Don Boudreaux's 1998 essay "Foolish Inconsistencies".
DB is on target.
------------------------------------------
When a domestic steel producer solemnly croons for the television cameras about how high tariffs on imported steel are good for the American economy, you can be sure that he is not really interested in the well-being of his fellow citizens. He is undoubtedly a swindler motivated by no ideal more elevated than fattening his own wallet at the expense of American consumers. The same is true of the great majority of interest groups whose lobbyists infest Washington and other seats of government power.
It’s a mistake, however, to suppose that all champions of intrusive government are out for gains at the expense of others. Many proponents of high taxes and intrusive government sincerely believe that the state can outperform the market.
The sincerity of such beliefs, however, does not render them correct. Indeed, even the most sincere statist is typically so confused that his ideas are a muddle of foolish inconsistencies.
Consider that statists are firmly convinced that capitalism is bad because capitalists are concerned exclusively with squeezing every drop of profit out of their businesses. And yet, many statists are no less firmly convinced that capitalism promotes racial and sex discrimination.
Both beliefs can’t be true. If capitalists care only about the bottom line, they will energetically pursue profitable deals with anyone regardless of skin color or sex. A capitalist focused only on maximizing profits will not refuse to hire a black woman if this black woman promises to add greater net value to the firm than does a white man competing for the same job. To be single mindedly focused on profit is to be unconcerned about irrelevant matters such as employees’ or customers’ skin color or sex. In contrast, a capitalist intent on satisfying his own racial or sexual bigotry when hiring employees or choosing customers will not focus exclusively on the bottom line.
Statists also believe that large corporations are simultaneously obsessed with profits and indifferent to relatively small expenses. I attended a conference recently at which a participant remarked that a $1 million per day fine doesn’t bother Microsoft “because Microsoft is worth billions.” Perhaps. But if the company is indeed indifferent to being fined $1 million per day, then it is not (contrary to accusations) dogged about maximizing its profits. Microsoft and other corporations will not be cavalier about even small unnecessary expenses if these corporations in fact are consumed with a passion for making their bottom lines as large as possible.
Among my favorite statist inconsistencies is their insistence, in one breath, that income inequality is an evil of the first rank, along with the accusation, in the next breath, that free-market advocates have an unsavory concern with material matters. Enemies of the market are forever applauding themselves for recognizing that non-material pursuits are far more ennobling and satisfying than the pursuit of financial gain.
Well, if non-material pursuits are deeper and more rewarding than are material pursuits, then income inequality should rank very low on statists’ list of capitalist outrages. The minimalist poet earns far less money than does the CEO of Coca-Cola, but the poet presumably enjoys far greater spiritual and mental rewards than does the corporate chieftain. Rather than taxing the CEO more heavily than the poet, perhaps government should offer the CEO a lower tax rate to help compensate him for his meager spiritual rewards.
Statists are also inconsistent in their assessments of self-interested actions. Corporations are scolded for seeking profits for their shareholders, while labor unions are glorified for seeking higher wages for their workers. There are, of course, differences between the self-interested actions of private corporations and those of labor unions. Corporations unaided by government privilege profit only by making those with whom they deal better off. Modern labor unions, in contrast, derive most of their effectiveness from government privileges and achieve their gains only by making those with whom they deal – and even many with whom they do not deal [chiefly, other workers]! — worse off.
Another statist inconsistency is the confused attitude toward change. Statists today condemn the market because it brings change. Once-thriving industries are rendered obsolete by newer products and sources of supply. Towns once built around a particular industry are depopulated by the demise of that industry. Dejected workers, pink slips in hand, trudge haplessly across the television screen. Abandoned factories, windows broken and weeds overrunning their parking lots, appear in faux-poignant newspaper photos. The message is clear that market forces unfeelingly unleash immense changes that upset familiar and cherished ways of life.
The market is indeed a force for change, but always change that results in far more improvement than harm. Anyone who doubts that the market is a continual source of improvements for humankind need only reflect on what life in America was like, say, 50 years ago. Polio still raged, only the wealthy elite could afford air travel, all but the very rich sweated through the summer heat without air conditioning, and even top-of-the-line automobiles broke down with appalling frequency. Advances spawned by entrepreneurs and made widely available by the free market solved these and countless other problems that plagued Americans in 1948.
It’s true that workers who manufactured iron lungs for polio victims suffered job losses when Dr. Jonas Salk rendered their services unnecessary. But should we condemn the market for this change? Or should we applaud the market for making possible Salk’s cure? The answer is obvious — and the same answer holds for all changes, big and small, promoted by free markets.
Yet it is these improvements that statists condemn while going on in speech after speech about the nobleness of efforts to “change the world.”
They can’t have it both ways. If change is bad, then it’s bad whether it’s achieved by government or by markets. If some change is acceptable, then statists must make the case that change sponsored by government is superior to change sponsored by markets. But such a case is never made. Statists are content to condemn market-directed change and to praise all change that results in greater politicization of our lives.
If inconsistency of thought is a symptom of bad ideas, then the “ideas” sported by statists are surely about as bad as ideas get.
Tuesday, January 02, 2018
Sunday, December 31, 2017
Defensive gun uses
By AWR Hawkins, an award winning columnist.
Hawkins notes that the Second Amendment is not about duck hunting or plinking, but protecting our lives and liberty from threats as they arise. The following 25 defensive gun uses in 2017 show that law-abiding Americans understand this and are putting their guns to good use.
-------------------------------------
January 2, 2017–Kay Dickinson was attacked while entering her Wilmington, North Carolina, apartment. WWAY repoted that Dickinson had just gotten off work and was going into her apartment at Colonial Parke when she was attacked.” The suspect held her at gunpoint, “beat her and then tied her up with a broken belt in her bedroom.” She was able to work free, retrieve her gun, and kill the suspect.
January 12, 2017–An concealed carry permit holder saw an Arizona State Trooper being beaten on the side of Interstate 10. The permit holder pulled over, asked the Trooper if he needed help, then intervened when the Trooper answered in the affirmative. The permit holder ordered the attacker to stop, then shot him dead after he refused to comply. It turned out that the suspect had shot the Trooper before the permit holder arrived, then climbed on top of him in a rage and began beating him on the side of the road. The permit holder saved the Trooper’s life.
January 20, 2017–Charlotte, North Carolina’s Kim Badger was attacked in “broad daylight” by a home invasion suspect armed with a baseball bat. WCNC reported that the attacker struck Badger with the bat, then pursued her through the house. Throughout the attack Badger fought to deny the suspect control of a knife that was on a counter and, eventually, to deny him access to a sword. Badger’s teenage son joined the fight to keep the suspect away from the sword. As the son fought, the mother retrieved her gun and shot the suspect dead.
Government's version of Justice
From Jonathan Turley's blog.
This describes a case in Britain. Such miscarriages of justice happen all over, including the US.
All too often Prosecutors and Police are out to make a name for themselves, as opposed to providing justice. It is sad that, all too often, they get away with it, as do the true perpetrators.
------------------------------------------
Danny Kay, 26, will greet the New Year as a free man after being convicted of a rape that was based on altered evidence submitted by the alleged victim. His freedom is due not to police work but the work of his sister in law Sarah Maddison. Maddison decided to take a minute and look at the Facebook messages sent between Kay and the unnamed woman who accused him of rape. What she found was that the police used messages that were misleadingly edited by the woman and that the real messages directly contradicted her claims. The police revealed an utter incompetence in the investigation and the prosecutors have expressed no intent in looking at possible charges against the woman who is accused of changing the meaning of the messages from exculpatory to incriminating. This follows an equally shocking reversal where the police were found to have withheld 40,000 messages from the defense in another rape case.
Archived versions of the original messages found by Maddison showed not only a consensual relationship but a desire to continue the relationship.
The messages showed that the evidence had been altered in clearly misleading ways. For example, The jury were shown a message where Kay appears to apologize for the rape. The response “sorry” in the message however was actually in response to the woman asking him why he was ignoring her. The question was deleted. Also deleted was her response: “Dnt [sic] be.” Likewise, one early message involved Kay asking the woman for her age. She responded “nearly 17” and showed police that he responded “same here.” That was untrue. He actually response with question if she was single and she replies “yep.” That is what he responded to in saying “same here.”
She also deleted messages where he wrote her to say that he lost her number (after the alleged rape). She then send him her number with four kisses and also sends a message ‘im still here for ya!’ When the couple later split up, she sent a message “I thought u woulda at least tried to get me back.”
The court reviewed the evidence and quashed the conviction. Kay however had already spent two years in jail.
There is no indication that the woman will face any charges for submitting what appears to be altered evidence and a false claim of rape. She remains unidentified as a sexual assault victim.
This describes a case in Britain. Such miscarriages of justice happen all over, including the US.
All too often Prosecutors and Police are out to make a name for themselves, as opposed to providing justice. It is sad that, all too often, they get away with it, as do the true perpetrators.
------------------------------------------
Danny Kay, 26, will greet the New Year as a free man after being convicted of a rape that was based on altered evidence submitted by the alleged victim. His freedom is due not to police work but the work of his sister in law Sarah Maddison. Maddison decided to take a minute and look at the Facebook messages sent between Kay and the unnamed woman who accused him of rape. What she found was that the police used messages that were misleadingly edited by the woman and that the real messages directly contradicted her claims. The police revealed an utter incompetence in the investigation and the prosecutors have expressed no intent in looking at possible charges against the woman who is accused of changing the meaning of the messages from exculpatory to incriminating. This follows an equally shocking reversal where the police were found to have withheld 40,000 messages from the defense in another rape case.
Archived versions of the original messages found by Maddison showed not only a consensual relationship but a desire to continue the relationship.
The messages showed that the evidence had been altered in clearly misleading ways. For example, The jury were shown a message where Kay appears to apologize for the rape. The response “sorry” in the message however was actually in response to the woman asking him why he was ignoring her. The question was deleted. Also deleted was her response: “Dnt [sic] be.” Likewise, one early message involved Kay asking the woman for her age. She responded “nearly 17” and showed police that he responded “same here.” That was untrue. He actually response with question if she was single and she replies “yep.” That is what he responded to in saying “same here.”
She also deleted messages where he wrote her to say that he lost her number (after the alleged rape). She then send him her number with four kisses and also sends a message ‘im still here for ya!’ When the couple later split up, she sent a message “I thought u woulda at least tried to get me back.”
The court reviewed the evidence and quashed the conviction. Kay however had already spent two years in jail.
There is no indication that the woman will face any charges for submitting what appears to be altered evidence and a false claim of rape. She remains unidentified as a sexual assault victim.
Saturday, December 30, 2017
Milton Friedman on the Donahue show
Here is a link to the full video of a 1979 appearance of Milton Friedman on the Donahue show.
Watch it an learn some economics and why almost everything you are being told is wrong.
Watch it an learn some economics and why almost everything you are being told is wrong.
Friday, December 29, 2017
Economists as Public Intellectuals
From John Cochrane - a really competent economist who has a lot of common sense.
--------------------------------------
I ran across a video by my former Chicago Booth colleague Austan Goolsbee that prompts some reflection on the role of economists as public intellectuals. (In addition to my gentle scolding of Greg Mankiw in the last post.)
Austan:
"Hi, I'm an actual economist (MIT PhD degree shown)
and I promise you
Donald Trump's tax plan is a scam. ...
This tax cut was designed to help Johnny Marshmallow (Billionaire, with monopoly man image) ...
President Trump believes that if you give more money to big corporations and billionaires that money will trickle down to you..."
Let us analyze the rhetoric of these amazing sentences carefully.
"I'm an actual economist (MIT PhD degree shown)"
This is an argument by authority, by credentialism. He, Austan, has a PhD from a Big Name institution. What follows is therefore a result of that special knowledge, that special insight, that special training, that actual economists have. He doesn't have to offer logic or fact, which you won't understand, and you aren't allowed to argue back with logic or fact, unless perhaps you too have a Big Name PhD. What follows isn't just going to be Austan's personal opinions, it inherits the aura of the whole discipline. By implication, anyone who disagrees isn't an "actual economist."
"Donald Trump's tax plan is a scam"
"Scam" is the single most interesting word.
"scam." noun. informal
1. a dishonest scheme; a fraud. "an insurance scam."
synonyms: fraud, swindle, fraudulent scheme, racket, trick; pharming; informalcon, hustle, flimflam, bunco, grift, gyp, shakedown. "the scam involved a series of bogus investment deals"
(-Google dictionary)
(I would be curious to find the source and history of the phrase. But I'm not patient enough at google searching to do it.)
So this is not clever Austan rhetoric. Austan is repeating a well-orchestrated bit of democratic party spin, talking point, or propaganda. It's the second dog-whistle.
Political parties do this. They search for some phrase that catches the ear. They aim primarily to marshal moral outrage and demonize the political opposition. Hence "scam" not "distorted incentives" or "misplaced priorities" [growth vs. redistribution]. The phrases are fairly meaningless. But if you repeat them over and over again, they start to get meaning and energize the base.
Really, Austan? Is this the best you can do? Is the role of public intellectuals and "real economists" to assert their intellectual superiority by their credentials, and then to repeat whatever buzzword their chosen political party is pushing these days, be it "tax cuts for the rich" "make america great again" or ,"tax scam?"
--------------------------------------
I ran across a video by my former Chicago Booth colleague Austan Goolsbee that prompts some reflection on the role of economists as public intellectuals. (In addition to my gentle scolding of Greg Mankiw in the last post.)
Austan:
"Hi, I'm an actual economist (MIT PhD degree shown)
and I promise you
Donald Trump's tax plan is a scam. ...
This tax cut was designed to help Johnny Marshmallow (Billionaire, with monopoly man image) ...
President Trump believes that if you give more money to big corporations and billionaires that money will trickle down to you..."
Let us analyze the rhetoric of these amazing sentences carefully.
"I'm an actual economist (MIT PhD degree shown)"
This is an argument by authority, by credentialism. He, Austan, has a PhD from a Big Name institution. What follows is therefore a result of that special knowledge, that special insight, that special training, that actual economists have. He doesn't have to offer logic or fact, which you won't understand, and you aren't allowed to argue back with logic or fact, unless perhaps you too have a Big Name PhD. What follows isn't just going to be Austan's personal opinions, it inherits the aura of the whole discipline. By implication, anyone who disagrees isn't an "actual economist."
"Donald Trump's tax plan is a scam"
This are the most interesting 7 words.
It is not, in fact, "Donald Trump's" tax plan. It is, clearly, a tax plan hashed out by Republicans in Congress, with some input from the administration, mostly the Treasury department. Almost nothing in this comes form Donald Trump. Just how many nights was President Trump up late on his laptop sweating over the income and depreciation limits of pass-through income deductions? Not many, I'd wager. So why is Austan calling it "Donald Trump's tax plan," not (say) "Congressional Republican's tax plan?"
Once you ask, I think it's obvious. President Trump is a reviled figure in the audience that Austan is aiming his video at. So personalizing it, wrapping policy up in Trump's personality, loading the actions of our complex political system into the actions of one person, though it manifestly is nothing of the sort, serves an obvious rhetorical purpose. Hate Trump, hate the plan. It is the first of many dog-whistles.
It is not, in fact, "Donald Trump's" tax plan. It is, clearly, a tax plan hashed out by Republicans in Congress, with some input from the administration, mostly the Treasury department. Almost nothing in this comes form Donald Trump. Just how many nights was President Trump up late on his laptop sweating over the income and depreciation limits of pass-through income deductions? Not many, I'd wager. So why is Austan calling it "Donald Trump's tax plan," not (say) "Congressional Republican's tax plan?"
Once you ask, I think it's obvious. President Trump is a reviled figure in the audience that Austan is aiming his video at. So personalizing it, wrapping policy up in Trump's personality, loading the actions of our complex political system into the actions of one person, though it manifestly is nothing of the sort, serves an obvious rhetorical purpose. Hate Trump, hate the plan. It is the first of many dog-whistles.
"Scam" is the single most interesting word.
"scam." noun. informal
1. a dishonest scheme; a fraud. "an insurance scam."
synonyms: fraud, swindle, fraudulent scheme, racket, trick; pharming; informalcon, hustle, flimflam, bunco, grift, gyp, shakedown. "the scam involved a series of bogus investment deals"
(-Google dictionary)
Now, detecting "scams" is not the sort of thing that Real Economists are trained to do. We can analyze incentive effects and distribution tables, spot budget constraints, and argue over deficits and economic growth effects. But "scam" is an accusation that the intentions of those writing the tax bill are malign. Just how does Herr Prof. Dr. Austan Goolsbee, "real economist," know anything at all about the intentions behind the tax bill? To say nothing of (now that he personalized it) Donald Trump's intentions?
But I am giving Austan too much credit to treat this as an interesting or original rhetorical device. You've heard "tax scam" before, I presume. "#GOPtaxscam" was right there on a big billboard in front of Nancy Pelosi as she denounced the bill. It's already a hashtag Her official website starts with
“Today, President Trump signed into a law a GOP tax scam...
But I am giving Austan too much credit to treat this as an interesting or original rhetorical device. You've heard "tax scam" before, I presume. "#GOPtaxscam" was right there on a big billboard in front of Nancy Pelosi as she denounced the bill. It's already a hashtag Her official website starts with
“Today, President Trump signed into a law a GOP tax scam...
A quick google search reveals a whole website devoted to "GOP tax scam," and its many echoes in the political media.
So this is not clever Austan rhetoric. Austan is repeating a well-orchestrated bit of democratic party spin, talking point, or propaganda. It's the second dog-whistle.
Political parties do this. They search for some phrase that catches the ear. They aim primarily to marshal moral outrage and demonize the political opposition. Hence "scam" not "distorted incentives" or "misplaced priorities" [growth vs. redistribution]. The phrases are fairly meaningless. But if you repeat them over and over again, they start to get meaning and energize the base.
Really, Austan? Is this the best you can do? Is the role of public intellectuals and "real economists" to assert their intellectual superiority by their credentials, and then to repeat whatever buzzword their chosen political party is pushing these days, be it "tax cuts for the rich" "make america great again" or ,"tax scam?"
For those who think Government is the answer
From the New York Times.
Those who think Government is the answer are delusional.
Government is mostly good at collusion with Special Interests to steal tax dollars.
For those who are interested in Finance and Microeconomics, I have italicized some "interesting" statements. Why they are interesting is left to the reader to figure out.
-----------------------------------------------------------
An accountant discovered the discrepancy while reviewing the budget for new train platforms under Grand Central Terminal in Manhattan.
The budget showed that 900 workers were being paid to dig caverns for the platforms as part of a 3.5-mile tunnel connecting the historic station to the Long Island Rail Road. But the accountant could only identify about 700 jobs that needed to be done, according to three project supervisors. Officials could not find any reason for the other 200 people to be there.
“Nobody knew what those people were doing, if they were doing anything,” said Michael Horodniceanu, who was then the head of construction at the Metropolitan Transportation Authority, which runs transit in New York. The workers were laid off, Mr. Horodniceanu said, but no one figured out how long they had been employed. “All we knew is they were each being paid about $1,000 every day.”
The discovery, which occurred in 2010 and was not disclosed to the public, illustrates one of the main issues that has helped lead to the increasing delays now tormenting millions of subway riders every day: The leaders entrusted to expand New York’s regional transit network have paid the highest construction costs in the world, spending billions of dollars that could have been used to fix existing subway tunnels, tracks, trains and signals.
The estimated cost of the Long Island Rail Road project, known as “East Side Access,” has ballooned to $12 billion, or nearly $3.5 billion for each new mile of track — seven times the average elsewhere in the world. The recently completed Second Avenue subway on Manhattan’s Upper East Side and the 2015 extension of the No. 7 line to Hudson Yards also cost far above average, at $2.5 billion and $1.5 billion per mile, respectively.
The spending has taken place even as the M.T.A. has cut back on core subway maintenance because, as The New York Times has documented, generations of politicians have diverted money from the transit authority and saddled it with debt.
The Times found that a host of factors have contributed to the transit authority’s exorbitant capital costs.
For years, The Times found, public officials have stood by as a small group of politically connected labor unions, construction companies and consulting firms have amassed large profits.
Trade unions, which have closely aligned themselves with Gov. Andrew M. Cuomo and other politicians, have secured deals requiring underground construction work to be staffed by as many as four times more laborers than elsewhere in the world, documents show.
Construction companies, which have given millions of dollars in campaign donations in recent years, have increased their projected costs by up to 50 percent when bidding for work from the M.T.A., contractors say.
Consulting firms, which have hired away scores of M.T.A. employees, have persuaded the authority to spend an unusual amount on design and management, statistics indicate.
Public officials, mired in bureaucracy, have not acted to curb the costs. The M.T.A. has not adopted best practices nor worked to increase competition in contracting, and it almost never punishes vendors for spending too much or taking too long, according to inspector general reports.
At the heart of the issue is the obscure way that construction costs are set in New York. Worker wages and labor conditions are determined through negotiations between the unions and the companies, none of whom have any incentive to control costs. The transit authority has made no attempt to intervene to contain the spending.
“It’s sad, really,” said Lok Home, owner of the Robbins Company, which manufactured much of the tunneling equipment used for East Side Access. “Because if they controlled the costs, they could do twice as many expansion projects and still have more money for maintenance.”
Asked about The Times’s findings, union leaders and construction executives insisted that no money had been wasted. They said tunneling was difficult and dangerous work that must be well funded.
The M.T.A., for its part, did not dispute the findings.
Joseph J. Lhota, who was chairman of the authority in 2012 and returned to the job in June, said he had recently appointed working groups to study costs and the procurement process.
“We recognize this has been a problem. We’re never going to deny history,” Mr. Lhota said. “This is an issue that needs to be addressed. It needs to be attacked.”
New York’s struggles come as transit construction is booming around the world. At least 150 projects have been initiated since 1990, according to a recent study by Yale University researcher David Schleicher.
The approximate average cost of the projects — both in the U.S. and abroad — has been less than $500 million per track mile, the study concluded.
“There was one glaring exception,” Mr. Schleicher said. “New York.”
That exception has not gone unnoticed. Independent online journalist Alon Levy first noted the M.T.A’s high construction costs, and 28 City Council members urged officials to research the issue in October.
Mr. Lhota responded by defending the costs. He said in a letter, “There are unique challenges that contribute to high construction costs in New York City in general, and for M.T.A. projects in particular.”
Mr. Lhota listed 10 explanations, including aging utilities, expensive land, high density, strict regulations and large ridership requiring big stations.
To evaluate those arguments, The Times brought the list to more than 50 contractors, many of whom had worked in New York as well as in other cities. The Times also interviewed nearly 100 current and former M.T.A. employees, reviewed internal project records, consulted industry price indexes and built a database to compare spending on specific items. And The Times observed construction on site in Paris, which is building a project similar to the Second Avenue subway at one-sixth the cost.
The review found evidence for one of the issues cited by the M.T.A.: Because most countries have nationalized health care, projects abroad do not have to fund worker health insurance. That might explain a tenth of the cost differences, contractors said.
But the contractors said the other issues cited by the M.T.A. were challenges that all transit systems face. Density is the norm in cities where subway projects occur. Regulations are similar everywhere. All projects use the same equipment at the same prices. Land and other types of construction do not cost dramatically more in New York. Insurance costs more but is only a fraction of the budget. The M.T.A.’s stations have not been bigger (nor deeper) than is typical.
“Those sound like cop-outs,” said Rob Muley, an executive at the John Holland engineering firm who has worked in Hong Kong and Singapore and visited the East Side Access project, after hearing Mr. Lhota’s reasons.
Those who think Government is the answer are delusional.
Government is mostly good at collusion with Special Interests to steal tax dollars.
For those who are interested in Finance and Microeconomics, I have italicized some "interesting" statements. Why they are interesting is left to the reader to figure out.
-----------------------------------------------------------
An accountant discovered the discrepancy while reviewing the budget for new train platforms under Grand Central Terminal in Manhattan.
The budget showed that 900 workers were being paid to dig caverns for the platforms as part of a 3.5-mile tunnel connecting the historic station to the Long Island Rail Road. But the accountant could only identify about 700 jobs that needed to be done, according to three project supervisors. Officials could not find any reason for the other 200 people to be there.
“Nobody knew what those people were doing, if they were doing anything,” said Michael Horodniceanu, who was then the head of construction at the Metropolitan Transportation Authority, which runs transit in New York. The workers were laid off, Mr. Horodniceanu said, but no one figured out how long they had been employed. “All we knew is they were each being paid about $1,000 every day.”
The discovery, which occurred in 2010 and was not disclosed to the public, illustrates one of the main issues that has helped lead to the increasing delays now tormenting millions of subway riders every day: The leaders entrusted to expand New York’s regional transit network have paid the highest construction costs in the world, spending billions of dollars that could have been used to fix existing subway tunnels, tracks, trains and signals.
The estimated cost of the Long Island Rail Road project, known as “East Side Access,” has ballooned to $12 billion, or nearly $3.5 billion for each new mile of track — seven times the average elsewhere in the world. The recently completed Second Avenue subway on Manhattan’s Upper East Side and the 2015 extension of the No. 7 line to Hudson Yards also cost far above average, at $2.5 billion and $1.5 billion per mile, respectively.
The spending has taken place even as the M.T.A. has cut back on core subway maintenance because, as The New York Times has documented, generations of politicians have diverted money from the transit authority and saddled it with debt.
The Times found that a host of factors have contributed to the transit authority’s exorbitant capital costs.
For years, The Times found, public officials have stood by as a small group of politically connected labor unions, construction companies and consulting firms have amassed large profits.
Trade unions, which have closely aligned themselves with Gov. Andrew M. Cuomo and other politicians, have secured deals requiring underground construction work to be staffed by as many as four times more laborers than elsewhere in the world, documents show.
Construction companies, which have given millions of dollars in campaign donations in recent years, have increased their projected costs by up to 50 percent when bidding for work from the M.T.A., contractors say.
Consulting firms, which have hired away scores of M.T.A. employees, have persuaded the authority to spend an unusual amount on design and management, statistics indicate.
Public officials, mired in bureaucracy, have not acted to curb the costs. The M.T.A. has not adopted best practices nor worked to increase competition in contracting, and it almost never punishes vendors for spending too much or taking too long, according to inspector general reports.
At the heart of the issue is the obscure way that construction costs are set in New York. Worker wages and labor conditions are determined through negotiations between the unions and the companies, none of whom have any incentive to control costs. The transit authority has made no attempt to intervene to contain the spending.
“It’s sad, really,” said Lok Home, owner of the Robbins Company, which manufactured much of the tunneling equipment used for East Side Access. “Because if they controlled the costs, they could do twice as many expansion projects and still have more money for maintenance.”
Asked about The Times’s findings, union leaders and construction executives insisted that no money had been wasted. They said tunneling was difficult and dangerous work that must be well funded.
The M.T.A., for its part, did not dispute the findings.
Joseph J. Lhota, who was chairman of the authority in 2012 and returned to the job in June, said he had recently appointed working groups to study costs and the procurement process.
“We recognize this has been a problem. We’re never going to deny history,” Mr. Lhota said. “This is an issue that needs to be addressed. It needs to be attacked.”
New York’s struggles come as transit construction is booming around the world. At least 150 projects have been initiated since 1990, according to a recent study by Yale University researcher David Schleicher.
The approximate average cost of the projects — both in the U.S. and abroad — has been less than $500 million per track mile, the study concluded.
“There was one glaring exception,” Mr. Schleicher said. “New York.”
That exception has not gone unnoticed. Independent online journalist Alon Levy first noted the M.T.A’s high construction costs, and 28 City Council members urged officials to research the issue in October.
Mr. Lhota responded by defending the costs. He said in a letter, “There are unique challenges that contribute to high construction costs in New York City in general, and for M.T.A. projects in particular.”
Mr. Lhota listed 10 explanations, including aging utilities, expensive land, high density, strict regulations and large ridership requiring big stations.
To evaluate those arguments, The Times brought the list to more than 50 contractors, many of whom had worked in New York as well as in other cities. The Times also interviewed nearly 100 current and former M.T.A. employees, reviewed internal project records, consulted industry price indexes and built a database to compare spending on specific items. And The Times observed construction on site in Paris, which is building a project similar to the Second Avenue subway at one-sixth the cost.
The review found evidence for one of the issues cited by the M.T.A.: Because most countries have nationalized health care, projects abroad do not have to fund worker health insurance. That might explain a tenth of the cost differences, contractors said.
But the contractors said the other issues cited by the M.T.A. were challenges that all transit systems face. Density is the norm in cities where subway projects occur. Regulations are similar everywhere. All projects use the same equipment at the same prices. Land and other types of construction do not cost dramatically more in New York. Insurance costs more but is only a fraction of the budget. The M.T.A.’s stations have not been bigger (nor deeper) than is typical.
“Those sound like cop-outs,” said Rob Muley, an executive at the John Holland engineering firm who has worked in Hong Kong and Singapore and visited the East Side Access project, after hearing Mr. Lhota’s reasons.
Monday, December 25, 2017
Noninvasive Cardiac Radiation for Ablation of Ventricular Tachycardia
From practiceupdate.com by Douglas P. Zipes, MD
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Seven months ago, I wrote an editorial in which I stated, “…In the not too distant future, I envision a totally noninvasive ablation approach. Using advanced ECG and cardiac imaging technology, it is possible to construct patient-specific models of the arrhythmic substrate to non-invasively identify ablation targets likely to eliminate the arrhythmia. Then, using a transcutaneous focused energy delivery source, such as laser, ultrasound, or stereotactic external beam radiation, the area can be ablated, rendering the patient arrhythmia-free without a surgical procedure.”1
The present authors have proven the prescience of that comment in a tour de force study that will transform clinical cardiac electrophysiology. Using anatomical imaging combined with noninvasive epicardial mapping, Cuculich et al. located ablation sites during ventricular tachycardia (VT) induced by implanted ICDs in 5 awake patients with recurrent VT. They delivered precise ablative radiation with a single fraction of 25 Gy stereotactic body radiation (SBRT) to targeted scar regions.
The results were impressive. The mean noninvasive ablation time was 14 minutes. Before treatment, patients had a combined history of 6577 episodes of VT in a 3-month period. After a 6-week blanking period (to allow post-ablation inflammation to subside), patients had 4 episodes of VT over the next 46 patient-months, for a reduction from baseline of 99.9%. One patient with a history of atrial fibrillation had a fatal stroke 3 weeks after treatment, despite a reduction of VT episodes and LVEF rising from 15% to 30%.
The authors appropriately caution that this procedure should not be considered suitable for clinical use until further research is performed, particularly on the effects of radiation on other cardiac structures such as coronary arteries, specialized conduction system, and overall cardiac function. Nevertheless, the observation will be transformative and ultimately noninvasive mapping and ablation of cardiac arrhythmias will become the norm. We are not there yet, but hopefully will be soon.
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Seven months ago, I wrote an editorial in which I stated, “…In the not too distant future, I envision a totally noninvasive ablation approach. Using advanced ECG and cardiac imaging technology, it is possible to construct patient-specific models of the arrhythmic substrate to non-invasively identify ablation targets likely to eliminate the arrhythmia. Then, using a transcutaneous focused energy delivery source, such as laser, ultrasound, or stereotactic external beam radiation, the area can be ablated, rendering the patient arrhythmia-free without a surgical procedure.”1
The present authors have proven the prescience of that comment in a tour de force study that will transform clinical cardiac electrophysiology. Using anatomical imaging combined with noninvasive epicardial mapping, Cuculich et al. located ablation sites during ventricular tachycardia (VT) induced by implanted ICDs in 5 awake patients with recurrent VT. They delivered precise ablative radiation with a single fraction of 25 Gy stereotactic body radiation (SBRT) to targeted scar regions.
The results were impressive. The mean noninvasive ablation time was 14 minutes. Before treatment, patients had a combined history of 6577 episodes of VT in a 3-month period. After a 6-week blanking period (to allow post-ablation inflammation to subside), patients had 4 episodes of VT over the next 46 patient-months, for a reduction from baseline of 99.9%. One patient with a history of atrial fibrillation had a fatal stroke 3 weeks after treatment, despite a reduction of VT episodes and LVEF rising from 15% to 30%.
The authors appropriately caution that this procedure should not be considered suitable for clinical use until further research is performed, particularly on the effects of radiation on other cardiac structures such as coronary arteries, specialized conduction system, and overall cardiac function. Nevertheless, the observation will be transformative and ultimately noninvasive mapping and ablation of cardiac arrhythmias will become the norm. We are not there yet, but hopefully will be soon.
Substantial Variation in Prostate MRI Interpretation Among Radiologists
From practiceupdate.com
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- Multivariable regression analysis was used to assess the diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI) in identifying clinically significant prostate cancer (Gleason score ≥7). The multivariable analysis was adjusted for Prostate Imaging Reporting and Data System (PIRADS) scores, prostate-specific antigen (PSA) levels, age, and radiologist. Detection of clinically significant cancer on fusion-biopsy varied greatly by radiologist. The proportion of “false negatives” (ie, PIRADS ≤2) ranged from 13% to 60% across radiologists.
- Uniform interpretation of mpMRI of the prostate across radiologists cannot be assumed. Institution-specific training for mpMRI interpretation and assessment of internal validity may limit the variability.
FDA Clears Stereotactic Radiotherapy System for Use in Treating Breast Cancer
From practiceupdate.com
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Today, the U.S. Food and Drug Administration cleared a new noninvasive stereotactic radiotherapy system intended for use in treating cancer in breast tissue.
“With today’s clearance, patients will have access to a treatment option that provides greater accuracy in delivering radiation therapy to breast tumors while saving surrounding breast tissue,” said Robert Ochs, Ph.D., acting deputy director for radiological health in the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health.
Radiation therapy is an important treatment option for cancer patients. Approximately 60 percent of all cancer patients will be treated with some form of radiation therapy. During radiation therapy, tumor cells are killed when their DNA is damaged by the radiation being absorbed into them. While radiation therapy has the potential to kill tumor cells, it can also damage healthy tissue around the tumor.
The GammaPod system is intended for use in the noninvasive stereotactic delivery of a radiation dose to a portion (partial volume) of the breast in conjunction with breast conserving treatment. During the procedure, radiation is delivered to specific areas of the breast. The GammaPod has not been shown to be as effective as whole breast radiation therapy (WBRT) and is not intended to replace WBRT.
The GammaPod system is a dedicated stereotactic radiation therapy technology designed to treat breast cancer. GammaPod uses thousands of focused beams of radiation from 36 rotating radioactive Cobalt-60 sources in combination with a two-layer, vacuum-assisted cup that immobilizes the breast to achieve a more accurate delivery of radiation. The GammaPod design to immobilize the breast during treatment provides the benefit of minimizing the radiation dose to the surrounding healthy tissues in the breast, heart and lungs.
For today’s clearance, the FDA reviewed scientific evidence including a clinical study of 17 patients that tested the feasibility of accurately delivering the prescribed dose to the breast tumor while minimizing radiation to the healthy tissue. The clinical evidence supports delivering the prescribed dose to the breast tumor with minimal radiation-induced side effects such as skin redness or erythema.
The GammaPod system was reviewed through the premarket notification 510(k) pathway. A 510(k) is a premarket submission made by device manufacturers to the FDA to demonstrate that the new device is substantially equivalent to a legally marketed predicate device.
The FDA granted clearance of the GammaPod to Xcision Medical Systems, LLC.
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Today, the U.S. Food and Drug Administration cleared a new noninvasive stereotactic radiotherapy system intended for use in treating cancer in breast tissue.
“With today’s clearance, patients will have access to a treatment option that provides greater accuracy in delivering radiation therapy to breast tumors while saving surrounding breast tissue,” said Robert Ochs, Ph.D., acting deputy director for radiological health in the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health.
Radiation therapy is an important treatment option for cancer patients. Approximately 60 percent of all cancer patients will be treated with some form of radiation therapy. During radiation therapy, tumor cells are killed when their DNA is damaged by the radiation being absorbed into them. While radiation therapy has the potential to kill tumor cells, it can also damage healthy tissue around the tumor.
The GammaPod system is intended for use in the noninvasive stereotactic delivery of a radiation dose to a portion (partial volume) of the breast in conjunction with breast conserving treatment. During the procedure, radiation is delivered to specific areas of the breast. The GammaPod has not been shown to be as effective as whole breast radiation therapy (WBRT) and is not intended to replace WBRT.
The GammaPod system is a dedicated stereotactic radiation therapy technology designed to treat breast cancer. GammaPod uses thousands of focused beams of radiation from 36 rotating radioactive Cobalt-60 sources in combination with a two-layer, vacuum-assisted cup that immobilizes the breast to achieve a more accurate delivery of radiation. The GammaPod design to immobilize the breast during treatment provides the benefit of minimizing the radiation dose to the surrounding healthy tissues in the breast, heart and lungs.
For today’s clearance, the FDA reviewed scientific evidence including a clinical study of 17 patients that tested the feasibility of accurately delivering the prescribed dose to the breast tumor while minimizing radiation to the healthy tissue. The clinical evidence supports delivering the prescribed dose to the breast tumor with minimal radiation-induced side effects such as skin redness or erythema.
The GammaPod system was reviewed through the premarket notification 510(k) pathway. A 510(k) is a premarket submission made by device manufacturers to the FDA to demonstrate that the new device is substantially equivalent to a legally marketed predicate device.
The FDA granted clearance of the GammaPod to Xcision Medical Systems, LLC.
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