Quotulatiousness

January 10, 2015

Living with diphallia

Filed under: Health, Randomness — Tags: , — Nicholas @ 04:00

BBC Newsbeat on the plight of a poor American boy who lives a secret life due to his rare diphallia condition:

A man with two penises has been speaking to Newsbeat about living with the condition.

Known only as Triple D, the 25-year-old from the east coast of America claims to have had 1,000 sexual partners.

He suffers from diphallia which is a rare condition where a male is born with two penises.

According to a report by the BMJ — the global healthcare knowledge provider — one-in-five million males in the world are born this way.

[…]

Triple D describes himself as “very much bisexual” and has been in polyamorous relationships — sexual or romantic relationships that are not exclusive to one person.

He says his longest relationship was with a couple.

Everyday things like buying underwear are an issue — so he tells Newsbeat he doesn’t wear any.

Both penises are fully functioning. “I can urinate and ejaculate through both at the same time,” he explains.

“Entering into the porn industry has crossed my mind. I knew people who worked in the sex industry and some of them knew what I had, some had heard what I had.

“Nobody had seen it. I remember thinking about it but I don’t want to become a novelty. My dignity is priceless.”

Newsbeat has seen photographs which support Triple D’s claims but cannot independently verify his identity.

The four kinds of healthcare spending

Filed under: Bureaucracy, Business, Economics, Government, Health, USA — Tags: , , , — Nicholas @ 03:00

Megan McArdle explains why healthcare costs more than you think it should:

Milton Friedman famously divided spending into four kinds, which P.J. O’Rourke once summarized as follows:

  1. You spend your money on yourself. You’re motivated to get the thing you want most at the best price. This is the way middle-aged men haggle with Porsche dealers.
  2. You spend your money on other people. You still want a bargain, but you’re less interested in pleasing the recipient of your largesse. This is why children get underwear at Christmas.
  3. You spend other people’s money on yourself. You get what you want but price no longer matters. The second wives who ride around with the middle-aged men in the Porsches do this kind of spending at Neiman Marcus.
  4. You spend other people’s money on other people. And in this case, who gives a [damn]?

Most health-care spending in the U.S. falls into category three. In theory, the people who are funding our expenses — the proverbial middle-aged men in Porsches, except that they’re actually insurance executives and government bureaucrats — have every incentive to step in, cut up the charge cards, and substitute a gift-wrapped box of Hanes briefs with the comfort-soft waistband. In practice, legislators frequently intervene to stop them from exercising much cost-control. The managed care revolution of the 1990s died when patients complained to their representatives, and the representatives ran down to their offices to pass laws making it very hard to deny coverage for anything anyone wanted. Medicare cost-controls, such as the famed Sustainable Growth Rate, fell prey to similar maneuvers. The only system that exhibits sustained cost control is Medicaid, because poor people don’t vote, or exit the system for better insurance.

The result is a system where everyone complains that we spend much too much on health care — and the very same people get indignant if anyone suggests that they, personally, should maybe spend a little bit less. Everyone wants to go to heaven — but nobody wants to die.

Unfortunately, this is what cost-control actually looks like, which is to say, like people not being able to spend as much on health care. Oh, to be sure, we could achieve this end differently — instead of asking patients to pay a modest share of their own costs (the article suggests that this amount is less than 10 percent, in the case of Harvard professors) — we could simply set a schedule of covered treatment, and deny patients access to off-schedule treatments, or even better, not even tell them that those treatments exist. But people don’t like that solution either, which is why medical dramas are filled with rants about insurers who won’t cover procedures, and the law books are filled with regulations that sharply curtail the ability of insurers to ration care. And the third option, refusing to pay top-dollar for care, would be a bit tricky for Harvard to implement, given that they run exactly the sort of high-cost research facilities that help drive health-care costs skyward. Nor do I really think that the angry professors would be mollified by being given a cheap insurance package that wouldn’t let them go see the top-flight specialists their elite status now entitles them to access.

Instead, they persist in our mass delusion: that there is some magic pot of money in the health-care system, which can be painlessly tapped to provide universal coverage without dislocating any of the generous arrangements that insured people currently enjoy. Just as there are no leprechauns, there is no free money at the end of the rainbow; there are patients demanding services, and health-care workers making comfortable livings, who have built their financial lives around the expectation that those incomes will continue. Until we shed this delusion, you can expect a lot of ranting and raving about the hard truths of the real world.

Sub-orbital airliners? Not if you know much about economics and physics

Filed under: Economics, Technology — Tags: , , , , , — Nicholas @ 02:00

Charles Stross in full “beat up the optimists” mode over a common SF notion about sub-orbital travel for the masses:

Let’s start with a simple normative assumption; that sub-orbital spaceplanes are going to obey the laws of physics. One consequence of this is that the amount of energy it takes to get from A to B via hypersonic airliner is going to exceed the energy input it takes to cover the same distance using a subsonic jet, by quite a margin. Yes, we can save some fuel by travelling above the atmosphere and cutting air resistance, but it’s not a free lunch: you expend energy getting up to altitude and speed, and the fuel burn for going faster rises nonlinearly with speed. Concorde, flying trans-Atlantic at Mach 2.0, burned about the same amount of fuel as a Boeing 747 of similar vintage flying trans-Atlantic at Mach 0.85 … while carrying less than a quarter as many passengers.

Rockets aren’t a magic technology. Neither are hybrid hypersonic air-breathing gadgets like Reaction Engines‘ Sabre engine. It’s going to be a wee bit expensive. But let’s suppose we can get the price down far enough that a seat in a Mach 5 to Mach 10 hypersonic or sub-orbital passenger aircraft is cost-competitive with a high-end first class seat on a subsonic jet. Surely the super-rich will all switch to hypersonic services in a shot, just as they used Concorde to commute between New York and London back before Airbus killed it off by cancelling support after the 30-year operational milestone?

Well, no.

Firstly, this is the post-9/11 age. Obviously security is a consideration for all civil aviation, right? Well, no: business jets are largely exempt, thanks to lobbying by their operators, backed up by their billionaire owners. But those of us who travel by civil airliners open to the general ticket-buying public are all suspects. If something goes wrong with a scheduled service, fighters are scrambled to intercept it, lest some fruitcake tries to fly it into a skyscraper.

So not only are we not going to get our promised flying cars, we’re not going to get fast, cheap, intercontinental travel options. But what about those hyper-rich folks who spend money like water?

First class air travel by civil aviation is a dying niche today. If you are wealthy enough to afford the £15,000-30,000 ticket cost of a first-class-plus intercontinental seat (or, rather, bedroom with en-suite toilet and shower if we’re talking about the very top end), you can also afford to pay for a seat on a business jet instead. A number of companies operate profitably on the basis that they lease seats on bizjets by the hour: you may end up sharing a jet with someone else who’s paying to fly the same route, but the operating principle is that when you call for it a jet will turn up and take you where you want to go, whenever you want. There’s no security theatre, no fuss, and it takes off when you want it to, not when the daily schedule says it has to. It will probably have internet connectivity via satellite—by the time hypersonic competition turns up, this is not a losing bet—and for extra money, the sky is the limit on comfort.

I don’t get to fly first class, but I’ve watched this happen over the past two decades. Business class is holding its own, and premium economy is growing on intercontinental flights (a cut-down version of Business with more leg-room than regular economy), but the number of first class seats you’ll find on an Air France or British Airways 747 is dwindling. The VIPs are leaving the carriers, driven away by the security annoyances and drawn by the convenience of much smaller jets that come when they call.

For rich people, time is the only thing money can’t buy. A HST flying between fixed hubs along pre-timed flight paths under conditions of high security is not convenient. A bizjet that flies at their beck and call is actually speedier across most intercontinental routes, unless the hypersonic route is serviced by multiple daily flights—which isn’t going to happen unless the operating costs are comparable to a subsonic craft.

QotD: Honour and politics

Filed under: Politics, Quotations, USA — Tags: , — Nicholas @ 01:00

It is almost an axiom that no man may make a career in politics in the Republic without stooping to such ignobility: it is as necessary as a loud voice. Now and then, to be sure, a man of sounder self-respect may make a beginning, but he seldom gets very far. Those who survive are nearly all tarred, soon or late, with the same stick. They are men who, at some time or other, have compromised with their honour, either by swallowing their convictions or by whooping for what they believe to be untrue.

H.L. Mencken, Notes on Democracy, 1926.

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