Society

Closure 80+ Years in the Making

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And now for something inspiring:

Eugene Drucker: In this photo taken Wednesday, May 27, 2015, Grammy Award-winning American violinist Eugene Drucker, plays his violin during a rehearsal concert at the Music Hall in Raanana, central Israel. In 1933, the violinist Ernest Drucker left the stage midway through a Brahms concerto in Cologne at the behest of Nazi officials, in one of the first anti-Semitic acts of the new regime. Now, more than 80 years later, his son, Eugene, has completed his father’s interrupted work. With tears in his eyes, Drucker performed an emotional rendition of the Brahms Violin Concerto in D Major, Op. 77, over the weekend with the Raanana Symphonette Orchestra.In 1933, the promising young Jewish-German violinist Ernest Drucker left the stage midway through a Brahms concerto in Cologne at the behest of Nazi officials, in one of the first anti-Semitic acts of the new regime.

Now, more than 80 years later, his son, Grammy Award-winning American violinist Eugene Drucker, has completed his father’s interrupted work. With tears in his eyes, Drucker performed an emotional rendition of the Brahms Violin Concerto in D Major, Op. 77, over the weekend with the Raanana Symphonette Orchestra.

“I think he would feel a sense of completion. I think in some ways many aspects of my career served that purpose for him,” the 63-year-old Drucker said of his father, who passed away in 1993. “There is all this emotional energy and intensity loaded into my associations to this piece.”

Check out the full story at MSN.

Christianity, the Invention of Childhood, and the Failure of Total Success

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895 - Suffer the Little Children
Still image from video, “Suffer the Little Children to Come Unto Me.” Click image to view.

There is an idea, I believe I first encountered it when reading Free to Choose, that prior to capitalism material comfort was the rare privilege of the elite, and as a result no one much wondered at its scarcity. But after capitalism fueled tremendous rise in standards of living that made comfort accessible to a very large number of people, the question of why some still had to do without became acute. When everybody is poor, poverty is taken for granted. When only some are poor, then poverty becomes an outrage. Before, it demanded no explanation. Now, it did. Thus, by making most people substantially better off than they had been, capitalism became its own worst enemy. It was blamed for the evils and inequalities that it had exposed as though it had caused them.

A recent article by Pascal-Emmanuel Gobry at The Week makes a similar case for Christianity and the idea of childhood: How Christianity invented children. The first task of the article is to convince the reader that the way we view children today (“Today, it is simply taken for granted that the innocence and vulnerability of children makes them beings of particular value, and entitled to particular care.”) is an anomaly that requires an explanation rather than the natural state of affairs.

By contrast, “in ancient Greece and Rome, children were considered nonpersons.” Part of this is due to high infant mortality (it’s hard to get attached when your child is likely to die), partially this is due to the fact that children were associated with women (and women were already considered feebler, weaker versions of men), and partially it’s just a consequence of the eternal oppression of the vulnerable by the powerful. Particularly, in this case, as men viewed young children (especially boys) as objects of sexual gratification. Against this context, Gobry argues that:

This is the world into which Christianity came, condemning abortion and infanticide as loudly and as early as it could. This is the world into which Christianity came, calling attention to children and ascribing special worth to them.

Gobry concedes that “like everything else about Christianity’s revolution, it was incomplete,” but he insists that above all:

Christianity’s invention of children — that is, its invention of the cultural idea of children as treasured human beings — was really an outgrowth of its most stupendous and revolutionary idea: the radical equality, and the infinite value, of every single human being as a beloved child of God. If the God who made heaven and Earth chose to reveal himself, not as an emperor, but as a slave punished on the cross, then no one could claim higher dignity than anyone else on the basis of earthly status.

That much is beautiful and inspirational, but Gobry ends on a bittersweet note that gets back to my first paragraph describing the curse of capitalism’s success:

That was indeed a revolutionary idea, and it changed our culture so much that we no longer even recognize it.

In this particular area–the invention of children–Christianity was so successful that people have forgotten that it was ever any other way, and have therefore forgotten the important role Christianity continues to play in our society. Like the prosperity afforded by capitalism, the special protection afforded to children is not naturally occurring and–if we discard the social infrastructure that guarantees it–can and will be lost once more.

Forthcoming ‘Markets Without Limits’: An Excerpt

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Presidential candidate Bernie Sanders recently made headlines when he stated in an interview, “You don’t necessarily need a choice of 23 underarm spray deodorants or of 18 different pairs of sneakers when children are hungry in this country.” Many have criticized the comment, while others have labeled it “one of the most substantive of the campaign so far.” Over at Bleeding-Heart Libertarians, philosopher Jason Brennan of Georgetown University responded to Sanders with an excerpt from the forthcoming book Markets Without Limits: Moral Virtues and Commercial Interests. I’m quite excited for this volume and those interested in economics and the morality of markets should be too. Here is a snippet:

Philosophers advocate that we do what economists say doesn’t work and avoid doing what economists say does work. On this point, [philosopher] Bas van der Vossen rebukes his colleagues:

As a profession, we are in an odd but unfortunate situation. Our best philosophers and theorists develop accounts of global justice that are disconnected from the best empirical insights about poverty and prosperity. Reading these theories, one might think that our best prospects for alleviating poverty around the world lie in policies of redistribution, foreign aid, reforms to the international system, new global institutions, and so on. And one might think that markets, property rights, and economic freedom are at best incidental, and more likely inimical, to the eradication of global poverty. Such ignorance, if not denial, of the empirical findings about development and growth is irresponsible.

We share van der Vossen’s concerns.

Mainstream development economics, in a nutshell, holds that the poverty is an institutional problem. More precisely, poverty is human being’s natural state. Poverty is normal and does not need to be explained, but wealth does. The main reason some nations are rich and others poor is not because some nations have better geography, better natural resources, or better genes. Rather, rich countries are rich because they have better institutions. Rich countries have institutions that incentivize growth and development. These institutions include strong private property rights, inclusive and honest governments, stable political regimes, a dependable and inclusive legal system characterized by the rule of law, open and competitive markets, and free international trade. Poor countries have institutions that fail to incentive growth and development, and often instead have institutions that encourage predation. These countries have weak recognition or active disregard of property rights, exclusive and dishonest governments, instable political regimes, undependable legal systems characterized by the capricious rule of men rather than the rule of law, and closed, rent seeking, crony capitalist markets, or few markets at all, and little international trade.

Check out the full excerpt and be sure to pre-order Brennan’s book. You can watch an interview with Brennan on his Why Not Capitalism? below:

The Great Gatsby Curve: A Brookings Conversation

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“Every so often,” announces the Brookings Institution, “an academic finding gets into the political bloodstream. A leading example is “The Great Gatsby Curve,” describing an inverse relationship between income inequality and intergenerational mobility. Born in 2011, the Curve has attracted plaudits and opprobrium in almost equal measure. Social Mobility Memos is taking a look at opinions from both sides of the argument.”

Thus far, there are posts by:

Check out the series.

Globalization Leads to Mass Human Flourishing

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That’s what Ronald Bailey argues in the June issue of Reason. What are his reasons? Globalization–which he defines as “the open exchange of goods”–produces:

  • Longer, Healthier Lives
  • Women’s Liberation
  • Less Child Labor
  • Faster Economic Growth
  • Higher Incomes
  • Less Poverty
  • More Trees
  • Peace
  • More Productive Workers
  • Better Job Prospects

Each section has a number of studies to bolster his claim. Check it out.

Feeding the World With GMOs

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Golden rice was possible only with genetic engineering. The crop was stalled for more than ten years by the working conditions and requirements demanded by regulations…For example, we lost more than two years for the permission to test golden rice in the field and more than four years in collecting data for a regulatory dossier that would satisfy any national biosafety authority. I therefore hold the regulation of genetic engineering responsible for the death and blindness of thousands of children and young mothers.

This comes from Ingo Potrykus’ rather famous article in a July 2010 issue of Nature and is a written slap in the face to anti-GMO activists and the politicians who embrace them. This opposition has been described as partisan, though the anti-science stances of various parties are much closer than we often assume. I was reminded of the above quote after reading an article in Newsweek discussing new biotechnology and its opposition:

In 2012, a new tool was invented that revolutionizes how scientists can examine—and manipulate—plant genetic processes. It’s called CRISPR-Cas9, and unlike its predecessors in the world of genetic modification, it is highly specific, allowing scientists to zero in on a single gene and turn it on or off, remove it or exchange it for a different gene. Early signs suggest this tool will be an F-16 jet fighter compared with the Stone Age spear of grafting, the traditional, painstaking means of breeding a new plant hybrid. Biologists and geneticists are confident it can help them build a second Green Revolution—if we’ll let them.

…The process can easily modify plant DNA without changing the plant’s essence—except to make it tastier, more nutritious, quicker to market, easier to ship, machine-pickable, less needy of water and/or able to flourish in a heat wave. And we can do it for big companies and small, the world at large and isolated communities…In the old days, relying on hit-or-miss natural processes to breed plants took many years. Norman Borlaug, father of the first Green Revolution—a hugely successful effort to improve food-crop productivity in poor countries that began in the 1940s and eventually doubled or even quadrupled what many plants could produce—needed almost two decades to create a better wheat variety. With CRISPR-Cas9, we can compress that development cycle to a few days or weeks.

And yet, the activists continue to protest:

  • “Mexico, where maize was first domesticated, must now import it to meet local demand because activists there will not allow genetically modified organism hybrids. Mexico’s maize growers get yields 38 percent lower than the world average and three times below the U.S., where 90 percent of the maize crop is an insect-resistant GMO hybrid. Mexico’s fields are beset by such crop ravishers as the corn earworm, black cutworm and fall armyworm, which cost the country up to half its crops and incite farmers to spray their land with thousands of tons of chemical insecticides.”
  • “The European Union has approved just one genetically modified crop, a type of maize used for animal feed. The reasons are political and bureaucratic: A majority of member countries must approve a biotech plant, and anti-GMO sentiment runs strong in places where phrases like naturel and natürliche are more about what’s been done for centuries than what it actually means for something to exist in or be caused by nature.”
  • “The notion of GMOs has spooked environmental groups such as Greenpeace, which has resisted GMOs with violent action, including destroying an experimental Golden Rice field last year in the Philippines. This despite the fact that Golden Rice is being offered to the world by a nonprofit, with no commercial stipulations, and is likely to save many lives.”
  • ““No GMO” is now being embraced by consumer brands; the ascendant “fast-casual” chain Chipotle posts just such a sign in its restaurants. It makes sense: If over two-thirds of Americans think GMOs are unhealthy, declaring yourself GMO-free is a lucrative proposition. Local governments are also weighing in. Vermont now demands that all GMO foods sold there be labeled as such. Two rural counties in Oregon have banned GMO crops within their borders.”

The article ends with a quote from Gengyun Zhang, head of life sciences for BGI (China’s giant state-sponsored genetic engineering center): “With today’s technology, I have no doubt that we can feed the world.” Considering that the number of scientists who think GMOs are safe is slightly higher than those who think climate change is mostly due to human activity, perhaps we should give science a chance and activists the cold shoulder.

In Which: People Respond to Incentives (and Patients Die) [RETRACTED]

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UPDATE: Commenter JohnM points out that the source for this story is a satirical website. I checked, and sure enough it even says “Earth’s Finest Medical Satire News Website” right at the top of the page.

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Obviously, I’m incredibly embarrassed. I put a lot of thought and effort into a story that is 100% fake. I’ve been tricked on the Internet before (who hasn’t?) but never so thoroughly. I was strongly tempted to delete this post and pretend it had never happened, but in the interests of transparency, I’ve decided to just add this note but otherwise leave it up in all its humiliating glory.

The discipline of economics has lost a lot of prestige since the start of the Great Recession, and there’s some validity to that.[ref]I’ve still got a particular ax to grind when it comes to dynamic stochastic general equilibrium models.[/ref] In addition, everyone writing about cognitive biases and irrational behavior likes to pound on economists for their assumption that humans are fundamentally rational agents. There’s even a snarky term for it: Homo economicus. Sneering at economists and their silly, unrealistic models of human behavior can be taken too far, however. The reality is that economists and their assumptions of human rationality actually do provide some pretty useful insights into human nature. Far and away the most useful of these can  be distilled into a simple mantra: people respond to incentives.

This is one of those things that seems obvious right up until you realize that it isn’t. Or, rather, that people (other than economists in particular) are really, really bad at keeping it in mind. Ergo, you get absolutely crazy ideas like paying doctors based on patient satisfaction. Now, if you’d asked an economist about that plan, they could have told you pretty quickly that it was a Bad Idea. But, since nobody bothered to ask an economist[ref]What do they know about human nature?[/ref], the study went right on ahead until someone looked at the preliminary data and realized that it had more than doubled patient mortality. Yes: this policy increased deaths by 238%. Oops.

Why? Because people respond to incentives. And so if you pay doctors for, in effect, how happy they make their patients than doctors will alter their behavior to make patients happier. Which, as it turns out, might not make them healthier. Or, you know, alive at all. Some examples:

The problem with linking reimbursement to patient satisfaction is completely flawed from the start.  Here’s an example.  A patient that weighs 340 pounds comes into your clinic.  We all know the healthiest intervention for this patient is weight loss.  However, if a doctor mentions weight loss to the patient and they get upset, guess what? Negative patient satisfaction survey, which could mean decreased reimbursement.  A doctor looking for increased reimbursement will possibly tell the patient that everything looks great and just keep doing what you are doing in eating those cheeseburgers.  Guess what, excellent patient satisfaction survey.

Here’s how non-economists react to this kind of thing. First, if you predict it ahead of time, they frown at you for your cynical, reductive view of human nature. Second, when it actually happens, they get frustrated with how callous and immoral people are. As a general rule, non-economists therefore tend to (1) vastly over-estimate the morality of human actors when confronted with perverse incentives and (2) attribute the consequences of perverse incentives to moral defects in certain classes of people. This explains Marxism’s ongoing popular appeal, by the way. It incorporates both the naive faith in centralized planning and communal ownership and also retroactive anger at the behavior of those at the top of the pyramid. The reality of the former (centralized planning and communal ownership) is that they don’t work. The reality of the latter (the evils of the capitalist class) is that rich people don’t become rich because their immorality lets them profit from exploitation. Rather, rich people tend to become exploitative because they are responding in predictable ways to their economic interests. In other words: people respond to incentives.

Now, don’t get me wrong. I’m not saying that incentives excuse bad behavior. I’m just saying that we should avoid conflating moral judgment (where the character of the individual means everything) with policy design (which is and ought to be one-size fits all). In terms of morality, you can get mad that people respond to incentives and wish they wouldn’t. You can even work hard to help people resist and behave in deliberate, rational, self-aware altruism. But please, please don’t design policy that depends on that! Because, as economists will tell you, people respond to incentives. And they’re very, very good at it.

Cherry picking healthy patients and avoiding sicker patients was clearly evident in the study.  “One physician told a dialysis patient that it was OK to skip a week of dialysis so that the patient could head down to Disneyland,” said an undercover internal medicine physician.

He had the patient fill out a glowing survey before leaving the clinic.  A week later when the patient returned with chest pain and peaked T waves, the physician forced his junior partner to see the patient, so that he could see teenager sports physicals.  For the physicals he just signed on the bottom line and had all patients in and out in 5 minutes.  He received glowing satisfaction surveys from parents due to the quickness of his exams, without ever laying a stethoscope on them.

You can sputter in rage about this kind of hypocritical profiteering all you want. I’m sure the designers of the study were angry as well as dismayed. But they still stopped the study. Better still? The should never have concocted such an absurd policy to test out in the first place. Here’s one more unintended consequence, by the way:

The study also showed an 858% increase in antibiotic prescriptions to patients with viral like symptoms in the survey group. Those patients developed more antibiotic resistant infections and C. diff than over the placebo group. ER physician, Dr. Rachel Kenners said, “If we don’t give antibiotics to patients who come to the ER for their runny nose and cough, than we are almost guaranteed a negative survey. To get paid and to keep our jobs, we have to prescribe antibiotics even though they aren’t warranted.”

 

Couple of final observations.

First, this particular study could have been improved vastly by changing the time at which patient satisfaction is measured. A lot of the problems were about short-run vs. long-term consequences. Tell somebody who is morbidly obese that everything is fine and they might be happy in the moment, but come back in a year and ask them then.

Second, I’m not saying that economists could have perfectly predicted the exact consequences of this policy. I do think that they would have been far more skeptical, but human beings are very innovative hackers. That’s part of our nature. And the doctors who actually lived in this system had a much greater incentive to figure out ways to game it than the scholars who came up with it. So, since people respond to incentives, you could hardly expect policy makers in general to be as clever at breaking the system as the people it will be applied to. But that itself is a lesson: be careful about trying to manipulate people with cleverly designed policies.

 

Secret to More Income or Marriage: Location

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Where you live affects both your income and your chance of getting married according to recent research by economist Raj Chetty and others at the Equality of Opportunity Project. Both studies were covered in a couple interactive articles in The New York Times. On location and income, the NYT reads,

Location matters – enormously. If you’re poor and live in the Dallas area, it’s better to be in Cooke County than in Kaufman County or Dallas County. Not only that, the younger you are when you move to Cooke, the better you will do on average. Children who move at earlier ages are less likely to become single parents, more likely to go to college and more likely to earn more. Every year a poor child spends in Cooke County adds about $210 to his or her annual household income at age 26, compared with a childhood spent in the average American county. Over the course of a full childhood, which is up to age 20 for the purposes of this analysis, the difference adds up to about $4,100, or 16 percent, more in average income as a young adult…These findings, particularly those that show how much each additional year matters, are from a new study by Raj Chetty and Nathaniel Hendren that has huge consequences on how we think about poverty and mobility in the United States. The pair, economists at Harvard, have long been known for their work on income mobility, but the latest findings go further. Now, the researchers are no longer confined to talking about which counties merely correlate well with income mobility; new data suggests some places actually cause it…“The broader lesson of our analysis,” Mr. Chetty and Mr. Hendren write, “is that social mobility should be tackled at a local level.”

You can actually check to see how your county stacks against others. Mine (Denton County, TX) is “about average in helping poor children up the income ladder. It ranks 1,171st out of 2,478 counties, better than about 47 percent of counties.”

But where you live doesn’t just affect income, but the odds of marriage:

The most striking geographical pattern on marriage, as with so many other issues today, is the partisan divide. Spending childhood nearly anywhere in blue America — especially liberal bastions like New York, San Francisco, Chicago, Boston and Washington — makes people about 10 percentage points less likely to marry relative to the rest of the country. And no place encourages marriage quite like the conservative Mountain West, especially the heavily Mormon areas of Utah, southern Idaho and parts of Colorado. These conclusions — based on an Upshot analysis of data compiled by a team of Harvard economists studying upward mobility, housing and tax policy — are not simply observations about correlation. The economists instead believe that they have identified a causal role that geography plays in people’s lives. The data, which covers more than five million people who moved as children in the 1980s and 1990s, suggests that children who move from, say, Idaho to Chicago really do become less likely to marry, even if the numbers can’t explain exactly why these patterns exist.

Political ideology isn’t the only thing that may encourage or discourage marriage. The Deep South encourages affluent children to marry, while discouraging low-income children of all races. Small towns (or low population density) also encourage marriage.

While this isn’t addressed in the articles, I’m curious if the influence on income and marriage are linked. Either way, Chetty’s work is very exciting. I’m watching him with growing interest.

Divorce and Declining Christianity

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A recent blog post at Patheos made an important point regarding recent declines in Christianity throughout the United States:

Some will attempt to spin this as a victory for atheists, implying that people are “seeing the light” and the light is exposing the lie that religion really is.  That view, however, is not really supported by other research on what accounts for the flight from religion.  In particular,  research by Elizabeth Marquardt and other research by Ken Pargament shows that divorce and the resulting inability to idealize caregivers is behind a great deal of the move to unbelief. In order to feel at home in a religious community, two things need to happen.  First, kids need to feel like they have a spiritual home, but children of divorce struggle to do this.  As Marquardt explains it, children of divorce rarely end up going to church consistently, or going to the same church from  week to week.  This means, that rather than being able to use religion as a resource for constructing a coherent story for the meaning and purpose of their lives as many children from intact church-going families do, children of divorce have to go it alone.  They can’t trust their parents or their infrequently visited and divergent church communities to help them make sense of their lives…People raised in this environment struggle to let anyone else offer feedback or guidance.  They learn that they can’t trust the sources they are supposed to be able to trust for guidance and formation.  For these individuals church becomes just one more bunch of hypocritical grown-ups who can’t get their own crap together trying to tell other people how to live their lives.

With new research arguing that the divorce rate has actually increased, perhaps we shouldn’t be surprised that religiosity has decreased.

An Interview with a Product of Surrogacy

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I found this interview at Chelsea Zimmerman’s Reflection of a Paralytic blog, and I’m re-using her post title. I’m fairly certain that she’s intentionally riffing on one of the most notorious euphemisms from the abortion debate: “products of conception.” The point of that euphemism was to elide the humanity of the unborn human being by (1) picking such an opaque term and (2) conflating the developing human being with the other “uterine contents” like the placenta. The term “product of surrogacy” is an ironic twist on that, referring to the way in which surrogacy tends to commoditize and thus dehumanize the children who are purchased this way.

This all sounds like fairly strong language, of course, but I think it’s important to let the children who have grown up in this system speak for themselves. And that’s what this interview is about.

The video features Center for Bioethics and Culture President and Founder Jennifer Lahl interviewing Jessica Kern. It’s an important interview, I think, and full of insights that I had never considered. Jennifer and Jessica have also worked together on the film Breeders which I haven’t seen yet, but hope to see soon. You can watch the entire video here.