world is static (that the world moves around us)?

Less taxes and smaller government are standards not morality.  We should have the smallest government and the lowest level of taxation consistent with our place in the world.  Less for the sake of less is not different than more for the sake of more.  Both are evidence of mental imbalance and faulty reasoning.  One is named greed; the other has no name (though it is the opposite of patriotic).

Why do we have government?  According to the Preamble to the Constitution, We, the People, have created the government defined in the Consitution for the purpose of:   form[ing] a more perfect Union, establish[ing] Justice, insur[ing] domestic Tranquility, provid[ing] for the common defence, promot[ing] the general Welfare, and secur[ing] the Blessings of Liberty to ourselves and our Posterity.  THAT is the why and it impossible to justify Cut Taxes and Balance The Budget [someday] as the how.

What's Good For The Economy...

I confess, I am REALLY losing heart when the candidate says (again) that experience in business is the best qualification for leading a nation.  The justification is the Economy.  We need to capitalize it to make it seem like something real.  The Economy IS real but not in the same way that Philadelphia is real.  Well, maybe there are similarities, but my point is that you can't put your arms around the Economy, you can't see the limits, there are no signs that say "now entering The Economy."

First of all, let me say that our nation, The United States of America, even though it does have boundaries, is every bit as subjective a thing as The Economy.

Would we continue to be The United States of America even if The Economy changed?  Of course we would--and we have.  The United States of America is whatever We, The People, are willing to stand up for.

Changes in The Economy have forced many of We, The People, to change the way we think of ourselves and our roles as individuals, citizens, providers, dependents, students, family members, soldiers, sailors, marines, teachers, mayors...  Initially change is hard.  It's like Letting Go of the pool gutter when learning to swim.  Finally though, we understand that we need to Get To The Other Side.  It's only then that we learn to swim.  The Letting Go is only part of the change.  This is the kind of change that we have to focus on because it's the only kind that positions us for the next one.

It is so SMALL and LIMITING and, yes, disheartening to think that business holds the answers for The United States of America.  We, The People, are this nation and let there be no doubt about it.  Not The Economy, not National Defense, not Business, not Education, not anything except each other.  When we stop doing the things that make each other healthier, more knowledgeable, safer, more secure in our hopes for the future and instead focus our efforts on making corporations safer and more secure, we are no longer part of The United States of America.  We have become something else, a virus that manifests as Us versus Them, They Shouldn't Be Able To, What About Me, This Is Mine, There Isn't Enough For You and a host of other symptoms.  None of the symptoms alone can destroy The United States of America, but untreated they spread until they gain control and We, The People, disappear.  When that happens The United States of America disappears except as a multicolored area on a map or globe.

The Middle Class

We have all been hearing a lot about the "middle class" lately and, honestly, I'm beginning to feel insulted by the references.  Much of this feeling probably stems from Barbara Tuchman's book, A Distant Mirror, which I am currently reading.

To try to provide a bit of perspective, I have read Atlas Shrugged (Ayn Rand) and I confess to a sense of horror and revulsion while reading the first quarter or so of the book.  I get it that Congressman Ryan felt the same things.  By the time I reached the end of the book, though, I was experiencing feelings that were the same but directed at the conclusions reached by Ms Rand.  From this I am willing to entertain the possibility that Congressman Ryan quite possibly never finished the book.  If he did then I'm forced to feel horror and revulsion at his conclusions.

A Distant Mirror is a history of the 14th Century in Europe.  The period from 1300 AD to 1400 AD certainly suggests itself as a distant mirror of our own times.  There was schism in what at that time was THE Christian church prompted by political concerns on the part of Church leaders.  Two Popes in two different capitals was the result.  Nobility was a constant theme.  "What is the noble choice?" the question most frequently asked by those in charge (who were, of course, those of noble genetic line).

The "companies," marauding bands of soldiers led by knights (who were nobles) without property, terrorized the countrysides of Europe and were ignored by the King and the landed nobles.

The Black Death made several appearances, killing nearly two-thirds of the population.  This was a serious drain on the economy but, of course, "the ecomony" was an unrecognized concept.  The King and The Church still had need of revenues to fund the lifestyles in which they had grown accustomed and the only source of those revenues was the Middle Class which was taxed unmercifully.

Education was not a concept that entered into any planning by the nobles and they paid bitterly during uprisings by the peasants and middle class when there was indiscriminate killing and destruction.  Fine distinctions as to who or what was responsible for suffering were beyond the abilities of people whose sources of information were gossip and the King's crier.

The most overwhelming indictment of the Nobles was quite simply that neither had knowledge of nor consideration for the lives lived by anyone else.  Glory and wealth (both obtained through constant warfare) were the reason (and reason enough) for whatever actions they chose to take.

The source of my discontent is the apparent notion (in our classless nation) held by a "leader class" that there are in fact lower classes which they may use for whatever ends suit them.  I'm quite sure that this is the source for much of the dissatisfaction we are seeing around the world as well.  The U.S. (leaders) sees itself as the upper class among nations with the duty to pillage and occasionally protect the lower class nations.

"Those who are ignorant of history are doomed to repeat it."