September 2011

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Apparently, Professor James Miller at the University of Wisconsin (Stout campus) is a Firefly fan, because he had on his office door a poster of Nathan Fillion as Captain Mal Reynolds, with the quote “You don’t know me, son, so let me explain this to you once: If I ever kill you, you’ll be awake. You’ll be facing me. And you’ll be armed.”

That sentiment so enraged the morons in the campus police department that they ripped down the poster. and Chief Lisa Walter sent Miller a nastygram:

Dr. Miller,

I wanted to notify you that I removed a printed/copy (pictures attached) of a poster from the outside of your office. I don’t know if you posted it or if someone else placed it on your board, but it is unacceptable to have postings such as this that refer to killing.

I knocked on your office door while there, but it appeared as though you were not in your office at the time.  Contact me if you have any questions.


Chief Walter

When someone complains about something because it “refers to” a killing or “refers to” drug use or “refers to” some actual conduct, it’s almost always a sign that they are censorious bastards trying to stretch a loophole to cover something they don’t like.

Miller’s reply was short and to the point:

Unacceptable to whom?

How dare you act in a fascistic manner and then sign your email “respectfully!” Respect liberty and respect my first amendment rights.

Walter, who hasn’t learned that you don’t have to respond to everything people say to you, responded thus:

I appreciate and understand the First Amendment, but also understand my responsibilities as the Chief of Police at UW Stout regarding postings that refer to violence and/or harm.

There’s that stretchy “refer to” again.

My actions are appropriate and defensible. Speech can be limited on a reasonable expectation that it will cause a material and/or substantial disruption of school activities and/or be constituted as a threat. We were notified of the existence of the posting, reviewed it and believe that the wording on the poster can be interpreted as a threat by others and/or could cause those that view it to believe that you are willing/able to carry out actions similar to what is listed.  This posting can cause others to fear for their safety, thus it was removed.

I am willing to schedule a meeting with you to discuss this further, if you wish.  If you choose to repost the article or something similar to it, it will be removed and you could face charges of disorderly conduct.

As Professor Miller points out, this is insane: 

Postings that “refer” to violence constitute a threat? As in a poster from Hamlet? Or a news clipping about Hockey players that commit violent murder?

Don’t threaten me with charges that have no basis in reality–I am a committed pacifist and a devotee of non-violence, and I don’t appreciate card carrying members of the NRA who are wearing side arms and truncheons lecturing me about violence.

Exactly right. Police officers have no business complaining that words on a poster can cause people to fear for their safety. Not when they’re carrying weapons.

Miller responded with another poster on his door, this one showing a diagram of a cop beating someone down, with the text “Warning: Fascism. Fascism can cause blunt head trauma and/or violent death. Keep fascism away from children and pets.”

On the one hand, calling this incident Fascism is a bit over-blown. This is just a run-of-the-mill case of an overbearing bureaucrat abusing her power for her own self-aggrandizement. On the other hand, Chief Lisa Walter certainly seems to be trying to live up to Professor Miller’s expectations with her response to the new poster:

Dr. Miller,

My office removed another posting from the outside of your office. The posting depicts violence and mentions violence and death. The campuses threat assessment team met yesterday and conferred with UW System Office of General Counsel and made the decision that this posting should be removed. It is believed that this posting also has a reasonable expectation that it will cause a material and/or substantial disruption of school activities and/or be constituted as a threat.

Got that? A college Professor puts up a poster showing police beating someone and the police tear it down because it depicts violence. It doesn’t get much more blatant than that.

This part gets me: “The campuses threat assessment team…made the decision that this posting should be removed.”

As it happens, I know a little bit about threat assessment. A very little bit. As in, I’ve read a few books on the subject. That’s it. I am far from an expert. And yet I’m pretty sure I know more about distinguishing actual threats than the entire University of Wisconsin (Stout campus) threat assessment team.

The materials in question — one from a popular television series and the other an anti-fascism message — simply aren’t indicative of any kind of threat. They lack specificity, especially as to the target of the threat, and they therefore lack the intimacy that makes it likely the threat will result in action. Miller’s responses to the chief are hardly enraged or indicative of unstable emotions. I suppose his references to Fascism could indicate a paranoid over-reaction, although the chief did threaten to have him arrested for a poster. And technically a fascination with violent entertainment is an indicator, although I don’t think ordinary American television counts.

In fact, as the wording of the email indicates, they didn’t do a threat assessment at all. They simply decided that people seeing the poster could feel threatened. That’s really not what a threat assessment is about. That’s not how a threat assessment team should be used.

Fortunately, University Chancellor Charles W. Sorensen stepped in and reminded Chief Walter that the campus police are there to support the university’s faculty, and that trying to suppress their First Amendment rights is unacceptable…Nah! Just kidding. Chancellor Sorensen was actually a total dick:

UW-Stout administrators believe strongly in the right of all students, faculty and staff to express themselves freely about issues on campus and off.  This freedom is fundamental on a public university campus.

Don’t be fooled. That’s just the standard bureaucratic tyrant’s obligatory genuflection to free speech. It always comes right before they explain why they’re suppressing free speech:

However, we also have the responsibility to promote a campus environment that is free from threats of any kind–both direct and implied. It was our belief, after consultation with UW System legal counsel, that the posters in question constituted an implied threat of violence. That is why they were removed.

This was not an act of censorship. This was an act of sensitivity to and care for our shared community, and was intended to maintain a campus climate in which everyone can feel welcome, safe and secure.

Of course it was an act of censorship. Free speech is not limited to only speech which makes people feel safe and secure. Although, really, if either of the things that Miller had on his door makes you feel threatened, you’re kind of a wimp. Or a liar.

The Foundation for Individual Rights in Education has gotten involved.

I’ve haven’t been writing very much lately, but other people are keeping busy, and I thought I’d share a few items with you folks.

  • Ken Lammers at Crimlaw has written a fascinating series of posts about how the criminal justice system (at least in his Virginia) determines the value of a stolen item for purposes of charging and sentencing. He covers items with a fairly obvious price tag, items without a price tag, and intangible property like music and software. It seems like a fairly thoughtful balance between an economically meaningful valuation and the need to have bright lines for making clear decisions.
  • Meanwhile, over at Popehat, Ken is posting a multi-part series about his investigation of someone who tried a fake invoice scam on him: Chapter 1, Chapter 2, Chapter 3. [Update: Chapter 4] He shows how much information you can get about someone like this with simple, inexpensive online tools.
  • And here’s the important op-ed of the day, by Orin Kerr. Looks like the government is about to get its wish and make us all guilt of something.

(Hat tip: Greenfield)

I’ve written a few posts about 9/11 over the years. My wife used to work for Aon, which lost over 170 people on 9/11, and she’d met at least one of them, a nice guy named Jim Berger. And a few years ago, I stumbled across the memoral for U.S. Navy Commander Dan F. Shanower in Naperville. Then last year, I wrote about my discomfort over the 9/11 memorial in Manhattan, and I explained why I had nothing more to say about 9/11.

As it turns out, I have a few more thoughts about 9/11 bouncing around in my brain after all, and this is as good a time as any to ramble on about them.

First of all, remember that the number of Americans who died on 9/11 is much larger than the three thousand people who died in the World Trade Center, in the Pentagon, and on the hijacked airplanes. I don’t have an exact figure, but the true death toll for September 11, 2001, is much closer to ten thousand people.

That’s not some conspiracy theory, it’s mortality statistics. There are about 300 million people in the United States, and a small percentage of them die every day. If 9/11 was otherwise a typical day, it means that in addition to the 3000 deaths from terrorism, another 7000 Americans passed away for other reasons.

I can’t get it out of my head that the families of some of those people have got to feel a bit…cheated, maybe? Imagine, for example, the wife of some liquor store clerk who was shot to death in a robbery on the night of September 10th, 2001. She wakes up the next morning for one of the worst days of her life, only to discover that nobody seems to care.

I don’t want to be all holier-than-thou about this, but just this once, when we think of the people who died on 9/11, let’s try to think of all the people who died on 9/11.

On another matter, I’m bothered by how often we we make the mistake of judging people’s actions by the results, rather than by the expected probability distribution when they acted. Consider a guy who buys a lottery ticket and wins a million bucks. Was he smart to buy that lottery ticket? If you say yes, because he won all that money, you’re part of the problem.

At the time he made the decision and acted by purchasing a ticket, he didn’t know he was going to win. All he knew is that there was a very small chance he would win, and a much larger chance he would lose. A typical state lottery probably only gives away half the money as prizes, which means that, speaking in terms of probability (and simplifying a lot), he could expect to lose half of what he spent on the ticket. Financially speaking, buying that ticket was a bad move. It’s only pure luck that prevented him from paying the price.

I bring this up in connection with 9/11 because the exact same argument applies to the firefighters, police officers, and EMTs who responded to the World Trade Center and died in the collapse. We call them heroes, and indeed they are. But they didn’t know they were going to die when they made the decision to respond to the scene and enter the towers. All they knew was that there was a risk —  a non-zero probability of death — and they went ahead and did it anyway. They are heroes not because they died, but because they risked death.

I think that’s an important distinction because there are plenty of other people — other firefighters and police and EMTs and anyone else who helped — who took the same risk that day, and happened by chance to survive. That they didn’t die does not in any way diminish their heroism. So remember the dead heroes, but also remember the heroes who still walk among us.

Everybody knows at least one line from Shakespeare’s Henry VI: “The first thing we do, let’s kill all the lawyers.”

But really, that line is hundreds of years old. Anybody writing today wouldn’t put lawyers first on the list. Not while there are still people alive in medical billing departments.

My God, this is a stupid business.

My wife had surgery a few months ago, and I’m in the process of cleaning up the last of the bills. As near as I can tell, there are seven different entities sending us bills:

  • My wife’s regular doctor who took the initial complaint and helped us decide what to do about it.
  • The surgeon who went in and fixed the problem.
  • The anesthesiologist who knocked my wife out and brought her back.
  • The hospital where the procedure was performed.
  • The completely different hospital that did the lab tests.
  • The radiologists who analyzed images of the problem.
  • The pathologist who evaluated tissues that had been removed.

We got some of these bills relatively quickly, but others took weeks to get here, and I have no way of knowing if there are any more bills still to come. (When I had very minor surgery last summer, the surgeon’s bill took months to arrive, and it arrived in the form of a collection notice for non-payment.)

By comparison, around the same time, my car had an unfortunate encounter with some suicidal geese. It took about four days to repair the car, but unlike with my wife’s surgery, the entire bill was available immediately, and more importantly, the entire bill was payable to the bodyshop. I didn’t have to pay the paint supplier or the Toyota parts supplier or the specialty shop that reclaimed the coolant from the air conditioner and refilled it. Even the insurance company had already promised to pay their share. It was a single, consolidated bill.

That’s pretty much how everybody else handles billing. If you hire a photographer for your wedding, you don’t have to pay his assistant or the lab that makes the prints. If you add a room to your house, you pay the general contractor, and he pays all his suppliers and subcontractors. Consolidating the bill is a very common service.

So, the first question is: Why can’t medical billing be this simple? Why couldn’t I pay for my wife’s surgery with a single payment? It wouldn’t necessarily have to be a single payment to the surgeon or the general practitioner. In fact, given the unpredictability of medical costs, it would probably have to be an intermediary with reasonably deep pockets. The hospital or the insurance company are both obvious candidates.

Or, given that there’s money involved, perhaps it should be a new niche for the banks. It all went on my American Express card, so maybe they’d like more of the action. After all, if they can offer Travel Services, why not a new Medical Services division?

It seems like everybody from the doctors to the hospitals to the patients — heck, maybe even the insurance companies — would benefit from making this process more efficient. And they ought to be willing to pay someone to do it. So why isn’t it happening?

I don’t know. If I had to guess, I’d say that this is the sort of customer-be-damned inefficency that is at the heart of any monopoly. Since there’s no obvious monopoly player, I’m guessing that it’s actually a cartel of medical service providers, probably enforced by the government. This is not entirely just libertarian suspicion of government: The hospital cartel is right out in the open in many states, enforced by Certificate Of Need requirements before any hospital can open or expand. The ban on interstate sale of health insurance also serves to cartelize the insurance companies of each state, protecting them against competition in a national market.

Now we come to the second and more important question: What else in healthcare is this inefficient? I can recognize the inefficiency of the billing process because it is a relatively simple non-medical matter. I don’t have to know a lot about medicine or hospital management or actuarial science to see the problem.

So if the small part I can see and understand is so absurdly inefficient, what else is screwed up just as badly, except that I don’t know enough to spot it? Operating room scheduling? Radiology equipment maintenance? Laboratory workflow? Ten other things that I don’t even know exist? If the problem with billing is systemic (as I suspect) there’s nothing to stop it from affecting every part of healthcare.