Data-mining is not free speech, says federal court

The lede:

A federal appeals court ruling that upheld New Hampshire’s ban on commercial use of prescribing data could clear the way for other states to pursue legislation restricting drugmakers’ access to information they use to tailor marketing pitches to doctors.

The 1st U.S. Circuit Court of Appeals in November found that the 2006 New Hampshire law did not violate the First Amendment, overturning a lower court ruling. The court’s three-judge panel rejected the plaintiffs’ argument that the law prohibited free flow of information.

The judges said the law regulates conduct, not speech, and the state had presented evidence to show that prescribing data was used to fine-tune drug reps’ marketing pitches for higher-cost, brand-name drugs that were not always more efficacious.

“While the plaintiffs lip-synch the mantra of promoting the free flow of information, the lyrics do not fit the tune,” wrote U.S. Court of Appeals Judge Bruce M. Selya in his opinion.

The whole shebang.

Pondering placebos

The lede:

Doctors know there’s little clinical value in prescribing medications that won’t work. But that doesn’t keep patients from asking for them.

Mitchell Kahn, MD, knows this struggle. The Bellingham, Wash., internist prefers to talk patients through their problems and offer therapeutic reassurance. But the reality is that days are long, time is short and sometimes, he said, patient demands just wear you down.

Dr. Kahn is not alone. Patients who demand antibiotics for the common cold or ask their doctors to recommend vitamins are found frequently in physician exam rooms. They present doctors with an ethical dilemma: When all else fails, is it OK to harness the power of the placebo effect, and what should patients be told?

According to a British Medical Journal study, more than half of American physicians regularly recommend treatments aimed primarily at achieving a placebo effect.

The whole shebang.

Link rot

Information overload — news overload, to be more precise — can be a problem, though it is a wonderful problem to have.

The main reason people read “the news” — is to satisfy a general sense of obligation to “know what’s going on.” It is to avoid that terrible sense of embarrassment you might feel if you had no idea what a co-worker was talking about when she asked, “Can you believe what those monsters did in Mumbai?”

This need, as well as the desire to follow news of deep personal interest such as how your favorite stock or sports team is doing, used to be easily satisfied by reading the daily newspaper. Now that you could probably spend hours a day researching your stock or your sports team, the question of when enough is enough is highly pertinent. Each new link seems to ask, “Do you want more information?” How do you think about answering that question? How can news organizations help you decide the answer to that question?

Daniel Luzer attempts to take on the issue in a piece for the Columbia Journalism Review called “Linked Out.” The gist:

In mid-October, I decided to spend a day following the news through hyperlinks only. I followed every link I could find. I stuffed myself full of news to understand the potential and problems of the hyperlink. How much does the hyperlink matter? Is it an incidental addition to news, or does it actually change the way people consume information?

To describe this approach as conceptually stillborn would be polite. To describe it as idiotic and moronic would be impolite, but perhaps more apt. The methodology is akin to studying urban sprawl by randomly taking every highway off ramp for a day or consumerism by walking into every store on a street. It is a pointless gimmick that does not in any way resemble how real people behave, or tell us anything useful about the subject at hand.

Really difficult syndication

So, I’ve come to your Web site. Looks interesting. No, I’m not going to bookmark it, because then I’d have to remember (1) where I bookmarked it and (2) to click on the bookmark. What I’d love to do is add your RSS feed to my news aggregator of choice. But why do so many news sites make that a daunting prospect?

For example, I’ve heard good things about the pro-am/citizen journalism Web site, Chi-Town Daily News. But check out the RSS page.  There are more than 20 feed options, and not a one of them is a general site feed or “top news” or “top headlines” or “front page” or whatever. And worse, many of the feeds carry vague titles such as “Thesis 11” and “Reality of my surroundings.” So, which feed do I subscribe to?

Gapers Block is another Chicago news site guilty of the same sin. No general or “top news” or “main” feed. And would you have guessed the “Mechanics” feed covers politics, not auto repair? Yeah, me neither. (That should not be confused, of course, with “Transmission,” which covers music.) Site editor Andrew Huff says there is some sort of technical hurdle to providing a general site feed. I take him at his word, but that doesn’t make it any less irritating.

Don’t get me wrong: I love the fact that I can subscribe to the Boston Globe’s Celtics and Red Sox coverage without getting the rest of its news content. But check out how logical the Globe’s RSS feeds page is. There are ways of doing this well.

Sites should make syndication quick, easy and intuitive. Is that too much to ask?

By the way, Russ Smith’s new Web site, Splice Today, does something I find odd for this Web day and age. It prominently asks users to “make Splice your home page.” Isn’t that awfully presumptuous for a brand new Web site? Most users are already attached to a page that’s been their starting site for a while, often years. It’s sort of like someone proposing marriage on the first date.

Update: Chi-Town Daily News head honcho Geoff Dougherty tells me the all-news feed shows up in the “subscribe to this page” option now available in many Web browsers’ URL bars (not mine, however). Nevertheless, the RSS feeds page still could use some clarity given that many users are interested in drilling down to more specific syndication options.

Primary care shortage a primary concern

The lede:

The lack of access to primary care doctors leads to worse health outcomes and higher costs, according to an American College of Physicians report released in November and aimed at influencing the shape of impending health system reform. As the population ages and demands on health services increase, Americans will find it more difficult to locate primary care physicians to help coordinate care in a fragmented system.

The 63-page ACP white paper reviews more than 100 studies from the last 20 years and concludes that the proportion of primary care doctors in a community is related to population health outcomes and system costs. The number of U.S. medical graduates entering residences in family medicine and internal medicine has dropped by half in the last decade as physicians pursue less time-squeezed and higher-paying specialties, the ACP report said.

The report comes amid signs from Capitol Hill that politicians are taking the work force shortage seriously.

The whole shebang.

Wise up

Roger Ebert adds “Magnolia” to his list of “great movies” today, writing a new review for the occasion. He concludes:

“Magnolia” is one of those rare films that works in two entirely different ways. In one sense, it tells absorbing stories, filled with detail, told with precision and not a little humor. On another sense, it is a parable. The message of the parable, as with all good parables, is expressed not in words but in emotions. After we have felt the pain of these people, and felt the love of the policeman and the nurse, we have been taught something intangible, but necessary to know.

This should not come as too much of a surprise, considering that Ebert has always been very supportive of Paul Thomas Anderson’s work and gave “Magnolia” four stars when it came out. Still, it is nice to see this unfairly derided film get such a high profile plaudit.

A thankless proposition

Unlike some people, I adore each element of the traditional Thanksgiving meal. I wish I could have Thanksgiving dinner all year ’round. How about a theme restaurant where every day is Thanksgiving? All the great fixings without any of the hassle — or in-laws.

Call it … Thanks!

You know, waiters in pilgrim outfits, waitresses dressed like Indians wearing feathers in their hair. Breakfast is turkey omelettes with a side of stuffing. Lunch is “leftover” turkey sandwiches. TVs showing the Detroit Lions losing on a loop. Have a section of the menu with 1621-style offerings.

Some taglines:

  • Thanks! — Thanksgiving day, any day of the year
  • Thanks! — We’re grateful you came
  • Thanks! — Thanksgiving leftovers delivered fresh to your table

This started in my mind as a joke, but now it’s developed into a half-baked idea.

Tomorrow keeps turning around

As some of you may already know, Karen and I got divorced last month after two and a half years of separation and more than six years of marriage. I’m not sure what explication I’m willing — or able, really — to provide on the matter.

I can say that we are still on very good terms. Indeed, we carpool together to work on those mornings I manage to get myself out of bed on time.

It was 10 years ago this fall that Karen and I met online, back when that was an oddity. Despite the turn of our tale, I think it’s appropriate to note — on this Thanksgiving Day — how grateful I am, and how grateful I always will be, that Karen came into my life.

Momentary lapse in judgment

The world is a lot freer and better off than it was 40 years ago. And we may be even freer and richer 40 years from today. But we are manifestly not experiencing any kind of “Libertarian Moment,” as Nick Gillespie and Matt Welch wishfully and lamely argue in the 40th anniversary issue of Reason magazine.

Now, these fellows are not idiots. They read the news. Even when they wrote this thing up before the election, it was clear the way things were headed. Obama and the Democrats were going to win by demonizing the fictional deregulatory bugaboo of the Bush administration even as Hank Paulson & Co. shoveled hundreds of billions toward Wall Street. Jeepers. Sure doesn’t seem like a libertarian moment, does it? The article very well could have been titled “The Libertarian Moment (Except for the Libertarian Part).”

So Gillespie and Welch came up with a clever way around the reality of the moment: Politics doesn’t matter. Specifically, politics is “always a crippled, lagging indicator of social change.” You see, thanks to technological innovation and ever-rising wealth, individuals are (and will only grow increasingly) more in control of their own lives and destinies than ever before. True, perhaps.

But, you know, whatever you might say about conservatives and liberals they don’t usually say they oppose wealth and innovation. True, they have different ideas about how to achieve those ends, but that is why politics matters. Libertarians need to persuade policymakers (and to some extent, the public) about why their distinctive proposals are the best way to encourage economic growth, innovation and social harmony.

Further, the priority that libertarians place on — oh, just to name one thing — liberty is one that the vast majority of people simply do not share, at least to the same radical degree or level of consistency. Gillespie and Welch know all that. They spend every working day chronicling the idiocy of politicians and the manifest number of ways in which the values libertarians care about are treated like dog shit, not to put too fine a point on it. They even discuss the sad state of affairs succinctly in the article.

So to get around the facts of the matter, they made this bogus cultural argument that is so loaded with caveats and weasel words that it amounts to nothing, really. Some of it is profoundly moronic. Just one example:

… social networking sites such as MySpace and Facebook do not structure interaction as much as provide a not-so-temporary autonomous zone to facilitate it. Individual users tailor the experience to their own desires rather than submit to a central authority. The inhabitants of such a world are instinctively soft libertarians, resisting or flouting most nanny-state interference, at least on issues that affect their favorite activities.

Huh? Do you know what a “soft libertarian” is? Yeah, me neither. How can you be instinctively soft about something? I’ve got an instinct to eat and drink regularly to, you know, survive. But I’m pretty hard core about it. I’m not just nitpicking here. These young, Web-native social networkers were the very ones who supposedly helped win the election for Barack Obama — who is a liberal Democrat, which last I checked was distinct from libertarian. But who knows? Perhaps he is one of those soft (flaccid?) libertarians I keep reading about.

Indeed, two-thirds of voters 18-29 went for Obama. This is the guy now pushing for a $500 billion stimulus package courtesy of the Next Century’s Taxpayers Are Good For It Piggy Bank, who OKd warrantless wiretapping and whose first instinct was to name a torture backer to run the CIA.

It is obviously true that people enjoy wealth, and want to have a say in their own lives. In that very superficial sense, there are lot of soft libertarians out there. But the through line between those near universal desires and the understanding of the political elements that best bring those things about is nonexistent or exists in only the most haphazard sense.

It is that gap — the fact that the vast majority of the public and nearly all politicians  either do not buy the libertarian arguments or disagree with libertarian values (at least when rigidly defined) — that is a recipe for something far from the libertarian moment. Indeed, it does not take much imagination to see how we may be at a critical turning point where impending decisions could make the world a lot poorer and less free when the time comes for Gillespie and Welch’s successors to assess the moment in 2048.

Reason is a fine publication, and I get that they wanted a positive hook to hang their 40th anniversary on. But that is no excuse for libertarian triumphalist baloney. The real story is that all that wealth and technology — the yield of the still sheltered sphere of liberty — is under threat now, and is constantly under threat. It’s not a happy story, though. It never is. But it needs to be told, most of all to ourselves.

(Also posted to Sinners in the Hands of an Angry Blog.)

Gain, then maintain

Folks all over are working to not pack on any pounds over the winter holidays as part of “maintain, not gain” fitness campaigns. Well, the approach I believe I’ve perfected is to eat as gluttonously as though it were the holiday season for the other 10 months of the year. It’s hard to gain much when you’ve already given yourself the leeway of 70 pounds’ excess weight.

The AMA goes green

The lede:

Orlando, Fla. — Most climate scientists say the Earth is getting hotter and that human activity is speeding up the process. At its Interim Meeting in November, the AMA House of Delegates agreed with the scientific consensus.

The house endorsed the findings of the United Nations’ Intergovernmental Panel on Climate Change. Delegates also warned that climate change could have dramatic public health consequences, causing heat waves, drought and flooding, cutting potable water supplies, displacing populations and spreading infectious diseases.

Policymakers should “work to reduce human contributions” to global warming, says the AMA’s new policy, which is based on a report from the Association’s Council on Science and Public Health.

The whole shebang.