Basketball is an awful sport. Here’s why.

Basketball is difficult to watch. What makes it so for me is the way the games end. I can’t think of another sport in which breaking the rules can result in an advantage for the team which does so. Here is what I mean.

A typical scenario is that the Lakers are leading the Knicks by 9 points with two minutes to go. At this point, the strategy for the Knicks is to foul the worst free-throw shooter on the Lakers as soon as he touches the ball. The idea is that if he misses his shots, the Knicks will gain possession with a chance to narrow their deficit. This goes on and on until the game mercifully ends 20 or 30 minutes later.

The reason the end of the game takes so long is that the clock stops when the foul occurs and the free-throws are taken. And each team has about 10 time-outs which are called at every whistle. To me, there are basically two phases of a basketball game. Phase I consists of about 38 minutes of what passes for basketball today. That is, a lot of one-on-one offense and minimal-to-no defense. There is no such thing as “traveling’ or “palming the ball” any more. Phase II is the last two minutes which involves a lot more walking back and forth than a soldier on guard duty can imagine.

Try as I might to come up with something, I just don’t think there is any other sport that rewards rule-breaking. Baseball? No. Football? No [but certainly right up there with basketball as far as the duration of the last two minutes of a game is concerned]. Hockey? No, in fact a foul gets you a chance to play with fewer men. Soccer? No. Tennis? No. Golf? No. Swimming? No. NASCAR? No [not a sport].

Why don’t they just skip the basketball game altogether and have dunking contests instead? Then it could be more like gymnastics, figure skating or diving.

Slate Says Mauritius Is the Greatest Country on Earth. Huh?

Slate, the on-line magazine, posted an article on March 7, 2011 claiming that Mauritius is the “Greatest Country on Earth.” The article’s subtitle reads, “What the United States can learn from the tiny island nation of Mauritius.” According to the author of the piece, Joseph Stiglitz, Mauritius, an island nation of 1.3 million people, provides “free education through university for all of its citizens, transportation for school children, and free health care—including heart surgery—for all” despite the fact that it is not rich and has no budget problems. And 87% of its people own their own homes, a figure not nearly matched by the United States. Stiglitz thinks we should emulate Mauritius and provide similar amenities for our citizens. Over 1200 comments have been logged with a high percentage of them expressing skepticism.

I sent the link to the article to a friend who recently lived in Mauritius for six months. He had plenty to say. He asked to remain anonymous as he still does business there.

He started with this, “While I think Mauritius is a beautiful country and has some very nice people, the standard to which they have attained some of the ‘achievements’ is based on a pretty low bar, and I would question many of the author's statistics.”

On medical care he wrote, “while medical care may be freely available, our experience with the local medical community left me feeling that I would not want to have any medical procedures done there, unless the alternative was death.”

On transportation, we have, “Roads are a nightmare, with only one main road through the whole island, going from the airport in the south east to the nice beach area in the NW. It goes right through the main city of Port Louis, and is a continuous traffic jam from 7 AM to 9 PM.”

Home ownership, “The home ownership statistic intrigued me and I cannot figure how they arrived at it, unless they include the large number of squatters who live in houses made of corrugated tin with stolen billboards for roofs (my company lost a billboard in the middle of the night that way). For those that do own their own homes, most are small, made of cinderblock and only partially finished…” And this: “…the 87% stat has to be fiction. Interestingly, a large percentage of houses remain unfinished (usually unpainted on the outside or with only a framework for a second floor) because you don't have to pay property taxes until it is completed. So it never is.”

It’s not all negative, in fact he said: “Mauritius has accomplished a great deal since independence, and should be very proud of what they have done. I actually think Mauritius is a lovely country with great people in charge who, for a population of 1.3 million, have done a fabulous job of developing the local economy and raising the standard of living in what I hope will be a sustainable fashion. The education system is solid, which is critical for the future and has been a very wise investment. Their approach is very tied to the local culture, where people's goals, expectations and standards are not the same as the US. So projecting it as a solution for…the US and Europe is a bit of a stretch.”

Stiglitz said that he recently visited Mauritius. One wonders just what he saw or perhaps was shown. Maybe he wrote the article just to see what kind of reaction he could stir up. If that was the goal, it worked although one could argue that 1200 comments from a nation of 325 million people is not really a massive response. Read the article and see for yourself.

Air Fares, Price Fixing and Justice

On March 6, 2011 AP reported that 21 non-US airlines were fined some $1.7 billion for fixing passenger and cargo fees. Several executives have been charged with four having been sentenced to prison. The cases were brought by the US Department of Justice.

I have always wondered about this. Everyone knows that gas stations peg their prices to what nearby gas stations are charging. To me, that smacks of price fixing too. But how do airlines get away with their fare policies? Today [March 7, 2011 at 9:30 a.m. EST] I went to the Orbitz website to book a trip From LaGuardia, NY to Chicago. Here is what I found.


How can it be that multiple airlines have the exact same fares? And it is not just Orbitz. If you go to the carrier’s websites, the $176.00 fare appears on all of them.

What is interesting is that I have always been told that if a surgeon discusses his fee structure with another surgeon, we would both be guilty of anti-trust violations. But somehow, the airlines can all just happen to have the same fares for their routes and no one says anything.

I wish someone would explain this to me.

Difficult Choice for Men: ED or Parkinson’s Disease

Would you rather have (a) erectile dysfunction or (b) Parkinson’s disease?

Research published in the last few days has shown that the use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS) can lead to a 22% higher incidence of erectile dysfunction (ED). Conversely, men who use the NSAID ibuprofen (Motrin, Advil) on a regular basis may lower their risk of developing Parkinson’s disease by 33%.

Let’s think it through. You don’t take NSAIDS so your risk of ED is lower. But your chances of getting Parkinson’s disease are higher and Parkinson’s can cause ED too. Wait, no, take the NSAIDS and lower your chances of getting Parkinson’s while increasing your risk of ED.

No sure what to do? Here’s some more useful information. While offering relief for arthritis and other painful conditions, regular NSAID use has also been associated with an increased chance of suffering a stroke or heart attack. Other risks associated with NSAID use include gastrointestinal bleeding and kidney failure. But the use of aspirin and other NSAIDS may actually decrease the risk of developing colon cancer.

OK, it’s all settled now.

Nine Maryland Hospitals Report Higher-Than-Average Complication Rates

On March 2, 2011 the Consumers Union Safe Patient Project posted the following tweet:


If you click on the link, you will find that of the 46 hospitals in Maryland, 9 did indeed have worse complication rates than the others. Another 23 had better-than-average rates of complications. The rest were average with the exception of one which reported no data. The complication rates were based the predicted number of complications [derived from the average number of risk-adjusted complications per hospital in the state] vs. the actual number of complications at each hospital.

At first glance, this seems like a good idea, track the hospitals and post the information for all to see. But wait a second. Whenever you do something like this, there are going to be some hospitals with better, some with average and some with worse rates of complications. The only way this would not be true is if all 46 Maryland hospitals somehow were average, which is highly unlikely. And every hospital cannot be above average. There is only one group that I am aware of that contains nearly all above average people and that is medical students. [See my previous blog on that subject.]

Also, comparing them to the average rate of complications for the state could be misleading. For example, what if Maryland hospitals have a much higher average rate of complications than the average national hospital complication rate? Then the average rate, or even the better-than-average rate, for Maryland might still be an unacceptable rate of complications.

It’s good marketing fodder for the 23 hospitals with better-than-average complication rates. But it will send each of the 9 poor performers into a tizzy. There will be task forces, ad hoc committees, consultants and meetings, meetings, meetings.

Will it result in better patient care? I don’t know. What I do know is that next year there will be some hospitals with better-than-average, some with average and some with worse-than-average complication rates.

More from the Book of Existential Mathematics

Here is another question from the interesting fifth grade math book that I have highlighted in previous posts here and here.


In case you can’t read it, it says, “Number Sense: How do you know that 5 1/4 is less than 5 4/10?" This question has puzzled philosophers through the ages. I am not sure that a fifth grader can explain it, nor do I think he should have to.

Perhaps this concept can be extended to other areas. Here are some potential candidates:

1. Why does air exist?
2. Why is a monkey called a monkey?
3. Why are there nine innings in a baseball game?
4. Why is water made of hydrogen and oxygen?
5. Why are there 435 members in the House of Representatives?
6. Why are daffodils yellow?
7. How do you know that this isn’t all a dream?

America’s Top 50 Hospitals. Says Who?

If you are looking for a chuckle, read the recently published HealthGrades list of America’s top 50 hospitals. The Healthgrades people have come up with a formula that selected 50 hospitals based on the following two parameters: “To be recognized with this elite distinction, hospitals must have had risk-adjusted mortality and complication rates that were in the top 5% in the nation for the most consecutive years. On average, patients treated at America’s 50 Best Hospitals had a nearly 30% lower risk of death and 3% lower rate of complications.”

That’s nice but it leads to some curious anomalies. For example, there are no university teaching hospitals on the list. By university teaching hospital, I mean a university hospital that serves as the primary teaching hospital for a medical school. Teaching affiliates rarely have the resources and research backup that university hospitals have. There are a few university-affiliated teaching hospitals on the list such as Hackensack University Medical Center in New Jersey. [Note: for those of you outside the New York City metropolitan area, there is no Hackensack University.] But even if you want to count the university-affiliated hospitals, there are not even 10 on the list. Twelve of America’s top 50 hospitals are in Florida with an impressive six of those located near the apparent Mecca of modern medicine [if you believe HealthGrades], West Palm Beach.

Let’s say I live in New York City and get sick. No hospitals in the states of New York or Connecticut made the top 50 list. My choices for hospital care are either the aforementioned Hackensack University Medical Center or the Community Medical Center of Tom’s River, both in New Jersey. I have never set foot in either place. They might be great hospitals. But I think I’ll take my chances at Columbia Presbyterian, Cornell or NYU.

Do you live in St. Louis? Sorry, no top 50 hospitals there. But you can go to the only hospital in Missouri on the list, St. Luke’s Hospital in Chesterfield. Pennsylvania? Sorry, no top 50 hospitals in Pittsburgh or Philadelphia but there are four in the Allentown-Bethlehem-Scranton area. Boston? Too bad. No Massachusetts hospital is good enough to be included in the HealthGrades Top 50 list. I hope Mass General, Deaconess and the Brigham don’t have to shut down.

I could go on. But see for yourself.

I posted a similar blog on this topic in August of 2010. I think lists like this are misleading, if not actually harmful. I wish they would stop publish them. But I guess the unsuspecting public eats this stuff up. Oh, and it is certainly a boon for the public relations people at the 50 lucky hospitals on the list.