Wednesday, June 16, 2021

New Alzheimer drug

The Food and Drug Administration (FDA) recently approved use of a new drug -- Aduhelm or aducanumab developed by Biogen -- for treating Alzheimer’s disease. 

Three medical experts on an FDA advisory panel resigned from the panel after deciding the drug's effectiveness has not been sufficiently shown or that the drug will do more harm than good. Link.

The financial effect of the approval on Medicare and Medicare Advantage programs and beneficiaries will be huge. Only time will tell how huge. Medicare’s long-standing practice is to make coverage determinations without taking cost into consideration.  This article from the Kaiser Foundation puts an expected price tag on the drug of $56,000 per patient per year. Since the drug will be physician-administered, it will be covered by Medicare Part B, for which Medicare covers 80% of the cost and the patient 20% (up to the annual out-of-pocket maximum of $7,550 for in-network care and $11,300 for combined in-network and out-of-network care in 2021).

"[T]he drug’s approval could trigger hundreds of billions of dollars of new government spending, all without a vote in Congress or indeed any public debate over the drug’s value." "If even one-third of the estimated 6 million people with Alzheimer’s in the United States receives the new treatment, health-care spending could swell by $112 billion annually." (The Atlantic).

Social Security, Medicare, and Medicaid are sacred cows to politicians and more than half of federal government spending. 

Sunday, June 6, 2021

Philosophy and science compared

The book The Neural Basis of Free Will by Michael Tse gives an interesting comparison of philosophy and science in the Introduction.

Why has philosophy been unable to make substantial progress in solving the mind-body problem? The root of philosophy’s impasse is that its main tools – logical argumentation, “thought experiments,” “intuition pumps,” and persuasion – are inadequate to the task. By themselves, these tools are incapable of settling basic debates between scholars with conflicting views rooted in incompatible starting assumptions. Logic can derive conclusions for axioms, but it cannot derive axioms, or, for that matter, the assumptions, biases, hunches, or intuitions that seem to underlie so much philosophical argumentation. With no objective way to settle a conflict, it is rare to find a philosopher who has written, “I was wrong and my rivals were right.” Without an objective arbiter of truth such as that imposed by falsifiability, why would a philosopher ever concede, especially when doing so might diminish career standing? A field cannot move forward to the next stage of a problem, and acknowledge that what was once a problem has now been solved, unless those on the wrong side of the debate are forced to concede they were wrong. Science, in contrast, has nature to falsify theories and models, and the scientific method of experimentation and model-correction/abandonment that forces scientists to stand on the shoulders of giants. Whether or not scientists concede they were wrong does not matter in the long run. Nature forces their concessions. Scientists who dogmatically maintain a position despite concrete evidence to the contrary are left behind. Whereas philosophers receive acclaim for occupying a position and defending it persuasively, scientists receive acclaim for making new discoveries that push the field to modify existing models of reality. Science makes astonishing progress year after year, whereas philosophy makes slow progress over centuries – at least concerning mental causation, free will and the mind-body problem – because debates can be objectively settled in science but cannot be objectively settled in philosophy.

One could quibble with some of this, but I believe it is largely accurate. Some might take this to discredit philosophy, but such a critic has to rely on some philosophy when science has no good answer to some questions.

Sunday, May 30, 2021

Uber and Lyft prices

Uber and Lyft prices have sharply increased along with car rental prices. Waiting times are longer, too.

Prepare to Pay More for Uber and Lyft Rides

Friday, May 28, 2021

Car rental prices

There have been several news stories lately about the high prices of rental cars. CBS News example. Prices are especially high in Hawaii, e.g. $700 per day. Revenues and net income of car rental companies plunged in 2020 due to the pandemic curtailing travel. Many companies suffered big losses and sold off inventory, probably to meet cash needs. With the pandemic's decline and travel demand surging, the supply of rental cars is well below demand. So prices have risen sharply.

While I haven't seen stories about "price gouging", I will not be surprised if I see some.  Of course, accusers will likely conveniently ignore what happened in 2020, and the now high prices are enabling paying interest, adding to inventory, and reducing debt rather than producing windfall profits.

Wednesday, May 19, 2021

Major league baseball batting slump

The 2021 major league baseball season is only about one-quarter over. Yet there have been five no-hitters so far, whereas the whole season average is about two. The overall major league batting average so far this year is only .236, the lowest it has been since .237 in 1968. 1968 was dubbed "the year of the pitcher" for the weak hitting (link).  As a result the pitcher's mound was lowered and the size of the strike zone was reduced for 1969.

The number of home runs per team game has not fallen to 1968's 0.61. The overall major league number of home runs per team game this year is 1.14. That is less than the previous two years (1.28 and 1.39) but still well above what it was 2010-15 (range 0.86 to 1.02). Strikeouts are up slightly, 8.97 per team game. This number exceeded 7.0 for the first time in 2010. It exceeded 8.0 for the first time in 2016 and has remained there. 

What's going on? It seem that hitters are trying to swing for home runs more and more. I saw it claimed the lower batting average is mainly due to fewer singles, not fewer extra base hits. The stats I see here don't clearly support that. Extra-base hits have fallen about as much. The number of singles per team game is 5.05 this year. That is about the same as last year (a shortened season due to the pandemic) but less than 2019's 5.34. The statistic has fallen steadily since 2008's 6.02. The number of runs scored per team game is 4.36, down from 4.65 last year and 4.83 in 2019. Runs batted in (RBIs) per team game is 4.13, down from 4.44 last year and 4.63 in 2019. On the other hand, pitchers may have gotten better. The overall average ERA is down and strikeouts per team game are up.

Update 5/20: Corey Kluber pitched the 6th no-hitter of the year yesterday.

Sunday, May 16, 2021

Coronavirus - new mask guidelines

There are lots of news articles about the CDC's (Center For Disease Control And Prevention) new guidelines about wearing masks. Here are examples:

https://www.nytimes.com/2021/05/15/us/cdc-mask-guidance-americans.html

https://www.usatoday.com/story/money/food/2021/05/15/starbucks-mask-policy-update-may-17-optional-vaccinated-customers/5100124001/

https://www.nytimes.com/2021/05/15/world/nurses-union-cdc-mask-vaccinated.html

Saturday Night Live satirized the new rules. 

https://www.nbcnews.com/pop-culture/tv/saturday-night-live-satirizes-sometimes-confusing-no-mask-guidelines-n1267515

Obviously the new guidelines rely heavily on voluntary compliance. They are very difficult to enforce. Is Walmart or any other place going to ask for proof of vaccination if a person is not wearing a mask? How would the enforcer know if the proof of vaccination is fake or borrowed or not? If a person walks in with a mask, is the person going to be watched to assure the person doesn't remove it?

Thursday, May 13, 2021

Cryptocurrency energy usage

This article says Tesla's CEO Elon Musk and former Federal Reserve chairperson Janet Yellen are concerned about the huge amount of energy used for cryptocurrency mining. Tesla has halted purchases of vehicles with bitcoin due to such concern.

The price of Bitcoin (BTC-USD) fell about 13% in the last two days. The price of Ethereum (ETH-USD) fell about 10% in the last two days. I suspect the amount of energy that mining consumes is a major driver for the price drops. The mining -- done by many miners -- is to verify transactions on the blockchain.

For many months I have suspected the amount of energy mining uses is a growing problem and will inhibit the growth of cryptocurrencies unless something is done to require less energy. On the other hand, some are less concerned. Professor Carol Alexander said: “Almost all the trading is not done on the blockchain. It’s done on secondary markets, centralized exchanges. They’re not even recorded on the blockchain.”

I assume Alexander refers to exchanges like Grayscale's trusts (e.g. tickers GBTC, ETHE). If somebody buys or sells shares in the trust, there is a counterparty selling or buying shares. The cryptocurrency per se, Bitcoin or Ethereum, is not traded and therefore the transaction doesn't need mined. Only the beneficial owner of the shares changes. The trust holds legal title to the Bitcoin the same way before and after. 

P.S. I didn't post for about two weeks due to selling our previous house, moving into our new house, and a vacation for several days to Zion National Park, Bryce Canyon, the Grand Canyon, and Phoenix.