Thu Nov 16 14:14:45 EST 2017

Health Matters

Some links about the health care system and being healthy.

  • The problem is the prices (for health care)

    Opaque and sky high bills are breaking Americans -- and our health care system.

    The health care prices in the United States are, in a word, outlandish. On average, an MRI in the United States costs $1,119. That same scan costs $503 in Switzerland and $215 in Australia.
    ...
    High prices are hurting American families. Most Americans who get insurance at work now have a deductible over $1,000. High prices are why medical debt remains a leading cause of bankruptcy in the United States, and nowhere else.
    ...
    We rarely know what our bill will be when we enter a doctor's office, or even when we leave. The prices aren't listed on the wall or a website as they would be in most other places where consumers spend money.
    ...
    The real culprit in the United States is not that we go to the doctor too much. The culprit is that whenever we do go to the doctor, we pay an extraordinary amount.
    ...
    Our health care legislation in the United States focuses on the question of who pays for health care. In order to have real progress, however, we're going to tackle a new question: How much do we pay? Until we do, we're likely to continue living in a world of $25,000 MRIs and $629 Band-Aids that families struggle to pay for.

    To help improve things see, Hospitals keep ER fees secret. Share your bill to help change that.

  • Depression: How effective are antidepressants?

    The various antidepressants have been compared in many studies. Overall, the commonly used tricyclic antidepressants SSRIs and SSNRIs performed equally well. Studies of adults with moderate or severe depression showed:

    • Without antidepressants: About 20 to 40 out of 100 people who took a placebo noticed an improvement in their symptoms within six to eight weeks.
    • With antidepressants: About 40 to 60 out of 100 people who took an antidepressant noticed an improvement in their symptoms within six to eight weeks.
    In other words, antidepressants improved symptoms in about 20 more people out of 100.

  • Exercise and the Prevention of Depression: Results of the HUNT Cohort Study

    The American Journal of Psychiatry

    Regular leisure-time exercise of any intensity provides protection against future depression but not anxiety. Relatively modest changes in population levels of exercise may have important public mental health benefits and prevent a substantial number of new cases of depression.

  • Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis

    British Journal of Sports Medicine (BJSM)

    Physical exercise improved cognitive function in the over 50s, regardless of the cognitive status of participants. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that patients obtain both aerobic and resistance exercise of at least moderate intensity on as many days of the week as feasible, in line with current exercise guidelines.


Posted by mjm | Permanent link | Comments

Tue Oct 31 20:11:15 EDT 2017

Items of Interest

Various web links I found to be of interest recently.

  • We Libertarians Were Really Wrong About School Vouchers

    Some studies suggest that voucher programs do modest good; others suggest that they do very little; and a few suggest that the impacts are actually negative. My overall takeaway from the literature is that voucher programs probably do a little bit of good. But the emphasis is on the word "little"; they are not a cure-all, or even much of a cure for anything. It was reasonable to think, in 1997, that voucher programs could change the world. Now we have two decades of evidence.
    ...
    But the quality of the pedagogy isn't the only thing that shapes student outcomes in schools. The peer group matters a great deal; families with higher socioeconomic status are better able to navigate the educational system, and they value education very highly, traits they pass on to their children. Those parents also work hard to improve the quality of the schools their children attend.

    The socioeconomic status of the students in a school is somewhat easier for parents to observe than the quality of the pedagogy. It's not then, all that surprising that when researchers sat down to analyze parental decision-making in New York City public school, peer group seemed to be what parents were looking at. And peer group matters a great deal.

  • DeepMind's Go-playing AI doesn't need human help to beat us anymore

    The company's latest AlphaGo AI learned superhuman skills by playing itself over and over

    The original AlphaGo demonstrated superhuman Go-playing ability, but needed the expertise of human players to get there. Namely, it used a dataset of more than 100,000 Go games as a starting point for its own knowledge. AlphaGo Zero, by comparison, has only been programmed with the basic rules of Go. Everything else it learned from scratch. As described in a paper published in Nature today, Zero developed its Go skills by competing against itself. It started with random moves on the board, but every time it won, Zero updated its own system, and played itself again. And again. Millions of times over.
    ...
    After three days of self-play, Zero was strong enough to defeat the version of itself that beat 18-time world champion Lee Se-dol, winning handily -- 100 games to nil. After 40 days, it had a 90 percent win rate against the most advanced version of the original AlphaGo software. DeepMind says this makes it arguably the strongest Go player in history.

  • This year's economics Nobel winner invented a tool that's both brilliant and undemocratic

    "Nudges" aren't good for democracy.

    The problem -- as Carnegie Mellon's Cosma Shalizi and I have discussed elsewhere -- is that government-by-nudging amounts to a kind of technocracy, which assumes that experts will know which choices are in the interests of ordinary people better than those people know themselves. This may be true under some circumstances, but it will not be true all of the time, or even most of the time, if there are no good opportunities for those ordinary people to voice their preferences.

  • The New York Times: Promoting False Hope as Journalism

    Criticism of book The Other Side of Impossible promoting alternative medicine.

    We have already explored at length the problems with anecdotal evidence. Meadows' casual dismissal of these problems by stating that "an example of one" has meaning in terms of giving hope is itself a harmful deception. You could probably write a book filled with stories of people who played the lottery as the solution to their financial situation and won. You could cherry pick the winners, and then explore what they did to choose their winning numbers. a statistically negligible hope. Focus on the hope and the winners.
    ...
    Of course, only the most dramatic examples are going to make it into such a book. They are by definition not representative. There are also all the other problems with anecdotal evidence. We don't really know if the original diagnosis was accurate. We don't know which of the many treatments used were actually effective. We don't know that the outcome wasn't just the natural course of the illness or a spontaneous remission. There is also a lot of subjective judgement involved.

    The original New York Time article by Jane E. Brody is,
    Hitting a Medical Wall, and Turning to Unproven Treatments

    Also see this criticism of the original article from Respectful Insolence in Science Blogs,
    The New York Times publishes fake news false hope in the form of a credulous account of dubious alternative medicine testimonials

  • Researchers have ditched the autism-vaccine hypothesis. Here's what they think actually causes it.

    Genes and the microbiome are some of the most promising leads.

    Of all the issues doctors have explored in children's health, none has been more exhaustively researched than the question of whether vaccines are linked to autism. After hundreds and hundreds of studies in thousands of children, "We can say with almost as much certainty than anybody could ever say that vaccines don't cause autism," Mayo Clinic autism researcher Dr. Sunil Mehta told me.
    ...
    "The bottom line is that when you add up all of the genetic risks, it looks like genetics can account for 50 percent of the risk for autism, which is very high," said David Amaral, an autism specialist at the UC Davis MIND Institute. To put that into context, compared to other common health problems -- like heart attacks, or cancer -- autism is much more genetic, with well over 100 genes now implicated.
    ...
    Exposure to infections and certain medicines during pregnancy may be linked to autism.
    ...
    The disorder seems to affect boys about four times more than girls.

  • Meet the nocebo effect, the placebo effect's evil twin that makes you feel pain

    A fascinating new study finds patients report worse side effects when a drug costs more money.

    Doctors even see a placebo response in patients who are told they are on a placebo. And the more invasive, expensive, and drastic the placebo intervention, the greater the healing effect. Fake surgeries -- where doctors make some incisions but don't actually change anything -- make people feel better than placebo pills alone.
    ...
    But the placebo effect has an evil twin: the nocebo. It can kick in when negative expectations steer our experience of symptoms and create side effects where none should occur.

    This means, incredibly, that you can get side effects from a sugar pill. And sometimes these side effects are so severe that patients drop out of clinical trials, as a 2013 paper in Nature Reviews explains. A review of fibromyalgia drug trials revealed that 72 percent of people who left the trial did so because they felt severe side effects while on placebo.
    ...
    When patients are led to believe one drug is less expensive than another they're also less likely to report painful side effects.


Posted by mjm | Permanent link | Comments

Wed Oct 25 00:00:00 EDT 2017

Health Matters

Some links about the health care system and being healthy.

  • Is Health Care a Right?

    Atul Gawande in The New Yorker

    It's a question that divides Americans, including those from my home town. But it's possible to find common ground.

    A right doesn't distinguish between the deserving and the undeserving, and, for many in my Ohio home town, that rankled.
    ...

    As he saw it, government existed to provide basic services like trash pickup, a sewer system, roadways, police and fire protection, schools, and health care. Do people have a right to trash pickup? It seemed odd to say so, and largely irrelevant. The key point was that these necessities can be provided only through collective effort and shared costs. When people get very different deals on these things, the pact breaks down. And that's what has happened with American health care.

    The reason goes back to a seemingly innocuous decision made during the Second World War, when a huge part of the workforce was sent off to fight. To keep labor costs from skyrocketing, the Roosevelt Administration imposed a wage freeze. Employers and unions wanted some flexibility, in order to attract desired employees, so the Administration permitted increases in health-insurance benefits, and made them tax-exempt. It didn't seem a big thing. But, ever since, we've been trying to figure out how to cover the vast portion of the country that doesn't have employer-provided health insurance: low-wage workers, children, retirees, the unemployed, small-business owners, the self-employed, the disabled. We've had to stitch together different rules and systems for each of these categories, and the result is an unholy, expensive mess that leaves millions unprotected.

  • Single-payer isn't the only progressive option on health care

    There are several routes to universal coverage -- some more politically feasible than others.

    As we consider the most effective strategy for achieving universal coverage, progressives should keep two admonitions in mind. First, we must not conflate our foremost health care goal (universal coverage) with competing pathways toward achieving that goal
    ...
    America's unique history and politics make the successful promotion of a single-payer system an unlikely pathway to universal health coverage. There are three reasons. The first involves the inevitable strong and well-funded opposition of special-interest groups.
    ...
    The second political impediment is the potential backlash to the cost of single-payer, and how it will be financed.
    ...
    Finally, as both Democrats and Republicans have now learned, once people have health care coverage, they are sensitive about efforts that might take it away or potentially diminish its quality. Today, approximately half of the US population receives health coverage through the workplace. If that coverage is replaced with a single-payer system, workers will be vigilant about making sure the new coverage is at least as good as what they had before.

    Over time, there's no reason incrementalism can't get us all the way to 100 percent coverage. Single-payer isn't the only route to that goal. In the foreseeable future, the step-by-step approach is the strategy progressives should pursue.

    • Expanding Medicaid in 19 states
    • Providing coverage for immigrants
    • Fixing the so-called "family glitch"
    • Extending CHIP
    • Paying for quality, rather than quantity, of health care
    • Reducing prescription drug prices
    • Remedying anti-competitive health system market domination
    • Promoting a "public option"

  • What Makes Singapore's Health Care So Cheap?

    And it spends far, far less than the United States does. Yet it achieves some outcomes Americans would find remarkable. Life expectancy at birth is two to three years longer than in Britain or the United States. Its infant mortality rate is among the lowest in the world, about half that of the United States, and just over half that of Britain, Australia, Canada and France. General mortality rates are impressive compared with pretty much all other countries as well.
    ...
    Americans tend to think that they have a highly privatized health system, but Singapore is arguably much more so. There, about two-thirds of health care spending is private, and about one-third is public. It's just about the opposite in the United States.
    ...
    In other words, Singapore discovered that, as we've seen many times before, the market sometimes fails in health care. When that happened in Singapore, government officials got more involved. They established the proportion of each type of ward hospitals had to provide, they kept them from focusing too much on profits, and they required approval to buy new, expensive technology.

  • One-Fifth of Medical Care Is Unnecessary, Doctors Say

    Americans spend at least $3.2 trillion on health care each year. That's well beyond any other country in total and per capita. A great many factors feed the glut, but a primary contributor is overtreatment. Unnecessary tests and procedures account for at least $200 billion in spending every year.
    ...
    The most cited reason for overtreatment was "fear of malpractice." An astounding 84.7% of the responding physicians feared a lawsuit if they didn't exercise every treatment precaution. "Patient pressure/request" and "difficulty accessing prior medical records" were the next most common reasons, at 59% and 38.2% respectively.
    ...
    "Only 2-3% of patients harmed by negligence pursue litigation, of whom about half receive compensation. Paid claims have declined by nearly 50% in the last decade..." they wrote.

    Also see How drug companies make you buy more medicine than you need.

  • Poor diet is a factor in one in five deaths, global disease study reveals

    Study compiling data from every country finds people are living longer but millions are eating wrong foods for their health.

    Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes.

  • New Study Offers Support for Prostate Testing

    For men who are weighing the pros and cons of prostate cancer screening, a new study strengthens the evidence that testing can reduce deaths from this cancer, something two earlier large landmark clinical trials appeared to reach different conclusions about.
    ...
    "I personally believe that results from models are less convincing than data from actual clinical trials, so I doubt there's anything here that would move the needle on PSA screening," said Dr. Kenneth Lin, an associate professor of family medicine at Georgetown University Medical Center.


Posted by mjm | Permanent link | Comments

Sat Sep 30 12:36:04 EDT 2017

Items of Interest

Various web links I found to be of interest recently.

  • The Incredible Shrinking Corporate Tax Bill

    Corporations are paying a lot less in taxes than they used to. Let's figure out why.

    Pre-tax profits aren't anywhere near a record, are about as high as they were for most of the 1940s and 1950s, and are not far above the highs of the 1960s and 1970s. After-tax profits, on the other hand, have for most of the past decade-plus been markedly higher than at any time since 1929, when the top corporate income tax rate was just 11 percent.
    ...
    But the biggest reason seems to be the explosion in corporation-like entities that are not, for tax purposes, corporations.

  • America's Superstar Companies Are a Drag on Growth

    Lack of competition lets them gouge consumers, underpay workers and invest too little.

    Since the 1980s, antitrust enforcement has gotten weaker. As a result, a few big companies have managed to capture a much bigger share of the market in various industries. Technology may have helped too, by letting big companies spread their geographic reach, and by creating network effects that keep customers locked in to platforms like Facebook. Anyway, as a result of this increased market power, the big superstar companies have been raising their prices and cutting their wages. This has lifted profits and boosted the stock market, but it has also held down real wages, diverted more of the nation’s income to business owners, and increased inequality. It has also held back productivity, since raising prices restricts economic output.

  • The only safe email is text-only email

    Simply put, safe email is plain-text email -- showing only the plain words of the message exactly as they arrived, without embedded links or images. Webmail is convenient for advertisers (and lets you write good-looking emails with images and nice fonts), but carries with it unnecessary -- and serious -- danger, because a webpage (or an email) can easily show one thing but do another.

    I convert my html email to text with the html to ascii converter vilistextum and 99% of the time there is no loss of important information.

  • Cities are not the future

    When the creative people move out of a city due to high rents, all that is left are aging landowners, overstretched professionals, and urban slums. It’s no longer a pleasant place to live. Suburbs look a lot better than cities, and given the powerful psychological effect of nature, it’s worth taking that seriously.

  • Calling Bullshit

    Data Reasoning for the Digital Age`

    Our aim in this course is to teach you how to think critically about the data and models that constitute evidence in the social and natural sciences.

  • The World Turned Upside Down (and what to do about it)

    Russ Roberts thoughts about the current political climate.

    So we manage to convince ourselves that the evidence speaks so loudly, so emphatically, that we have no choice but to declare our allegiance to a particular tribe as a result of that evidence. The red tribe. Or the blue one. Or the white one. Or the black one. It rarely crosses our minds to notice that causation is probably going the opposite direction--the tribe we are in determines the evidence we notice and accept.
    ...
    I would summarize these suggestions as saying--when the world is increasingly uncivilized, take a step toward civility.

    1. Don’t be part of the positive feedback problem.
    2. Be humble.
    3. Imagine the possibility not just that you are wrong, but that the person you disagree with could be right.


Posted by mjm | Permanent link | Comments

Thu Aug 31 18:06:04 EDT 2017

Items of Interest

Various web links I found to be of interest recently.

  • The Curse of Middle-Aged Capitalism for Trump, Rest of Us

    A similar story applies to corporate investment in buildings and machinery (computers, vehicles). From 1975 to 2015, this capital investment has dropped from 8% of corporate assets to 4%. Interestingly, this decline in investment was mostly offset by increases in corporate research and development (R&D) -- reflecting the need to develop new digital products and programs, say Kahle and Stulz. But the R&D spending was heavily skewed toward bigger firms. Half of publicly traded firms showed no R&D.
    ...
    But what if the weaknesses go deeper? For example: It's hard to argue that cuts in corporate taxes will accelerate economic growth if many companies are already suffering losses -- and don't benefit from tax cuts. Similarly, large, very profitable firms, with huge piles of cash but few appealing investment projects, won't suddenly find new projects if their taxes are cut.

  • How your mind protects you against hallucinations

    These examples suggest hallucinations arise when the brain gives more weight to its expectations and beliefs about the world than to the sensory evidence it receives, says study author and Yale psychiatrist Philip Corlett.
    ...
    The team hypothesized that people who hear voices would be more likely to "believe" in auditory hallucinations. That's precisely what they found: Both the schizophrenics and self-described psychics were nearly five times more likely to say they heard the nonexistent tone than healthy controls. They were also about 28% more confident that they had heard the tone when none was there, the researchers report today in Science.

  • How To Know You're In a Mass Hysteria Bubble

    Scott Adams (Dilbert)

    The most visible Mass Hysteria of the moment involves the idea that the United States intentionally elected a racist President. If that statement just triggered you, it might mean you are in the Mass Hysteria bubble. The cool part is that you can't fact-check my claim you are hallucinating if you are actually hallucinating. But you can read my description of the signs of mass hysteria and see if you check off the boxes.

    If you're in the mass hysteria, recognizing you have all the symptoms of hysteria won't help you be aware you are in it. That's not how hallucinations work. Instead, your hallucination will automatically rewrite itself to expel any new data that conflicts with its illusions.
    ...
    On November 8th of 2016, half the country learned that everything they believed to be both true and obvious turned out to be wrong. The people who thought Trump had no chance of winning were under the impression they were smart people who understood their country, and politics, and how things work in general. When Trump won, they learned they were wrong. They were so very wrong that they reflexively (because this is how all brains work) rewrote the scripts they were seeing in their minds until it all made sense again. The wrong-about-everything crowd decided that the only way their world made sense, with their egos intact, is that either the Russians helped Trump win or there are far more racists in the country than they imagined, and he is their king. Those were the seeds of the two mass hysterias we witness today.

  • How to Stop Gentrification

    Individuals moving to newly-hip neighborhoods admit they are part of the problem. What can they do?

    Drawing on earlier urban scholars, Moskowitz breaks the process down into four basic steps. First, individuals seeking cheap rents begin moving to a disinvested neighborhood, sometimes forming their own sub-communities: artists, radicals, and so on. Before long, more middle-class people follow, and real-estate interests catch on. Soon enough, the new middle-class residents take their place in the neighborhood"s institutions and begin reshaping power dynamics, attracting more amenities (and, notably, police), as well as bigger-money developers. By the time "managerial-class professionals" find their way to the neighborhood, the original gentrifiers can no longer afford it and get pushed out, starting the process over again in another neighborhood.

  • How "Despacito" became the biggest song of 2017

    An anatomy of what made "Despacito" the most popular song of the year.

    Also related How Did Pop Music Get So Slow.

  • Prediction Markets & Crowdsourced Forecasting

    DOES (HUMAN + MACHINE) x GEOPOLITICAL FORECASTING = HYPERACCURACY? (Philip Tetlock)

    The Hybrid Forecasting Competition (HFC) is a government-sponsored research program designed to test the limits of geopolitical forecasting. By combining the ingenuity of human analysts with cutting edge machine systems (including statistical models and algorithms), HFC will develop novel capabilities to help the U.S. Intelligence Community improve their forecasts in an increasingly uncertain world.

  • An Introduction to Emergent Order in Our Daily Lives

    Russ Roberts

    There is order sprinkled liberally throughout the chaotic nature of nature. The planets orbit the sun. Birds of a feather flock together. Fish make schools of fish. Ants create colonies. No ant is in charge of the ant colony, yet an order emerges from the actions of the individual ants that no one of them intends. The colony and the bee hive seems to have a mind of their own that can respond to challenges and change, independent of any of its members.
    ...
    We humans create emergent order as well--order that is the product of human action but not human design. It looks like someone is in charge yet no one and no group intends these outcomes we observe and experience. These parts of our lives are incredibly orderly and reliable. They look as if someone or a group of people have convened to take action together. It looks like someone is steering the system to achieve certain goals. But no single human being is in charge or intending what actually occurs.

  • What Meditation Can Do for Us, and What It Can't

    Examining the science and supernaturalism of Buddhism.

    Wright sets out to provide an unabashedly American answer to all these questions. He thinks that Buddhism is true in the immediate sense that it is helpful and therapeutic, and, by offering insights into our habitual thoughts and cravings, shows us how to fix them. Being Buddhist-that is, simply practicing Vipassana, or "insight" meditation-will make you feel better about being alive, he believes, and he shows how you can and why it does.
    ...
    What Wright correctly sees as the heart of meditation practice-the draining away of the stories we tell compulsively about each moment in favor of simply having the moment-is antithetical to the kind of evidentiary argument he admires. Science is competitive storytelling. If a Buddhist Newton had been sitting under that tree, he would have seen the apple falling and, reaching for Enlightenment, experienced each moment of its descent as a thing pure in itself. Only a restless Western Newton would say, "Now, what story can tell us best what connects those apple-moments from branch to ground?
    ...
    Science is putting names on things and telling stories about them, the very habits that Buddhists urge us to transcend.


Posted by mjm | Permanent link | Comments

Thu Aug 17 12:57:17 EDT 2017

Health Matters

Some links about health care matters.

  • A radical new hypothesis in medicine: give patients drugs they know don't work

    Why the placebo effect is weirder and potentially more useful than we imagined.

    Placebos only affect what the brain can modulate. It's not going to shrink a tumor. It's not going to deal with malaria. But it will deal with pain, fatigue, and nausea. Or will deal with feeling malaise. But it's not going to deal with killing bacteria. That doesn't happen on the level of the brain.
    ...
    The first open-label study we did was in irritable bowel syndrome. People on no treatment got about 30 percent better. And people who were given an open-label placebo got 60 percent improvement in the adequate relief of their irritable bowel syndrome.

  • Please Calm Down: Coconut Oil Is Fine

    In response to articles like: Coconut oil 'as unhealthy as beef fat and butter'

    The studies don't link eating more coconut oil to heart disease-they link it to a changing cholesterol metric. A metric that, if you look for it, has lots of conflicting data as to how it makes things worse and how badly (may I point you to Gary Taubes' Good Calories, Bad Calories).
    So, coconut oil is fine. It's not fantastic. It's not horrible. It's just a source of saturated fat probably not as bad as butter. Which we also don't think is that bad.

  • Chiropractors are bullshit

    You shouldn't trust them with your spine or any other part of your body.

    Chiropractic care, I'm sorry to say, is little more than the buffoonery of a 19th-century lunatic who derived most of his medical theory from séances. It has not evolved much since its creation. Chiropractic beliefs are dangerously far removed from mainstream medicine, and the vocation's practices have been linked to strokes, herniated discs, and even death. Chiropractors can't replace your doctor, and I'm amazed that they're still even allowed to practice. You shouldn't trust them with your spine or any other part of your body, and here's why.
    ...
    Though some chiropractors are now making an effort to introduce evidence-based practices into their treatment, chiropractic as a whole hasn't evolved like other areas of medicine -- with hypotheses, experimentation, and peer review. Instead, it was birthed by a strange combination of hocus pocus, guesswork, and strongly held religious beliefs. I'm not being hyperbolic when I cite hocus pocus. Palmer held séances to contact a dead physician named Jim Atkinson, and said that those séances helped him develop chiropractic.

    Also see the skeptics guide to everything chiropractic.

  • Why I Won't Get a PSA Test for Prostate Cancer

    Physicians are still recommending the blood test for prostate cancer even though it harms far more men than it helps.

    The problem is that inflammation and other problems unrelated to cancer can also elevate PSA levels. And when the PSA test correctly detects cancer, it is often so slow-growing that it would never have caused death or even impairment of health. Detection of these non-deadly cancers is called overdiagnosis.
    ...
    Just to be clear: you are 240-120 times more likely to misdiagnosed as a result of a positive PSA test and 80-40 times more likely to get unnecessary surgery or radiation than you are to have your life saved.


Posted by mjm | Permanent link | Comments

Mon Jul 31 16:04:42 EDT 2017

Items of Interest

Various web links I found to be of interest recently.

  • Economics: The new astrology

    By fetishising mathematical models, economists turned economics into a highly paid pseudoscience

    Every economist I interviewed agreed that conflicts of interest were highly problematic for the scientific integrity of their field - but only tenured ones were willing to go on the record. 'In economics and finance, if I'm trying to decide whether I'm going to write something favourable or unfavourable to bankers, well, if it's favourable that might get me a dinner in Manhattan with movers and shakers,' Pfleiderer said to me. "I've written articles that wouldn't curry favour with bankers but I did that when I had tenure."
    ...
    Economists who rationalise their discipline's value can be convincing, especially with prestige and mathiness on their side. But there's no reason to keep believing them. The pejorative verb 'rationalise' itself warns of mathiness, reminding us that we often deceive each other by making prior convictions, biases and ideological positions look 'rational', a word that confuses truth with mathematical reasoning. To be rational is, simply, to think in ratios, like the ratios that govern the geometry of the stars. Yet when mathematical theory is the ultimate arbiter of truth, it becomes difficult to see the difference between science and pseudoscience. The result is people like the judge in Evangeline Adams's trial, or the Son of Heaven in ancient China, who trust the mathematical exactitude of theories without considering their performance - that is, who confuse math with science, rationality with reality.

  • No, Seattle's $15 Minimum Wage Is Not Hurting Workers

    Contrary to what one unrepresentative study found, the city's workers are actually benefiting from the wage hike.

    There are, of course, naysayers. A recent University of Washington study argued that Seattle's wage hike would actually hurt workers overall because an hourly increase would be offset by a reduction of workers' hours and decreased employment. But IRLE researchers and others challenged that study as excessively limited in scope, based on an unrepresentative sample of workers. The Berkeley researchers contend that their analysis focuses on material impacts in a more representative sector.

    Probably an example of how one's politics can influence your conclusions.

  • The weird power of the placebo effect, explained

    Belief is the oldest medicine known to man.

      The family of placebo effects ranges from the common sense to some head scratchers.

    1. Regression to the mean
      When people first go to a doctor or start on a clinical trial, their symptoms might be particularly bad (why else would they have sought treatment?). But in the natural course of an illness, symptoms may get better all on their own. In depression clinical studies, for instance, researchers find around one-third of patients get better without drugs or placebo.
    2. Confirmation bias
      A patient may hope to get better when they're in treatment, so they will change their focus. They'll pay closer attention to signs that they're getting better and ignore signs that they're getting worse.
    3. Expectations and learning
      ... So awareness that you're being given something that's supposed to relieve pain seems to impact perception of it working.
      ... The research also suggests that fake surgeries - where doctors make some incisions but don't actually change anything - are an even stronger placebo than pills.
      ... The research also suggests that fake surgeries - where doctors make some incisions but don't actually change anything - are an even stronger placebo than pills.
      ... There is such thing as the nocebo effect: where negative expectations make people feel worse.
    4. Pharmacological conditioning
      For instance, Colloca has found that individual neurons in the brains of patients with Parkinson's disease will still respond to placebos as though they are actual anti-Parkinson's drugs after such conditioning has taken place.
    5. Social learning
      When study participants see another patient get relief from a placebo treatment they have a greater placebo response.
    6. A human connection
      ... The warm, friendly acupuncturist was able to produce better relief of symptoms.
      ... This may be the least-understood component of placebo: It's not just about pills. It's about the environment a pill is taken in. It's about the person who gave it to you - and the rituals and encounters associated with them.
    Also see Surgery Is One Hell Of A Placebo about sham surgery.
  • The Myth of Drug Expiration Dates

    Hospitals and pharmacies are required to toss expired drugs, no matter how expensive or vital. Meanwhile the FDA has long known that many remain safe and potent for years longer.

    The idea that drugs expire on specified dates goes back at least a half-century, when the FDA began requiring manufacturers to add this information to the label. The time limits allow the agency to ensure medications work safely and effectively for patients. To determine a new drug's shelf life, its maker zaps it with intense heat and soaks it with moisture to see how it degrades under stress. It also checks how it breaks down over time. The drug company then proposes an expiration date to the FDA, which reviews the data to ensure it supports the date and approves it. Despite the difference in drugs' makeup, most "expire" after two or three years.
    ...
    Pharmacists and researchers say there is no economic "win" for drug companies to investigate further. They ring up more sales when medications are tossed as "expired" by hospitals, retail pharmacies and consumers despite retaining their safety and effectiveness.
    ...
    A 2006 study of 122 drugs tested by the program showed that two-thirds of the expired medications were stable every time a lot was tested. Each of them had their expiration dates extended, on average, by more than four years, according to research published in the Journal of Pharmaceutical Sciences.

  • High US health care spending is quite well explained by its high material standard of living

    When properly analyzed with better data and closer attention to detail, it becomes quite clear that US healthcare spending is not astronomically high for a country of its wealth.

  • Fareed Zakaria made a scary prediction about democracy in 1997 - and it's coming true

    Democracy is rising, but not the good kind.

    Zakaria's piece made an important distinction between democracy and liberalism, constructs that are often conflated. Democracy is a process for choosing leaders; it's about popular participation. To say that a state is democratic is to say little about how it is actually governed.

  • The more things change

    What kinds of sex one has varies enormously over time, as does with what kinds of and how many people. We can see this over big periods of history and within living memory in our own culture.


Posted by mjm | Permanent link | Comments

Thu Jul 13 13:34:31 EDT 2017

Politics / Democracy

Some links about politics and democracy in the United States.

  • The problem with democracy is voters

    Democracy for Realist by Christopher H. Achen & Larry M. Bartels
    Why Elections Do Not Produce Responsive Government
    Why almost everything you think about democracy is wrong.

    Even voters who pay close attention to politics are prone - in fact, more prone - to biased or blinkered decision-making. The reason is simple: Most people make political decisions on the basis of social identities and partisan loyalties, not an honest examination of reality.
    ...
    So much of politics, not surprisingly, turns out to be about expressive behavior rather than instrumental behavior - in other words, people making decisions based on momentary feeling and not on some sound understanding of how those decisions will improve or hurt their life.
    ...
    I think it's hard to see how the public as a whole would steer the country in any particular direction. Usually when we think about public input, we think about public input in response to particular kinds of choices that have been framed by political elites of one kind or the other, whether they're party leaders or elected officials.
    ...
    History clearly demonstrates that democracies need parties to organize and simplify the political world. But parties don't make the fundamental problems of democratic control disappear; they just submerge them more or less successfully. When professional politicians are reasonably enlightened and skillful and the rules and political culture let them do their job, democracy will usually work pretty well. When not, not.
    ...
    If you think about democracy in the terms we prefer, you might say the biggest limitation at the moment is that we don't know how to incorporate the role of political elites in a constructive way into the governing process or to somehow make it possible to ensure that they're working on behalf of the interests of ordinary people.
    ...
    It seems clear to us that a lot of the actual ways in which people of ordinary education or ordinary means or just not much power, the ways in which they are disadvantaged are often occurring at the level of policymaking rather than at the level of elections themselves. The financial sector, for instance, is having a lot of policy success in Washington, in ways that ordinary people, if they really understood what was happening, would not approve. But they don't follow it closely enough, they don't understand, and the policy process is tilted toward moneyed interests that ordinary people have no chance.

  • I was a lobbyist for more than 6 years. I quit.

    My conscience could't take it anymore. "The hypocrisy from both sides is staggering."

    Today, most lobbyists are engaged in a system of bribery but it's the legal kind, the kind that runs rampant in the corridors of Washington. It's a system of sycophantic elected leaders expecting a campaign cash flow, and in return, industry, interest groups, and big labor are rewarded with what they want: legislation and rules that favor their constituencies.
    ...
    Know this: Lobbyists are not bad people. They're simply doing their jobs, and those jobs are not only legal but protected by the First Amendment. The political left loves to shit all over lobbyists, but they dial for dollars just like their Republican brethren. And as for the political right? Well, at least they make no bones about paying to play. It's "free speech by God. The Supreme Court makes it so!"

  • Alan Dershowitz pulverizes liberal anti-Trump Russia theories

    But Harvard Law professor Alan Dershowitz, a liberal who voted for Hillary Clinton, believes Mueller's appointment will help Trump - not bring his downfall like so many Democrats want.

  • The Bullshitter-in-Chief

    Donald Trump's disregard for the truth is something more sinister than ordinary lying.

    As the Princeton University philosophy professor Harry Frankfurt put it in a famous essay, to lie presumes a kind of awareness of and interest in the truth - and the goal is to convince the audience that the false thing you are saying is in fact true. Trump, more often than not, isn't interested in convincing anyone of anything. He's a bullshitter who simply doesn't care.
    ...
    When Trump says something like he's just learned that Barack Obama ordered his phones wiretapped, he's not really trying to persuade people that this is true. It's a test to see who around him will debase themselves to repeat it blindly. There's no greater demonstration of devotion.


Posted by mjm | Permanent link | Comments

Fri Jun 30 11:29:56 EDT 2017

Items of Interest

Various web links I found to be of interest recently.

  • Is Demography Destiny For US GDP Growth?

    The future is still uncertain, of course. But to the extent that demography dictates economic growth, the case appears weak for predicting a significant acceleration in the macro trend. That doesn't preclude an encouraging pop in growth for a quarter or two every so often. But assuming that output will rise on a sustainable basis for the longer run is probably assuming too much.

  • Corporations in the Age of Inequality

    Inequality isn't just about individuals - it's risen between companies, too.

    In other words, the increasing inequality we've seen for individuals is mirrored by increasing inequality between firms. But the wage gap is not increasing as much inside firms, our research shows. This may tend to make inequality less visible, because people do not see it rising in their own workplace.
    ...
    What is clear is that over the past 35 years, firms have divided between winners and losers, and between those that rely heavily on knowledge workers and those that don't. Employees inside winning companies enjoy rising incomes and interesting cognitive challenges. Workers outside this charmed circle experience something quite different. For example, contract janitors no longer receive the benefits or pay premium tied to a job at a big company. Their wages have been squeezed as their employers routinely bid to retain outsourcing contracts, a process ensuring that labor costs remain low or go ever lower. Their earnings have also come under pressure as the pool of less-skilled job seekers has expanded, due to automation, trade, and the Great Recession. In the process, work has begun to mirror neighborhoods - sharply segregated along economic and educational lines.

  • An Index-Fund Evangelist Is Straying From His Gospel

    Burton Malkiel, 84, who long endorsed passive investing, has had a change of heart.

    Wealthfront stressed that it was not abandoning the essence of Mr. Malkiel's long-held belief in passive investing, and it calls its new approach PassivePlus. "Burt Malkiel is still the high priest of passive investing," said Jakub Jurek, vice president for research at Wealthfront. "To be absolutely clear, we're not stock pickers. There are decades of research on active investors, which show they underperform." At the same time, he said, "there are small adjustments you can make to improve after-tax returns."

    In addition to value and momentum factors, Wealthfront's approach embraces stocks with high dividend yields, low market beta and low volatility, all factors that "have proven robust across long time periods, geographies and asset classes," Mr. Jurek said. (Wealthfront excluded another widely cited factor, small market capitalization, because its investment universe is limited to large-cap issues.)

  • Amazon's New Customer

    This is the key to understanding the purchase of Whole Foods: from the outside it may seem that Amazon is buying a retailer. The truth, though, is that Amazon is buying a customer - the first-and-best customer that will instantly bring its grocery efforts to scale.

    Today, all of the logistics that go into a Whole Foods store are for the purpose of stocking physical shelves: the entire operation is integrated. What I expect Amazon to do over the next few years is transform the Whole Foods supply chain into a service architecture based on primitives: meat, fruit, vegetables, baked goods, non-perishables (Whole Foods' outsized reliance on store brands is something that I'm sure was very attractive to Amazon). What will make this massive investment worth it, though, is that there will be a guaranteed customer: Whole Foods Markets.

    In the long run, physical grocery stores will be only one of Amazon Grocery Services' customers: obviously a home delivery service will be another, and it will be far more efficient than a company like Instacart trying to layer on top of Whole Foods' current integrated model.

    I suspect Amazon's ambitions stretch further, though: Amazon Grocery Services will be well-placed to start supplying restaurants too, gaining Amazon access to another big cut of economic activity. It is the AWS model, which is to say it is the Amazon model, but like AWS, the key to profitability is having a first-and-best customer able to utilize the massive investment necessary to build the service out in the first place.

  • I Fought For a Better Israel Than This

    Fifty years ago I was a soldier during the Six-Day War. We saved our nation, but the occupation has cost us dearly in the long run.

    In 1967, I was proud to be an Israeli. That is still the case, but a lot more complicated. I am not as at peace with Israel today as I was then and I fear for the future of Israel as a Jewish and democratic country, something that never even occurred to me at the time. In 1967, as a young soldier, I felt like I helped shape the future of my adopted country. I don't feel that way now. I feel unable to change its course and once again I wonder what kind of a future our children and grandchildren will have here. Israel has achieved much over the years, but the occupation has to stop before it conquers us all.

  • The Art and Science of Comedic Timing

    People who make their living by making people laugh have a much more nuanced appreciation of comic timing - as an art, rather than a science. Greg Dean, a Los Angeles comedian who has been performing and teaching stand-up for 40 years, said that when people talk about a comedian having great timing, they really mean that he or she has found a way to both lead and respond to the energy of the audience, like a drummer might with a dancer.


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Thu Jun 15 16:17:36 EDT 2017

Life on Earth

Some things to think about concerning life on earth and climate change.

  • The Oxygenation Catastrophe

    Approximately 2.3 billion years ago, Earth could have been easily mistaken for a hostile alien planet. Methane spewed into the atmosphere by constant volcanic activity, and fatal UV radiation bombarded the surface without the protection of an ozone layer. The primordial seas were blood red, a hue caused by the massive amounts of suspended iron in the water. It is beneath these red waves in which almost all life on the planet survived, most of which would require a microscope to view. Anaerobic single celled organisms were the dominant life form on earth at the time; they lived in the hostile chemical make up of the primordial sea without the need of oxygen. However just one of these single celled organisms may have caused the greatest extinction event on planet Earth: the Cyanobacteria.

    What was formerly known as blue-green algae, the Cyanobacteria are actually bacteria that have the unique ability of photosynthesis. This single-celled organism had emerged only a few hundred millions years before, at a time where all other organisms relied on methods of anaerobic respiration. By creating its own energy from the sun, this bacterium was able to generate up to 16 times more energy than its counterparts, which allowed it to outcompete and explode in reproduction. This seemingly innocent organism would spell doom for most of life on the planet, as photosynthesis produced free oxygen molecules as a byproduct.
    ...
    In a relatively short amount of time, Earth went from having very little oxygen to what may be the highest levels of atmospheric oxygen it has ever had. This event had wiped out most of life on the planet to which the oxygen was poisonous. Some of these anaerobic organisms were though to have survived by burrowing into the earth where oxygen levels were survivable. What may have the biggest change is that when oxygen accumulated in the methane rich atmosphere, the concentration of this greenhouse gas dwindled, causing temperature levels to drop. They dropped so low in fact, that this oxygen event is thought to have triggered the Huronian glaciation, the longest snowball Earth period.

  • Chemists may be zeroing in on chemical reactions that sparked the first life

    Chemical reactions on early Earth could have created all four building blocks of RNA molecules, triggering the beginning of life.

    Now, chemists have identified simple reactions that, using the raw materials on early Earth, can synthesize close cousins of all four building blocks. The resemblance isn't perfect, but it suggests scientists may be closing in on a plausible scenario for how life on Earth began.

  • Why Uncertainty About Climate Change Is What Scares Me Most

    If projections about the future of climate change are prone to considerable potential error, we must allow for that error to go in both directions. There is nothing necessarily reassuring about climate change uncertainty; those error bars encompass a space in which our worst nightmares find refuge.

    The moment we concede the uncertainty about climate change projections - magnitude, pace, impact - that Mr. Stephens asks of us, we are obligated to allow for the entire expanse of that potential error. That's what scares me most.


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