Archive for health care

Statistics and Health Care Fraud & Measuring Crime [ASA book reviews]

Posted in Books, Statistics with tags , , , , , , , , , , , , , , , , on May 7, 2019 by xi'an

From the recently started ASA books series on statistical reasoning in science and society (of which I already reviewed a sequel to The Lady tasting Tea), a short book, Statistics and Health Care Fraud, I read at the doctor while waiting for my appointment, with no chances of cheating! While making me realise that there is a significant amount of health care fraud in the US, of which I had never though of before (!), with possibly specific statistical features to the problem, besides the use of extreme value theory, I did not find me insight there on the techniques used to detect these frauds, besides the accumulation of Florida and Texas examples. As  such this is a very light introduction to the topic, whose intended audience of choice remains unclear to me. It is stopping short of making a case for statistics and modelling against more machine-learning options. And does not seem to mention false positives… That is, the inevitable occurrence of some doctors or hospitals being above the median costs! (A point I remember David Spiegelhalter making a long while ago, during a memorable French statistical meeting in Pau.) The book also illustrates the use of a free auditing software called Rat-stats for multistage sampling, which apparently does not go beyond selecting claims at random according to their amount. Without learning from past data. (I also wonder if the criminals can reduce the chances of being caught by using this software.)

A second book on the “same” topic!, Measuring Crime, I read, not waiting at the police station, but while flying to Venezia. As indicated by the title, this is about measuring crime, with a lot of emphasis on surveys and census and the potential measurement errors at different levels of surveying or censusing… Again very little on statistical methodology, apart from questioning the data, the mode of surveying, crossing different sources, and establishing the impact of the way questions are stated, but also little on bias and the impact of policing and preventing AIs, as discussed in Weapons of Math Destruction and in some of Kristin Lum’s papers.Except for the almost obligatory reference to Minority Report. The book also concludes on an history chapter centred at Edith Abbott setting the bases for serious crime data collection in the 1920’s.

[And the usual disclaimer applies, namely that this bicephalic review is likely to appear later in CHANCE, in my book reviews column.]

absurd graph [if relevant warning]

Posted in pictures, Statistics, Wines with tags , , , , , , , on August 28, 2018 by xi'an

A pretty silly graph opposing countries with an overwhelming majority of non-Muslims and countries with an overwhelming majority of Muslims in terms of alcohol consumption. Surprise, surprise! And not incorporating the average amount or anything useful… In a Guardian article reporting on a Lancet paper about the lack of health benefit from drinking even moderate amounts of alcohol. Although, as pointed out by David Spiegelhalter at the bottom of the article, an increased risk of 0.5% associated with one unit of alcohol a day [half a pint]  , as opposed to 7% for two units [a pint!], should not get occasional drinkers too worried:  “Come to think of it, there is no safe level of living, but nobody would recommend abstention.”

and it only gets worse…

Posted in Kids, pictures with tags , , , , , , , , , , , , , , , , , , , , , , , on July 23, 2018 by xi'an

“David Brooks, the New York Times columnist, recently summed up the “Trumpian world-view” writing, “Trump takes every relationship that has historically been based on affection, loyalty, trust and reciprocity and turned it into a relationship based on competition, self-interest, suspicion and efforts to establish dominance.” NYT, June 14

“Donald Trump has dismissed concerns about the widely condemned human rights record of the North Korean dictator, Kim Jong-un, praising him as a “tough guy”, a “smart guy” and a “great negotiator”.” The Guardian, June 14

“Clinics that call themselves crisis pregnancy centers are not obliged to tell women when state aid may be available to obtain an abortion, according to a US supreme court ruling that represents a blow to pro-choice groups (…) All three of the court’s female members dissented.” The Guardian, June 27

“A resolution to encourage breast-feeding was expected to be approved quickly and easily by the (…) United Nations-affiliated World Health Assembly. Based on decades of research, the resolution says that mother’s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes. Then the United States delegation, embracing the interests of infant formula manufacturers, upended the deliberations. The intensity of the administration’s opposition to the breast-feeding resolution stunned public health officials and foreign diplomats, who described it as a marked contrast to the Obama administration.” NYT, July 8

“President Trump on Tuesday pardoned a pair of Oregon cattle ranchers who had been serving out sentences for arson on federal land (…) The pardons undo an Obama administration appeal to impose longer sentences for the Hammonds and show that, at least in this case, the Trump administration is siding with ranchers in the battle over federal lands.” NYT, July 10

“President Trump stood next to President Vladimir V. Putin of Russia on Monday and publicly challenged the conclusion of his own intelligence (…) “No prior president has ever abased himself more abjectly before a tyrant,” Senator John McCain, Republican of Arizona, said in a statement. “Today’s press conference in Helsinki was one of the most disgraceful performances by an American president in memory.” ” NYT, July 16

“The Interior Department on Thursday proposed the most sweeping set of changes in decades to the Endangered Species Act, the law that brought the bald eagle and the Yellowstone grizzly bear back from the edge of extinction but which Republicans say is cumbersome and restricts economic development.” NYT, July 20

and it only gets worse…

Posted in Kids, pictures with tags , , , , , , , , , , , , , , , , , on June 3, 2018 by xi'an

“Donald Trump’s attacks on the press are “out of control” and damaging “the civic life and debate of the country”, the editor of the New York Times said on Sunday. Dean Baquet was responding to a tweet in which the president attacked his main rival. “The Washington Post is far more fiction than fact,” Trump wrote. `Story after story is made up garbage – more like a poorly written novel than good reporting. Always quoting sources (not names), many of which don’t exist.’ ” The Guardian, April 8

The Trump administration is expected to announce today a rule that would strip federal funding from clinics that provide abortions or refer patients to places that do. The rule, a return to a Reagan-era policy, is a victory for social conservatives. It’s also a jab at Planned Parenthood, which serves 41 percent of women who receive federally funded family planning services.2  NYT, May 18

“Donald Trump pulled the US out of the landmark nuclear deal with Tehran on Tuesday, moving to re-impose sanctions on Iran and defying pleas from close allies who had called for the agreement to be preserved. The decision marks a bitter defeat for America’s European allies, who have spent months beseeching Mr Trump to stay in a deal that he has denounced as “insane”. Critics warned it would further endanger stability in the Middle East. ” FT, May 8

“Donald Trump has slammed the gun laws of major US allies, claiming foreign countries could better protect their citizens – and possibly stop terrorist attacks – by loosening their gun control laws. In a speech to the NRA Leadership Forum, Mr Trump sought to reassure members of the US’s largest gun rights lobbying group of his support for the Second Amendment, after briefly expressing support for gun control measures in the wake of a school shooting in Florida.” The Independent, May 5

 

and it only gets worse…

Posted in Kids, pictures with tags , , , , , , , , , , , , , on July 14, 2017 by xi'an

“Medicaid pays for most of the 1.4 million people in nursing homes (…) With more than 70 million people enrolled in Medicaid, the program certainly faces long-term financial challenges. Certainly, nursing homes would be part of those cuts, not only in reimbursement rates but in reductions in eligibility for nursing home care.” NYT, June 14, 2017

“…the architects of the Trump contraceptive reversal, Ms. Talento, a White House domestic policy aide, and Mr. Bowman, a top lawyer at the Department of Health and Human Services, have the experience and know-how that others in the administration lack. As a lawyer at the Alliance Defending Freedom, Mr. Bowman assailed the contraceptive coverage mandate on behalf of colleges, universities and nonprofit groups that had religious objections to the rule. Ms. Talento, a former aide to Senator Thom Tillis, Republican of North Carolina, spent years warning about the health risks of birth control pills.” NYT, July 11, 2017

“Mr. Trump’s revised executive order, issued in March, limited travel from six mostly Muslim countries for 90 days and suspended the nation’s refugee program for 120 days. The time was needed, the order said, to address gaps in the government’s screening and vetting procedures. Two federal appeals courts have blocked critical parts of the order. The administration had asked that the the lower-court ruling be stayed while the case moves forward. The court granted part of that request in its unsigned opinion. NYT, June 24, 2017

The proposed legislation, which Planned Parenthood labels “the worst bill for women’s health in a generation,” would strip the organization of federal funding for one year and bar any federal tax credits from being used to help buy private health plans that cover abortions.” NYT, June 23, 2017

and it only gets worse…

Posted in Kids, pictures with tags , , , , , , , , , , , , on May 30, 2017 by xi'an

“Four years after Texas gave up millions of dollars in federal Medicaid funds so it could ban Planned Parenthood from participating in a family planning program for low-income women, the state is asking the Trump administration for the money back. If the administration agrees to restore the funding for Texas, it could effectively give states the green light to ban Planned Parenthood from Medicaid family planning programs with no financial consequences.” NYT, May 16, 2017

“According to budget documents obtained by the Washington Post, the Trump administration plans to end the Public Service Loan Forgiveness program, which more than 400,000 people are counting on as part of their financial future. Signed into law in 2007 by George W Bush (…), the program offers those whose jobs benefit society – government and non-profit employees – the chance to have their student loans forgiven after 10 years of on-time, income-based payments.” The Guardian, May 20, 2017

The analogy is pervasive among his critics: Donald Trump is like a child. Making him the president was like making a 4-year-old the leader of the free world. But the analogy is profoundly wrong, and it’s unfair to children. The scientific developmental research of the past 30 years shows that Mr. Trump is utterly unlike a 4-year-old. Four-year-olds care deeply about the truth (…) are insatiably curious (…) can pay attention (…) have a strong moral sense.” NYT, May 21, 2017

“If any president tries to impede an investigation — any president, no matter who it is — by interfering with the F.B.I., yes, that would be problematic,” Senator Marco Rubio, on the Senate Intelligence Committee, said on CNN. “It would be not just problematic. It would be, obviously, a potential obstruction of justice that people have to make a decision on.”  NYT, May 21, 2017

“A bill to dismantle the Affordable Care Act that narrowly passed the House this month would leave 14 million more people uninsured next year than under President Barack Obama’s health law — and 23 million more in 2026. Some of the nation’s sickest would pay much more for health care.” NYT, May 25, 2017