On his broadcast yesterday, Robertson delivered this absurdity:

And you know Christy, something happened a long time ago in Haiti and people might not want to talk about it. They were under the heel of the French, uh, you know Napoleon the third and whatever. And they got together and swore a pact to the devil. They said we will serve you if you’ll get us free from the French. True story, and so the Devil said OK it’s a deal. And they kicked the French out. You know, the Haitians revolted and got themselves free. But ever since they’ve been cursed by one thing after the other.”

His broadcasting operation, CBN, doesn’t seem to be bothered by this. They admit it in this release, and they have the video online. (My system wouldn’t play it, but that’s okay, it’s all over the place, including right here.

Now it happens that a voodoo priest named Dutty Boukman performed a ceremony in August of 1791 which precipitated the start of the revolution, which lasted until 1804. I’ve not seen any accounts that include the number of people involved, but as it wasn’t broadcast we can assume that there were a half million Haitian slaves that had nothing to do with this, other than sharing the desire to end their slavery. I’ve not seen any account that suggests that Satan attended, nor that he clearly committed himself to a deal. We do know that Napoleon III was captured in battle, and the monarchy he led was dissolved on 4 September 1870. He was the last Napoleon to have anything to do with the government of France, and he died on 9 January 1873. Robertson’s pact with the devil didn’t take place until over twenty years after the last Napoleon left power.

I suppose it’s a waste of time to point out that earthquakes are the result of tectonic motion in the rigid structure immediately below the surface of this liquid-centered globe we live on. That’s not covered in the only book Robertson really accepts, my telling him the details of how the planet God created works would be lost on him.

It’s hard to admit to being a Christian when there are “Christian” embarrassments of this magnitude spewing their nonsense on national television. I want to make one thing clear: Pat Robertson doesn’t speak for me. I seriously doubt that he speaks for Jesus Christ. If he does, he has managed to find a Jesus that isn’t present in the Gospel I’ve read. Never mind that he has the historical scholarship of a third grader and the intellectual capacity of cauliflower.

Elsewhere I have stated my opinion that fully 50% of all health care spending could be eliminated with a combination of electronic records and diagnostic software. Electronic records would make it easy to use data-mining software to evaluate the success of different treatment regimes for various ailments. (If a patient knew there was an 80% probability of success with a $1,000 treatment and an 80% probability of success with a $1,000,000 treatment, which one would they choose?) Diagnostic software would help focus diagnosis, eliminating billions in wasted tests.

But as Kessler points out, the health-care industry makes more money when it consumes more resources. The bias of practitioners with an economic stake will always be to spend more. There are few, if any, practitioners with no economic stake.

This is, and will remain, a stubborn problem. If I Were King it would be no different. Better health insurance will not help, that just means that each patient has more resources available. The only thing that has a chance is a combination of patient understanding of the costs and benefits of different options, and an economic stake in choosing among them.

Should we spend a million bucks to keep Mom on life support for another six months? What if that means that nobody in the family will see a dentist for the next ten years? Clearly there are times when heroic (read: expensive) efforts are worthwhile, and times when they provide no more benefit than burning the same amount of currency.

We need better understanding of the costs and benefits, which open electronic records will enable, and then we need to empower patients and families, consulting with health-care professionals, to make judgments about the resources to be used. The industry’s motivation will always be towards growth in spending, I see no reason why we can’t cut that spending in half in the next ten years.

This is curious. In fact, this is nonsense. The issue is that the press is constantly comparing Apple to Dell or HP in this regard, but the comparison is silly. What they are overlooking is that Apple’s margin includes both the margin on the hardware, which is probably better than Dell’s but probably not all that much better, and its margin on the operating system, which is probably not as high as Microsoft’s margin on Windows. When Microsoft reports their margin, it’s closer to 85% on Windows. I have no idea what Dell pays Microsoft for an OEM copy of Windows Vista, but though it isn’t anything like the retail price, it isn’t trivial.

On server products, the advantage probably goes to Dell/MS or HP/MS. When a Windows server is sold, the base operating system is in the total to the tune of $500 and up, for five users, on which MS earns their 85%. But there isn’t much reason to buy a real server for five users, so the client buys sets of CALs – Client Access Licenses. Five additional CALs cost about $150, on which the MS margin has to be on the order of 99%.

In other words, the constantly repeated theme that Apple is making dramatically higher margins than their competitors is the result of poor logic and arithmetic skills on the part of the media. As has been said before on these pages, If I Were King, education would be focused on addressing this, and nobody with a high school diploma would be likely to make such an error. We assume that the media would continue to hire only those who have at least that level of education.

In the first piece, the Times rightly excoriates the FDA for not adequately collecting and auditing information about the financial relationships between the manufacturers and the physicians that contract to do their testing, based on a report from the DSHS inspector general. One bizarre item was that the inspector general suggested that the FDA gather this information before trials began, which the agency opposed. The Times properly considers this to be backwards, far better to disqualify a contractor based on conflicts before the trial rather than attempt to evaluate a report afterwards when a conflict is revealed — which is probably impossible.

The second article covers a Government Accountability Office report dealing with testing of medical equipment. Apparently, a manufacturer of a pace maker, for example, having been through rigorous testing for one model can bring in the next one and get expedited clearance with very little testing based on the similarity. The story quotes Dr Peter B. Bach of Memorial Sloan-Kettering Cancer Center as saying: “So on the one hand, the manufacturer wheels in their new Ferrari to the FDA and says, ‘Look, it’s a car just like the Model T,’ Then they go out in the marketplace and say to doctors, ‘Why would you drive anything but a Ferrari?’ This drives up the cost of care without any necessary actual improvement in outcomes.”

While both articles raise valid questions about how the FDA does it’s job, both miss the point that the FDA is doing a job that shouldn’t be done by government at all. It makes a certain amount of sense for a government agency to run a new drug or device through a series of trials to make sure it is not generally dangerous, but to put a government stamp of approval on a product, endorsing its efficacy in a certain arena, does not. That information can only rarely be derived from limited tests. The most famous case has to be thalidomide, a powerful drug with good results in treating a range of conditions. Unfortunately, it can cause severe birth defects when taken by pregnant women. When widespread use demonstrated that the drug in its original form could not safely be used during pregnancy, a great hue and cry arose and the drug was pulled off the market around the world in 1961.

In 1964 an Israeli physician found that thalidomide was helpful in treating certain complications of leprosy, so the lightning-fast FDA approved its use in that area a third of a century later (1998). In 2006 the FDA approved the drug for use in treatment of multiple myeloma, and the drug is successfully being used in treatments for AIDS, various cancers, certain skin diseases, and macular degeneration. But for thirty years, the benefits of this powerful drug were unavailable to patients.

What we can learn from this is that clinical trials are not a reliable way to identify problems in specific cases, but that intelligent analysis of results in the general population are. We need to have the FDA take a quick look to make sure that a new drug or product isn’t widely dangerous, then get the hell out of the way. We further need to dramatically accelerate the adoption of computerized medical records so that investigators (and by this we mean scientists, not bureaucrats) can more quickly learn the conditions under which a drug should not be used and the relative benefits of different treatments for different situations. The current system tends to suggest that whichever product the FDA most recently approved for a specific condition must be the most efficacious, despite the fact that even the FDA makes no such claims.

If the FDA has a role, the best use of their energies will be to ensure a transparent marketplace in information, so intelligent patients and dedicated health-care professionals will know what analyses were written by doctors who were beholden to the drug companies, and thus make informed decisions. Federal gatekeepers are not the solution, they’re a large part of the problem. If I Were King, the FDA would be much smaller, and dedicated to a beneficial mission that it could perform instead of a dubious mission that it cannot.

What’s dangerous about it is that much of the climate-science community, certainly the political parts of it, is convinced that global warming is anthropogenic. Unfortunately, the political part so overwhelms the scientific part that we’re not likely to ever know for sure. The evidence to date is certainly far short of logical certainty, and a lot of time and effort is being spent trying to prove that the temperature swings of the past never happened. The very real possibility is that the warming is caused by the same things that caused the Medieval Climate Optimum or the warm weather that allowed the Roman Empire to thrive, in which case cutting back on our “greenhouse gas” emissions is going to do diddly squat.

If that’s the case, what we really need to do is develop strains of crops that will provide better yield at warmer temperatures. For example, scientists at the University of Washington are working on a project called “Nutritious Rice for the World”. This is a distributed-computing effort to analyze DNA sequences in rice that could lead to rice strains that will better serve a warmer planet. (I have four CPUs here running the program in the background, and tens of thousands of others are contributing CPU power to the cause as well.) That is something that could actually help.

Those who pretend that the cause of the current warming trends are known, and who sneer at those of us who are skeptical, aren’t helping. Pretending that they have a case not only endangers our future directly, it is bringing about an age when obvious logical fallacies go unrecognized and constantly repeated. I’m one who feels that having a populace that can think logically is a boon, even if it would be a real hardship to demagogues like Al Gore.

If I Were King, I would not only have a bully pulpit for pointing out widespread logical errors, but I would support efforts to prepare for changes in the climate. Given the climatic variations over the last few million years, and the fact that we are running close to the high end of the range, I’d support efforts to prepare for a bit more warming as well as the dramatic cooling that is, based on history, rather more likely.

Fertilizing frozen eggs is a recent development, and apparently controversial. You can’t just take mammalian ova and shove them in with the ice cream, crystals form in the cell fluid and destroy the cell walls. By replacing some of the water with sugar or glycerol solutions and freezing either very slowly or very rapidly, lab technicians have been able to avoid that problem, and now have a 20-25% success rate – about half the rate for fertilizing fresh eggs.

In this case, the couple secured donated eggs, but when the eggs were ready it was discovered that the husband’s sperm had been mistakenly destroyed so the clinic froze the eggs until the husband was back in town and could, you know, come up with some more. Seems like a pretty sensible response to the problem.

Apparently not. The story laments that IVF clinics “operate largely without federal oversight”, although all of the procedures they use are governed by standard medical regulations and the doctors can always be sued for malpractice if it occurs. On top of that, the American Society for Reproductive Medicine recommends that the procedure be used only for cancer patients and research. (Many cancer treatments lead to sterility, or at least reduced fertility, so a young woman diagnosed with cancer could have several ova removed and frozen immediately to protect her future ability to give birth.) Dr Marc Fritz of the ASRM is quoted: “What it boils down to is a clinical investigation of an experimental procedure in patients at their expense. That is what the society feels is not appropriate.”

First, I’m not convinced that federal government oversight has helped the rest of the medical system, and it’s obvious to me that it has made it more expensive, so the lack of federal involvement doesn’t concern me in the slightest. Second, Dr Fritz is on the fritz logically here, there is no “experimental procedure in patients” going on at all. The only experimental aspect is freezing and thawing the eggs, and that happens in the lab, not in the patient. If the eggs are thawed and fertilized successfully, the procedure to transfer the resultant embryo or embryos to the mother’s uterus is exactly the same as in regular IVF.

I may not think that having a kid when you’re nearly fifty is a good idea, but I don’t have to. If there are couples out there that want it, with the scratch to pay for it all, it’s none of my flipping business. It’s fascinating, and I’m glad I can learn the technical details online, but who has it done and why is up to the prospective parents and the doctors they choose. I hope Dr Stassart makes a lot of families happy, and I hope he makes a ton of money doing it. If I Were King, the national government would leave them alone, and the American Society for Reproductive Medicine would be, uh, encouraged to get to work on solving problems, not meddling in the business of my subjects.

Until now, all the press coverage of extracting energy from the tides has seemed to be instant approval. There are no greenhouse gases, no radioactive waste, no smoke in the air; the perfect answer to our energy needs. They almost say, “We love this coastline, where incredible power thrusts waves and tides against the rocks day in and day out. We love the sound of it, the shapes it has carved, the fact that the resurgence of that water keeps everything pristine. But if you want to come along with huge commercial ventures to extract some of that energy that made the coast the way it is today, and diffuse some part of the rest, well, why not? If you’re going to label it green or ecological, of course we’re in favor of it!”

Or rather, they just say they’re in favor of it, with no thought to the concept that the energy in the sea is part of what makes the coast what it is. I’m not sure that they’re wrong, but it sounds about as intelligent as the Russian engineers who built the Aswan Dam without any understanding of how important all that silt in the river was to the communities down stream, or just how rapidly their reservoir would shrink when they stopped the silt from washing to the Med.

The real killer in the debate is almost certain to be the impact on views. Here on Whidbey, the mussel rafts in Penn Cove have led to anger from homeowners who paid tens of thousands of dollars for their unspoiled views. On the Pacific coast of Oregon and Washington, most of the waterfront is public property so we won’t see quite the same fight, you can still expect a stink.

So far, I haven’t seen word one about what the impact of this sort of thing is actually going to be, particularly when scaled up to a meaningful level. And if they don’t scale it up to a meaningful level, what’s the point?

If I were king, I’d just tell them to figure it out in Finland or Korea first, mess with our Pacific coast only after we actually know what we’re doing.