Wall Street Doldrums and Dog Days
“Up and down, without much change,” sums up the market performance for this week. While not atypical for summer months in terms of its overall stagnancy, the market shows distinct signs of confusion in the wake of Ben Bernanke’s failure to hint at the direction of further interest rate adjustments in his most recent speech and the upward trend in crude prices on speculation over pending summer storms. Perhaps the annual retreat of the world’s central bankers to Jackson Hole this weekend will result in state-side monetary policy clarification though analysts are cynical.
Allen Sinai, chief global economist and president of Decision Economics, said whatever comments might emanate from Fed officials over the weekend, they are likely to stick to a “script” they have already laid out. “I think the members by and large in casual conversations, to the extent they have them, will stick to the script and the script is the consensus view of the economy and inflation, which is a transition to a moderate pace of growth and, very slowly, a winding down of inflation,” he said.
A not so quiet buzz continues over the real estate market. When the impact will be felt and of what order is speculative but that there is a building “storm” with market-shaking potential is a seeming certainty. One interesting article from last year attempted to show how the lion’s share of US GDP was driven by the housing boom and cheap credit following the dot com bust. Taking a defensive posture, John Fisher and Saad Quayyum, economists at the Chicago Fed have penned a new Fed study. “The housing boom has not been driven by unusually loose monetary policy,” they conclude, attributing the boom to increased productivity.
Acceptable Medical Losses?
In a Canadian retro-review of 1240 heart attack cases only 3% (41 patients) survived after efforts to restart a heart through CPR, electric shock and transport to hospital, discouraging results to be sure.
Lead researcher Dr. Laurie J. Morrison of the University of Toronto then isolated three criteria to help rural paramedics determine when to cease resuccitation efforts in the field and avoid additional measures that can severely strain healthcare delivery systems and that pose unique hazards of their own. ”Taking such lost causes to the hospital ties up ambulances and emergency departments, and the race to get there is hazardous for rescue workers and other motorists,” the researchers said.
The team’s recommendations specified that paramedics terminate CPR if a pulse couldn’t be restored, if the defibrillator determined that an electric shock shouldn’t be given and if the cardiac arrest wasn’t witnessed by a rescue worker. The criteria were applied in the course of ongoing emergency responses. Researchers say that the test closely predicted throughout the study who was likely to die. Overall, 776 patients met all three criteria, and all except four died, a survival rate of 0.5 percent (1 in 200).
“If the test were applied,” said the article, “it would reduce by about two-thirds the number of patients taken to the hospital, the researchers said. When two more criteria were added — paramedic arrival time of more than eight minutes and an attack not witnessed by a bystander — the test worked even better.”
For Feedback:
1) What level of payoff is insignificant for emergency care? 1 in 200? 1 in 400?…
2) Are you comfortable allowing a rural paramedic with 2 years or less of training to decide whether you live or die?
Health Care Rationing and the NHS London’s Troubling Precedent
NHS London is the Strategic Health Authority for London, England. A paper leaked in April of this year openly acknowledged NHS London’s new mandate for cost containment through health care rationing, this, despite it’s stated mission to “deliver world-class care.”
Among the cost cutting measures:
1) Panels were established across London to monitor the rates at which General Practitioners refer patients to hospital. Local health trusts were instructed to cut GP referral rates to the levels of the lowest 10% nationally at an estimated annual saving of 25m pounds.
2) Consultant to consultant referrals are also to be limited, effectively denying second opinons. In an earlier draft paper Hammersmith and Fulham reportedly found that a fifth of consultant-to-consultant referrals were “clinically not necessary.” Trimming back referrals accross London is expected to save another 7 million, though the administrative burden is estimated at 1.6 million.
3) Emergency care practitioners in emergency departments will “redirect” 40-70 per cent of patients back to GPs or walk-in centres. If they treat those who could have been treated non-emergently, they will not be paid.
The British Medical Association condemned the plan. Hamish Meldrum, the chairman of the association’s GP committee, said that they left patients in limbo, with no one clear where the responsibility lay if the condition worsened or the patient died.
From the article:
“The plan, which is still in draft, was produced by the London Transition Team, led by John Bacon, a senior NHS manager. It is typical of the action being taken nationally to save money by reducing referrals, or, putting it more plainly, treating fewer patients.
There are serious questions about whether such systems will work. say two experts in general practice in this week’s British Medical Journal.
Myfanwy Davies and Glyn Elwyn, of the Centre for Health Services Research at Cardiff, say there is little evidence that referral management centres work to improve the quality of referrals or save money.
They say that the centres have “appeared overnight in an evidence-free zone”.”
For Feedback:
America’s costs for publicly funded healthcare are similarly spiraling out of control. How closely should we look at London’s model? Should healthcare be rationed? If so, how?
Name Change — this blog only!
I’ve changed the name of this blog to both broaden the content area and to establish a point of view.
St. John’s Bible, A Masterwork in Progress
St. John’s University is in the process of producing a, handwritten, illuminated Bible of the sort produced in medieval days. Why? Here’s the first Q&A from their faq:
Q1. Why has Saint John’s University commissioned a handwritten Bible? What is the significance of a handwritten Bible?
- Igniting spiritual imagination
- First handwritten Bible in the modern era, commissioned by a Benedictine Monastery
- Using ancient techniques
- Incorporating modern methods and themes
At the onset of a new millennium, Saint John’s University and the monks of Saint John’s Abbey are seeking to ignite the spiritual imagination of people throughout the world by commissioning a work of art that illuminates the world today. This will be the first time in 500 years that a Benedictine Monastery has commissioned a handwritten, illuminated Bible. Its construction will parallel that of its medieval predecessors, written on vellum, using quills, natural handmade inks, hand-ground pigments and gold leaf while incorporating modern themes, images and technology of the 21st century.
Walking the Walk
It really doesn’t matter who we are, none of us are consistent in our practice of the worldview that we hold. If we are unbelievers who have thought through exactly what we do and don’t believe, we can only come out with a final conculsion that the world and all the individual things in it, are absurd. As Francis Schaeffer used to say, the result of “the impersonal plus time, plus chance.”
Schaeffer used to point out that the both notorious, and noted athiest, Bertrand Russel, had concluded that humanity’s final destination was an ignominious consignment to return to the dirt. Nevertheless, he gave himself to those issues that he viewed as moral causes. Though he thought that it really didn’t matter whether one behaved “well” or “badly” he often championed the cause of peace. Even an athiest cannot behave like one consistently.
From the starting point of Christian faith, one faces a high bar indeed. The Bible is clear that we all miss the mark of God’s perfect standard. Who is consistent in living out the most fundamental of the precepts of the faith? Nevertheless, in another way the Christian is the most consistent of all in that the Christian is the thankful participant in the redemptive work of Christ. By His finished work even our worst inconsistencies may be stricken from remembrance forever!
God knows what we are made of and has provided for those of our inconsistencies that are truly sinful, but appropriation of that provision is only possible by faith.
Economic Forecasting Survey: August
The Wall Street Journal’s survey of economists listed the following as the 5 greatest downside risks to their GDP forecasts for 2006 (average prediction cut from 3.0% growth to 2.8%):
1) Energy Prices (43%); 2) Housing Market (15%); 3) Higher than expected interest rates (13%); 4) Slower than expected consumer spending (13%); 5) Slower than expected business spending (11%)
CPI is predicted to rise by 3.3% in November of 2006 and by 2.8% in May of 2007j.
When asked how high oil prices would need to rise to threaten economic expansion the average of responses was $98.22 per barrel. If fuel prices rose to $4.08 per gallon, expansion would be similarly threatened in the opinons of the economists.