When the passage of H.R.3590 kicked up a shitstorm two weeks ago, I thought of Jorge Luis Borges’ short story entitled “The Improbable Impostor Tom Castro.” This 1911 piece tells of Arthur Orton, a ne’er-do-well operating under the alias of “Tom Castro.” When he meets fellow conman Ebenezer Bogle, the two men hatch a plan to scam Lady Tichborne, a grieving mother who is unable to accept the fact of her son’s death at sea. Hoping to squeeze some buckeroos from this rich old biddy, Bogle decides that Orton/Castro should travel to England to impersonate the late Roger Charles Tichborne even though Castro looks nothing like young Mr. Tichborne at all.

Tichborne had been a slim, genteel young man with a reserved and somewhat self-absorbed air. He had sharp features, straight black hair, tawny skin, sparkling eyes, and an irritatingly precise way of speaking. Orton was an irrepressible rustic, a “yokel,” with a vast belly, features of infinite vagueness, fair and freckled skin, wavy light-brown hair, sleepy eyes, and no, or irrelevant, conversation.

…The plan had an irrational genius to it… Bogle knew that a perfect facsimile of the beloved Roger Charles Tichborne was impossible to find; he knew as that any similarities he might achieve would only underscore certain inevitable differences. He therefore gave up the notion of likeness altogether. He sensed that the vast ineptitude of his pretense would be a convincing proof that this was no fraud, for no fraud would ever have so flagrantly flaunted features that might so easily convinced (emphasis mine).

So here’s the Tom Castro Strategy: when an approximation of truth would too easily reveal yourself as fraudulent, shoot for the moon and become as absurdly outlandish as possible.


Unconscionable Math

Post-of-the-week is an entry by “Taunter” that’s blowing up the internets. His must-read essay entitled “Unconscionable Math” explains the healthcare industry’s practice of canceling your policy — known as “rescission” — right when you need it most. The money quote:

If, as I suspect, rescission is targeted toward the truly bankrupting cases – the top 1%, the folks with over $35,000 of annual claims who could never be profitable for the carrier – then the probability of having your policy torn up given a massively expensive condition is pushing 50%. One in two.  You have three times better odds playing Russian Roulette.

I don’t have much to add to Taunter’s post, it’s really worth reading all the way through. But it’s scary to think that we’re not even talking about the millions of people who can’t get insurance — these are people who’ve done everything right. So even if you have a great plan, the profit motive requires these corporations to maximize earnings by denying care to people — like Shelly Andrews-Buta or Nataline Sarkisyan — who desperately need life-saving help.

The Perils of Sloganeering (healthcare edition)

There’s so much political stupidity on Facebook that I have to just ignore 99% of it. But yesterday I noticed a very conservative friend — known for his opposition to universal healthcare in any form — quip that “the city of Pittsburgh has more MRI machines then [sic] all of Canada…”

I took a particular interest in this bumper-sticker fact not just because I’ve previously spent a lot of time researching universal healthcare, but also because the claim seemed to be doing more intellectual work for these conservatives than it was doing for me. That is, I didn’t think such an isolated statistic was so thoroughly devastating to the case for universal healthcare… there had to be more to the story, right?

In looking into it I discovered that this quip — “Pittsburgh has more MRI machines than Canada” — has been turned into an endlessly quoted slogan that is rarely cited or examined. But here’s where things get funny: the origin of this phrase lies in a 2008 Forbes article by David Whelan in which this statistic is mentioned to show precisely what’s wrong with the U.S. healthcare system (oh, the irony!). Whelan’s point was that spending was out of control, and that advanced imaging machines (both MRI & CT) purchases were above and beyond what was necessary. What was a throwaway line by one journalist to point out the weaknesses of the U.S. system is now being brandished by right-wingers to point out the supposed superiority of the U.S. system.

Note, however, that Whelan doesn’t actually cite where he got this statistic. My best guess is that he was relying on a 2005 Pittsburgh Tribune-Review article. The piece paraphrases Vic Panza — V.P. of National Imaging Associates and a man with a vested interest in high sales of MRI machines — as saying that Western Pennsylvania (not just Pittsburgh) has 160 total machines. However, according to the O.E.C.D., in 2005 Canada had some 183 MRI machines (and some 250+ by this year). So even if you trust Panza’s estimate, the whole statistic seems fairly suspect to me. (more…)