Wednesday, August 29, 2018
Trump voters are all druggies
That's how the more extreme media outlets will headline the latest piece of research in the medical journals. But it aint so. A bit hard to know where to begin. I probably should start by congratulating the authors on their quite humble conclusions. They say nothing like my headline above. But, as Churchill said of Clement Attlee, they have much to be humble about.
They know and admit that their data is what statisticians call "ecological" (group based) but fail to mention that the correlations emerging from such data are usually much higher than what emerges in correlations using individual data. So their results are a poor guide to what individuals do.
And the fact that they had individual data but did not use it suggests that all relationships in the individual data were negligible, meaning that there was NO tendency for Trump voters to overuse prescription opiods. That is a highly critical interpretation but, in view of the revelations inspired by Ioannidis, that is actually a conservative conclusion. What Ioannidis showed can be summarized simply as "Medical researchers are crooks". Sad. And when an opportunity to bash Trump offers itself, the temptation to cheat could well be overwhelming.
But let me be charitable and assume that all the work was honestly done and all the relevant findings were reported. The big issue then with the research is the problem of control. Why was there greater use of prescription opioids in counties where the voters favoured Trump? The obvious explanation would be that Trump voters are poor and are tired of being looked down on by leading Democrats, who used to represent them (See Hillary's "deplorables"). So was that examined in the present study?
They made a good attempt at it and did find that socioeconomic variables explained two thirds of the relationship between Trump-voting and prescription opioid use. But they apparently had no data on income so they used rough proxies of it. Much error could flow from that. Better income data might have shown that opioid use was irrelevant and all the Trump voting could have been accounted for by income. I doubt that it was but the present research cannot exclude it.
On a technical note, they based their analysis on quintiles -- a common but disreputable technique. Why group your data when you can use it individually? I am afraid that the usual reason is that there is no overall relationship in the data. You can show a relationship only by throwing away three fifths of it. Sad.
Finally, let me point out that, even if we accept their findings, there are many possible interpretations of them. One that occurs to me is that Obamacare has made it more difficult for poor people to get treated for their ailments (overcrowded waiting rooms, doctors not taking welfare patients, doctors quitting medicine to go and play golf rather than spend half their day on paperwork etc.) and they blame that on the architects of Obamacare -- the Democrats. So Mr Trump's talk of dumping Obamacare would be attractive
And prescription opioids are only half the story It could be that the poor mainly use doctors to get their fix. Because of being poor, they cannot afford to buy from street dealers. So the Trump voters were actually more law abiding. I think Mr Trump might like that interpretation.
Association of Chronic Opioid Use With Presidential Voting Patterns in US Counties in 2016
James S. Goodwin et al.
Abstract
Importance The causes of the opioid epidemic are incompletely understood.
Objective: To explore the overlap between the geographic distribution of US counties with high opioid use and the vote for the Republican candidate in the 2016 presidential election.
Design, Setting, and Participants: A cross-sectional analysis to explore the extent to which individual- and county-level demographic and economic measures explain the association of opioid use with the 2016 presidential vote at the county level, using rate of prescriptions for at least a 90-day supply of opioids in 2015. Medicare Part D enrollees (N = 3 764 361) constituting a 20% national sample were included.
Main Outcomes and Measures: Chronic opioid use was measured by county rate of receiving a 90-day or greater supply of opioids prescribed in 2015.
Results: Of the 3 764 361 Medicare Part D enrollees in the 20% sample, 679 314 (18.0%) were younger than 65 years, 2 283 007 (60.6%) were female, 3 053 688 (81.1%) were non-Hispanic white, 351 985 (9.3%) were non-Hispanic black, and 198 778 (5.3%) were Hispanic. In a multilevel analysis including county and enrollee, the county of residence explained 9.2% of an enrollee’s odds of receiving prolonged opioids after adjusting for individual enrollee characteristics. The correlation between a county’s Republican presidential vote and the adjusted rate of Medicare Part D recipients receiving prescriptions for prolonged opioid use was 0.42 (P < .001). In the 693 counties with adjusted rates of opioid prescription significantly higher than the mean county rate, the mean (SE) Republican presidential vote was 59.96% (1.73%), vs 38.67% (1.15%) in the 638 counties with significantly lower rates. Adjusting for county-level socioeconomic measures in linear regression models explained approximately two-thirds of the association of opioid rates and presidential voting rates.
Conclusions and Relevance: Support for the Republican candidate in the 2016 election is a marker for physical conditions, economic circumstances, and cultural forces associated with opioid use. The commonly used socioeconomic indicators do not totally capture all of those forces.
Source (doi:10.1001/jamanetworkopen.2018.0450)
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Trump and Mexican President Announce New Trade Deal to Replace NAFTA
Evidence that Trump's use of tariffs is just a tool to achieve fairer terms for American workers. The tariffs were not intended to be permanent
President Donald Trump and Mexican President Enrique Peña Nieto announced on Monday that they had reached an “understanding” to replace the North American Free Trade Agreement.
In an Oval Office announcement, which included Peña Nieto on speaker phone, Trump told reporters that the U.S. and Mexico are putting the finishing touches on will be “one of the largest trade deals ever made.”
“It’s a big day for trade. It’s a big day for our country,” the president said. “I’ll be terminating the existing deal and going into this deal.”
“They use to call it NAFTA,” Mr. Trump said. “We’re going to call it the United States-Mexico trade agreement. We’ll get rid of the name NAFTA. It has a bad connotation because the United States was treated very very badly for NAFTA.”
Mexico is the United States’ third largest trading partner behind China and Canada. Through June of this year, U.S. exports to Mexico totaled $131.3 billion and imports were $169.3 billion or a deficit of $38 billion.
SOURCE
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Illegal Obamacare Fees Trigger $839M Reimbursement to Several States
King Obama thought he could ignore the law
The Internal Revenue Service must repay more than $839 million to six states because of an Obama-era Health and Human Services Department requirement, a federal court ruled.
The U.S. District Court for the Northern Division of Texas said the requirement unlawfully imposed a costly fee on state Medicaid programs.
In October 2015, Texas Attorney General Ken Paxton led a multistate lawsuit against the federal government over the Obama-era regulation that “threatened to choke off Medicaid funds for the health needs of millions of Texas citizens unless Texas taxpayers paid a portion of the Health Insurance Providers Fee to help fund Obamacare.”
The states of Indiana, Kansas, Louisiana, Nebraska and Wisconsin joined Texas in suing the federal government, HHS and its acting secretary, Alex Azar, the IRS and its acting commissioner, David Kautter, alleging that they violated the Affordable Care Act by requiring that state governments pay a Health Insurance Providers Fee.
Notwithstanding Congress’s exemption of the states in the ACA, HHS enacted a regulation (the ‘Certification Rule’) that empowered a private actuarial board to require Plaintiffs to account for the HIPF in payments to their respective managed care organizations (‘MCOs’)– the medical providers who contract with Plaintiffs to service their Medicaid recipients,” the plaintiffs argued. “Plaintiffs’ amended complaint challenged the legality and constitutionality of both the HIPF and the Certification Rule.”
Plaintiffs requested 13 types of relief and financial recompense.
After a series of rulings and hearings, denied requests and appeals, the plaintiffs asked the court to reconsider four aspects of the case, including whether the HIPF was considered a tax or a fee. This week, the court ruled in favor of the states, in part, by ordering the IRS to repay the HIPF money it collected.
“Obamacare is unconstitutional, plain and simple,” Attorney General Paxton, who led the coalition, said. “We all know that the feds cannot tax the states, and we’re proud to return this illegally collected money to the people of Texas.”
Texas stands to be repaid $304,730,608.
The IRS was ordered to repay Indiana $94,801,483, Kansas $142,121,776, Louisiana $172,493,095, Wisconsin $88,938,850 and Nebraska $36,238,918.
“Obamacare has always been an economic house of cards, and this ruling has again exposed it for what it is: a money laundering scheme,” Louisiana Attorney General Jeff Landry said. “This is a prime example of the deep administrative state doing something that Congress expressly forbids.”
Even though the ACA forbids imposing the HIPF, Landry said “the federal government found a way to do it anyway. The government threat to disapprove our managed care plans risked the loss of those Medicaid funds.”
The ruling protects the state from having to paying any such fees in the future, Landry said. Once the IRS returns the money to Louisiana, Gov. John Bel Edwards “should return any net dollars directly to the hard-working Louisianans who were forced to pay these costs,” he added.
Texas and Wisconsin will argue at a hearing on Sept. 5 that Obamacare, as amended by the recent tax bill, is unconstitutional in its entirety.
SOURCE
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Bald faced hypocrisy: Before McCain Was Their Hero Fighting Trump, Media Called Him Unhinged Racist
You can tell a lot about the weather by looking at what the wind is doing — and you can learn a lot about politics by noticing how narratives change over time.
The political winds have shifted a lot when it comes to the late Arizona Sen. John McCain, particularly from the liberal media. McCain, of course, died on Saturday after battling with brain cancer.
Tributes and acknowledgements poured in from across the political spectrum, with mourners ranging from George W. Bush to Barack Obama offering kind words about the long-serving senator and military veteran.
There’s certainly nothing wrong with being civil when a man like McCain passes, even in light of the objections many differences have had with him in the past.
Somewhat surprisingly, the left also took the opportunity to put the former Republican presidential candidate on a pedestal … but the way the same liberals attacked him just a few years ago is an eye-opening example of how narratives work.
When you compare how left-leaning outlets spoke of McCain after his death versus when he was alive, it’s hard to think of a more dramatic 180-degree reversal in tone.
There seems to be one common theme: The same outlets that savaged the senator a decade ago are now singing his praises now that they can use his passing to take shots at President Donald Trump.
That’s exactly what several pundits including independent journalist Mike Cernovich pointed out on Twitter. A series of screenshots demonstrate how eagerly outlets like The Huffington Post trashed and slandered McCain when he was a leading Republican, only to seemingly develop bipolar disorder the moment he died.
“They all hated McCain, now they use his death to attack Trump. It’s a bunch of lies,” Cernovich wrote. He backed that opinion up with a series of tweets from Cher, the celebrity singer and outspoken leftist.
Cher — while not noted for her towering intelligence — called McCain a “teabagger” and implied that he was Nero in 2013. She also suggested that he was some sort of hell-bent demon, declaring “SULFUR FOLLOWS HIM WHEREVER HE GOES!”
Fast forward to this week. Suddenly, the same Cher was defending McCain and scolding President Donald Trump for not commenting on the senator’s then-impending death. It seems the singer had suddenly found a soft spot for the “teabagger” the moment he could be used against Trump.
Then there’s The Huffington Post.
“Compare what the media is saying about McCain to what they said – in 2008 – when it actually mattered,” pointed out Cernovich. “Today oh they love the guy, but when he was running for POTUS, they called him a Nazi, racist, white supremacist, and mentally unfit for office.”
Other commentators made similar points, providing numerous screenshots of articles then and now to show the contrast.
SOURCE
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New book about ancient Europe
Language can tell you a lot
Introducing Dr John V. Day’s The Alphabet Code, a new book about ancient Europe.
Why, for more than a century now, have academics treated ancient Europeans as culturally backward?
According to academia, the only civilizations to invent writing were in Egypt, Mesopotamia, the Indus Valley, east Asia and Central America. In other words, not in Europe.
And according to academia, the only civilizations to invent numerals were in the same places, plus the Andes. So, again, not in Europe.
As for our own alphabet, academics maintain that it was invented either in the Near East or in Egypt, and that our so-called Arabic numerals were invented in India.
But now a new book by a recognized prehistorian restores the cultural worth of ancient Europe. John V. Day, Ph.D., acclaimed author of Indo-European Origins: The Anthropological Evidence, spent more than ten years researching and writing The Alphabet Code.
His book proves that Indo-Europeans living in prehistoric Europe invented the forerunner of the Greek alphabet and also the forerunner of our numerals. The Alphabet Code even identifies several parallels between the numerals and the early part of the alphabet, implying that our numerals and letters once coincided.
For example, Indo-Europeans used the word kap to denote a hand. Hence kap gave rise to Latin captāre, to grasp; Greek kaptō, to snatch; Albanian kap, to grab; Hittite kappuwa-, to count; and Persian kp-, to hit. Normal humans being endowed with ten fingers, many languages have related words for hand and ten (or five). That’s why Indo-European kap also gave rise to Greek kappa, the alphabet’s tenth letter.
Indo-Europeans used another word for a hand in deḱ. Hence deḱ gave rise to Latin index, a forefinger; Greek dekomai, to take; Greek dektēr, a collector; Greek deksia, the right hand; and Tocharian B täk-, to fetch and to touch. Humans having ten fingers, Indo-European deḱ also gave rise to Cornish dec, Latin decem and Greek deka, all meaning ten, the tenth number. And note the similarity in form between the Greek alphabet’s kappa, Κ, and the Roman numeral for ten, X.
* Covering from Α to Ω (or alpha to omega), The Alphabet Code is the only book that offers a true picture of what each letter means.
* Covering from 0 to X (Roman ten), The Alphabet Code is the only book that offers a true picture of what each numeral means.
* The Alphabet Code is easy to read and contains over fifty illustrations.
* Yet it’s scholarly too, the endnotes running to nearly 900 references.
Available now as an e-book for Kindle. Buy The Alphabet Code for only $3.95 from www.amazon.com
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