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	<title>John Barrdear &#187; Health Care</title>
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	<link>http://barrdear.com/john</link>
	<description>Thoughts about economics, politics and life in general</description>
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		<title>Running (February 2011)</title>
		<link>http://barrdear.com/john/2011/03/01/running-february-2011/</link>
		<comments>http://barrdear.com/john/2011/03/01/running-february-2011/#comments</comments>
		<pubDate>Tue, 01 Mar 2011 09:11:07 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Personal]]></category>
		<category><![CDATA[Running]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=1158</guid>
		<description><![CDATA[My resumption of running continues.  February managed to nail January in both distance and pace. Count:  14 runs (January was 16) Distance:  100km (January was 94km) Av. Pace:  5:39/km (January was 5:59/km) I&#8217;ve now managed over 200km in total, which was #5 of my running goals, and which also makes this the best block of [...]]]></description>
			<content:encoded><![CDATA[<p>My <a title="Running (January 2011)" href="http://barrdear.com/john/2011/01/31/running-january-2011/">resumption</a> of running continues.  February managed to nail January in both distance and pace.</p>
<p>Count:  <strong>14 runs</strong> (January was 16)</p>
<p>Distance:  <strong>100km</strong> (January was 94km)</p>
<p>Av. Pace:  <strong>5:39/km</strong> (January was 5:59/km)</p>
<p>I&#8217;ve now managed over 200km in total, which was #5 of <a title="Running" href="http://barrdear.com/john/running/">my running goals</a>, and which also makes this the best block of running I&#8217;ve had in terms of total distance for over 13 years:</p>
<p><a href="http://barrdear.com/john/wp-content/uploads/2011/03/Running-1-March-2011.png"><img class="aligncenter size-full wp-image-1159" title="Running Summary - 1 March 2011" src="http://barrdear.com/john/wp-content/uploads/2011/03/Running-1-March-2011.png" alt="" width="937" height="361" /></a></p>
<p>All exercise is publicly visible <strong><a title="My RunKeeper.com account" href="http://runkeeper.com/user/JohnBarrdear" target="_blank">here</a></strong> (on runkeeper.com).</p>
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		<title>Running (January 2011)</title>
		<link>http://barrdear.com/john/2011/01/31/running-january-2011/</link>
		<comments>http://barrdear.com/john/2011/01/31/running-january-2011/#comments</comments>
		<pubDate>Mon, 31 Jan 2011 13:31:07 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Personal]]></category>
		<category><![CDATA[Running]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=1145</guid>
		<description><![CDATA[I resumed my stop-start relationship with running on Christmas Day.  January has been my best month for running in over 12 years (I&#8217;ve lost all records prior to 1998). Count:  16 runs (previous best was 13 in Feb 1998, Jul 1998 and Aug 2008). Distance:  94km (previous best was 74km in Feb 1998, followed by [...]]]></description>
			<content:encoded><![CDATA[<p>I resumed my stop-start relationship with running on Christmas Day.  January has been my best month for running in over 12 years (I&#8217;ve lost all records prior to 1998).</p>
<p>Count:  <strong>16 runs</strong> (previous best was 13 in Feb 1998, Jul 1998 and Aug 2008).</p>
<p>Distance:  <strong>94km</strong> (previous best was 74km in Feb 1998, followed by 69km in Aug 2008).</p>
<p>Av. Pace:  <strong>5:59/km</strong> (Feb 1998 was 5:05/km, but we&#8217;ll ignore that for now).</p>
<p>I&#8217;ve now hit 100km in total, too, which brings up #2 on <a href="http://barrdear.com/john/running/" target="_blank">my running goals</a>.</p>
<p>All exercise is publicly visible <strong><a title="My RunKeeper.com account" href="http://runkeeper.com/user/JohnBarrdear" target="_blank">here</a></strong> (on runkeeper.com).  I&#8217;m finding the chatter with a mate and one of my brothers (the other being a lazy git) in Australia to be a real help.</p>
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		<title>In today&#8217;s episode of Politically Dicey But Important Topics Of Research &#8230;</title>
		<link>http://barrdear.com/john/2010/07/01/in-todays-episode-of-politically-dicey-but-important-topics-of-research/</link>
		<comments>http://barrdear.com/john/2010/07/01/in-todays-episode-of-politically-dicey-but-important-topics-of-research/#comments</comments>
		<pubDate>Thu, 01 Jul 2010 09:15:21 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Academia]]></category>
		<category><![CDATA[Development]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Welfare]]></category>
		<category><![CDATA[Flynn effect]]></category>
		<category><![CDATA[IQ]]></category>
		<category><![CDATA[The Guardian]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=1059</guid>
		<description><![CDATA[The newspaper article summarising the research: http://www.guardian.co.uk/science/2010/jun/30/disease-rife-countries-low-iqs People who live in countries where disease is rife may have lower IQs because they have to divert energy away from brain development to fight infections, scientists in the US claim. The controversial idea might help explain why national IQ scores differ around the world, and are lower [...]]]></description>
			<content:encoded><![CDATA[<p>The newspaper article summarising the research:<a href="http://www.guardian.co.uk/science/2010/jun/30/disease-rife-countries-low-iqs"> http://www.guardian.co.uk/science/2010/jun/30/disease-rife-countries-low-iqs</a></p>
<blockquote><p>People who live in countries where disease is rife may have lower IQs because they have to divert energy away from brain development to fight infections, scientists in the US claim.</p>
<p>The controversial idea might help explain why national IQ scores differ around the world, and are lower in some warmer countries where debilitating parasites such as malaria are widespread, they say.</p>
<p>Researchers behind the theory claim the impact of disease on IQ scores has been under-appreciated, and believe it ranks alongside education and wealth as a major factor that influences cognitive ability.</p>
<p>[...]</p></blockquote>
<p>The actual research article:<a href="http://rspb.royalsocietypublishing.org/content/early/2010/06/29/rspb.2010.0973.full?sid=f65fe5b5-b8d4-4e62-82ee-60c7bd44e3d3"> http://rspb.royalsocietypublishing.org/content/early/2010/06/29/rspb.2010.0973.full?sid=f65fe5b5-b8d4-4e62-82ee-60c7bd44e3d3</a></p>
<blockquote><p><strong>Abstract</strong></p>
<p>In this study, we hypothesize that the worldwide distribution of cognitive ability is determined in part by variation in the intensity of infectious diseases. From an energetics standpoint, a developing human will have difficulty building a brain and fighting off infectious diseases at the same time, as both are very metabolically costly tasks. Using three measures of average national intelligence quotient (IQ), we found that the zero-order correlation between average IQ and parasite stress ranges from r = ?0.76 to r = ?0.82 (p &lt; 0.0001). These correlations are robust worldwide, as well as within five of six world regions. Infectious disease remains the most powerful predictor of average national IQ when temperature, distance from Africa, gross domestic product per capita and several measures of education are controlled for. These findings suggest that the Flynn effect may be caused in part by the decrease in the intensity of infectious diseases as nations develop.</p></blockquote>
<p>For reference, the Flynn effect:  <a href="http://en.wikipedia.org/wiki/Flynn_effect">http://en.wikipedia.org/wiki/Flynn_effect</a></p>
<blockquote><p>The Flynn effect describes an increase in the average intelligence quotient (IQ) test scores over generations (IQ gains over time). Similar improvements have been reported for other cognitions such as semantic and episodic memory.[1]  The effect has been observed in most parts of the world at different rates.</p>
<p>The Flynn effect is named for James R. Flynn, who did much to document it and promote awareness of its implications. The term itself was coined by the authors of The Bell Curve.[2]</p>
<p>The effect&#8217;s increase has been continuous and approximately linear from the earliest years of testing to the present. There are numerous explanations to the Flynn effect and also some criticism. There is currently a discussion if the Flynn effect has ended in some developed nations since the mid 1990s.</p></blockquote>
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		<title>America and health care</title>
		<link>http://barrdear.com/john/2010/03/23/america-and-health-care/</link>
		<comments>http://barrdear.com/john/2010/03/23/america-and-health-care/#comments</comments>
		<pubDate>Tue, 23 Mar 2010 15:47:06 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Justice/Law]]></category>
		<category><![CDATA[Personal]]></category>
		<category><![CDATA[Politics]]></category>
		<category><![CDATA[Religion]]></category>
		<category><![CDATA[USA]]></category>
		<category><![CDATA[Welfare]]></category>
		<category><![CDATA[Congress]]></category>
		<category><![CDATA[Ethics]]></category>
		<category><![CDATA[Free market]]></category>
		<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[House of Representatives]]></category>
		<category><![CDATA[Moral]]></category>
		<category><![CDATA[Senate]]></category>
		<category><![CDATA[Socialism]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=999</guid>
		<description><![CDATA[In the light of the recent passage by the U.S. House of Represenatives of the Senate&#8217;s version of healthcare reform and the ensuing wailing, gnashing of teeth and smearing of soot in the hair by opponents of said reform, let me give my view &#8211; as an outsider &#8211; on the matter: It&#8217;s a question [...]]]></description>
			<content:encoded><![CDATA[<p>In the light of the recent passage by the U.S. House of Represenatives of the Senate&#8217;s version of healthcare reform and the ensuing wailing, gnashing of teeth and smearing of soot in the hair by opponents of said reform, let me give my view &#8211; as an outsider &#8211; on the matter:</p>
<p>It&#8217;s a question of morality.</p>
<p>It astounds me &#8212; and, frankly, every other non-American USA-watcher in the developed world &#8212; that the richest nation on earth, whose very constitution proclaims the pursuit of <em>life</em>, liberty and happiness to be it&#8217;s highest ideals, whose citizenry so loudly profess to live by Christian virtues, would not guarantee that some form of basic, <em>minimum</em> healthcare be available to all of its citizens independently of their ability to pay.  It utterly astounds me.  If I were American, it would disgust me that this had not happened 50 years ago.</p>
<p>If my income and my wealth is above average for my society, I have <em>an ethical duty</em> to subsidise the health care of those who are, for whatever reason, at the lower end of the spectrum.  Yes, there are issues of free riders and of personal responsibility, but they simply do not matter when answering the basic question.  The government of a country, acting on behalf of that country&#8217;s people, has a moral imperative to provide a minimum level of care to all of its citizens.</p>
<p>I am not saying this as a screaming socialist.  I freaking hate socialism.  I love the market (when it&#8217;s allowed to function properly with full transparancy).  I  support (at least partially, and possibly fully) privitised social  security.  I like the idea of small government.  I rage against the nanny-state in Australia and in the UK.  I worry about encouraging dependency and a sence of entitlement in those people assisted by the government.  But those concerns take a back seat on this issue.</p>
<p>So, yes, the second question (a two-for) is to ask what the minimum level should be and how to pay for it.  But first question should have been a no-brainer.</p>
<p>If all the country can afford is a polio shot and a packet of aspirin, then that&#8217;s what they should provide (hopefully a charity or two might help out, too).  But if the country is the richest in the history of the planet, they should be able to stump up for a bit more.</p>
<p>And, yes, for the next criticism, <em>this particular</em> reform by the U.S. Congress is nominally promising more than it will reallly provide when it comes to the fiscal deficit.  Yes, again, given America&#8217;s political structure, U.S. government spending won&#8217;t be truely corrected until there is a real crisis approaching (as opposed to the make-believe crises being proclaimed by people opposed to the bailouts and stimulus package(s)).</p>
<p>I don&#8217;t care.  The child of an unemployed, drug-taking high-school dropout should not be deprived of basic access to a doctor just because we&#8217;re angry at their parents.  Nor should their parents, come to that.</p>
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		<title>Thinking about Human Rights (and UNICEF)</title>
		<link>http://barrdear.com/john/2010/02/16/thinking-about-human-rights-and-unicef/</link>
		<comments>http://barrdear.com/john/2010/02/16/thinking-about-human-rights-and-unicef/#comments</comments>
		<pubDate>Tue, 16 Feb 2010 15:24:13 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Development]]></category>
		<category><![CDATA[Economics]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Justice/Law]]></category>
		<category><![CDATA[Prostitution]]></category>
		<category><![CDATA[Welfare]]></category>
		<category><![CDATA[Children's rights]]></category>
		<category><![CDATA[Guaranteed minimum income]]></category>
		<category><![CDATA[Human rights]]></category>
		<category><![CDATA[Minimum wage]]></category>
		<category><![CDATA[UNICEF]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=974</guid>
		<description><![CDATA[Before I begin:  UNICEF has a campaign in the UK at the moment to raise awareness of children being denied their rights around the world.  You can see the homepage for the campaign here.  You can donate here. Here are some things to keep in mind when thinking about human rights: A right is a [...]]]></description>
			<content:encoded><![CDATA[<p>Before I begin:  UNICEF has a campaign in the UK at the moment to raise awareness of children being denied their rights around the world.  You can see the homepage for the campaign <a title="UNICEF:  Put it right" href="http://www.unicef.org.uk/putitright/index.aspx" target="_blank"><strong>here</strong></a>.  You can donate <a title="UNICEF:  Put it right (make a donation)" href="http://www.unicef.org.uk/putitright/donate.aspx" target="_blank"><strong>here</strong></a>.</p>
<p>Here are some things to keep in mind when thinking about human rights:</p>
<ul>
<li>A right is a particular form of liberty.  It is the freedom to do something.</li>
</ul>
<ul>
<li>An obligation or mandate is the opposite of a right.  A right involves a conscious choice; thus the phrase &#8220;to <em>exercise</em> one&#8217;s right.&#8221;  If there is no choice available, there is no right.</li>
</ul>
<ul>
<li>One person having a right often implies denying another right from a second person.  Suppose that you work for me.  If I have the right to fire you, you cannot have the right to a guaranteed job with me.  If you have the right to go on strike, I cannot have the right to fire you for going on strike.</li>
</ul>
<ul>
<li>Sometimes having a right <em>does not</em> impede the rights of others.  A right to make use of a <a title="Wikipedia:  Rivalry (economics)" href="http://en.wikipedia.org/wiki/Rivalry_%28economics%29" target="_blank">non-rival good</a> is the classic example.</li>
</ul>
<ul>
<li>Exercising a right is not necessarily in a person&#8217;s best interest.  I have the right to gamble all of my money at a casino, but it probably wouldn&#8217;t be wise to do so.</li>
</ul>
<ul>
<li>Every decision of consequence for everybody, everywhere, is subject to a constraint of some kind.  There are only 24 hours in a day, the resources at your disposal are finite and, eventually, you will die.</li>
</ul>
<ul>
<li>If a person, operating under a constraint, chooses to not do something, it <em>does not imply</em> that their right has been denied to them.</li>
</ul>
<p>These last two points, while logical, create problems for many advocacy groups.  Consider the woman who, subject to constraints in her finances and the wages on offer for various jobs she can perform, chooses to become a prostitute.  Consider the subsistence-farming family that, subject to constraints in it&#8217;s finances and the wages on offer for alternative work, chooses to keep it&#8217;s children away from school and working on the farm.</p>
<p>It is largely for this reason that many people advocate what they call<em> &#8220;economic rights&#8221;</em>.  Although there are various versions of this (e.g. minimum wages, the welfare state, etc.), you can think of them as a government, on behalf of the entire population, instituting a <a title="Wikipedia:  Guaranteed minimum income" href="http://en.wikipedia.org/wiki/Guaranteed_minimum_income" target="_blank">guaranteed minimum income</a>.</p>
<p>Now, while there are strong moral arguments for such a guarantee (which I fully support and agree with), <span style="text-decoration: underline;"><em>this is not a right</em></span>.  This is a mandated transfer of income from high-income citizens to low-income citizens.  For the rich, it is an obligation (the opposite of a right) and for the poor, it does not directly increase the range of choices available to them.  Instead, it <em>indirectly</em> increases that range by relaxing one of their constraints.</p>
<p>I say again:  I fully support providing a minimum income to all people by means of a welfare state; nobody should live in poverty.  But this is not a right.  It is a moral duty.  Calling this an &#8220;economic right&#8221; is a deliberate obfuscation for marketing purposes.  People pay more attention and money when a person&#8217;s &#8220;rights&#8221; are being denied than when they simply have a moral obligation to help.</p>
<p><a href="http://www.unicef.org.uk/putitright/donate.aspx"><img class="alignright size-full wp-image-975" title="unicef_donation_breakdown" src="http://barrdear.com/john/wp-content/uploads/2010/02/unicef_donation_breakdown.jpg" alt="" width="233" height="190" /></a> I love the work done by UNICEF.  I think they are just about the best NGO on the planet.  My wife and I donate money to them.  They make an express point of telling you how much of the money you give will go to administration costs or to more fundraising.</p>
<p>I just wish they could raise those funds without confusing things by saying that <a href="http://www.unicef.org.uk/putitright/story.aspx?child=Aklima&amp;page=1" target="_blank">Aklima&#8217;s right to education is being denied to her</a>.  I recognise that they have to.  I just wish that they didn&#8217;t.</p>
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		<title>Auto-appendectomy: the removal of one&#8217;s own appendix</title>
		<link>http://barrdear.com/john/2010/01/15/auto-appendectomy-the-removal-of-ones-own-appendix/</link>
		<comments>http://barrdear.com/john/2010/01/15/auto-appendectomy-the-removal-of-ones-own-appendix/#comments</comments>
		<pubDate>Fri, 15 Jan 2010 16:39:07 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Umm .. Other stuff]]></category>
		<category><![CDATA[Antarctica]]></category>
		<category><![CDATA[Appendicities]]></category>
		<category><![CDATA[British Medical Journal]]></category>
		<category><![CDATA[Russia]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=917</guid>
		<description><![CDATA[Those crazy Russians!  In 1961, a team of 12 Russians spent the winter in Antarctica.  The doctor, a surgeon, developed appendicitis and eventually cut out his own appendix. The story is in the 15 December 2009 edition of the British Medical Journal. The skill at writing that the guy possessed is incredible.  Look at this, [...]]]></description>
			<content:encoded><![CDATA[<p>Those crazy Russians!  In 1961, a team of 12 Russians spent the winter in Antarctica.  The doctor, a surgeon, developed appendicitis and eventually cut out his own appendix.</p>
<p><a href="http://www.bmj.com/cgi/content/full/339/dec15_1/b4965" target="_blank">The story</a> is in the 15 December 2009 edition of the British Medical Journal.</p>
<p>The skill at writing that the guy possessed is incredible.  Look at this, written in his journal <em>while suffering appendicitis</em>:</p>
<blockquote><p>&#8220;I did not sleep at all last night. It hurts like the devil! A snowstorm whipping through my soul, wailing like a hundred jackals. Still no obvious symptoms that perforation is imminent, but an oppressive feeling of foreboding hangs over me.&#8221;</p></blockquote>
<p>Here he describes the operation:</p>
<blockquote><p>&#8220;I didn’t permit myself to think about anything other than the task at hand. It was necessary to steel myself, steel myself firmly and grit my teeth. In the event that I lost consciousness, I’d given Sasha Artemev a syringe and shown him how to give me an injection. I chose a position half sitting. I explained to Zinovy Teplinsky how to hold the mirror. My poor assistants! At the last minute I looked over at them: they stood there in their surgical whites, whiter than white themselves. I was scared too. But when I picked up the needle with the novocaine and gave myself the first injection, somehow I automatically switched into operating mode, and from that point on I didn’t notice anything else.</p>
<p>&#8220;I worked without gloves. It was hard to see. The mirror helps, but it also hinders—after all, it’s showing things backwards. I work mainly by touch. The bleeding is quite heavy, but I take my time—I try to work surely. Opening the peritoneum, I injured the blind gut and had to sew it up. Suddenly it flashed through my mind: there are more injuries here and I didn’t notice them . . . I grow weaker and weaker, my head starts to spin. Every 4-5 minutes I rest for 20-25 seconds. Finally, here it is, the cursed appendage! With horror I notice the dark stain at its base. That means just a day longer and it would have burst and . . .</p>
<p>&#8220;At the worst moment of removing the appendix I flagged: my heart seized up and noticeably slowed; my hands felt like rubber. Well, I thought, it’s going to end badly. And all that was left was removing the appendix . . .</p>
<p>&#8220;And then I realised that, basically, I was already saved.&#8221;</p></blockquote>
<p>There are a couple of pictures in the link, too.</p>
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		<title>Not raising the minimum wage with inflation will make your country fat</title>
		<link>http://barrdear.com/john/2009/11/10/not-raising-the-minimum-wage-with-inflation-will-make-your-country-fat/</link>
		<comments>http://barrdear.com/john/2009/11/10/not-raising-the-minimum-wage-with-inflation-will-make-your-country-fat/#comments</comments>
		<pubDate>Tue, 10 Nov 2009 11:39:57 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Academia]]></category>
		<category><![CDATA[Article Summary]]></category>
		<category><![CDATA[Economics]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Thinking on the margin]]></category>
		<category><![CDATA[USA]]></category>
		<category><![CDATA[BMI]]></category>
		<category><![CDATA[Chen]]></category>
		<category><![CDATA[Fast food]]></category>
		<category><![CDATA[Greg Mankiw]]></category>
		<category><![CDATA[Meltzer]]></category>
		<category><![CDATA[Obesity]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=836</guid>
		<description><![CDATA[Via Greg Mankiw, here is a new working paper by David O. Meltzer and Zhuo Chen: &#8220;The Impact of Minimum Wage Rates on Body Weight in the United States&#8220;. The abstract: Growing consumption of increasingly less expensive food, and especially “fast food”, has been cited as a potential cause of increasing rate of obesity in [...]]]></description>
			<content:encoded><![CDATA[<p>Via <a href="http://gregmankiw.blogspot.com/2009/11/unintended-consequences.html" target="_blank">Greg Mankiw</a>, here is a new working paper by David O. Meltzer and Zhuo Chen:  &#8220;<a title="NBER:  The Impact of Minimum Wage Rates on Body Weight in the United States" href="http://papers.nber.org/papers/w15485" target="_blank">The Impact of Minimum Wage Rates on Body Weight in the United States</a>&#8220;.  The abstract:</p>
<blockquote><p>Growing consumption of increasingly less expensive food, and especially “fast food”, has been cited as a potential cause of increasing rate of obesity in the United States over the past several decades. Because the real minimum wage in the United States has declined by as much as half over 1968-2007 and because minimum wage labor is a major contributor to the cost of food away from home we hypothesized that changes in the minimum wage would be associated with changes in bodyweight over this period. To examine this, we use data from the Behavioral Risk Factor Surveillance System from 1984-2006 to test whether variation in the real minimum wage was associated with changes in body mass index (BMI). We also examine whether this association varied by gender, education and income, and used quantile regression to test whether the association varied over the BMI distribution. We also estimate the fraction of the increase in BMI since 1970 attributable to minimum wage declines. We find that a $1 decrease in the real minimum wage was associated with a 0.06 increase in BMI. This relationship was significant across gender and income groups and largest among the highest percentiles of the BMI distribution. <strong>Real minimum wage decreases can explain 10% of the change in BMI since 1970.</strong> We conclude that the declining real minimum wage rates has contributed to the increasing rate of overweight and obesity in the United States. Studies to clarify the mechanism by which minimum wages may affect obesity might help determine appropriate policy responses.</p></blockquote>
<p>Emphasis is mine.  There is an obvious candidate for the mechanism:</p>
<ol>
<li>Minimum wages, in real terms, have been falling in the USA over the last 40 years.</li>
<li>Minimum-wage labour is a significant proportion of the cost of &#8220;food away from home&#8221; (often, but not just including, fast-food).</li>
<li>Therefore the real cost of producing &#8220;food away from home&#8221; has fallen.</li>
<li>Therefore the relative price of &#8220;food away from home&#8221; has fallen.</li>
<li>Therefore people eat &#8220;food away from home&#8221; more frequently and &#8220;food at home&#8221; less frequently.</li>
<li>Typical &#8220;food away from home&#8221; has, at the least, more calories than &#8220;food at home&#8221;.</li>
<li>Therefore, holding the amount of exercise constant,  obesity rates increased.</li>
</ol>
<p><em>Update: </em>The magnitude of the effect for items 2) &#8211; 7) will probably be greater for fast-food versus regular restaurant food, because minimum-wage labour will almost certainly comprise a larger fraction of costs for a fast-food outlet than it will for a fancy restaurant.</p>
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		<title>Restarting running:  100 days in</title>
		<link>http://barrdear.com/john/2009/10/30/restarting-running-100-days-in/</link>
		<comments>http://barrdear.com/john/2009/10/30/restarting-running-100-days-in/#comments</comments>
		<pubDate>Fri, 30 Oct 2009 20:32:04 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Personal]]></category>
		<category><![CDATA[Habits]]></category>
		<category><![CDATA[Running]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=823</guid>
		<description><![CDATA[Between 1999 and 2008 inclusive, the best I ever managed in a single block was a pathetic 17 runs over 41 days.  In 1998 I did manage 37 runs in a &#8220;block&#8221; but it was haphazard, with several two-week breaks and a couple of spurts of 5 runs per week that were, frankly, dangerous.  It [...]]]></description>
			<content:encoded><![CDATA[<p style="text-align: center;"><a href="http://barrdear.com/john/wp-content/uploads/2009/10/Running_30Oct2009.png"><img class="aligncenter size-large wp-image-824" title="Running_30Oct2009" src="http://barrdear.com/john/wp-content/uploads/2009/10/Running_30Oct2009-1024x465.png" alt="Running_30Oct2009" width="1024" height="465" /></a></p>
<p>Between 1999 and 2008 inclusive, the best I ever managed in a single block was a pathetic 17 runs over 41 days.  In 1998 I did manage 37 runs in a &#8220;block&#8221; but it was haphazard, with several two-week breaks and a couple of spurts of 5 runs per week that were, frankly, dangerous.  It took me 128 days (18 and a half weeks) to get through those 37.  I should reach 37 this time after 103 days (14 and a half weeks).  I attribute my sticking with it this time to:</p>
<ol>
<li>Running shorter distances than I have in the past</li>
<li>Resisting the urge to increase my speed too quickly</li>
<li>Never running more than three times per week</li>
<li><a title="John Barrdear:  Forever starting" href="http://barrdear.com/john/2009/08/26/forever-starting/" target="_blank">This</a></li>
</ol>
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		<title>Just a smidgen more on US healthcare reform</title>
		<link>http://barrdear.com/john/2009/10/13/just-a-smidgen-more-on-us-healthcare-reform/</link>
		<comments>http://barrdear.com/john/2009/10/13/just-a-smidgen-more-on-us-healthcare-reform/#comments</comments>
		<pubDate>Tue, 13 Oct 2009 18:42:49 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Politics]]></category>
		<category><![CDATA[USA]]></category>
		<category><![CDATA[Baucus]]></category>
		<category><![CDATA[Healthcare]]></category>
		<category><![CDATA[John Hempton]]></category>
		<category><![CDATA[Paul Krugman]]></category>
		<category><![CDATA[Silver]]></category>
		<category><![CDATA[Snowe]]></category>
		<category><![CDATA[Talking Points Memo]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=772</guid>
		<description><![CDATA[My previous comment on US healthcare reform, which was actually a comment on the current Australian system, got quite a few eyeballs thanks to John Hempton&#8217;s shout-out.  Anyway, I thought I&#8217;d highlight a couple of new developments for my little audience. First, Republican Senator Olympia Snowe (of Maine), who sits on the Senate Finance Committee, [...]]]></description>
			<content:encoded><![CDATA[<p>My <a href="http://barrdear.com/john/2009/08/20/a-description-of-australias-healthcare-system/" target="_blank">previous comment</a> on US healthcare reform, which was actually a comment on the current Australian system, got quite a few eyeballs thanks to John Hempton&#8217;s shout-out.  Anyway, I thought I&#8217;d highlight a couple of new developments for my little audience.</p>
<p>First, Republican Senator Olympia Snowe (of Maine), who sits on the Senate Finance Committee, <a title="Bloomberg:  Republican Snowe to Vote for Baucus Health-Care Plan (Update2) " href="http://www.bloomberg.com/apps/news?pid=20601087&amp;sid=aWUX8JA8_i.w" target="_blank">has said</a> that she will vote in favour of the suggested bill being proposed by that committee&#8217;s chairman, Max Baucus.  That is good for the Democrats as it will provide valuable political cover.  It&#8217;s no guarantee that she will vote in favour of whatever the Senate as a whole end up producing, or for whatever the Senate and House then negotiate as the final bill, but it&#8217;s still a significant move and the probability of her voting for those later versions has just increased.</p>
<p>Second, we have the fact that the healthcare insurance industry has recently done an about-face, from actively promoting reform to actively fighting against it.  <a title="Nate Silver:  Why The Insurance Industry is Fighting Mad" href="http://www.fivethirtyeight.com/2009/10/why-insurance-industry-is-fighting-mad.html" target="_blank">Nate Silver points out why</a>:</p>
<blockquote><p>Take a look at what&#8217;s happened to the share prices of the six largest publicly-traded health insurance companies since Labor Day, which was about the point at which the Democrats appeared to regain their footing &#8212; at least up to a point &#8212; on health care.</p>
<p><a href="http://3.bp.blogspot.com/_5ieXw28ZUpg/StMoRu1r9RI/AAAAAAAABWQ/XTk6UBvK8IM/s1600-h/hcstocks.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img id="BLOGGER_PHOTO_ID_5391697463988712722" style="cursor: pointer; width: 351px; height: 210px;" src="http://3.bp.blogspot.com/_5ieXw28ZUpg/StMoRu1r9RI/AAAAAAAABWQ/XTk6UBvK8IM/s400/hcstocks.png" border="0" alt="" /></a></p>
<p>Weighted for market capitalization, these insurance stocks have lost 11 percent of their value since Labor Day, wiping out about $10 billion in value. And that&#8217;s understating the case since the major indices have gained 5-8 percent over the same period &#8212; the insurance industry stocks are underperforming the market by just shy of 20 percent.</p></blockquote>
<p>So why have they tanked in the stock market?  Nate suggests two reasons:</p>
<blockquote><p>Firstly, the individual mandate has been weakened to the point where it&#8217;s arguably a tokenish provision. There are good, policy reasons to be worried about this, although the insurance lobby&#8217;s reasons for being opposed &#8212; they&#8217;ll have less guarantee of an incoming phalanx of high-margin customers &#8212; are not necessarily the same as the public&#8217;s at large. The second factor is that the Baucus bill in certain ways treats the insurers fairly harshly, both taxing them directly as well as levying a surcharge on high-cost insurance plans.</p></blockquote>
<p>I&#8217;d also suggest that the compromise version of the public option (that it be in the bill, but with states able to opt out if they wish [<a href="http://krugman.blogs.nytimes.com/2009/10/08/opt-out-public-option" target="_self">Paul Krugman</a>, <a href="http://tpmdc.talkingpointsmemo.com/2009/10/conservative-and-liberal-democrats-warm-to-public-option-compromise.php" target="_blank">Talking Points Memo</a>]) will have scared the insurance companies and investors as well.</p>
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		<title>Forever starting</title>
		<link>http://barrdear.com/john/2009/08/26/forever-starting/</link>
		<comments>http://barrdear.com/john/2009/08/26/forever-starting/#comments</comments>
		<pubDate>Wed, 26 Aug 2009 12:27:22 +0000</pubDate>
		<dc:creator>John Barrdear</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Personal]]></category>
		<category><![CDATA[Thinking on the margin]]></category>
		<category><![CDATA[Habits]]></category>
		<category><![CDATA[Running]]></category>

		<guid isPermaLink="false">http://barrdear.com/john/?p=711</guid>
		<description><![CDATA[I am a chronic starter.  It seems that every week or two I start something new.  This would be great, if only I then kept doing whatever it is that I start. One of the things that I start doing on a regular basis is running.  Just about every year, usually about half-way through summer, [...]]]></description>
			<content:encoded><![CDATA[<p>I am a chronic starter.  It seems that every week or two I start something new.  This would be great, if only I then kept <em>doing</em> whatever it is that I start.</p>
<p>One of the things that I start doing on a regular basis is running.  Just about every year, usually about half-way through summer, I start running again.  Every year I keep a careful log of what I do, every year I try not to build up too quickly, every year I become tremendously enthusiastic, every year I dream of completing the <a title="Virgin London Marathon" href="http://www.virginlondonmarathon.com/" target="_blank">London Marathon</a> and every year, without fail, I stop running after a month and a half.</p>
<p style="text-align: center;"><a href="http://barrdear.com/john/wp-content/uploads/2009/08/Starting_20090825.png"><img class="size-medium wp-image-712  aligncenter" title="Forever starting running" src="http://barrdear.com/john/wp-content/uploads/2009/08/Starting_20090825-225x300.png" alt="Forever starting running" width="225" height="300" /></a></p>
<p style="text-align: center;">(Click on the image for a bigger version.  Distances are in kilometres; rates are min/km)</p>
<p>I used to <em>be</em> a runner.  Back in 1992, my final year of high school, I ran four times a week on top of two weekly sessions of soccer training in the winter and cricket in the summer.  In the middle of that year I ran the <a title="Gold Coast Marathon" href="http://www.goldcoastmarathon.com.au/" target="_blank">Gold Coast Half-Marathon</a> in 1:38:37 (4 min 40 sec per kilometre).  Later that year I ran a cross-country 8km in 32 minutes flat.  I was in the Queensland junior <a title="Wikipedia:  Orienteering" href="http://en.wikipedia.org/wiki/Orienteering" target="_blank">orienteering</a> team.</p>
<p>I&#8217;ve always thought of myself <em>as</em> a runner (well, okay, a lapsed runner).  I&#8217;ve blamed everything I could imagine for my repeated failure to get into a habit again.  Diet.  Running too far.  Running too quickly.  Not enough time to rest  between runs.  Too much time between runs.  Not running on the same days of the week.  Insufficient variety in my routes.  Not running with music.  Not running enough with other people.</p>
<p>I generally hold that with exercise (hell, with anything), what propels you forward is novelty in the short term, discipline in the medium term and habit in the long term.  The trick, then, is to find a way to deal with a chronic lack of self-discipline in the medium term when you&#8217;ve ruled out options like joining the military to have discipline imposed upon you.</p>
<p>Here&#8217;s an email I sent to some of my friends <em>last year </em>(21 Aug 2008):</p>
<blockquote><p>It&#8217;s not that I get bored with the runs when I&#8217;m on them &#8211; I tend to vary my courses and occasionally run with a club.  As far as I can tell, I just get to a point where I can&#8217;t be arsed going today, tell myself I&#8217;ll go tomorrow, end up only going in three or four days and then repeat the process with the lags becoming longer until I just forget about it altogether.  I have tended to get quite tired after the first couple of weeks, which suggests that an inappropriate diet might be the cause, but I&#8217;m hesitant to use that as the explanation when the phrase &#8220;I&#8217;m a lazy bastard&#8221; is swimming gently across my forebrain.  There&#8217;s also the possibility that I rapidly envisage absurdly ambitious goals when I first start and manage to discourage myself before I&#8217;ve even built the habit of running.</p>
<p>So.  I&#8217;m looking for suggestions on how to keep it going this time. I&#8217;ve managed nine runs so far and all pretty evenly spaced (see attached).  The 5km runs are on the Heath, the 7km runs are with a running club of 80+ people around Hyde Park and Kensington Gardens.  Runs on the Heath are infinitely variable.  I don&#8217;t start back at uni for six weeks and have no work planned, so it&#8217;s a perfect opportunity to build up a weekly ritual.</p></blockquote>
<p>My friend Chris replied (22 Aug 2008) with:</p>
<blockquote><p>My most successful tactic:  grinding down the barriers of participation.</p>
<p>The thing that makes it hard to run is NOT the running.  It&#8217;s the transition from comfort and inertia to physical discomfort and effort (usually in the dark and cold in England).  You have to look at what you need to achieve: in the first few months you are trying to achieve a HABIT.  Nothing else.  You&#8217;re not trying to achieve physical fitness, training, distance or anything else.</p>
<p>So looking at it as habit training, the best thing you can do is work on the habit above all else.  It doesn&#8217;t matter a toad&#8217;s cloaca whether you go out and run 12k or 400 metres, if you stop a fortnight later.  And as you know, stopping is never a decision to stop running.  It&#8217;s a decision to take tonight off and go tomorrow instead.  Then tomorrow.  Then tomorrow&#8230;</p>
<p>The only way to succeed is to form the habit above all else, and the only workable way to form the habit is to make the habit easy.  So, change your goal.  It&#8217;s not to go for a run, it&#8217;s to put your tights on and step outside the door.  Make THAT what you do 3 times/week (or better, every Tues, Thurs and Sunday, since &#8220;3/week&#8221; gives you wiggle room).</p>
<p>So 3 times a week you will put your shoes and silver bodysuit on, and walk to the gate.  What happens then is purely a matter of how you&#8217;re feeling at the time.  Until you are standing at the gate, you are not planning anything else.</p>
<p>Pound down the delta between what you are doing now (vegging in a warm lounge room) and what you will be doing in 10 minutes (standing outside your door).  Smash the crap out of that delta, because that&#8217;s your only enemy.</p></blockquote>
<p>Which is eminently sensible advice, but as you&#8217;ll see above in the image, I stopped running two weeks later.  There was something missing.</p>
<p>Another friend, Anthony, also suggested last year that I</p>
<blockquote><p>drop down a lot of cash on an event, such as Noosa Tri, which gives [you] some financial and pride incentives not to look like a fat unfit bastard on the day.</p></blockquote>
<p>Again, excellent advice, but unless I have a basic belief that even with no training at all I can still cough and wheeze my way around the course, there&#8217;s a fair chance that if it&#8217;s all seeming a bit too hard I&#8217;ll just give up and call the cash gone.  However, it does lead into the classic economist&#8217;s way of solving any problem:  financial incentives.  In January 2008, Ian Ayres, Jordan Goldberg and Dean Karlan (two of them economists) lauched <a href="http://www.stickk.com" target="_blank">stickK.com</a>.  It&#8217;s a site that will let you set up a contract on yourself (e.g. to lose weight).  If you don&#8217;t meet the terms of the contract, you forfeit money.</p>
<p>I think it&#8217;s a neat idea, but it&#8217;s never really sat well with me.  If your money is potentially going to a charity that you hate, then that&#8217;s just stupid.  If it&#8217;s going to a charity that you like, then your incentives are all screwed up.  So instead, I&#8217;ve decided on a different idea:</p>
<p>As soon as I finish writing this post, I&#8217;m going to go to the bank and withdraw £520.  I will then divide it across eight envelopes and give them all to a good friend, Dimitri, with strict instructions to return the money back to me piecemeal as <em>he</em> is satisfied that I have gone for a run.  The amounts returned will be increasing over time, so the first run will get me £30 back, the second £40 and so on up to the eighth run being worth £100.  There will be a time limit of three weeks on my claiming the money back and a limit of no more than four runs being claimed per week. Here are the benefits, as I see them:</p>
<ul>
<li>Dimitri is a good friend and I trust him not to run off with my money.</li>
<li>If I don&#8217;t meet the requirements, I also trust Dimitri to not turn Good Bloke and give me the money back anyway.</li>
<li>He is pretty fit at the moment, having just competed in the <a href="http://www.thelondontriathlon.co.uk/" target="_blank">London Triathlon</a>, and is training regularly himself.</li>
<li>It&#8217;ll be up to Dimitri to judge whether he believes me when I say I went for a run.</li>
<li>The total amount of money is large enough that I will really want to get it back.</li>
<li>The incentive is increasing over time, so I won&#8217;t be tempted to just go for a couple of runs and call it quits.</li>
<li>The overall time limit combined with the restriction of no more than four runs per week will make sure that I don&#8217;t put it off and that I don&#8217;t end up hurting myself.</li>
<li>Possibly most importantly of all, it extends the period of novelty well into the period that would otherwise be solely governed by (a lack of) discipline.</li>
</ul>
<p>Eight more runs will take me to 20 in total.  If it goes well and Dimitri is willing, I might then repeat the process.  After that, I should hopefully have been running for long enough that I can get myself out the door without the financial incentive.</p>
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