Opinion : A plan to get rid of undue Pharmaceutical influence

In the last two years or so, there has been a lot of progress and publicity on the issue of pharmaceutical companies influencing medical trials. This article in Slate adds some useful information to the debate by uncovering new insidious ways that pharmaceutical companies are wielding influence on science. While the author's solution of making journals follow the same disclosure that scientists do is a good start, I think that there is a much better way to solve the whole situation. The best way to promote full disclosure in the pharmaceutical industry is simply to require each pharmaceutical company to submit a detailed and itemized list of all the parties that they have spent promotional or development money on for each budget year.

I would imagine that this is neither a difficult solution to legislate, or to comply with. It could be a simple form that is attached to the company's regular SEC filings for each fiscal year. This would create a government mandate for public disclosure that could be reviewed by accountants and for which executives could be held accountable. I am sure that some place in each company there exists a detailed lists of expenditures so that each company can track how effective these are. I cannot think of any objections to the public interest for mandating that each company make these itemized reports available to the public. While I realize that few people would bother to look their doctor up, it would give activists and investigators an important tool to demand accountability of healthcare professionals. This tool would also enable stronger peer review as conflicts of interest would be readily apparent to other scientists and scientific editors.

Great Article : The decline of the US auto industry

As Toyota prepares to claim the title of the worlds largest car maker, this article from the BBC is a fascinating look at the decline of the big three American automakers. It is a sad story (for americans at least) of a spectacular fall and an important lesson for industrial giants everywhere. The British seem to blame it mostly on the vague force of "globalization", but i think it has to do with poor decisions, greedy near sighted American investors, and shoddy engineering as well. I have predicted the fall of GM for awhile now (although it looks at the moment that Ford is even more likely to go first), and when the post mortems are finally written, there will be a lot of blame to go around. The article also looks at the local human impact, which I suppose is also sad...

Opinion : Philadelphia (my Sim City)

After a lot of complaining about the state of things in the city of brotherly love, people maybe wondering what I would do to fix it. Well, I have played a lot of simcity in my day, so here are my suggestions to improve the place.

1. Goal : reduce vacancy and improve quality of life. Feasibility: very reasonable

Problem: in many neighborhoods are vacant buildings, particularly row houses and abandoned factories. As many city dwellers flee to the suburbs, their old homes are written off and fall into disrepair

Solution: bulldoze the vacant structures. it seems simple, yet it is rarely done. The city should step up efforts to condemn these buildings and level them. Especially the factories. The second step would be to plant grass and trees on the empty lots.

Intended results: At minimum this will help the environment. Those rotting townhouses and factories are loaded with lead and asbestos, and this is likely a cause of the huge asthma rates in north philly kids. Parks will also add aesthetic value to improve quality of life. As for the economics, it should help increase property values in many areas and would also reduce crime by giving drug dealers fewer places to operate from. It may also spur new development in some areas.

2. Goal: reduce transportation congestion Feasibility: Only with federal funding

Problem: Highways are choked by volume delays even at non peak times. Most of the population is under-served by public transit. A car is always needed in Philly, even if you live in city high rises.

Solution : Increase highway volumes by adding lanes. this could be done by simply widening some routes (blue route and other suburban commuter roads) and by stacking lanes on I-76 and I-95 (think the FDR in NYC). Also they need to get rid of the lane pinches on each end of I-676 (worst highway design ever) Finally they need to over or underpass every intersection in the express lanes of Roosevelt blvd. Pedestrian walkovers on Roosevelt and Vine steets would also save several lives per year.
Moving on to the Mass transit system, they need to build subway lines (or elevated rail) to serve built up areas such as south Philly, Columbus ave. (the tracks are already there for god sakes, and btw, this would eliminate the need to drive to go shopping), Northeast philly (maybe run a line down Roosevelt ave.) Germantown, and Manyunk. The train service barely cuts it and the buses take forever and are unpredictable. Also, the transit system should run 24/7.

Intended results: should reduce congestion and pollution. Also should help businesses outside of Center City and make Philly a more walkable city. Highway improvements would also reduce the very high motor vehicle accident rates.

3. Goal: Improve City Quality of life Feasibility: very reasonable

Problem: Homeless people everywhere. Garbage all over many streets and covering vacant lots. all the transit stops reek of urine. Even thriving business and neighborhoods look cheap and run down.

Solution : Rudy Guliani style, "broken windows theory" ordinance enforcement (ie. copy NYC). Make the local police enforce aesthetic violations. Forcibly remove vagrants, especially from city statues and transit stations. Crack down on unlicensed vendors and bar any vendors from setting up on narrow sidewalks. Intersection cameras throughout the grid and anti-noise and horn laws should be passed. Make business maintain the exterior of there properties even if it is in a bad neighborhood (ahem, Uhaul) and fine them heavily if junk is on the left on the property of landscaping is not maintained. City should do its part and clean up around transit lines (especially the North philly rail corridor) and recreation centers.

Intended results: City should be a healthier place to live. Property values and tourists should increase.

4. Goal: Reduce crime Feasibility: reasonable

Problem: Young black men are safer in Baghdad. Property crimes are rampant, even in nice areas. It is not safe to walk around at night.

Solution : Lots of things need to be done. First, reduce unemployment and fix schools (see below). Second, a lot more police officers (Gov. Rendell's "troop surge" of about 1000 officers seems about right) The police need to be able to respond to minor complaints such as break ins and car thefts. Detective resources need to be increased to solve many more of the cities murders. Also, youth need something to do so add more all night rec centers and finish the wireless/laptop computing project. Community policing initiatives like having officers patrol streets on bikes or walk neighborhoods in plain clothes would also help( Drexel U. has apparently ordered its rent-a-cops to start doing this). Adopting NJ's gun control laws would also help. Improving access to mental health care is also needed.


5. Goal: Reduce unemployment Feasibility: reasonable

Problem: High unemployment and poverty

Solution : Create jobs with both private commercial development and public works initiatives. I would expand the CC program that pays those people in green shirts to walk around and clean things. That is a win-win program that would benefit the whole city. Also I would encourage more big-box development in former industrial parks. This worked so well in south Philly, it should be expanded to North and West Philly. Casinos should help
Also schools and job training programs need to be improved.


6. Goal: Targeted re-development Feasibility: some parts reasonable

Problem: Odd development patterns plague parts of this planned city. Also see #1.

Solution : Needed projects for selected areas:

around convention center: get rid of homeless shelters, adult stores, and parking lots on arch street. Replace with restaurants and shops, and probably another hotel

on North Broad: bulldoze the shady businesses and develop nice residential to connect the Fairmount and Northern Liberties neighborhoods.

with old MCP Hospital: develop high rise condos. That is a perfect spot on the hill overlooking the river.

Italian market area and chinatown: Needs nice restaurants

Area around temple: bulldoze the row houses and build a sports complex and low-rise student housing. The money they spent on that Edge complex could have improved probably 20 city blocks.

Area on edge of U City: Same as above. (Drexel led the way with W. Philly athletic complex.) They need to get more businesses on west market street and more college buildings out west.

Along Delaware River and in Old city: build high-rise condos. This is a part of the city people actually want to live in...they should try to pack them in.

maybe more to come later...

Opinion : The end of a good car

The news that Honda is canceling its Accord hybrid makes me sad. At the auto show a year ago, I though this car was the best all around practical car on the market. It was fast, looked cool, got great gas mileage, and looked cool. Alas, lately the auto industry is being more driven by marketing than technology (at least more so that usual) as several companies try to cut costs and look cool. I would say the biggest victim of this trend is Honda. (honorable mention to Ford, which has actually made a few decent cars lately) Honda has clearly been the biggest innovator of late and it has nothing to show for it. It was the first to the market with hybrid technology (with the Insight), the first to put that technology in a normal model (the civic) and its latest redesigns simply look cooler than their Toyota rivals and they haven't been plagued with as many recalls as Toyota or Mitsubishi. Problem is they are getting crushed in the market. Toyota is outselling them in pretty much every category, and they are the slowest growing Japanese automaker. (to be fair, it isn't all hype, Nissan, Mitsubishi and Mazda 08 models all look cooler and generally go faster)
While I would probably by a Nissan if i had the cash, it bothers me as an engineer and a tech fan when the innovator loses out to a rival with simply better hype.


Disclaimer: for financial reasons, I currently drive a beat up 92 Corrrolla

Great article : poor getting poorer

While checking my email in the med library today, I stumbled across this report about how the rich get richer by making the poor poorer. This is a very well written article, with a huge amount of actual data and statistics, that doesn't take sides but presents both very clearly. Th answer to the question of "who is responsible?" (the greedy business men or the uneducated poor) is unequivocally both. Gluttony and sloth are both deadly sins. The good news however is that there is a relatively simple fix. First, pass laws that make loan disclosures simple graphically and standardized (think food labels). This should coincide with a public service media campaign to show people how to read them. Laws that tighten the usury rate laws (say standardizing rates for any length loan to a per year standard) and outlawing the issuing of credit beyond a certain percentage of a individuals yearly income would almost completely solve the problem. Maybe this subprime loan mess will finally make it happen.


Full disclosure: I made a fair amount of money last year when ECC sold its subprime unit to Bear Sterns.

Opinion : Flirting with economics

I just finished reading the book Freakenomics, which has gotten me thinking of economics. Actually I always think in questions about numbers, I guess the book really has just inspired me to write about it. Anyway here are two examples, questions I had and the answers that I found:

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First, Congratulations to Exxon Mobil, (EM) who announced last week that they had another record profit (just over $40 Billion). With Gas prices always fluctuating, (supposedly to help the sellers to cope with crude oil price changes) I was wondering how much profit that is per gallon of gas that EM sells. I figure if that profit just is a few cents a gallon, then they are entitled to it. If the profit share is significant however, I have to wonder if the competitive forces are efficiently regulating the gas market.

To find how much Exxon Mobil makes on a gallon of gas, I looked at their 2005 financial and operating review. For the year 2005, EM made $36.13 billion in profit for all operations. To find out how many gallons of gas they sold, I looked at the downstream sales number for the US, which is 621,960,000 barrels. Using a conversion factor of 31.5 b/gal, that comes out to a grand total of 1.5917 e10 (~ 15 billion - holy crap) gallons of gas sold in 2005. Dividing their profit by sales, EM managed to make about $0.54 in profit for every gallon of gas they sold in the US.

Now I realize that it is not fair to compare the total profit to one small segment of a global vertically integrated company (only 52% of EM gas sales are in the US), but that does make me wonder if a 3 cent hike for any given week is really necessary.

Other interesting facts: Exxon Mobil sells an average of just over 1 million gallons (1004828) of gas per year at each gas station. It sells 38.6 gallons per year per capita.

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My next inquiry came from reading that John Edwards proposed to establish Universal healthcare by simply buying plans for people who do not have insurance and paying for it by raising taxes. He claimed it would only cost $120 billion. Now I would never trust a round number from a politician, but that got me wondering how much it would cost to simply buy everyone health insurance.

To figure out the actual amount, I went to a health insurance comparison site and shopped around. Without community payments, our current system gives different prices to different people, so I attempted to estimate a per-person cost based on an average of the lowest (approx. me) and the highest (male smoker, 60yo, chronic disease) rates for plans in the Philadelphia area (fairly representative and average for nationwide markets) To eliminate under-insurance, I picked the cheapest plan that had a reasonable deductible (<$1000) and no coinsurance. This leaves us with the HMO offered by Aetna, which costs an avg of $338.31 per month or $4,059.72 /yr. (range $113.62 - $563 /month) (HSA plans were 50% cheaper but carried huge deductibles and are therefore not practical for older individuals or those with chronic disease) It is claimed that there are 47 million un or under-insured people in this country (I have no idea how they got that number, lets just roll with it) which means that to simply buy them all insurance it would cost $1.90806 e11 (~$190 billion ). To extrapolate per capita, it would cost $1.217916 e12 (~$ 1.2 trillion) to pay for insurance for everyone at current rates.

Now Edward's guess wasn't that bad (poloticians use wider tolerances than engineers...) although my calculated price would skew upward a bit if the uninsured population had more chronic illnesses or lived in more expensive markets, both of which are very likely. It is worth noting though that this price is less then half or national defense budget or current deficit, and wouldn't represent much of a tax increase to cover. Unfortunately health care costs are rising at almost triple the rate of inflation, so I doubt this would be a sustainable plan for very long without other measures. Also it would tempt businesses to offload their employee benefits on the government...then again, that could be the market way to establish a single payer system...