One of the reasons for the push to Obamacare and away from the health care status quo is that our system costs way more than other places and yields results that are the same or worse as other countries. One of the metrics that lets us know our health care system is worse is that our infant mortality rate is worse than our peer countries. So, what explains the infant mortality rates?

Those in favor of the health care system status quo like to blame the differential on the measurements. It’s not that the U.S. actually has worse outcomes for infants, we just measure things more thoroughly and report more infant deaths. Aaron Carroll at the Incidental Economist has a post discussing a study that looks at this issue. And, in fact, these advocates have a point it seems. The reporting differences might explain up to 40% of the infant mortality differential — but that leaves us a long way to go.

It seems that one major area where our health system fails is in the period between one month and one year old. And, in particular, it fails infants who don’t have the good sense to be born to white, college-educated, married mothers. Those infants have a similar mortality rate as their European counterparts. The other infants are more likely to die.

I think it’s safe to say that being poor in the U.S. is a lot tougher than being poor in other Western countries.

I was struggling through the General Assembly’s barely usable website (somewhat visible framed PDFs everywhere!) and found a relatively interesting hearing conducted by the interim study committee on the judiciary concerning SB 27 from last session and the issue of whether the consent of a father who has abandoned a child should be required for the mother to put the child up for adoption. (Maybe it’s SB 27, I see references to legislation introduced by Rep. Steuerwald but went to his legislative page and can’t see such a House Bill listed. But, again, the General Assembly’s unnecessarily complicated web page is unnecessarily complicated.)

The Indiana Council of Juvenile and Family Court judges submitted a letter with concerns, stating that: 1) abandonment of the mother doesn’t necessarily equate to abandonment of responsibilities to the child; 2) the timing with which the father can be served with a notice of adoption or file a petition to establish paternity; 3) the situation where a pregnant woman refuses contact with the putative father without “justifiable cause;” 4) an inadequate definition of “abandonment.”

A letter from a birth mother about a situation where, in her mind, allowing the biological father to prevent adoption by requiring his consent even though he would have been unable to provide financially for the child or mother would be unfair. “If a man is able to prevent a woman from choosing adoption . . . and encumbers her with the ensuing responsibilities and expenses then it is only prudent that he shares in those responsibilities.”

Adoptions of Indiana submitted a letter indicating that there is a need for a law regarding pre-birth abandonment in the situation where a father signs up on the putative father’s registry or file a paternity action “out of a desire to control and spite the expectant father.” The letter suggests that, where the putative father fails to support the mother financially during the pregnancy, that is evidence that the father has abandoned the expectant mother.

Rick Callahan, writing for the Associated Press, reports that the Indiana Toll Road is in financial trouble and that the Indiana Finance Authority has sent a 90 day letter ITR Concession Co., a subsidiary of Cintra-Macquarie, requiring the company “to show that it can meet its obligations to its lenders in compliance with the company’s lease responsibilities.”

The Toll Road operator is reportedly considering bankruptcy and selling its interest in the toll road to someone else. We are something like 11% of the way through the 75 year lease at this point.

Niki Kelly, writing for the Fort Wayne Journal Gazette, has an article entitled “State’s infant death statistics grim.” She is reporting on information received by the Indiana Commission on on Improving the Status of Children.

•Indiana’s 2012 infant mortality rate is 6.7. It was only the second time in more than 100 years it has dipped below 7.

•Two-thirds of all deaths under the age of 18 are infants.

•One baby dies every 13 hours in Indiana.

Among the issues listed were premature births and low birth weight, congenital malformations, sudden infant death syndrome, and the mother’s smoking or obesity.

Sounds like a lot of the resulting education campaign is going to focus on telling women not to smoke and drink and telling them to breastfeed. None of those are bad things, but I’m not surprised that the efforts will focus on relatively cheap and morally righteous scolding rather than, say, spending a bunch of money combatting the sorts of poverty that is usually associated with poor infant health. Also, just throwing this out there: I find that breast feeding advocates can go a little overboard on the zealotry.

Sheila Kennedy has a post discussing Indiana’s economic activity and sales tax. She references an Indiana Business Journal report indicating that low wages are bad for business and hurt the economy. Discussing Indiana’s heavy reliance on sales taxes, she also references Standard & Poor indicating that “the slowdown in wage growth for most Hoosiers means they’re not spending much more money than before. And our wealthiest residents tend to save a greater share of their income and spend it on untaxed services.”

None of this is surprising. Sales taxes are known to be more volatile than property taxes, declining as the economy declines — which is often when government expenditures are most needed by the citizens. And discretionary consumer income drives the economy because as Mr. Ford reputedly observed, “if I pay a man enough to buy my car, he’ll buy my car.”

But wages are kind of a tragedy of the commons sort of thing. As a business owner, focused on profits, you’d probably be ideally situated if you can produce your stuff with low wage labor and sell your stuff to people with high wages. But, as more businesses pursue this model, there will be fewer and fewer high wage customers. Eventually the economy stagnates.

Like the man said, “pigs get fat, hogs get slaughtered.” A little bit of greed makes the economic system hum. Too much greed will make the whole system seize up.

I guess the news about Vikings running back Adrian Peterson hitting his kid in the name of discipline has prompted some new discussions about corporal punishment – a fancy term that helps us avoid saying “hitting kids.” I see from this Baltimore Sun editorial that the U.S. is joined only by Somalia in refusing to ratify the U.N. Convention on the Rights of the Child ‘in part because the treaty aimed at ending child trafficking includes language about “acting in the best interest of a child.’ That, in turn, has been interpreted by some in the U.S. Senate as anti-parental rights or anti-spanking.” But, when you have Somalia on your side, you’re in pretty stout company.

You can tell that this devotion to spanking is going to resist any number of studies showing that spanking children doesn’t help them. I think that’s at least in part because there is a deep cultural distrust of happiness in this country. Hard work and suffering are inextricably linked to probity.

Withhold not correction from the child: for if thou beatest him with the rod, he shall not die.

Thou shalt beat him with the rod, and shalt deliver his soul from hell.

Proverbs 23:13-14.

I suppose some parents think they need to hit their kid to make them behave. I don’t blame generations past who thought that’s the way things had to be. But now we have studies and experience showing that you can raise good kids without hitting them and, in fact, are more likely to raise good kids if you don’t hit them. Hitting your kids these days reflects a lack of patience and a lack of imagination.

It’s not o.k. to hit anyone else in the world except the most defenseless person who trusts you most? Seems legit.

I was sad to learn of the passing of former Tippecanoe County Circuit Court Judge Ron Melichar. He served as a Circuit Court Judge for three terms, from (I believe) 1984 – 2002. Before that he was a member of my firm (well before I joined!). He and our founding partner, Fred Hoffman, practiced together for quite some time.

By the time I joined the firm, Ron had been the Circuit Court judge for quite some time and I came to enjoy the trivia questions he put up on the white board in the court room. Although, to be honest, I can’t remember if it was a daily or weekly question he liked to put up. I can’t say I knew him well, but he was an enthusiast of the civil war, vacations in northern Michigan, and the Chicago Tribune.

Rest in Peace, Judge Melichar.

Sheila Kennedy has a good post this morning on the similarities between football and religion; particularly the group dynamics involved. She mentions an anthropologist named Harvey Whitehouse who has suggested that belief in the supernatural is incidental to religion – what really matters are the rituals that foster group cohesion, creating personal bonds that people are willing to die for.

Rather than generate new content on this (hopefully) lazy Sunday (not to be confused with lazy Muncie), I’ll just cut & paste my comment:

Reminds me of an extension of the development of complex organisms in the first place. First the replicating single-cell organisms had no worries – resources were abundant. Then they replicated themselves into scarcity. But, those who started eating the others had abundance. Then it became an arms race, cells combining to develop offensive and defensive mechanisms. Those who were most successful in defending themselves while eliminating the competition replicated the most DNA.

Eventually you get to where combining the organisms means forming packs and tribes and groups. And you’re not just replicating your DNA; you’re replicating memes like religious beliefs. The meme that surrounds itself with defense mechanisms and arranges for elimination of competing memes is more likely to replicate itself.

Few people are willing to die for their football team; but to a lot of people the particulars of the football that gets played is incidental. They don’t love their team because their team is objectively “the best.” Or even because the particular players on their chosen team remain the same from year to year and they feel a personal bond with the personnel. Rather, it’s a pretty clear “us” versus “them” event, and by choosing an “us,” you get to be part of a group. I don’t think that I’m atypical in finding most sporting events more exciting if I adopt a rooting interest – even an arbitrary one.

Rachel Morello, writing for State Impact Indiana, has a story about doctors recommending later school start times for middle schools and high schools to accommodate adolescents need for sleep and thereby improve their ability to learn while they’re at school. This will never catch on because life is a morality play, and anything that seems enjoyable or pleasant is immediately suspect. Can’t coddle “kids these days”(tm) you know. Misery builds fortitude which is why piling on homework and yelling at students to work harder will always be a more popular approach to education by policy makers.

Rick Callahan, writing for the Associated Press, has an article entitled “Health-care fears loom large in gay marriage cases.” The article discusses how health care benefits can be a strong motivating force for gay partners who want recognition of their relationship as a marriage which entitles them to their partner’s health care benefits.

Yesterday, Tony Cook, writing for the Indianapolis Star had an article on Seema Verma, an individual who works as a health care consultant for the State of Indiana, designing the “Healthy Indiana Plan” while working as a vendor for that plan.

No time to comment, but it’s unfortunate that health care protection can be so variable even while it’s so important to our lives, meanwhile it’s hard to escape the suspicion that the system is corrupt, and we’re chumps enriching some privileged few who have gamed the system.