Friday, July 15, 2022

The Mobile River Bridge is still not a good investment for the Mobile-Baldwin Community

Three years later, the MRB&B project is still a bad investment. The South Alabama Regional Planning Commission and members of both the Mobile and Eastern Shore Metropolitan Planning Organizations (MPO's) have done a lot of work planning and  cooperating with ALDOT to come up with a plan calling for somewhat reduced tolls for a $2.7 billion project. They believe the project can be completed in under seven years from dirt fly to ribbon cut. But the project's federal decision document has glaring and potentially fatal flaws. 

The following is the complete text of my public comments, uploaded to the comment form on the SARPC website today (minus contact info).

1. The SDEIS is NOT the correct designation for the MRB&B decision document because it replaces rather than supplements the alternatives evaluation of the 2014 EIS.
2. There is no economic analysis demonstrating that the project produces an economic OR financial benefit that is equal to or greater than the project costs.
3. Cumulative impacts to the local and national economy have not been addressed. This is a NEPA requirement that has not been met.
4. The alternative formulation and screening process required by NEPA is virtually nonexistent in the SDEIS, and a range of potentially feasible alternatives were not considered.
5. The evaluation of potential storm surge risk to the existing Bayway in Appendix G is incomplete without a consequence analysis, and storm surge risk is a key factor in the decision to examine any replacement alternatives for the Bayway.

These are HIGH SIGNIFICANCE and LITIGABLE issues that must be resolved without delay.

(The comment form has a 1,000 character limit)

A likely feasible alternative plan has never been evaluated. The recommended plan still has a benefit-cost ratio less than 1-to-1. The storm surge risk analysis is still halfway done. Cumulative impacts to the local and national economy have not been addressed. Any of these issues are litigable, which means that the project is likely to land before a U.S. District Court Judge or Magistrate and ALDOT's counsel will have to explain why a restraining order should not be issued forthwith.

I have offered twice to facilitate a thorough independent expert panel review (IEPR) of the project's planning and decision documents. The offers were made to representatives of both SARPC and ALDOT.  The offer was refused (politely but firmly) both times. The review would have a high probability of resolving the issues I have identified. It would probably find issues that have escaped my notice. 

I have more than three decades of experience conducting, reviewing and either defending or criticizing large infrastructure projects. I have been on both sides of the review process over the last 13 years. More than two dozen projects around the U.S. worth over $200 billion. All went through the process and not one was made worse by the effort. 

I believe a new route across the Mobile River and Delta is badly needed. I believe that a feasible plan can be developed. I believe that tolling cannot be dismissed. I do not believe the current recommended plan is the best buy alternative.

I produced a brief, single page Economic Impact Fact Sheet in 2019 and circulated it among MPO members and other stakeholders. Almost all of these have remained essentially the same but it needs updating. I intend to reevaluate this in the coming days.

I apologize for not keeping this blog active and that's unlikely to change anytime soon. I'm not getting younger and as I age, I'm finding more analog pursuits to enjoy. my megaphone may be dusty but it still boots up.  When I feel it's necessary to speak out, I will. -DL

Monday, November 2, 2020

Southern Cornbread in a 9" Cast Iron Skillet




  • 6 tablespoons unsalted butter melted,
  • 1 cup yellow cornmeal
  • 1 cup all-purpose flour
  • 1 tablespoon sugar (optional, improves crust browning)
  • 1 tablespoon baking powder
  • 1 teaspoon salt
  • 2 large eggs
  • 1 1/2 cups whole milk or buttermilk


Preheat the oven to 425ยบ F.

Beat the eggs and milk together. Mix the dry ingredients together. Melt the butter over very low heat. Add the wet ingredients and mix thoroughly, until there are no lumps larger than a BB.

Melt the remaining 1 or 2 tbsp butter in the baking skillet, making sure the bottom and most of the sides are coated. Bring heat up to medium-low and heat just until butter begins to brown.

Pout batter into skillet and continue to heat until bubbles begin forming along the sides or come up through the batter. Place in the oven and bake 25-30 minutes, or until the top turns golden brown but hasn’t scorched.

Let cool a few minutes and flip when you’re ready to serve.


Thursday, June 18, 2020

SCOTUS ruling on Dreamers policy is bureautocracy at its worst

The United States of America was never a Democracy and it's clear now that we're on the verge of no longer being a Republic. In a 5-4 decision, the United States Supreme Court ruled not that Congress alone has the power to make immigration policy. It ruled not on the constitutionality of Barack Obama's usurpation of that enumerated Congressional power by creating the Deferred Action on Childhood Arrivals. Nor did it rule that his administration violated the Administrative Procedures Act by ramming it through. No, the Court has ruled that the Trump administration violated the APA not by rescinding an unconstitutional executive action, but by not following the "rules" when it did so.

This is like recognizing that the guy you replaced at the widget factory made left-handed gadgets instead of right-handed gadgets, and broke company policy by doing it without permission.  When you restored harmony by resuming the production of right-handed gadgets, the lovers of the left-handed gadget flavor protested that you didn't have permission to change the flavor, and today the allegedly objective ombudsman agreed with the idiots.


Justice Clarence Thomas wrote a dissent that should have been the majority opinion. 

"Without grounding its position in either the APA or precedent, the majority declares that DHS was required to overlook DACA’s obvious legal deficiencies and provide additional policy reasons and justifications before restoring the rule of law. This holding is incorrect, and it will hamstring all future agency attempts to undo actions that exceed statutory authority. I would therefore reverse the judgments below and remand with instructions to dissolve the nationwide injunctions.”

"Today’s decision must be recognized for what it is: an effort to avoid a politically controversial but legally correct decision. The Court could have made clear that the solution respondents seek must come from the Legislative Branch. Instead, the majority has decided to prolong DHS’ initial overreach by providing a stopgap measure of its own. In doing so, it has given the green light for future political battles to be fought in this Court rather than where they rightfully belong—the political branches. Such timidity forsakes the Court’s duty to apply the law according to neutral principles, and the ripple effects of the majority’s error will be felt throughout our system of self-government.

"Perhaps even more unfortunately, the majority’s holding creates perverse incentives, particularly for outgoing administrations. Under the auspices of today’s decision, administrations can bind their successors by unlawfully adopting significant legal changes through Executive Branch agency memoranda. Even if the agency lacked authority to effectuate the changes, the changes cannot be undone by the same agency in a successor administration unless the successor provides sufficient policy justifications to the satisfaction of this Court. In other words, the majority erroneously holds that the agency is not only permitted, but required, to continue administering unlawful programs that it inherited from a previous administration. I respectfully dissent in part."

This decision also exposes a flaw in the conservative approach to leftist encroachment on constitutional liberty and separation of power. Conservatives have believed that plain reading of the Constitution should be enough to decide whether executive action is lawful and permissible. The left has used the APA as a shield to deflect such a plain reading test. Conservatives should use some political  jujitsu to seize that shield and use it to pummel future executive overreach. Obama's DACA order also violated APA, but no one ever made a case for overturning it on that basis. 

Sunday, June 7, 2020

The model predicting 'massive' increase in COVID-19 cases in Mobile badly missed the mark

A model that used social mobility data from May to predict a huge upswing of June COVID-19 cases in Mobile County didn't even come close. posted this news item from respected investigative reporter Brendan Kirby on May 22, 2020.
Even as Alabama moves to lift more restrictions imposed to fight the novel coronavirus, a new model suggests the state’s hardest-hit county is poised for an explosion of new cases.

The forecast, produced by the Children’s Hospital of Philadelphia Policy Lab and the University of Pennsylvania, projects a six-fold increase in Mobile County’s daily average of new cases by the middle of June.

Unlike some other models, it is less concerned with the official polices in place and focuses more on what actually is happening on the ground. It includes factors like heat and humidity, which tend to slow the virus, and attempts to measure how well people are “social distancing.” As a proxy for that, the model uses cell phone GPS data from Unicast to determine how often people are going to “non-essential” businesses.
The model predicted a rate of new cases reaching 45/day on Memorial Day, then rising to more than 350/day by mid-June. The article is scary. Had you read it when it was published, you might have thought Mobile was in line for a disastrous few weeks.

It hasn't even been close.

I encourage you to follow the link to Kirby's report, and watch the two minute video. Pay particular attention to Rubin's comments.

Today is June 7 in the Year of our Lord 2020, a day on which there should have been a whopping 140 newly sickened patients. The actual number of new cases today: 56. That represents a significant increase from yesterday's observation of 25, but the jump has absolutely nothing to do with social distancing regime that was in place last month. Social distancing is the most influential predictor in the Children’s Hospital of Philadelphia, according to what Director David Rubin told Fox10. If anything, Mobile County has gotten worse in social distancing since  mid-May, not better. The intervening period includes high school graduations, the Memorial Day Weekend and days of public protesting. We may yet see an increase in positive COVID-19 cases as result of all of this highly social interaction, but we have no chance of seeing the dire trend predicted by this model. 

More than two months ago, this blog examined another model that predicted death and devastation for our fair state. That model also used specious data to produce a super scary forecast, and that one has also thankfully proved inaccurate. The Institute for Health Metrics and Evaluation's COVID-19 projections were garbage in April and are still garbage today. Yet Fox10 (and others) still portray them in pages on their websites. Why?

The chart below shows just how awful IHME has been in predicting the coronavirus pandemic in Alabama.

The bold, jagged brown line shows the daily confirmed infections statewide. The dashed line shows the model's predictions for infections. Since record keeping began and IHME has been producing forecasts, the model has horribly and consistently missed the actual case rate.

The chart I've included also shows a shaded area that represents the uncertainty interval for the model's results. The best way to understand that is to say, "there is a 95% chance that the actual result will fall with in the shaded area." The actual result almost never has.

The IHME model and the model produced by Children’s Hospital of Philadelphia both use their assessment of social distancing as a primary driver predicting infections, and both have produced garbage results.

Government officials and the media have been consistent in driving home the need for restrictive social distancing, and using these demonstrably worthless predictive models to convince people that if they don't practice proper social distancing, very bad things will happen.

Interesting, no?

Think of it this way: You saw the news reports in March and April. You saw the model predictions of a runaway virus killing people by the thousands in your community, and the officials' fervent pleadings and outright directives that you follow this new normal, or else. Now, you've learned that the models they used to force your compliance are garbage.

Thursday, June 4, 2020

Dear Drew Brees: It's ok to be both

There is nothing wrong with respecting the American flag. It's ok to honor the men and women who have served under it to protect what liberty we have left. It's ok to stand when our national anthem is played and the flag is presented. The feelings of gratitude and pride that wells up in you upon hearing "oh say can you see" is normal, as is the frog in your throat and the mist in your eyes. You are American and that is nothing to be ashamed of, nor should you have to apologize for it to anyone.

There is also nothing wrong for someone else to not share your feelings of pride, patriotism and gratitude. For whatever reasons they have, some people are not choked up by the sight of Old Glory or appreciative of the sacrifices made while serving under it. That's ok, too. Other Americans are under no obligation to share your heart or share your mind. So if they don't want to stand, place a hand over their heart and sing with you, they are just being American, too.

It is also ok to speak up and say that you disagree with those who do not share your pride. Reasonable men and women can disagree on such matters without being unreasonable. It would not be reasonable for you to demand that others show the same respect as you do. It is just as unreasonable for those other Americans to demand that you apologize for disagreeing with them.

It is ok to be a proud American and it is ok to disagree with those who are not. It is ok to support your fellow Americans' right to feel the way they do and it's ok that you're ok with them expressing their own thoughts and feelings on the flag, the national anthem and what they stand for.

People may say to you, "well, you're either for the protesters, or you're against them." What if you're neither? What if you disagree with their expression but agree that expression is rightful regardless of your agreement? What if you're actually a little of both? What if you simply refuse to deal in such binary absolutes?

Most people don't like where such absolutes end up. Most people believe that if there's no such animal as objective truth then they can believe whatever they want to believe and do whatever they want. It's only when subjective people start expecting others to abandon principle and adhere to their own lack of principles that problems begin. So it's best for us all to respect each other even when we disagree on principle.

It's ok to disagree. It's ok to respect and support anyway. It's ok to be both, and you shouldn't apologize.

Monday, June 1, 2020

Racial justice rioters are lashing out at a system they created

Since the death of George Floyd on May 25, 2020, large cities across the U.S. have been rocked with protests degenerating into riots. Mobs of angry people  are looting businesses, burning buildings, destroying cars and killing people.

Public demonstrations and the occasional destruction of property have been a part of the American experience since the Boston Tea Party. The right to publicly protest our grievances is enshrined in the very first Amendment to the U.S. Constitution. We have exercised that right too many times to count since the Founding Fathers put forth our more perfect union.

There is something different about the 21st century flavor of outrage. Labor protests, civil rights demonstrations and the anti-war movement of the 20th century all had something in common that the most recent acts of disobedience and destruction don't have. The 20th century protesters were organized against arguably bona fide systemic injustices that they had no part in creating. Employers set wages and used the force of law to prevent organization of labor to bargain as an co-equal collective. The civil rights movement rose up against a  racist political, social and economic system that black Americans demonstrably had no role in building. The anti-war movement protested an undeclared war that sent mostly poor and working middle class young men off to die without their consent.

Despite the creation of The Great Society and Lyndon Johnson's War on Poverty, the percentage of black Americans living in poverty (measured even by Democrats' ever-shifting standards) stands at about 25%. Despite nearly $20 trillion spent on fighting poverty since the mid-1960's, about one out of every four black Americans still lives in squalor. Housing programs failed Black America by pushing them into concentrated inner-city housing projects. Welfare programs failed black America by creating the insidious incentives that has all but destroyed the black American nuclear family headed by a married couple. Thanks to this truly systemic construct, there are multiple generations of black Americans who grew up without the benefit of both male and female role models.

The regulatory schemes created by the myriad of environmental and social engineering laws passed by liberal congresses from 1964 through 1994 severely hindered capital formation in the small business sector, while encouraging manufacturing corporations to move jobs overseas. This disproportionately limited job growth in lower skilled, lower income and entry level positions.  This, in turn, disproportionately affected black Americans.

By the mid-1990's, generational poverty and a general sense of hopelessness was hit head on by the shamefully named Violent Crime Control and Law Enforcement Act, written by then Senator and current presumptive Democrat Presidential nominee Joe Biden. Then signed into law by President Bill Clinton.

Donna Murch, writing at The New Republic, a liberal blog/opinion/news site, in 2016:
Both Hillary and Bill continue to enjoy enormous popularity among African Americans despite the devastating legacy of a presidency that resulted in the impoverishment and incarceration of hundreds of thousands of poor and working-class black people. Most shockingly, the total numbers of state and federal inmates grew more rapidly under Bill Clinton than under any other president, including the notorious Republican drug warriors Richard Nixon, Ronald Reagan, and George H. W. Bush.
Murch also notes something I'm about to remind you of: the fact that Democrats from Lyndon Johnson through Bill Clinton have enjoyed almost monolithic support from black American voters. From Johnson's Omnibus Crime Control and Safe Streets Act all the way through Clinton's Violent Crime Control and Law Enforcement Act, black Americans have handed control of the levers of power to the same bunch that has sought to divide, impoverish and imprison their brothers and sisters for generations.

Johnson made sure black Americans would find it hard to escape squalid housing projects and impoverished schools. Clinton made sure that those who had survived by any means necessary had room in the new high tech prisons his trust fund paid for.

If black Americans believe their backs are against the wall, then they should ask who built the system that put them there. It wasn't the rich white conservatives. No, the second worst danger a black American faces today is the rich white liberal who has screwed him over at every opportunity. Why do black Americans keep supporting the modern day embodiment of the benevolent plantation owner?

That's not the end of this indictment of liberal "leadership." Nearly all of the large cities in the U.S. have been wracked with violent demonstrations since Floyd's death. The larger the city, it seems the greater the breadth and depth of the anger demonstrated by the people in their streets. With very few exceptions, these cities have Democrats as Mayors, and most have either majority Democrat or super-majority Democrat councils/commissions. Local leadership is responsible for establishing local law, and Mayor & The Gang are also responsible for enforcement. They hire the cops and they establish department policy, including policy on use of force.

Over the same weekend that George Floyd lost his life, 10 of his brothers in Chicago lost theirs. The linked story explains that New York and Los Angeles reported similar numbers. One can safely conclude that cities like Houston, San Francisco, Detroit, Boston, Miami and Baltimore collectively saw scores of violent deaths, mostly black males and mostly by the hands of other black males. While the biggest danger to the average black American is another black American, that threat is the direct and demonstrable result of a political establishment imagined, built, financed and enforced by liberals who could never have been elected without the always reliable votes of black Americans.

Friday, May 15, 2020

Grim state and local media coverage don't tell the whole Alabama COVID-19 story

As you read this, remember that the job of today's mass media is to sell cars,  drugs, legal services and laundry detergent. In order to do this job, they have to report on the state of current affairs, and they've found that fear, uncertainty and doubt sells more stuff than sunshine and optimism.

Nothing epitomizes the media mindset on the Coronavirus pandemic better than this op-ed piece from's Kyle Whitmire. I hope you'll join me in walking straight past the bullshit to find the truth that there is every reason to be optimistic; that we aren't doing nearly as badly as our journalistic professionals would like you to believe.

The Alabama Department of Public Health has a website called the COVID-19 Data and Surveillance Dashboard, which includes case statistics and charts that help the public understand how the pandemic is affecting our state.

Real Clear Politics has another data aggregating website called the Coronavirus Tracker for the United States (they have a global aggregator page there, too).

These resources are updated in near real time, so when you load the pages the data you see are the freshest available and they are not edited.

Using the data provided by these resources, I've developed a set of interesting charts that strongly indicate that the worst of this disease's impacts are behind us (for this wave, anyway).

This shows the unweighted moving average of new cases reported to ADPH each day for the entire state. A moving average is used to smooth out the day-to-day "noise" in a time series and reveal trends that might not be discerned by looking at the noisy raw data.

Here's a plot of the same moving average for Mobile County. The shapes of the two plots are not radically different. Both show two peaks, occurring at about the same times. The state's second peak is higher, which is explained in part by higher levels of testing in more rural areas of the state. Neither of the two short term trends leading to the second peaks is sustainable because of the information revealed in the following chart.

This chart shows the percent positive vis-a-vis the number of positive test results. The percent positive line peaked at about the same time as the state's first peak in mid-April, but the total number of positive cases has trended generally higher. The only phenomenon that could cause such a divergence is the combination of increased testing and a decline in the proportion of the state population that has been infected with the virus. In other words, the state is looking harder for positive cases by increasing the number of tests, but is having a harder time finding positive test results. The total number of cases has gone up, but only because testing has gone up. The declining number of percent positive will probably continue, because stay-at-home, social distancing and quarantines have had their impact. All of the low hanging fruit has been harvested.

What about Alabama's status versus the rest of the country? According to the  RCP page in the link above, Alabama is:

  • 26th in the number of confirmed cases
  • 28th in the number of cases per 1 million population
  • 25th in the number of deaths
  • 25th in the number of deaths per 1 million population
  • 31st in confirmed case fatality rate
  • 22nd in tests performed 
So, an honest evaluation of how Alabama fares nationally would conclude that we're about average. About half of the country is doing better and about half is doing worse. In other words, it's not as bad as the tense, anxious news reports and op-eds would have you believe.

Friday, April 3, 2020

The IHME model showing mass COVID-19 deaths in Alabama is highly suspect

A model currently being used to make projections about the numbers of cases and fatalities due to the COVID-19 has serious flaws and its results should be viewed with great skepticism.

Risk management and numerical modeling is a major part of what I do in my day job. So I'm not parroting what I've heard from people who just don't like grisly numbers.

The basic problem with the model produced by the Institute for Health Metrics and Evaluation (IHME) is that it is using a horribly biased sample of existing cases in heavily populated areas of the United States. Then it is using inferential statistics with those data to reach conclusions about possible outcomes and thus producing expectations that are unrealistic. An analogy that I can communicate is this: It's as if I used a sample of homes taken from New York and New Jersey to represent floodprone properties in places like Elba, Geneva, Demopolis and Saraland in Alabama. Last month, I wrote a Facebook post about a quirk in the state's COVID-19 statistics, wherein I pointed out that Jefferson County's number of confirmed cases of the virus was out of whack with the county's proportion of the state population. Early on, JeffCo's case rate was as high as three times the county's population vis-a-vis the rest of the state. The county's population of about 660,000 is about 13.5% of Alabama's estimated 4.88 million souls but it was accounting for as much as 59% of our COVID-19 cases. Some of that can be explained by greater number of tests for the virus, but not all of it. As of this writing, the county has 340 of the state's 1340 cases, or about 25% of total cases. This has been a fairly stable rate for the last several days. Yet it is still twice the county's representation in the state population.

This pattern of a state's largest metro area see a case rate far out of balance with its representation in the state's population is occurring nearly everywhere else in the country.  The most extreme example is New York City. The Big Apple has 43% of the state's cases. That's a stable percentage and about where JeffCo was vis-a-vis Alabama. (New York City accounts for about 13% of all cases nationwide.)

The IHME approach has been to use the data with the most observations, and they have the most observations in New York and New Jersey, the epicenter of the pandemic in the U.S. They really can't be faulted for this--the Institute was tasked with rapidly producing a reasonable approximation of caseload and mortality for the purpose of planning for the numbers of hospital beds, ICU beds and ventilators. They had little choice but to use the large metro data because that's where all the data were. There are ways of testing for and adjusting the sample to remove bias, but the modelers either didn't have time or just didn't test and adjust their sample. This is an ad hoc planning model, after all.

Another problem I have is with how the planning model has been used in the media, and how news organizations are failing to properly communicate the importance of uncertainty, and how human intervention can drastically change what actually happens next week vs what's being forecast today. One average person making one good decision about how he interacts with others can remove entire branches of unfavorable outcomes in the decision tree. One average Joe making a stupid decision can add them all back again. The truth is that we just don't know, so modelers provide their forecasts with an uncertainty band. It allows the modeler to say something like, "we think the number could be as many as X, it could be as low as Y, but we think the actual number will be close to Z. But remember that this could all change tomorrow." None of that important context was presented in the story linked above or in the video segment that appeared on the station's news broadcast.

The takeaway is this--the IHME model has serious technical issues and that uncertainty is not being communicated properly by the media, causing undue alarm among a nervous public. It also causes people to be dismissive of modeling because the chance of the model's projections being realized down to the digit are infinitesimally small.

Friday, March 13, 2020

Beat Coronavirus -- Go Spend Money

The latest strain of a common cold virus has world leaders in abject panic. Part of the reason why they're freaking right the hell out is that this strain's higher-than-usual lethality rate threatens to swamp their government-run, inherently inefficient public healthcare systems. It is a fact--people are going to die because free healthcare is worth every cent you pay for it. We don't (yet) have such a healthcare disaster and we have an opportunity to keep it from happening when we vote in November's Presidential and Congressional elections.

We also have an opportunity to help the U.S. economy weather the storm of panic and reduced human contact. Common sense tells us to take precautions to reduce the rate of the virus' spread, and that means less person-to-person interaction and a slowdown in economic activity. These events--which economists refer to as "externalities"--are not caused by typical up-and-down economic cycles. The 1970's oil crisis was one. The 2004-2005 hurricanes were another. Sadly, so were the 9/11 terrorist attacks. No fiscal or monetary policies undertaken or contemplated cause these things to happen. They just do, and things usually right themselves sooner or later.

So, in the meantime, if you'd like to do your part to minimize the economic damage of COVID-19, go spend money.

It's ok to buy as much toilet paper, hand sanitizer, disinfectant wipes, rubbing alcohol and bleach as you can afford. The people who make all that stuff will just make more of it. By all means, stock up on canned goods, batteries, peanut butter, saltine crackers, bottled water, bandaids and aspirin/tylenol/ibuprofen. Their makers are also glad to have the business and will cheerfully restock shelves with all of your favorites.

If you don't need more of these things and are a little shy of people thinking you're a hoarder prepper doomsdayer, that's ok. Your car could probably use an oil change. Maybe a new set of tires or at least an inflate/rotate. Maybe fix those brakes or replace those belts that are whining at you all the time. Here on the gulf coast, mild temperatures and sunny days mean lots of pollen. and the automatic carwash folks are open for business. So, why not?

You know who else would appreciate your patronage? Your favorite fast food joint with drive-thru service. Sorry Five Guys... McDonalds, Burger King and Wendy's are social-distance friendly and their burgers ain't that bad, either. Tacos, chicken sandwiches, hotdogs and seafood are out there too, y'all. Partake in some nom-noms and be glad you did. Starbucks does drive-thru, don't they?

Earlier this month two of the most corrupt, authoritarian regimes in the world had a falling out over an oil price collusion scheme (that was doomed to fail, anyway). Both Russia and Saudi Arabia have thus opened their oil spigots in an attempt to drown each other in petroleum. As a result, gasoline is under $2.00/gallon on the gulf coast. Fill up your tank and smirk at the smarmy ecologist driving his now uneconomical electric golf-cart masquerading as a road-safe automobile. Funny how these things work, ain't it?

In the economic long run, free markets are never wrong. The collective, freely incentivized actions of consumers and suppliers will always allocate scarce resources in the most efficient manner. Unconstrained, unassisted buyers and sellers will always set the optimum price, and the desire to satisfy one's wants and needs will be met. As long as buyers buy, sellers will sell. People will have jobs and jobs mean money to spend, so forth and so on forever and ever, world without end, Amen.

So exercise your economic freedom, America.

Go buy stuff.

Thursday, March 12, 2020

Coronavirus in Italy is a snapshot of America if Democrats win in November

Newsweek has published what is purported to be an op-ed from an "anonymous doctor" who lives and works in Italy. The op-ed is long on finger-shaking at western laissez faire culture and short on science and medicine, so let that guide you in deciding whether you're reading the opinion of an MD or that of an ethics-challenged journo with an axe to grind.

It does give us some insight on how a socialized, "free" healthcare system actually works.
Fast-forward two months, and we are drowning. Statistically speaking—judging by the curve in China—we are not even at the peak yet, but our fatality rate is at over 6 percent, double the known global average.

Put aside statistics. Here is how it looks in practice. Most of my childhood friends are now doctors working in north Italy. In Milan, in Bergamo, in Padua, they are having to choose between intubating a 40-year-old with two kids, a 40-year old who is fit and healthy with no co-morbidities, and a 60-year-old with high blood pressure, because they don't have enough beds. In the hallway, meanwhile, there are another 15 people waiting who are already hardly breathing and need oxygen.

The army is trying to bring some of them to other regions with helicopters but it's not enough: the flow is just too much, too many people are getting sick at the same time.
The Italian public healthcare system is heavily regulated and care is strictly rationed. Here's a synopsis from AllianzCare, an international health insurance provider that caters to expats and people who spend a lot of time abroad for both work and leisure.
The healthcare system in Italy is a regionally based national health service known as Servizio Sanitario Nazionale (SSN). It provides universal coverage to citizens and residents, with public healthcare largely free of charge. Treatments which are covered by the public system and a small co-payment include tests, medications, surgeries during hospitalisation, family doctor visits and medical assistance provided by paediatricians and other specialists. Furthermore, medication, out-patient treatments, and dental treatments are also available. However, public healthcare facilities in Italy vary in terms of quality depending on the region.

While the standard of public hospitals in Italy is generally adequate there are some state hospitals that fall well below the standards that some expats would be accustomed to. Therefore, regardless of where one comes from, it is best to organise health insurance before moving to Italy. Without it, issuance of a Permesso di Soggiorno (permit to stay) may not be possible.


If moving to Italy as a non-European Union citizen, travellers will be required to have private insurance cover (sic). Upon arrival, there is an eight-day window to visit the local police station and present a health policy that is valid throughout the duration of one’s stay.
Italian healthcare is thus free for Italians. Everyone else...

When everyone is healthy and demand for medical services is low, the system may work just fine. Deficiencies in the level of care have fewer harsh consequences. But in the midst of an international health emergency, uh oh. From WSJ (subscription required):
“I never was at war, but that’s how I imagine it,” said Federica Brena, a medical oncologist at a hospital in Bergamo, another hard-hit area in northern Italy, on Facebook. “The health-care system risks collapse.”

A photo showing a sleeping nurse slumped over a computer while still wearing protective gear was widely shared on social media, becoming a symbol of the emergency and the strain the epidemic has put on medical personnel.

“We are doing everything humanly possible,” said Dr. Mangiatordi, who took the photo. “But sometimes I feel powerless.”

Medical staff risk getting the infection themselves. Despite protective equipment—double gloves, tightened face masks and scrubs—medical personnel account for about 12% of those infected in Lombardy.
The following is from The Atlantic, a publication that is far from being accused of right-wing propaganda.
Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air.

Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances. The document begins by likening the moral choices facing Italian doctors to the forms of wartime triage that are required in the field of “catastrophe medicine.” Instead of providing intensive care to all patients who need it, its authors suggest, it may become necessary to follow “the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources.”

The principle they settle upon is utilitarian. “Informed by the principle of maximizing benefits for the largest number,” they suggest that “the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.”
This is what socialized, public, "free" healthcare looks like, y'all. It's a clear snapshot of what the U.S. healthcare system will look like if the left gains control of the levers of power in November and implements their wacked out plans for our healthcare system. "Medicare for All" or the "public option" will transform the world's greatest healthcare marketplace into a third world system of rationing; where doctors and their bosses decide whether you live or die. Our system is great because it's private sector financed, despite the burdens already placed on it by the Obamacare debacle.

Make no mistake about this truth as well--if you're rich enough, powerful enough and connected enough, you will be treated in Italy today. If tomorrow's U.S. system looks anything like today's Italian mess, do you really think the Mike Bloombergs, Warren Buffets and Robert DeNiros will have to stand in line with the rest of us schmucks?