The April 2013 issue of Scientific American has the latest ("The Low-cost Ticket to Space" by S. Alan Stern) in a long series of articles predicting that the era of cheap and easy spaceflight is just about to break out. These stories usually have a "manned" bias. Explicitly or implicitly they assume that it is important for people to have direct access to space. I found the story just sad. It saddens me to see how little has changed in the past 50 years.
Fifty years ago the Apollo moon landings had just wrapped up and it was early days for the Space Shuttle. Some things have changed. The Shuttle has been retired. Some things have not. We haven't sent a man (or woman) to the moon since. We are yet again full of wide eyed plans to revolutionize access to space. Fifty years ago it was the Shuttle. Today it is private space launches. That's a change but not that big of one. And, depressingly, the sales pitch is still the same. Then the Shuttle was going to make it cheap and reliable to get to space. Why? Reusable components. Now private launches are going to make it cheap and reliable to get to space. Why? Reusable components. Sheesh.
Then the Space Shuttle was supposed to be the gateway to manned exploration of the moon and beyond. Guess what? The same is true for private space launches. It is nice that the Scientific American article does have another pitch. It says it is important for scientists to have access to space. Cheap and reliable (both pitched and predicted in the article) launches by private companies would actually be helpful to scientists if they ever come into being. And I truly hope it happens. But remember the International Space Station. Well, it's still there and it's still gobbling great chunks of NASA's budget. The justification for the ISS was all the great science it would enable. It never happened.
The premier technical journal of the science community that is published in the U.S. is called Science. It is published by the AAAS (American Academy for the Advancement of Science). I have subscribed to it for years. Several times a year it publishes a cluster of articles based on some space based scientific program. Recently, for instance, they published a cluster based on scientific returns from the MESSENGER probe orbiting Mercury. Scientists have found out some very interesting things about Mercury that completely justified the Science coverage.
And it's not just Mercury. They have also published clusters based on various probes to Mars, Jupiter, Saturn, and other parts of the Solar System. Science has published several clusters based on findings of the Hubble Space Telescope (no surprise). But they have also published clusters based on other "Astronomical Observatories". Several missions featured in Science packages are unfamiliar to most of the public. (Quick - what's the "Dawn" spacecraft up to?) My point is that Science does these packages frequently (several times per year) and on a wide variety of space missions. But they have yet to do a package based on science produced on either the Space Shuttle or the ISS. (I recall no Scientific American articles based on scientific research hosted on the Shuttle or ISS either.) "Supporting more scientific research" is an argument that has never had any traction when it comes to increasing support for space related activities. But I have digressed.
The main argument in the Scientific American article is one about cost. "Private companies will make space flight really cheap" paraphrases the article's main point nicely As I mentioned before, this argument parallels the previous argument that "the Space Shuttle will make space flight really cheap" that was propounded in the '70s while the Shuttle was under development. In the Shuttle's case it never really worked out. During its midlife the Shuttle had a cargo capacity of about sixty thousand pounds. And a launch cost (not counting Shuttle development costs of many billion dollars) about six hundred million dollars. This works out to a cost of ten thousand dollars per pound. That's really expensive and explains why space flight has always been a low volume operation. And remember the Shuttle was supposed to deliver low cost access to space.
Cost figures are hard to come by in coverage of the space program aimed at the general public. The Scientific American article is no exception. It is full of gee whiz and "trust me, it'll be really cheap" but it's short on actual numbers. A rare exception is the information that Virgin Galactic intends to (but hasn't actually) charge $200,000 to take 200 pounds on a suborbital mission. That's only a thousand dollars a pound, a 90% savings over the shuttle, right? But the Shuttle delivered its pound to low earth orbit and Virgin Galactic is only delivering its pound to "suborbital". Figure at least a doubling of cost to achieve LEO (low earth orbit - e.g. to the Space Station). In fact, Space X, one of the companies featured in the story, claims their costs figure out to be just under $2,000/lb. However, a Space X mission is costing NASA $133 million to deliver 29,000 lbs. of cargo to the ISS. This figures out to about $4,500/lb., a modest improvement over the older Shuttle costs. (Late stage Shuttle flights after all the safety fixes and allowing for general inflation penciled in at over a billion dollars per flight to deliver only about 50,000 lbs. of payload, about $20,000/lb.). The Shuttle carried all that extra "man rated" weight and overhead plus all that purported "government inefficiency" overhead, so this is not as impressive an improvement as it might otherwise seem. So what's the story?
It turns out the basic science of rocketry was figured out by Robert H. Goddard in the 1930s. He developed the first rockets that were not toys. And he almost single handedly developed the science of rocketry. The Nazis were almost the only ones who paid any attention. They used his work as the starting point for the design of their V-2, the first military rocket of any practical value. The V-2 opened the eyes of the rest of the world to the potential of rocketry. This led to the first successful satellite launch in 1957 and the first successful manned space flight a couple of years later. By the end of the '60s rocket science had reached a level of maturity that permitted the first manned moon landing. Unfortunately, since then not much has changed. The only big improvement has been the development of light, cheap, reliable computer technology. Coupled with great advances in instrumentation, helped greatly by the same advances in computer technology, it has since become possible to create very sophisticated robotic vehicles, some of which are quite small. But the basic "rocket" part of "rocket science" has changed very little.
Goddard figured out in the '30s that hydrogen/oxygen was the best rocket fuel in terms of efficiency. No one has come up with anything better since. By the '60s solid fuel rockets had been developed. These were less efficient but the fuel was a lot less expensive. This has led to a number of hybrid designs consisting of a solid fuel lower stage or solid fuel strap-on boosters combined with liquid fuel upper stages. (BTW, Goddard also pioneered the multistage rocket in the '30s.) This is a small advance in technology driven by cost considerations. The third type of rocket motor is one where the hydrogen is replaced by something cheaper and easier to handle like kerosene. This is intermediate in efficiency and cost between a solid fuel rocket motor and a hydrogen/oxygen rocket motor. Goddard pioneered kerosene/oxygen rocket motors in the '30s.
By the '60s most rocket designs were based on a 90/10 ratio. The rocket consisted of 90% fuel (by weight) and 10% everything else (structure, tanks, motors, guidance and control etc., and payload). As far as I can tell this ratio still holds. You can figure that a typical rocket on the launch pad is 90% fuel. And that "everything else", well there is a 90/10 rule here too. It turns out that the payload usually represents about 10%. Combining these two factors leads us to the conclusion that it takes about 99 lbs. of fuel to put one lb. of payload into LEO. So there is an absolute limit to how much you can reduce the cost of a rocket launch. You have to pay for all the fuel, which gets all burned up by the launch.
This leads me to ignore 99.9% of what I read about whatever the new idea is about how launching rockets into space is all of a sudden going to be real cheap. A hydrogen/oxygen rocket motor burns two lbs. of hydrogen and 8 lbs. of oxygen to produce ten lbs. of water. Those ratios are just chemistry. I showed above that it takes about 99 lbs. of fuel to provide the boost to put one lb. of payload into LEO. So tell me, how much does it cost to deliver 11 lbs. of liquid hydrogen and 88 lbs. of liquid oxygen to the fuel tanks of a rocket on the launch pad? That's the absolute minimum cost it is going to take to get that single pound into LEO.
A quick Internet search finds liquid hydrogen in large quantities running about $2.50/lb. and liquid oxygen (again in large quantities) running about $0.10/lb. I don't know how good these numbers are but I am going to use them for the rest of this article. They would translate to a cost of about $36 for our 99 lbs. of hydrogen/oxygen fuel (mostly for the hydrogen). Now the rest of it (structure and other components, design, launch services, etc.) is going to cost something. But figure it in multiples of the cost of our 99 lbs. of fuel. The current Space X contract of $4,500/lb. works out to 145 times fuel costs. It looks like there is room for improvement. Space X itself apparently thinks that it can improve the situation as it works down the learning curve. If it can deliver an improvement to $2,000/lb. this would work out to 55 times fuel.
The article denigrates the Atlas V, a vehicle developed and operated in the standard NASA / Military Industrial Complex environment. The article pegs Atlas V launch costs as being in the $150 million to $350 million range. Wikipedia lists the lift capacity of an Atlas V to LEO as 64,000 lbs. (a little more than the capacity of the pre safety fix Shuttle). This pegs the cost at $2350 - $5500 per lb. This translates to 65 to 150 times fuel cost. That puts it in the same range as Space X. So where's the big cost savings of Space X (and other "new and more efficient" vendors) over NASA? It looks like unmanned rockets save significant costs over a manned rocket like the Space Shuttle. But that's hardly a surprise. And it also looks like the new vendors like Space X have yet to come up with some great new way to get launch costs down to the point where they are way below an Atlas.
So, if we ignore history, ancient and new, what is the lowest feasible cost multiplier using fuel cost as our base and LEO as the target of our benchmark? An old article in Science in support of a now discontinued NASA program to develop a cheap efficient booster (it was discontinued not because it failed but because it never garnered any political support) thought that a target of $300/lb. was feasible. That was a few years ago so let's round the figure up to $360/lb. to allow for inflation (this probably underestimates inflation but it makes the math simple). This would work out to a cost of 10 times fuel. I have certainly seen no one suggest that a more aggressive target is feasible. Anyone who can deliver a cost of 10 (or even 20 or 30) times fuel cost is someone who has found a way to build a better mousetrap. But especially if the cost is 100 or more times the fuel cost "pay no attention to the man behind the curtain". What's going on is pure flimflam (or perhaps just good marketing).
Now let me focus for a few minutes on why I have been fixated on LEO. It turns out that if you don't have to be in a hurry (e.g. because you have people aboard) LEO gets you most of the way to anywhere you want to go in the solar system. We have already noted that it costs about half as much to get to "suborbital" (usually a "ballistic" flight with a peak altitude of about 100 miles but not enough oomph to get you into orbit at 100 miles) costs about half as much as LEO. So, if your rocket can put one pound into LEO it can put two pounds into suborbital. Similarly, if your rocket can put 1 lb. into LEO it can put about 0.7 lbs. into GEO (Geostationary orbit where all the communications satellites live). I don't know what the ratio is but I think the same rocket could put about a half a pound into the vicinity of the moon. Note: It takes extra energy to translate "vicinity of the moon" into lunar orbit).
"Vicinity of the moon" will also get you to the surface of the moon. But you would be going at a pretty good clip when you got there. If you want to survive the experience, you need extra energy to slow down. It goes without saying (that's why I am saying it) that it would take more energy to get you off the moon and back home too. I don't know how much energy it takes to get you to the vicinity of other planets but I think it's mostly pointing in a different direction rather than applying more energy. So let's say you could send about 0.4 lb. wherever you wanted in the rest of the solar system. Again, going into orbit or landing takes more energy. And the trip can take years. The "New Horizons" Pluto flyby mission was launched in 2006 and will finally fly by Pluto in 2015, about a decade later.
To summarize, when you are reading one of these gee whiz stories about how we are about to crack space wide open ask yourself "how much progress are we making on the cost front?" The Shuttle was billed as a giant cost saver. It wasn't. We are currently saying bad things about the Atlas V, Delta IV, and other traditionally developed and operated unmanned launch vehicles. But the new "cheaper and better" alternatives like the Space X Falcon don't look like a big improvement. Maybe these new options will get a lot cheaper as time goes by. We'll see.
Finally, if you want a web site that is chock full of hard core "this is how it really is" information then go here: http://www.projectrho.com/public_html/rocket/index.php. The site is maintained by Winchell Chung who does art work for various SciFi projects and comic books. The whole site is a lot of fun. But the link sends you to a lot of technical material. Subjects include the real world (e.g. how much energy does it take to get from here to there) to various fantasy/scifi subjects (e.g. if it was possible to build a nuclear rocket how would it work and how well would it work).
Saturday, March 23, 2013
Wednesday, March 20, 2013
Paranormal Activity
I have recently been reading some old Science Fiction by an author called Andre Norton. I used to read a lot of Science Fiction. Now I still read some but mostly I read fantasy. Somehow the whole NASA Moon Landing thing took a lot of oomph out of Science Fiction. Now Fantasy has mostly displaced it in my reading. But nevertheless, Science Fiction colored my perception of a number of things. A number of authors invented religions. Seeing what went into inventing a religion for fictional purposes caused me to reexamine "real" religions in a new light. The result was not pretty. I can't really tell a "real" religion from one that was made up solely to make a story more interesting. That eventually turned me into an atheist. Many would say that was a negative outcome.
But another subject that was popular in Science Fiction then was what is now referred to as "the paranormal". I was reminded of this because Norton used it frequently in her stories. I read a lot of her work when I was younger. She was the first popular female author in the genre. She was very popular at the time I was reading her stuff (the '50s and the '60s) and she remained popular for many decades to follow. She died in 2005 at the age of 93. And Norton wasn't the only one. Heinlein used it in several stories as did many others. This made me very receptive to the idea of paranormal phenomenon or Psi, as it was generally referred to at the time. Norton and other authors presented situations in which their characters demonstrated various paranormal abilities as a routine part of the story. This gave me an understanding of what the various talents might be and how they could be used. Now Science Fiction is fiction. So while Science Fiction opened me up and made me receptive to the possible existence of these abilities it did not prove their existence.
I have never been a practicing scientists. But many people who were practicing scientists had a similar experience. Exposure to Science Fiction or other life experiences made them receptive to the possibility that paranormal talents were real. And certainly positive proof by a scientist of the actual existence of one or more paranormal talents would have resulted in vast amounts of fame, glory, and very likely riches. (I know some people reject this characterization out of hand but bear with me. I will get back to the subject of the "war between science and the paranormal" below).
So anyhow I looked around to see what scientists had found and there was not much. So I waited and I waited and I waited. After waiting a decade or so I decided it was all bunk. And along the way I found out that there was a long history of people investigating paranormal talents. One of the oldest I am familiar with is Mark Twain. Twain got interested in "miracle works" at tent revival meetings. He quickly determined that they were fraudulent and went on to make fun of them. This was in the 1800's. Later Sir Arthur Conan Doyle, the creator of Sherlock Holmes, got interested in the subject. Now you can scour the Holmes cannon for any support for the existence of paranormal phenomenon but you will come up dry. But later in life Doyle became a believer. And, also later in life, he and Harry Houdini became friends. Houdini, as a result of the credulity of Doyle and for other reasons, got interested in mediums. He was very successful at exposing them for frauds. But Houdini was never able to convince Doyle that mediums were bunko artists.
So far I have talked about fraud, people who knew that what they were doing was dishonest, but pretended to be believers. There is a whole other group of people. These are people who are honest but believe in the paranormal for one reason or another anyhow. Again I want to dip into the annals of history to discuss a case that will demonstrate what I mean.
Clever Hans is a horse that lived in Germany around the turn of the 20th century (e.g. 1900). Hans could do arithmetic. Hans' owner, a fellow named Wilhelm von Osten was honest as the day is long. Everyone who investigated him came to that conclusion. If Hans was a fraud then Osten was not in on the con. This led a lot of people to conclude that Hans was the real deal. Then along came a man named Carl Stumpf. He did a very thorough and very careful investigation of Hans. Since Osten was completely honest he co-operated with Stumpf and his associates. For a long time they were stumped. It looked like Hans was the real deal. Then Stumpf noticed something. Hans got the wrong answer every once in a while. This was important because every time Hans got it wrong Osten also got it wrong. This caused Stumpf to conclude that Osten was unconsciously signaling Hans to tell the horse what the right answer was. This was easy to verify. Hans was tested in situations where he could see Osten and when he could not. Hans got the correct answer when he could see Osten and acted like a normal horse, arithmetic-wise, when he couldn't. (BTW, it turned out to be important to make sure that Hans could also not see any of the regular stable crew too.) Anyhow, the moral of the story is that it is possible to fool ourselves about whether paranormal phenomenon are happening, even if everyone is completely honest.
Returning to more modern times, by the 1960's some scientific work had been done on paranormal phenomena. Most of it was negative but some of it seemed to be positive. But the positive results were never clear cut. The typical experiment showed something happening at a rate above what pure chance would predict. These "confirmations" would come and go but they were never 100%. If something would be projected to happen 50% of the time based on chance then maybe it would happen 60% of the time. And only a few investigators were able to get any positive results at all. In many cases another scientist would reproduce the same experiment exactly as it had been reported and not be able to reproduce the positive result. This was very troubling. This caused scientists to carefully review the reported experimental technique and also the actual experimental technique. They found problems.
What the "Clever Hans" case demonstrates is that a lot of care needs to be taken when doing these kinds of experiments. Honest people can fool themselves into believing something that ultimately turns out to be false. Beyond that there is the problem of con artists. In many cases it is very hard to catch these people in the act. In many of the cases that Houdini investigated reputable scientists had vouched for the validity of the paranormal activity. Magicians are professional con artists. They know what to look for when evaluating whether someone is on the up and up. Scientists are equipped to deal with a nature that guards its secrets well. But they are not equipped to deal with people actively trying to pull the wool over their eyes.
In the past few decades various investigators have reported "encouraging preliminary results" a number of times. But a bigger more thorough investigation never seems to improve the situation. The results stay at the "intriguing" level or go away altogether. Other investigators are unsuccessful at reproducing the results. Interest fades. Then someone starts the cycle over a few years later. The new setup always is different than the old one. Careful investigation uncovers different but equally serious methodological or other problems. But otherwise, things follow the same trajectory. The science community in general has become fatigued with the process. So funding has dried up and interest has dried up.
A lot of water has passed under the bridge since I first got interested in paranormal phenomenon. Many of the kinds of phenomenon Science Fiction writers wrote about back then have gone out of style. We have actually regressed. The people that are currently active resemble the medium of old, the kind of person Houdini was investigating. Now the modern practitioner no longer gathers people around a table in a dark room so they can experience things that go bump in the night. Instead we have the "ghost hunter" traipsing around in a darkened house at night trailing a bunch of gear that looks very scientific. (What the gear is actually measuring is another question.) These shows are cheap to produce and popular enough to turn a nice profit so they are all over the place on cable. Although the TV people pretend to be scientists they do such a poor job of it that only the believers are fooled.
There is a popular explanation for what I have laid out above. It contends that paranormal phenomena are real but scientists have a bias, some would say a hatred for this sort of thing. "It's a conspiracy. These results would rock the foundations of science. So scientists cover up the results in order to save their skins (or their funding)." This perspective fundamentally misrepresents what science is. The idea is that "science" is what's in the science books and, if it's not in a science book then scientists would not be able to handle it and they would "do whatever it takes" to cover it up. But let's see what a real scientist thinks.
Richard P. Feynman is one of the outstanding scientists of the twentieth century. He worked on the Atom Bomb project at Los Alamos. He has won two Nobel prizes in Physics. He is one of the founders of something called Quantum Electrodynamics. For many years he was a Physics professor at Cal Tech. Just before he died in 1988 he was a member of the committee that investigated why the Challenger Space Shuttle blew up and killed everyone aboard. If you want to get a feel for the man I would suggest reading his book "Surely You're Joking, Mr. Feynman". It is completely nontechnical, quite funny, and full of insights about the human condition.
Feynman's most noted piece of professional writing is three volume series called "The Feynman Lectures on Physics". It is based on a series of lectures he gave over a period of two years to freshman and later sophomore students at Cal Tech. It was designed to be an introduction to Physics for the kind of very smart students who got into Cal Tech. The "Lecture" books became very popular, both among people with a deep interest in physics but also with the general public. They have since been reprinted a number of times, including a "Definitive and Extended" edition in 2005. My point in going on a bit is to emphasize the point that the material in these books was intended to represent mainstream thinking by scientists, specifically physicists. Here is an extended quote from chapter 2:
Scientists have been especially intrigued by a concept called entanglement for some time now. One of the properties of an electron is called "spin". An electron can be either "spin up" or "spin down". It is possible to entangle two electrons (the technical details don't matter). Then it is possible to separate the two electrons by hundreds of feet, all while maintaining the entanglement. Then the spin of either electron (it doesn't matter which) can be measured. When we measure the spin of the other electron a short time later it will always be the opposite. Scientists sometimes call this "spooky action at a distance". And it's not just one scientist or one lab. Dozens of scientists have done dozens of experiments involving entangled particles. It's gotten to be a cottage industry. And there are other particles you can do this with besides electrons. And there are other properties you can measure besides spin. And you can even do experiments involving more than two particles. And these particles can be entangled in very complicated ways. The result is always the same. If you measure one entangled particle and it comes up "heads" then the other particle will come up "tails". Now that's truly weird.
The fact that scientists call this "spooky action at a distance", even if only sometimes, tells you something. Scientists find it weird too. But scientists hew to "the sole test of the validity of any idea is experiment". They do experiments. They sometimes get truly weird results. Frequently they will go back over the experiment and find something wrong. When they fix it the weird result goes away. But sometimes no matter how hard they examine the experiment or its result they can't find anything wrong. And sometimes what their experiments tell them is that no sensible idea explains all the results. That's when they come up with weird theories. Twentieth century physics is littered with example after example where experimental results show that all sensible theories are wrong. But then a scientist comes up with a truly weird theory that does fit all the experimental results. It's almost gotten to the point where the fact that a theory is weird is considered a point in its favor.
The reason scientists reject the idea that paranormal activity is possible is not because it is too weird or too unbelievable. It is because there is no valid experiment that demonstrates the existence of paranormal activity. There are many experiments that point to weird and unbelievable phenomena. In many cases these phenomena are now considered part of mainstream science. And none of these phenomena emerged from the community of believers in paranormal phenomena. And scientists have now been burned over and over by claims of experimental confirmation of paranormal activity. Some of these experiments have been done by otherwise reputable scientists. And just because an experiment is done by someone without "proper scientific credentials" doesn't mean that the result is not scientifically valid. But the actual experiments done to date that purport to support the existence of paranormal activity have not been done in a scientifically valid manner.
This history of claims of experimental proof of the existence of one or another paranormal phenomenon later turning out to be bad scientific technique or on all too many occasions outright fraud, has resulted in most scientists who will address this area at all to fall back on "extraordinary claims demand extraordinary proof". It is important to remember that several examples of extraordinary claims have actually been followed by extraordinary proof in the realm of what is now mainstream science.
The Geologic theory now called "plate tectonics" was laughed out of the room when it was first proposed in 1912 by Alfred Wegner. But evidence slowly built up in its favor (and against the alternatives) and it came to be widely accepted within the community by about 1970 and more broadly accepted thereafter. Another example, also from Geology, is the theory first propounded by Louis Alvarez in 1980, that a giant meteor impact wiped out the Dinosaurs about 65 million years ago. When it was first floated it was greeted by a great deal of skepticism. But again many different kinds of evidence built up in support of the theory (and damage alternative theories) and it is now widely supported within the scientific community. Closer to home, the theory of Quantum Mechanics was subjected to a great deal of criticism when it was first developed. One thing that speeded its acceptance was that all sensible theories had been disproved by the time it came along. So given a choice between a truly weird theory that got the answers right and other theories that were either equally weird and less successful or not weird and totally unsuccessful the physics community came to accept Quantum Mechanics. But I think that too this day most scientists working in the field wished there was a less weird theory that worked. Unfortunately, no one has come up with such a theory.
Wegner, Alvarez, and the pioneers of Quantum Mechanics are now celebrated in the scientific community. Wegner did not live long enough to see his reputation rehabilitated. But Alvarez did. And so did many of the pioneers of Quantum Mechanics. Scientists understand how hard it is to do truly groundbreaking (i.e. weird at the time it is first proposed but later accepted as valid) work. So they try to identify and publicly support such people. Einstein is the classic example of this. When he began publishing groundbreaking work in 1905 he was not even a working scientist. He was a clerk in the Swiss Patent Office. Einstein's 1905 work was profoundly weird. But, like the Quantum Mechanics people a couple of decades later, he proposed solutions to problems that were generally accepted to have no "normal" solution. He also provided the thinking behind his solutions. Aside from its weirdness and profound originality, it was remarkably straight forward. And scientists were quickly able to devise and execute experiments based in his thinking that supported his conclusions.
Einstein went on to come up with other weird and original ideas that also worked out. So he became the model for what a scientist should be. A scientist should be able to think up weird and original ideas then provide straight forward reasoning for why they might be right. Scientists embraced weirdness in the post-Einstein era. It was seen as the fast track to success. So a scientist who came up with some piece of paranormal activity that actually passed the "experiment" test would see that as an opportunity. He could become the new Einstein, or at least the new Wegner or Alvarez. The problem has not been with the weirdness of paranormal phenomena. It has been with getting experimental verification.
Finally, let's say you are not and don't want to become a scientist. But you would like to do something to confirm the existence of paranormal phenomena. My recommendation to you is to do an experiment. But, you say, we already agreed you don't want to become a scientist. That's ok. My suggestion is that you perform your experiment in a decidedly nonscientific way and in a decidedly nonscientific environment. And, if your experiment works, you immediately get a whole lot of money. Many people, given a choice between fame and money, would be happy with the money. And you don't have to wait years for the Nobel committee to decide you are deserving before you get the prize money. Instead, you get the money right away. Does that sound like a deal you might be interested in? Good! Let's go to Las Vegas. Really? Really.
Many paranormal abilities can quickly, and legally be transformed into cold hard cash. Let's say you can read minds. Get yourself to a poker table. Texas Hold 'em is a game that involves a lot of bluffing. With a little study, however, it becomes easy to win and to win big if you just know if the other guy is bluffing or not. You bluff him if your mind reading tells you he thinks he has a weak hand. He will usually fold and you will win big. If you have a good hand and your mind reading tells you he's bluffing stick around. He'll either eventually fold or lose at the showdown. Easy peasy.
Now let's say you can read minds but only co-operating minds. Then the game for you is Bridge. You and your partner can play killer defense if each of you knows exactly what cards your partner holds. And Bridge is played for money all over the place. It also may be possible to win at Poker by placing your partner behind an opponent where your partner can see his cards. This is hard to do because your partner could just signal you without using any kind of mind reading. But I'm sure you can come up with other "tag team" strategies that would turn mind reading ability into cash.
Let's say you can't read minds but have telekinetic abilities. In other words, you can move things around at a distance. How about moving the roulette ball around. You don't have to make it drop in "17" all the time. You can just bet red or even and get it to drop into a red or even slot more often than it should. You can even just settle for it not dropping into a green slot. This won't win you any money but it will give you a chance to break even. Similar ideas will allow you to win big at craps by adjusting the fall of the dice.
Similarly, let's say you can read the future. Well, read which number the roulette ball is going to drop on before bets are closed off. Again, if you know which number a shooter is going to roll it is easy to clean up at craps. And, if you can read as much as a day into the future, then Wall Street is the place for you.
Other approaches are possible with other paranormal abilities. A ghost partner can be a big help, for instance. They can read cards instead of a corporeal partner, for instance. And they are much harder to catch, either physically or on tape. The point is that the real world is actually running millions of paranormal experiments each day. The fact that casino owners (and Wall Street bigwigs) do very well, thank you, argues that most paranormal abilities don't exist. Usually it is possible to quickly figure out how to make money, a lot of money, by applying a paranormal ability appropriately. But no one seems to be doing it.
People come up with various "morality" rules that prohibit using paranormal talents for monetary gain. But lots of people "read minds" or "hunt ghosts" on TV and make a lot of money doing it. Somehow the morality rule is ineffective in their case. There are a lot of people who have found many different ways to make a buck off of someone else's belief in the paranormal. And there seem to be no paranormal police whose job it is to step in and shut down the frauds. There is just no reason to believe that paranormal activity is possible and every reason to believe that it is not possible.
But another subject that was popular in Science Fiction then was what is now referred to as "the paranormal". I was reminded of this because Norton used it frequently in her stories. I read a lot of her work when I was younger. She was the first popular female author in the genre. She was very popular at the time I was reading her stuff (the '50s and the '60s) and she remained popular for many decades to follow. She died in 2005 at the age of 93. And Norton wasn't the only one. Heinlein used it in several stories as did many others. This made me very receptive to the idea of paranormal phenomenon or Psi, as it was generally referred to at the time. Norton and other authors presented situations in which their characters demonstrated various paranormal abilities as a routine part of the story. This gave me an understanding of what the various talents might be and how they could be used. Now Science Fiction is fiction. So while Science Fiction opened me up and made me receptive to the possible existence of these abilities it did not prove their existence.
I have never been a practicing scientists. But many people who were practicing scientists had a similar experience. Exposure to Science Fiction or other life experiences made them receptive to the possibility that paranormal talents were real. And certainly positive proof by a scientist of the actual existence of one or more paranormal talents would have resulted in vast amounts of fame, glory, and very likely riches. (I know some people reject this characterization out of hand but bear with me. I will get back to the subject of the "war between science and the paranormal" below).
So anyhow I looked around to see what scientists had found and there was not much. So I waited and I waited and I waited. After waiting a decade or so I decided it was all bunk. And along the way I found out that there was a long history of people investigating paranormal talents. One of the oldest I am familiar with is Mark Twain. Twain got interested in "miracle works" at tent revival meetings. He quickly determined that they were fraudulent and went on to make fun of them. This was in the 1800's. Later Sir Arthur Conan Doyle, the creator of Sherlock Holmes, got interested in the subject. Now you can scour the Holmes cannon for any support for the existence of paranormal phenomenon but you will come up dry. But later in life Doyle became a believer. And, also later in life, he and Harry Houdini became friends. Houdini, as a result of the credulity of Doyle and for other reasons, got interested in mediums. He was very successful at exposing them for frauds. But Houdini was never able to convince Doyle that mediums were bunko artists.
So far I have talked about fraud, people who knew that what they were doing was dishonest, but pretended to be believers. There is a whole other group of people. These are people who are honest but believe in the paranormal for one reason or another anyhow. Again I want to dip into the annals of history to discuss a case that will demonstrate what I mean.
Clever Hans is a horse that lived in Germany around the turn of the 20th century (e.g. 1900). Hans could do arithmetic. Hans' owner, a fellow named Wilhelm von Osten was honest as the day is long. Everyone who investigated him came to that conclusion. If Hans was a fraud then Osten was not in on the con. This led a lot of people to conclude that Hans was the real deal. Then along came a man named Carl Stumpf. He did a very thorough and very careful investigation of Hans. Since Osten was completely honest he co-operated with Stumpf and his associates. For a long time they were stumped. It looked like Hans was the real deal. Then Stumpf noticed something. Hans got the wrong answer every once in a while. This was important because every time Hans got it wrong Osten also got it wrong. This caused Stumpf to conclude that Osten was unconsciously signaling Hans to tell the horse what the right answer was. This was easy to verify. Hans was tested in situations where he could see Osten and when he could not. Hans got the correct answer when he could see Osten and acted like a normal horse, arithmetic-wise, when he couldn't. (BTW, it turned out to be important to make sure that Hans could also not see any of the regular stable crew too.) Anyhow, the moral of the story is that it is possible to fool ourselves about whether paranormal phenomenon are happening, even if everyone is completely honest.
Returning to more modern times, by the 1960's some scientific work had been done on paranormal phenomena. Most of it was negative but some of it seemed to be positive. But the positive results were never clear cut. The typical experiment showed something happening at a rate above what pure chance would predict. These "confirmations" would come and go but they were never 100%. If something would be projected to happen 50% of the time based on chance then maybe it would happen 60% of the time. And only a few investigators were able to get any positive results at all. In many cases another scientist would reproduce the same experiment exactly as it had been reported and not be able to reproduce the positive result. This was very troubling. This caused scientists to carefully review the reported experimental technique and also the actual experimental technique. They found problems.
What the "Clever Hans" case demonstrates is that a lot of care needs to be taken when doing these kinds of experiments. Honest people can fool themselves into believing something that ultimately turns out to be false. Beyond that there is the problem of con artists. In many cases it is very hard to catch these people in the act. In many of the cases that Houdini investigated reputable scientists had vouched for the validity of the paranormal activity. Magicians are professional con artists. They know what to look for when evaluating whether someone is on the up and up. Scientists are equipped to deal with a nature that guards its secrets well. But they are not equipped to deal with people actively trying to pull the wool over their eyes.
In the past few decades various investigators have reported "encouraging preliminary results" a number of times. But a bigger more thorough investigation never seems to improve the situation. The results stay at the "intriguing" level or go away altogether. Other investigators are unsuccessful at reproducing the results. Interest fades. Then someone starts the cycle over a few years later. The new setup always is different than the old one. Careful investigation uncovers different but equally serious methodological or other problems. But otherwise, things follow the same trajectory. The science community in general has become fatigued with the process. So funding has dried up and interest has dried up.
A lot of water has passed under the bridge since I first got interested in paranormal phenomenon. Many of the kinds of phenomenon Science Fiction writers wrote about back then have gone out of style. We have actually regressed. The people that are currently active resemble the medium of old, the kind of person Houdini was investigating. Now the modern practitioner no longer gathers people around a table in a dark room so they can experience things that go bump in the night. Instead we have the "ghost hunter" traipsing around in a darkened house at night trailing a bunch of gear that looks very scientific. (What the gear is actually measuring is another question.) These shows are cheap to produce and popular enough to turn a nice profit so they are all over the place on cable. Although the TV people pretend to be scientists they do such a poor job of it that only the believers are fooled.
There is a popular explanation for what I have laid out above. It contends that paranormal phenomena are real but scientists have a bias, some would say a hatred for this sort of thing. "It's a conspiracy. These results would rock the foundations of science. So scientists cover up the results in order to save their skins (or their funding)." This perspective fundamentally misrepresents what science is. The idea is that "science" is what's in the science books and, if it's not in a science book then scientists would not be able to handle it and they would "do whatever it takes" to cover it up. But let's see what a real scientist thinks.
Richard P. Feynman is one of the outstanding scientists of the twentieth century. He worked on the Atom Bomb project at Los Alamos. He has won two Nobel prizes in Physics. He is one of the founders of something called Quantum Electrodynamics. For many years he was a Physics professor at Cal Tech. Just before he died in 1988 he was a member of the committee that investigated why the Challenger Space Shuttle blew up and killed everyone aboard. If you want to get a feel for the man I would suggest reading his book "Surely You're Joking, Mr. Feynman". It is completely nontechnical, quite funny, and full of insights about the human condition.
Feynman's most noted piece of professional writing is three volume series called "The Feynman Lectures on Physics". It is based on a series of lectures he gave over a period of two years to freshman and later sophomore students at Cal Tech. It was designed to be an introduction to Physics for the kind of very smart students who got into Cal Tech. The "Lecture" books became very popular, both among people with a deep interest in physics but also with the general public. They have since been reprinted a number of times, including a "Definitive and Extended" edition in 2005. My point in going on a bit is to emphasize the point that the material in these books was intended to represent mainstream thinking by scientists, specifically physicists. Here is an extended quote from chapter 2:
We stated it in the first chapter: the sole test of the validity of any idea is experiment. If it turns out that most experiments work out the same way in Quito [Ecuador] as they do in Stockholm [Sweden], then those "most experiments" will be used to formulate some general law, and those experiments which do not come out the same we will say were a result of the environment near Stockholm. We will invent some way to summarize the results of the experiment, and we do not have to be told ahead of time what this way will look like. If we are told that the same experiment will always produce the same result, that is all very well, but if when we try it, it does not, then it does not. We will just have to take what we see, and then formulate all the rest of our ideas in terms of our actual experience. (emphasis in original)That's how actual scientists think about science. The basic argument of a lot of the paranormal crowd is "these paranormal results are just too weird for scientists to accept so they reject them even though they are true". This perspective is just wrong. It is wrong first of all because paranormal results are not very weird. As I indicated above, Science Fiction writers have been incorporating them into stories for decades. None of the ideas about paranormal activity are very hard to wrap your head around. On the other hand scientific results can be breathtakingly weird. Let me give you an example.
Scientists have been especially intrigued by a concept called entanglement for some time now. One of the properties of an electron is called "spin". An electron can be either "spin up" or "spin down". It is possible to entangle two electrons (the technical details don't matter). Then it is possible to separate the two electrons by hundreds of feet, all while maintaining the entanglement. Then the spin of either electron (it doesn't matter which) can be measured. When we measure the spin of the other electron a short time later it will always be the opposite. Scientists sometimes call this "spooky action at a distance". And it's not just one scientist or one lab. Dozens of scientists have done dozens of experiments involving entangled particles. It's gotten to be a cottage industry. And there are other particles you can do this with besides electrons. And there are other properties you can measure besides spin. And you can even do experiments involving more than two particles. And these particles can be entangled in very complicated ways. The result is always the same. If you measure one entangled particle and it comes up "heads" then the other particle will come up "tails". Now that's truly weird.
The fact that scientists call this "spooky action at a distance", even if only sometimes, tells you something. Scientists find it weird too. But scientists hew to "the sole test of the validity of any idea is experiment". They do experiments. They sometimes get truly weird results. Frequently they will go back over the experiment and find something wrong. When they fix it the weird result goes away. But sometimes no matter how hard they examine the experiment or its result they can't find anything wrong. And sometimes what their experiments tell them is that no sensible idea explains all the results. That's when they come up with weird theories. Twentieth century physics is littered with example after example where experimental results show that all sensible theories are wrong. But then a scientist comes up with a truly weird theory that does fit all the experimental results. It's almost gotten to the point where the fact that a theory is weird is considered a point in its favor.
The reason scientists reject the idea that paranormal activity is possible is not because it is too weird or too unbelievable. It is because there is no valid experiment that demonstrates the existence of paranormal activity. There are many experiments that point to weird and unbelievable phenomena. In many cases these phenomena are now considered part of mainstream science. And none of these phenomena emerged from the community of believers in paranormal phenomena. And scientists have now been burned over and over by claims of experimental confirmation of paranormal activity. Some of these experiments have been done by otherwise reputable scientists. And just because an experiment is done by someone without "proper scientific credentials" doesn't mean that the result is not scientifically valid. But the actual experiments done to date that purport to support the existence of paranormal activity have not been done in a scientifically valid manner.
This history of claims of experimental proof of the existence of one or another paranormal phenomenon later turning out to be bad scientific technique or on all too many occasions outright fraud, has resulted in most scientists who will address this area at all to fall back on "extraordinary claims demand extraordinary proof". It is important to remember that several examples of extraordinary claims have actually been followed by extraordinary proof in the realm of what is now mainstream science.
The Geologic theory now called "plate tectonics" was laughed out of the room when it was first proposed in 1912 by Alfred Wegner. But evidence slowly built up in its favor (and against the alternatives) and it came to be widely accepted within the community by about 1970 and more broadly accepted thereafter. Another example, also from Geology, is the theory first propounded by Louis Alvarez in 1980, that a giant meteor impact wiped out the Dinosaurs about 65 million years ago. When it was first floated it was greeted by a great deal of skepticism. But again many different kinds of evidence built up in support of the theory (and damage alternative theories) and it is now widely supported within the scientific community. Closer to home, the theory of Quantum Mechanics was subjected to a great deal of criticism when it was first developed. One thing that speeded its acceptance was that all sensible theories had been disproved by the time it came along. So given a choice between a truly weird theory that got the answers right and other theories that were either equally weird and less successful or not weird and totally unsuccessful the physics community came to accept Quantum Mechanics. But I think that too this day most scientists working in the field wished there was a less weird theory that worked. Unfortunately, no one has come up with such a theory.
Wegner, Alvarez, and the pioneers of Quantum Mechanics are now celebrated in the scientific community. Wegner did not live long enough to see his reputation rehabilitated. But Alvarez did. And so did many of the pioneers of Quantum Mechanics. Scientists understand how hard it is to do truly groundbreaking (i.e. weird at the time it is first proposed but later accepted as valid) work. So they try to identify and publicly support such people. Einstein is the classic example of this. When he began publishing groundbreaking work in 1905 he was not even a working scientist. He was a clerk in the Swiss Patent Office. Einstein's 1905 work was profoundly weird. But, like the Quantum Mechanics people a couple of decades later, he proposed solutions to problems that were generally accepted to have no "normal" solution. He also provided the thinking behind his solutions. Aside from its weirdness and profound originality, it was remarkably straight forward. And scientists were quickly able to devise and execute experiments based in his thinking that supported his conclusions.
Einstein went on to come up with other weird and original ideas that also worked out. So he became the model for what a scientist should be. A scientist should be able to think up weird and original ideas then provide straight forward reasoning for why they might be right. Scientists embraced weirdness in the post-Einstein era. It was seen as the fast track to success. So a scientist who came up with some piece of paranormal activity that actually passed the "experiment" test would see that as an opportunity. He could become the new Einstein, or at least the new Wegner or Alvarez. The problem has not been with the weirdness of paranormal phenomena. It has been with getting experimental verification.
Finally, let's say you are not and don't want to become a scientist. But you would like to do something to confirm the existence of paranormal phenomena. My recommendation to you is to do an experiment. But, you say, we already agreed you don't want to become a scientist. That's ok. My suggestion is that you perform your experiment in a decidedly nonscientific way and in a decidedly nonscientific environment. And, if your experiment works, you immediately get a whole lot of money. Many people, given a choice between fame and money, would be happy with the money. And you don't have to wait years for the Nobel committee to decide you are deserving before you get the prize money. Instead, you get the money right away. Does that sound like a deal you might be interested in? Good! Let's go to Las Vegas. Really? Really.
Many paranormal abilities can quickly, and legally be transformed into cold hard cash. Let's say you can read minds. Get yourself to a poker table. Texas Hold 'em is a game that involves a lot of bluffing. With a little study, however, it becomes easy to win and to win big if you just know if the other guy is bluffing or not. You bluff him if your mind reading tells you he thinks he has a weak hand. He will usually fold and you will win big. If you have a good hand and your mind reading tells you he's bluffing stick around. He'll either eventually fold or lose at the showdown. Easy peasy.
Now let's say you can read minds but only co-operating minds. Then the game for you is Bridge. You and your partner can play killer defense if each of you knows exactly what cards your partner holds. And Bridge is played for money all over the place. It also may be possible to win at Poker by placing your partner behind an opponent where your partner can see his cards. This is hard to do because your partner could just signal you without using any kind of mind reading. But I'm sure you can come up with other "tag team" strategies that would turn mind reading ability into cash.
Let's say you can't read minds but have telekinetic abilities. In other words, you can move things around at a distance. How about moving the roulette ball around. You don't have to make it drop in "17" all the time. You can just bet red or even and get it to drop into a red or even slot more often than it should. You can even just settle for it not dropping into a green slot. This won't win you any money but it will give you a chance to break even. Similar ideas will allow you to win big at craps by adjusting the fall of the dice.
Similarly, let's say you can read the future. Well, read which number the roulette ball is going to drop on before bets are closed off. Again, if you know which number a shooter is going to roll it is easy to clean up at craps. And, if you can read as much as a day into the future, then Wall Street is the place for you.
Other approaches are possible with other paranormal abilities. A ghost partner can be a big help, for instance. They can read cards instead of a corporeal partner, for instance. And they are much harder to catch, either physically or on tape. The point is that the real world is actually running millions of paranormal experiments each day. The fact that casino owners (and Wall Street bigwigs) do very well, thank you, argues that most paranormal abilities don't exist. Usually it is possible to quickly figure out how to make money, a lot of money, by applying a paranormal ability appropriately. But no one seems to be doing it.
People come up with various "morality" rules that prohibit using paranormal talents for monetary gain. But lots of people "read minds" or "hunt ghosts" on TV and make a lot of money doing it. Somehow the morality rule is ineffective in their case. There are a lot of people who have found many different ways to make a buck off of someone else's belief in the paranormal. And there seem to be no paranormal police whose job it is to step in and shut down the frauds. There is just no reason to believe that paranormal activity is possible and every reason to believe that it is not possible.
Saturday, February 23, 2013
Medical Costs
This subject has been around a long time. It has been a "front burner" item at least since the Obama Administration started trying to pass Obamacare. The proximate cause of this post is the publication of a long article in Time Magazine by Steven Brill. At the time I am writing this post it is available on the web at http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/. I don't know if Time intends to keep it up permanently. Mr. Brill makes a positive and useful contribution to the discussion. But it was neither the opening shot nor the final word.
Back in the olden days when I was born things were different. When my mother decided she was pregnant she sought out an OB/GYN she trusted. He charged a flat fee that covered everything: visits, hospital fees, drugs, the works. In those days few people had insurance and the Great Depression was not that far in the past. People expected to pay medical costs out of pocket and most medical procedures were fairly inexpensive. A "hospital bed" was just a bed that was not very different than a normal bed and the hospital was a building that was not very different than other buildings. There were few drugs and medical devices and both tended to be inexpensive.
After that medicine started getting much more expensive, complex, and specialized. And more and more people started getting medical insurance through their employers. For a good long time this insurance was pretty cheap because medicine in general was pretty cheap. So companies used medical plans as an inexpensive lure to attract employees. But medical costs started a long term trend of increasing at a rate much faster than other costs. And after a while company paid medical plans started getting expensive.
Back in the period when medical insurance started to become popular my parents signed us up for an HMO called Group Health. At the time Group Health was slightly more expensive than a traditional insurance plan, perhaps 10% - 20% more expensive. But many people thought the extra expense was worth it because they perceived the GHC product to be better than a standard medical plan. And at this time the competition was between nothing and GHC as most people were not covered by an employer funded insurance plan. And GHC was very successful during this period.
Eventually company insurance became quite common. Some companies offered an HMO option for a little more money but many did not. But then a law was passed that said employers had to offer an "HMO option". This did not work out as supporters expected. The insurance companies just started offering a slightly modified version of their standard insurance which they called an HMO option. Most people's experience with HMOs is with one of these phony HMO insurance option rather than a real HMO. So why am I going into all this?
Because the HMO model is a wellness approach. The idea is that you pay one standard fee. If the HMO can keep you healthy then they make money on you. Otherwise, they don't. The alternative approach is the one we all get now called "fee for service". The insurance company pays for some or all of the cost of whatever services you end up using. There is an argument you hear all the time now that if we only did wellness rather than fee for service medicine would be cheaper. GHC and other HMOs in those early years worked hard and worked smart in their wellness efforts. But they always ended up costing more than the insurance plans. Now it is possible that when you counted up all the costs the HMO approach was cheaper. But the premiums said it was more expensive. And what this tells us is that if the wellness approach is cheaper it's not cheaper by a lot. If it was a lot cheaper then HMOs would have been able to get their premiums below those of the insurance plans. I think the wellness approach is the better way to go. But I don't think it is going to save a lot of money. It might even slightly increase health care costs.
Mr. Brill does not seriously address the wellness versus fee for service debate. So let me move on to an area where he does spend a lot of time and effort. Who's the villain that is driving up health care costs. Mr. Brill says it is NOT doctors. But here some context is missing because the key events happened many years ago.
When people first started noticing that health care costs were climbing the dominant component was doctor fees. At this time hospitals were still relatively cheap as were drugs and medical devices. So people went after doctors. They essentially drove the fees doctors charged down relative to other medical costs. Before doctors could make a good living by charging fees that they thought were appropriate. And many of them would bundle in a lot of extras as did the OB/GYN my mother went to when I was in the process of coming along. But this bundled approach started being a bad idea from the doctor's point of view. One doctor might bundle in a lot of stuff and charge a higher rate compared to another doctor who bundled less in. Surveys were done as to how much each doctor was charging and standard rates were developed. So doctors did the sensible thing. They unbundled. Patients now got billed separately for everything so that the only thing that was included in the doctor charge was for the time the doctor spent.
This trend continued and intensified. This drove the hourly rate the doctor could charge down. And great amounts of creativity were applied to increasing the cost and number of things that were charged separately. Mr. Brill goes into the ridiculous lengths that are now employed to pad the bill by adding individual charges for individual items. One of his examples involves a single tablet of a Tylenol generic that is separately charged. Another example is a charge for the smock the doctor wears when he examines you. This ever finer slicing and dicing of medical charges have added greatly to the costs of medicine.
And by now this fierce pressure on the hourly rates doctors charged has proceeded long enough so that Mr. Brill now considers doctor rates to not be a major part of the problem. But there is another phenomenon related to the income of doctors that Mr. Brill does rightly spend a lot of time on. While the hourly rate doctors charge is now relatively low the amount of income doctors receive is now quite high. This is because doctors now get a lot of their income from other medical sources. They form group practices and the group practice creates subsidiaries that perform medical services like lab work, pharmaceutical services, CAT scans, MRI scans, X-Rays, etc. These services are ordered by the doctors in the practice and provided by the wholly owned subsidiary which charges high fees for the service. So doctors make large profits on the medical goods and services they order. In some cases doctors get a direct or indirect kickback from medical device makers for the device (e.g. replacement knee) that the doctor specifies. All these alternate sources of income are medical related but they don't show up as an increased hourly rate. They also encourage doctors to prescribe extra procedures. More procedures means more money for the doctor.
Mr. Brill spends most of his time dissecting actual medical bills received by patients. His point is that hospitals and other medical facilities jack prices way up. This results in a lot of profit for the hospital. The fact that many of these hospitals are considered non-profits by the IRS makes no difference at all. That just leaves more money for new buildings, new expensive medical devices like MRI scanners, and especially higher salaries for senior hospital executives. He singles out the salaries of a number of these executives. One case among several involves Yale University. The executive who oversees a hospital affiliated with the Yale Medical School makes several times as much as the president of Yale. (Actually, this sort of thing is not that unusual. In my state the highest paid state government employee is the football coach. He makes far more than the president of the university he nominally coaches for or the governor of the entire state.)
Mr. Brill spends a lot of time on something he calls the chargemaster. I have never heard of such a thing. What he describes sounds like what is usually called a price list. It is a list of all the goods and services a hospital provides and the nominal price for each. Calling it "chargemaster" rather than "price list" makes it sound more exotic I suppose. "Look at me! I have discovered this secret thing you have never heard of before. And its very bad." Whatever you call it, it is very bad. But not because it is some kind of exotic secret thing. Its bad because of how it is used and abused. Companies have been abusing price lists since time immemorial. "This widget is on sale at 50%, 70%, 90% off it's suggested retail price". We have all seen zillions of examples of this sort of thing going on all over the place. Anyone who doesn't think that the "list price" has been pumped up as much as the retailer thinks he can get away with should have his head examined.
Mr. Brill makes three general points. First, hospitals do this kind of inflation to an even more extreme extent that even the sleaziest retailer. He cites examples of prices that are thousands of percent too high. Second, hospitals provide no justification for the price they list. This item is no mystery to me. I will talk about it later. And finally, hospitals actually charge full list price to some of their customers. Insurance companies usually get a discount off this list price. A common amount is 30% off. But it may be 50% off or more. It is not unusual for Medicare to get 90% or more off. But if you are a walk in customer (i.e. no insurance or Medicare) they will usually initially charge you full list. If they give you a discount it is usually considerably less than the amount of the discount they give to insurance companies. Medicare charges are based on actual costs and not list price. And actual costs, even after a "Medicare markup" is added in, will frequently amount to a discount of 90% or more off the list price.
Mr. Brill never did get a straight answer as to how list prices are set. I can tell you how it works. The list price is whatever the hospital thinks the traffic will bear. They don't want to admit this so they give Mr. Brill a nonsense answer or no answer at all.
Partly what's going on here is the old balloon analogy. If you squeeze the balloon in at one place it just bulges out at another place. If doctors can't get enough income from charging higher rates they will find another way. They will have their practice buy a CAT scanner then order up a lot of CAT scans, as an example. If a hospital can't get a high enough room rate they will start charging by the pill for Tylenol or assess a fee for changing the sheets or jack up the price for X-Rays, etc.
We have seen where some part of the medical establishment decides they are not making enough so they game the system. And if the rules are changed to deal with one revenue enhancing technique people will adapt and find a new technique. One contemporary example of this that Mr. Brill discusses is drugs. Back in the olden days my HMO was known for pushing pills. Why? Because at that time drugs were usually cheaper than alternatives and studies showed they were effective. But times have changed. Drugs, as a general category, are no longer cheap. Some drugs can cost tens of thousands of dollars per month for a standard dose. Why? Because drugs used to be cheap. So there was little attention paid to what they cost. Some smart executive in the pharmaceutical industry figured this out and started rolling out extremely expensive drugs. It didn't take long for other pharmaceutical companies to start doing the same thing. The system has yet to come up with a counter for this strategy. So every year we see a number of extremely expensive new drugs hitting the market.
I think Mr. Brill does a good job of working us through why medicine is so expensive in the U.S. Since he doesn't go into any history he does a poorer job of explaining how we got where we are now. And I think his prescriptions for fixing things are extremely weak. So what do I think we should do? Let me first discuss what we should not do.
The first thing we need to do is understand the whole balloon thing where if you squeeze costs here you often end up just pushing costs to over there. I think in retrospect this clamping down hard on the hourly rate of doctors was a mistake. It just pushed the costs to other parts of the system. A piecemeal approach that just looks at part of the system (hospital charges and, to a lesser extent prescription drug prices), as Mr. Brill did will just cause the medical establishment to push costs somewhere else.
Mr. Brill also makes a common observation that is worth repeating. The medical industry is NOT a market as we commonly understand markets. It is an interlocking set of monopolies that have successfully organized themselves so that they have pricing power. They use that power in a variety of ways to raise prices. We should not be surprised that in this environment prices are high. Mr. Brill says he set out to do an apolitical analysis. But he also says he believes in the free market. That's fine if you can find a way to restructure things so that market forces are introduced into the medical industry. Mr. Brill never comes up with a method for doing this.
Mr. Brill suggests getting rid of the chargemaster. As I said, it's just a price list. The problem with the price list is not that it exists. It's that the prices in the list are too high. And generally speaking they are a secret. In general the price list is one of numerous areas where sunlight would help. It would be nice if these price lists were published so that comparison shopping would at least theoretically be possible. One of the good parts of Obamacare is that health care providers are required to spend 80% (in some situations) or 85% (in other situations) on medical care. Some companies have had trouble hitting these targets, which gives you an idea of how bloated they have become. If there is some sensible way to fix the problems with current price lists, I'm all for it. But I'm not sure that is possible. Now let me finally move on to what I think should be done.
The first thing I want to suggest is not a specific fix but a general approach to finding fixes that work. We as a country should do what successful companies often do: go to school on the competition. Here I am not talking about looking at one insurance company versus another, or one hospital versus another. There is benefit to doing that. But there is even greater benefit in studying how other countries do health care. General Motors studies Toyota. Why can't the U.S. study the Japanese health care system? There are many countries out there. They have all come up with different ways to do health care. Why not study each system carefully and figure out how it works. Then try to figure out what works well and what does not in that system. Actually a start has already been made. T.R. Reid, a writer for the Washington Post has written a book called "The Healing of America". In it he takes a look at the health care systems of not only Japan but the U.K. (Britain), Germany, Taiwan, and Switzerland. What he found was that each system is quite differently from the others. But all of them deliver health care of equivalent or better quality to the U.S.. All of these systems are much more popular in their native country than the U.S. system is in the U.S., and all of the systems are cheaper than the U.S. system. The Swiss system is considered the "Cadillac option" and even it is substantially cheaper. In many cases these systems have been operating for decades so you can really see how well they work over the long term.
I think it is impossible to effectively apply actual market forces to the health care system. If you want details of why it is likely impossible I refer you to Mr. Brill's story. Beyond that, there is the balloon issue I have been talking about.
Finally, let me deliver the short term good news and long term bad news. If we look at what other countries are doing it is obvious that health care costs can be drastically cut and health care quality improved (but probably only by a little). That means that if I could wave a magic wand and instantly make all the changes that should be made then costs would drop drastically and quality would go up. But as far as I can tell no country has solved the problem of the high rate of health care cost increase. This is a long established trend that is going on everywhere. It's nice that costs in Taiwan are much lower than they are in the U.S. But costs are increasing faster than inflation in Taiwan. The inexorable law of compound interest says that, while it may take a little longer for costs in Taiwan to go through the roof it will eventually happen. So, while I am optimistic that something can be done about costs in the short run I am pessimistic that anything can be done in the long run.
And that leads me inexorably to "death panels". Death panels are a bugaboo of conservatives as in "Obamacare equals government death panels." What this line of thinking ignores is that we currently have and have always had death panels. In days of yore the death panels were located in the family. Dad would decide that the family couldn't afford the medicine (or operation) that was necessary to keep aunt Edith alive. So aunt Edith would quietly be laid to rest. Current death panels are run by insurance companies. They decide what to cover and what not to. Mr. Brill has several examples of the effect of coverage limits. A policy would have a limit on how much it would cover for a particular year or for the lifetime of an individual. If the limit got exceeded then you were on your own. There used to be an exclusion for "experimental procedures" like heart transplants. After insurance companies lost enough law suits ("that nice person is so sick and the insurance company has so much money") they gave up on that sort of thing. Mr. Brill points our that 60% of all individual bankruptcies are caused by medical bills. Obamacare is phasing out the limits but it will raise rates. And nowhere in the Obamacare legislation is there anything that creates a government death panel. The closest thing is a very modest effort to study how to make things more efficient.
The medical industry is very good at making decisions into life and death decisions. "This $10,000 drug is cheap if it saves a life." You can easily plug "this operation" or "this medical device" into the previous sentence. Ultimately either medical costs will expand forever (impossible) or we will be confronted with a life and death decision. How much is aunt Edith's life worth? If we don't decide that the cost of saving aunt Edith is too high in some cases then ultimately we will be unsuccessful in containing health care costs.
One question no one asks is "how much is health care worth"? The answer is "it depends". Let's say that I invent a magical device. You spend 30 minutes in it twice per year. That's it! No doctor's visits. No more drugs or exercise. None of that. You just do your 30 minutes twice per year. What you get is the body of a healthy 30 year old. And not only is it healthy, it's fit and trim. You can stop exercising. You can smoke and drink. If you drink and crash your car, you're still dead but you are now immune from standard medical maladies. Now if you stick with your "30 minutes, twice a year" regime you live to be 150 years old. Then you die quietly in your sleep. How about that?
That's the setup. Now pretend you're Bill Gates and the magic machine treatment costs a billion dollars per person. If I were Bill Gates I would pay $5 billion and sign up myself, my wife, and my three children. The real Bill Gates would probably also sign up some other people like his father. But you get the idea. For Bill Gates this would be a good deal. Neither you nor I are Bill Gates so let's get a little more real.
Let's pretend you are Charlie Rose. Mr. Rose has a nightly talk show on PBS and does an hour in the morning on CBS. I don't know what his income or net worth is. But I think I can accurately characterize it as "very comfortable but not in the billionaire range". Now the deal for Mr. Rose is that the magic machine will cost him half his income. Mr. Rose is one of those lucky people who has enough money and knows it. He does things he likes to do like his two TV gigs but he doesn't own a bunch of homes scattered over the planet or his own private jet or any of those other super-rich trappings. And maybe Mr. Rose could cut his effective income in half and it would make no difference. But let's assume this in not true. I picked Mr. Rose for a specific purpose. His PBS show is supported by a number of blue chip corporate sponsors. If Mr. Rose needed to up his income he could just go to his current sponsors and ask for more money or rope in additional sponsors. Like most of us Mr. Rose doesn't like to hustle for money. So when he has lined up enough sponsorship money he quits. He is one of those few people who controls his income. So this "half your income" deal would be a good deal for Mr. Rose. At least it would be if I were Mr. Rose.
Now let's take another step down the income curve. Consider John and Jane Smith and their two children Bob and Mary. John and Jane both work full time and each pulls down $40,000 per year, close to the median income in this country. So the family income is $80,000 as Bob and Mary are too young to work. Now offer this same deal to the Smith family. They put half their income into health care. This is only $40,000 per year. It would take thousands of years to add up to the $5 billion we have asked from Mr. Gates. I'm sure half of Mr. Rose's income is far greater than $40,000. So it's a steal of a deal, right? No! Bargain though it may be, the Smith family can't afford to spend $40,000 per year on health care, even for the magically wonderful health care I have invented.
In my made up example I have made up a health care that is truly miraculous. The actual health care that is on offer falls far short of what I have made up. It is far less effective. The longest anyone has ever lived is 122 years. And our health is not perfect even at thirty. And it goes down hill steadily after that even if we have great health care and we live an exemplary life from a health standpoint. Almost none of us that live to be a hundred are able to live a full active life at that point. The best most of us can do is be reasonably vigorous into our eighties. And many of us don't even last that long without significant degradation. So actual health care is far short of my invented ideal.
Judging by the decisions people actually make most people believe that extreme measures should be taken for people they love as long as someone else is paying for it. But as a society we are paying for it. And most people are unwilling to admit that health care is a very inexact science. There is a common statistic to the effect that half of all lifetime health costs are incurred in the last six months of life. Assuming that is so, and it probably is, what are we supposed to do about it? The problem is that in many cases we don't know that it's the last six months. That happened to me recently. I had Christmas dinner with an acquaintance, an older gentleman. To my eye he looked like he had many years ahead of him. But less than three months later he is gone. He took sick unexpectedly and died. At no time did his illness look life threatening.
I don't know how much money is spent on people who don't pull through after it is obvious that they will not make it. This would seem like the area where the most and the most obvious cost savings exist. But people find it very hard to let people go under even these circumstances. Saying "it's just too expensive" in other areas of health care is even harder. But if we don't find a way to do just that then clever people will find a way to turn ever more expensive devices or drugs or procedures into "life and death" and medical expenses will continue to go up and up and up.
Back in the olden days when I was born things were different. When my mother decided she was pregnant she sought out an OB/GYN she trusted. He charged a flat fee that covered everything: visits, hospital fees, drugs, the works. In those days few people had insurance and the Great Depression was not that far in the past. People expected to pay medical costs out of pocket and most medical procedures were fairly inexpensive. A "hospital bed" was just a bed that was not very different than a normal bed and the hospital was a building that was not very different than other buildings. There were few drugs and medical devices and both tended to be inexpensive.
After that medicine started getting much more expensive, complex, and specialized. And more and more people started getting medical insurance through their employers. For a good long time this insurance was pretty cheap because medicine in general was pretty cheap. So companies used medical plans as an inexpensive lure to attract employees. But medical costs started a long term trend of increasing at a rate much faster than other costs. And after a while company paid medical plans started getting expensive.
Back in the period when medical insurance started to become popular my parents signed us up for an HMO called Group Health. At the time Group Health was slightly more expensive than a traditional insurance plan, perhaps 10% - 20% more expensive. But many people thought the extra expense was worth it because they perceived the GHC product to be better than a standard medical plan. And at this time the competition was between nothing and GHC as most people were not covered by an employer funded insurance plan. And GHC was very successful during this period.
Eventually company insurance became quite common. Some companies offered an HMO option for a little more money but many did not. But then a law was passed that said employers had to offer an "HMO option". This did not work out as supporters expected. The insurance companies just started offering a slightly modified version of their standard insurance which they called an HMO option. Most people's experience with HMOs is with one of these phony HMO insurance option rather than a real HMO. So why am I going into all this?
Because the HMO model is a wellness approach. The idea is that you pay one standard fee. If the HMO can keep you healthy then they make money on you. Otherwise, they don't. The alternative approach is the one we all get now called "fee for service". The insurance company pays for some or all of the cost of whatever services you end up using. There is an argument you hear all the time now that if we only did wellness rather than fee for service medicine would be cheaper. GHC and other HMOs in those early years worked hard and worked smart in their wellness efforts. But they always ended up costing more than the insurance plans. Now it is possible that when you counted up all the costs the HMO approach was cheaper. But the premiums said it was more expensive. And what this tells us is that if the wellness approach is cheaper it's not cheaper by a lot. If it was a lot cheaper then HMOs would have been able to get their premiums below those of the insurance plans. I think the wellness approach is the better way to go. But I don't think it is going to save a lot of money. It might even slightly increase health care costs.
Mr. Brill does not seriously address the wellness versus fee for service debate. So let me move on to an area where he does spend a lot of time and effort. Who's the villain that is driving up health care costs. Mr. Brill says it is NOT doctors. But here some context is missing because the key events happened many years ago.
When people first started noticing that health care costs were climbing the dominant component was doctor fees. At this time hospitals were still relatively cheap as were drugs and medical devices. So people went after doctors. They essentially drove the fees doctors charged down relative to other medical costs. Before doctors could make a good living by charging fees that they thought were appropriate. And many of them would bundle in a lot of extras as did the OB/GYN my mother went to when I was in the process of coming along. But this bundled approach started being a bad idea from the doctor's point of view. One doctor might bundle in a lot of stuff and charge a higher rate compared to another doctor who bundled less in. Surveys were done as to how much each doctor was charging and standard rates were developed. So doctors did the sensible thing. They unbundled. Patients now got billed separately for everything so that the only thing that was included in the doctor charge was for the time the doctor spent.
This trend continued and intensified. This drove the hourly rate the doctor could charge down. And great amounts of creativity were applied to increasing the cost and number of things that were charged separately. Mr. Brill goes into the ridiculous lengths that are now employed to pad the bill by adding individual charges for individual items. One of his examples involves a single tablet of a Tylenol generic that is separately charged. Another example is a charge for the smock the doctor wears when he examines you. This ever finer slicing and dicing of medical charges have added greatly to the costs of medicine.
And by now this fierce pressure on the hourly rates doctors charged has proceeded long enough so that Mr. Brill now considers doctor rates to not be a major part of the problem. But there is another phenomenon related to the income of doctors that Mr. Brill does rightly spend a lot of time on. While the hourly rate doctors charge is now relatively low the amount of income doctors receive is now quite high. This is because doctors now get a lot of their income from other medical sources. They form group practices and the group practice creates subsidiaries that perform medical services like lab work, pharmaceutical services, CAT scans, MRI scans, X-Rays, etc. These services are ordered by the doctors in the practice and provided by the wholly owned subsidiary which charges high fees for the service. So doctors make large profits on the medical goods and services they order. In some cases doctors get a direct or indirect kickback from medical device makers for the device (e.g. replacement knee) that the doctor specifies. All these alternate sources of income are medical related but they don't show up as an increased hourly rate. They also encourage doctors to prescribe extra procedures. More procedures means more money for the doctor.
Mr. Brill spends most of his time dissecting actual medical bills received by patients. His point is that hospitals and other medical facilities jack prices way up. This results in a lot of profit for the hospital. The fact that many of these hospitals are considered non-profits by the IRS makes no difference at all. That just leaves more money for new buildings, new expensive medical devices like MRI scanners, and especially higher salaries for senior hospital executives. He singles out the salaries of a number of these executives. One case among several involves Yale University. The executive who oversees a hospital affiliated with the Yale Medical School makes several times as much as the president of Yale. (Actually, this sort of thing is not that unusual. In my state the highest paid state government employee is the football coach. He makes far more than the president of the university he nominally coaches for or the governor of the entire state.)
Mr. Brill spends a lot of time on something he calls the chargemaster. I have never heard of such a thing. What he describes sounds like what is usually called a price list. It is a list of all the goods and services a hospital provides and the nominal price for each. Calling it "chargemaster" rather than "price list" makes it sound more exotic I suppose. "Look at me! I have discovered this secret thing you have never heard of before. And its very bad." Whatever you call it, it is very bad. But not because it is some kind of exotic secret thing. Its bad because of how it is used and abused. Companies have been abusing price lists since time immemorial. "This widget is on sale at 50%, 70%, 90% off it's suggested retail price". We have all seen zillions of examples of this sort of thing going on all over the place. Anyone who doesn't think that the "list price" has been pumped up as much as the retailer thinks he can get away with should have his head examined.
Mr. Brill makes three general points. First, hospitals do this kind of inflation to an even more extreme extent that even the sleaziest retailer. He cites examples of prices that are thousands of percent too high. Second, hospitals provide no justification for the price they list. This item is no mystery to me. I will talk about it later. And finally, hospitals actually charge full list price to some of their customers. Insurance companies usually get a discount off this list price. A common amount is 30% off. But it may be 50% off or more. It is not unusual for Medicare to get 90% or more off. But if you are a walk in customer (i.e. no insurance or Medicare) they will usually initially charge you full list. If they give you a discount it is usually considerably less than the amount of the discount they give to insurance companies. Medicare charges are based on actual costs and not list price. And actual costs, even after a "Medicare markup" is added in, will frequently amount to a discount of 90% or more off the list price.
Mr. Brill never did get a straight answer as to how list prices are set. I can tell you how it works. The list price is whatever the hospital thinks the traffic will bear. They don't want to admit this so they give Mr. Brill a nonsense answer or no answer at all.
Partly what's going on here is the old balloon analogy. If you squeeze the balloon in at one place it just bulges out at another place. If doctors can't get enough income from charging higher rates they will find another way. They will have their practice buy a CAT scanner then order up a lot of CAT scans, as an example. If a hospital can't get a high enough room rate they will start charging by the pill for Tylenol or assess a fee for changing the sheets or jack up the price for X-Rays, etc.
We have seen where some part of the medical establishment decides they are not making enough so they game the system. And if the rules are changed to deal with one revenue enhancing technique people will adapt and find a new technique. One contemporary example of this that Mr. Brill discusses is drugs. Back in the olden days my HMO was known for pushing pills. Why? Because at that time drugs were usually cheaper than alternatives and studies showed they were effective. But times have changed. Drugs, as a general category, are no longer cheap. Some drugs can cost tens of thousands of dollars per month for a standard dose. Why? Because drugs used to be cheap. So there was little attention paid to what they cost. Some smart executive in the pharmaceutical industry figured this out and started rolling out extremely expensive drugs. It didn't take long for other pharmaceutical companies to start doing the same thing. The system has yet to come up with a counter for this strategy. So every year we see a number of extremely expensive new drugs hitting the market.
I think Mr. Brill does a good job of working us through why medicine is so expensive in the U.S. Since he doesn't go into any history he does a poorer job of explaining how we got where we are now. And I think his prescriptions for fixing things are extremely weak. So what do I think we should do? Let me first discuss what we should not do.
The first thing we need to do is understand the whole balloon thing where if you squeeze costs here you often end up just pushing costs to over there. I think in retrospect this clamping down hard on the hourly rate of doctors was a mistake. It just pushed the costs to other parts of the system. A piecemeal approach that just looks at part of the system (hospital charges and, to a lesser extent prescription drug prices), as Mr. Brill did will just cause the medical establishment to push costs somewhere else.
Mr. Brill also makes a common observation that is worth repeating. The medical industry is NOT a market as we commonly understand markets. It is an interlocking set of monopolies that have successfully organized themselves so that they have pricing power. They use that power in a variety of ways to raise prices. We should not be surprised that in this environment prices are high. Mr. Brill says he set out to do an apolitical analysis. But he also says he believes in the free market. That's fine if you can find a way to restructure things so that market forces are introduced into the medical industry. Mr. Brill never comes up with a method for doing this.
Mr. Brill suggests getting rid of the chargemaster. As I said, it's just a price list. The problem with the price list is not that it exists. It's that the prices in the list are too high. And generally speaking they are a secret. In general the price list is one of numerous areas where sunlight would help. It would be nice if these price lists were published so that comparison shopping would at least theoretically be possible. One of the good parts of Obamacare is that health care providers are required to spend 80% (in some situations) or 85% (in other situations) on medical care. Some companies have had trouble hitting these targets, which gives you an idea of how bloated they have become. If there is some sensible way to fix the problems with current price lists, I'm all for it. But I'm not sure that is possible. Now let me finally move on to what I think should be done.
The first thing I want to suggest is not a specific fix but a general approach to finding fixes that work. We as a country should do what successful companies often do: go to school on the competition. Here I am not talking about looking at one insurance company versus another, or one hospital versus another. There is benefit to doing that. But there is even greater benefit in studying how other countries do health care. General Motors studies Toyota. Why can't the U.S. study the Japanese health care system? There are many countries out there. They have all come up with different ways to do health care. Why not study each system carefully and figure out how it works. Then try to figure out what works well and what does not in that system. Actually a start has already been made. T.R. Reid, a writer for the Washington Post has written a book called "The Healing of America". In it he takes a look at the health care systems of not only Japan but the U.K. (Britain), Germany, Taiwan, and Switzerland. What he found was that each system is quite differently from the others. But all of them deliver health care of equivalent or better quality to the U.S.. All of these systems are much more popular in their native country than the U.S. system is in the U.S., and all of the systems are cheaper than the U.S. system. The Swiss system is considered the "Cadillac option" and even it is substantially cheaper. In many cases these systems have been operating for decades so you can really see how well they work over the long term.
I think it is impossible to effectively apply actual market forces to the health care system. If you want details of why it is likely impossible I refer you to Mr. Brill's story. Beyond that, there is the balloon issue I have been talking about.
Finally, let me deliver the short term good news and long term bad news. If we look at what other countries are doing it is obvious that health care costs can be drastically cut and health care quality improved (but probably only by a little). That means that if I could wave a magic wand and instantly make all the changes that should be made then costs would drop drastically and quality would go up. But as far as I can tell no country has solved the problem of the high rate of health care cost increase. This is a long established trend that is going on everywhere. It's nice that costs in Taiwan are much lower than they are in the U.S. But costs are increasing faster than inflation in Taiwan. The inexorable law of compound interest says that, while it may take a little longer for costs in Taiwan to go through the roof it will eventually happen. So, while I am optimistic that something can be done about costs in the short run I am pessimistic that anything can be done in the long run.
And that leads me inexorably to "death panels". Death panels are a bugaboo of conservatives as in "Obamacare equals government death panels." What this line of thinking ignores is that we currently have and have always had death panels. In days of yore the death panels were located in the family. Dad would decide that the family couldn't afford the medicine (or operation) that was necessary to keep aunt Edith alive. So aunt Edith would quietly be laid to rest. Current death panels are run by insurance companies. They decide what to cover and what not to. Mr. Brill has several examples of the effect of coverage limits. A policy would have a limit on how much it would cover for a particular year or for the lifetime of an individual. If the limit got exceeded then you were on your own. There used to be an exclusion for "experimental procedures" like heart transplants. After insurance companies lost enough law suits ("that nice person is so sick and the insurance company has so much money") they gave up on that sort of thing. Mr. Brill points our that 60% of all individual bankruptcies are caused by medical bills. Obamacare is phasing out the limits but it will raise rates. And nowhere in the Obamacare legislation is there anything that creates a government death panel. The closest thing is a very modest effort to study how to make things more efficient.
The medical industry is very good at making decisions into life and death decisions. "This $10,000 drug is cheap if it saves a life." You can easily plug "this operation" or "this medical device" into the previous sentence. Ultimately either medical costs will expand forever (impossible) or we will be confronted with a life and death decision. How much is aunt Edith's life worth? If we don't decide that the cost of saving aunt Edith is too high in some cases then ultimately we will be unsuccessful in containing health care costs.
One question no one asks is "how much is health care worth"? The answer is "it depends". Let's say that I invent a magical device. You spend 30 minutes in it twice per year. That's it! No doctor's visits. No more drugs or exercise. None of that. You just do your 30 minutes twice per year. What you get is the body of a healthy 30 year old. And not only is it healthy, it's fit and trim. You can stop exercising. You can smoke and drink. If you drink and crash your car, you're still dead but you are now immune from standard medical maladies. Now if you stick with your "30 minutes, twice a year" regime you live to be 150 years old. Then you die quietly in your sleep. How about that?
That's the setup. Now pretend you're Bill Gates and the magic machine treatment costs a billion dollars per person. If I were Bill Gates I would pay $5 billion and sign up myself, my wife, and my three children. The real Bill Gates would probably also sign up some other people like his father. But you get the idea. For Bill Gates this would be a good deal. Neither you nor I are Bill Gates so let's get a little more real.
Let's pretend you are Charlie Rose. Mr. Rose has a nightly talk show on PBS and does an hour in the morning on CBS. I don't know what his income or net worth is. But I think I can accurately characterize it as "very comfortable but not in the billionaire range". Now the deal for Mr. Rose is that the magic machine will cost him half his income. Mr. Rose is one of those lucky people who has enough money and knows it. He does things he likes to do like his two TV gigs but he doesn't own a bunch of homes scattered over the planet or his own private jet or any of those other super-rich trappings. And maybe Mr. Rose could cut his effective income in half and it would make no difference. But let's assume this in not true. I picked Mr. Rose for a specific purpose. His PBS show is supported by a number of blue chip corporate sponsors. If Mr. Rose needed to up his income he could just go to his current sponsors and ask for more money or rope in additional sponsors. Like most of us Mr. Rose doesn't like to hustle for money. So when he has lined up enough sponsorship money he quits. He is one of those few people who controls his income. So this "half your income" deal would be a good deal for Mr. Rose. At least it would be if I were Mr. Rose.
Now let's take another step down the income curve. Consider John and Jane Smith and their two children Bob and Mary. John and Jane both work full time and each pulls down $40,000 per year, close to the median income in this country. So the family income is $80,000 as Bob and Mary are too young to work. Now offer this same deal to the Smith family. They put half their income into health care. This is only $40,000 per year. It would take thousands of years to add up to the $5 billion we have asked from Mr. Gates. I'm sure half of Mr. Rose's income is far greater than $40,000. So it's a steal of a deal, right? No! Bargain though it may be, the Smith family can't afford to spend $40,000 per year on health care, even for the magically wonderful health care I have invented.
In my made up example I have made up a health care that is truly miraculous. The actual health care that is on offer falls far short of what I have made up. It is far less effective. The longest anyone has ever lived is 122 years. And our health is not perfect even at thirty. And it goes down hill steadily after that even if we have great health care and we live an exemplary life from a health standpoint. Almost none of us that live to be a hundred are able to live a full active life at that point. The best most of us can do is be reasonably vigorous into our eighties. And many of us don't even last that long without significant degradation. So actual health care is far short of my invented ideal.
Judging by the decisions people actually make most people believe that extreme measures should be taken for people they love as long as someone else is paying for it. But as a society we are paying for it. And most people are unwilling to admit that health care is a very inexact science. There is a common statistic to the effect that half of all lifetime health costs are incurred in the last six months of life. Assuming that is so, and it probably is, what are we supposed to do about it? The problem is that in many cases we don't know that it's the last six months. That happened to me recently. I had Christmas dinner with an acquaintance, an older gentleman. To my eye he looked like he had many years ahead of him. But less than three months later he is gone. He took sick unexpectedly and died. At no time did his illness look life threatening.
I don't know how much money is spent on people who don't pull through after it is obvious that they will not make it. This would seem like the area where the most and the most obvious cost savings exist. But people find it very hard to let people go under even these circumstances. Saying "it's just too expensive" in other areas of health care is even harder. But if we don't find a way to do just that then clever people will find a way to turn ever more expensive devices or drugs or procedures into "life and death" and medical expenses will continue to go up and up and up.
Wednesday, January 30, 2013
Second Amendment Rights
This country has been arguing about gun rights for a long time. The argument has been hot and heavy at least going back to the Reagan Assassination attempt on March 30, 1981. That was over thirty years ago. The most recent iteration of the argument heated up immediately after the massacre at Sandy Hook Elementary School in Newtown Connecticut on December 14, 2012. In this instance 20 small children were killed as were a number of adults. As has frequently been the case in recent actions the perpetrator was killed.
I have frankly been surprised by the reaction to Sandy Hook. The details of these atrocities vary but we have shrugged off many of them in the past few years. What has stayed the same through many years now are the arguments of the various "sides", particularly the National Rifle Association. After each of these events they trot out the same old nonsense. Before Sandy Hook not much attention was paid to what they said. Nor was much attention paid to the arguments of various people disagreeing with them. The media had been quick to drop coverage after previous incidents because for years now reporters could recite the talking points of the actors almost word for word before they even opened their mouths. What has changed after Sandy Hook is that people are paying attention to what the NRA in particular is saying and reacting with outrage. This is different. I am at a loss to explain this change in behavior but I welcome it.
With that as background I would like to address a key component of the argument. Gun rights advocates argue that their rights are guaranteed by the Second Amendment of the U.S. Constitution. Is that really so? And, if so, to what extent? The Second Amendment is very short. So let me quote it in its entirety:
That's it. That's the whole thing. Now conservatives are big on something called "strict constructionism". The constitution means what it says, they opine. Looking at the words my strict interpretation would be "if you are properly associated with a militia you can have guns". But what do I know? Not much, according to the U.S. Supreme Court. The Court opined on the subject in 2008. They ruled in a case usually abbreviated as "Heller". The actual title of the case is "District of Columbia et al., petitioners, v. Dick Anthony Heller". The docket is 07-290. You can read their opinion at http://www.supremecourt.gov/opinions/07pdf/07-290.pdf. The whole thing is 157 pages long. But the pages are paperback sized and it is written so that normal people can follow the important parts. So that is not as hard as you might think. I read it all the way through several years ago. Note: There was a follow on case which I have not read. But the consensus was that it broke no new ground. It was necessary because Heller was a District of Columbia case where there was no State involved. The second case involved a State (Illinois, I believe) but the second case essentially said the rules were the same. So what does Heller have to tell us about what rights the Second Amendment protects and what rights it doesn't? It turns out it tells us a lot.
The majority opinion was written by Justice Antonin Scalia, a very conservative justice and a well known "gun rights" advocate. The opinion can be broken down into three parts. Part one is a general discussion of what the words of the Second Amendment mean and what should happen in the absence of any gun regulation. Scalia's opinion contains a lot of interesting history and analysis. Justice Souter delivered a dissent to this portion of Scalia's opinion. The second part is the one that would come as the biggest surprise to gun rights advocates. Quoting Scalia directly, "Like most rights, the right secured by the Second Amendment is not unlimited." I will be getting back to the details that follow in a minute. The third and final part discusses whether the specific law passed by the District of Columbia is appropriate (constitutional) or not. Scalia said "not". Justice Breyer filed a dissent to this section.
So let me paraphrase the decision. Part 1 argues that there is a general right of pretty much everyone to keep and bear arms in the absence of sensible regulation. Part 2 argues that there is such a thing as a sensible regulation. Part 3 argues that the DC regulation was not sensible and therefore unconstitutional. So the whole thing boils down to a "pornography" argument. Paraphrasing the pornography version: I can't define sensible gun regulations but I know them when I see them. Generally speaking I was swayed by Scalia's argument in part 1 that in the absence of sensible regulation guns are always legal. There was no dissent to part 2 (there is such a thing as sensible regulation) so that obviously represents the unanimous opinion of the court. I was swayed by Justice Bryer's dissent in part 3. I am convinced that the DC regulation was sensible and, therefore, constitutional. But the majority disagreed.
Since the Heller case came down with the exception of the case I mentioned above there have not been any big gun rights cases argued in front of the Supreme Court. I think the reason is similar to the reason there have been no big pornography cases argued for many years now. In the case of pornography the Court came to see that it all boiled down to personal opinion and decided they were tired of playing that game. So they stopped taking cases. In the gun situation I think the analysis is the same, it's just coming from the other end. Instead of the court turning cases down plaintiffs are not filing them. They are just not comfortable risking that the court will disagree with whatever side of the "reasonable gun law" argument they are on. And this "not comfortable" position applies to both "pro" and "anti" sides.
Now I want to get into some more detail about what Justice Scalia had to say about what he thought was "reasonable". There are some surprises. He is in favor of "prohibitions on carrying concealed weapons". He also says "nothing in our opinion should be taken to cast doubt on longstanding prohibitions on the possession of firearms by felons and the mentally ill, or laws forbidding the carrying of firearms in sensitive places such as schools and government buildings, or laws imposing conditions and qualifications on the commercial sale of arms." He also is OK with the ban on "M-16 rifles and the like".
This last item is particularly interesting. A large portion of his opinion is devoted to militias. The U.S. military adopted the M-16 during the Vietnam War ('60s). They have recently replaced it with the M-4. But the M-4 is an "M-16 and the like" weapon. It is an M-16 with a shorter barrel, a modified stock (the part you put to your shoulder), and a few other minor changes to make it easier to carry around. Militias in the form of state National Guard units are typically equipped with the same weapon the military uses. This means M-16s and now M-4s. Militia members at some times and in some places have been responsible for providing their own weapon. Applied in the modern context this means that they would be required to provide an M-16 or M-4. The obvious argument sounds reasonable to me (if you adopt Scalia's analysis) and would justify the Second Amendment requiring that it be legal for ordinary citizens to purchase M-16s then and M-4s now. But Justice Scalia explicitly rejects that argument by unequivocally stating that is is constitutional to regulate the sale and possession of M-16s (and by extension M-4s) by ordinary civilians.
Justice Scalia also says 'We think that limitation is fairly supported by historical tradition of prohibiting the carrying of "dangerous and unusual weapons"'. What is a "dangerous and unusual weapon"? I have absolutely no idea. I could possibly come up with a definition. But I have no way of knowing whether the Supreme Court would agree with me. If I had to put money down I would bet that the court would come up with a different definition than I would. And I have no idea how the Court's decision would differ from mine. Also, like pornography, what constitutes "dangerous and unusual" is likely to change with time. Something like say a Thompson submachine gun (see any thirties gangster movie if you are not sure what I am talking about) has now been around for something like 80 years. I think most people would have characterized it as "dangerous and unusual" in the '20s and '30s. But would they now?
I am confident that pro-gun types would be shocked to find out what Justice Scalia thinks (or at least thought in 2008) are appropriate gun regulations. And certainly many anti-gun people would be pleasantly surprised to find out how much cover Justice Scalia provides to them. But I think everyone who has studied the actual situation carefully is in the same position I am. They do not know with any kind of confidence what the state of play is on the "gun law" front. Polls on people's positions on various gun regulation ideas have been static for a couple of decades. But they seem to be changing very quickly in our post Sandy Hook world. This adds even more confusion and uncertainty to the situation. It is too soon to predict that any new laws will actually make it through at the Federal level given our political environment. And who knows what the Supreme Court will think of what might come out? All I know for sure is that I don't know.
I have frankly been surprised by the reaction to Sandy Hook. The details of these atrocities vary but we have shrugged off many of them in the past few years. What has stayed the same through many years now are the arguments of the various "sides", particularly the National Rifle Association. After each of these events they trot out the same old nonsense. Before Sandy Hook not much attention was paid to what they said. Nor was much attention paid to the arguments of various people disagreeing with them. The media had been quick to drop coverage after previous incidents because for years now reporters could recite the talking points of the actors almost word for word before they even opened their mouths. What has changed after Sandy Hook is that people are paying attention to what the NRA in particular is saying and reacting with outrage. This is different. I am at a loss to explain this change in behavior but I welcome it.
With that as background I would like to address a key component of the argument. Gun rights advocates argue that their rights are guaranteed by the Second Amendment of the U.S. Constitution. Is that really so? And, if so, to what extent? The Second Amendment is very short. So let me quote it in its entirety:
A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.
That's it. That's the whole thing. Now conservatives are big on something called "strict constructionism". The constitution means what it says, they opine. Looking at the words my strict interpretation would be "if you are properly associated with a militia you can have guns". But what do I know? Not much, according to the U.S. Supreme Court. The Court opined on the subject in 2008. They ruled in a case usually abbreviated as "Heller". The actual title of the case is "District of Columbia et al., petitioners, v. Dick Anthony Heller". The docket is 07-290. You can read their opinion at http://www.supremecourt.gov/opinions/07pdf/07-290.pdf. The whole thing is 157 pages long. But the pages are paperback sized and it is written so that normal people can follow the important parts. So that is not as hard as you might think. I read it all the way through several years ago. Note: There was a follow on case which I have not read. But the consensus was that it broke no new ground. It was necessary because Heller was a District of Columbia case where there was no State involved. The second case involved a State (Illinois, I believe) but the second case essentially said the rules were the same. So what does Heller have to tell us about what rights the Second Amendment protects and what rights it doesn't? It turns out it tells us a lot.
The majority opinion was written by Justice Antonin Scalia, a very conservative justice and a well known "gun rights" advocate. The opinion can be broken down into three parts. Part one is a general discussion of what the words of the Second Amendment mean and what should happen in the absence of any gun regulation. Scalia's opinion contains a lot of interesting history and analysis. Justice Souter delivered a dissent to this portion of Scalia's opinion. The second part is the one that would come as the biggest surprise to gun rights advocates. Quoting Scalia directly, "Like most rights, the right secured by the Second Amendment is not unlimited." I will be getting back to the details that follow in a minute. The third and final part discusses whether the specific law passed by the District of Columbia is appropriate (constitutional) or not. Scalia said "not". Justice Breyer filed a dissent to this section.
So let me paraphrase the decision. Part 1 argues that there is a general right of pretty much everyone to keep and bear arms in the absence of sensible regulation. Part 2 argues that there is such a thing as a sensible regulation. Part 3 argues that the DC regulation was not sensible and therefore unconstitutional. So the whole thing boils down to a "pornography" argument. Paraphrasing the pornography version: I can't define sensible gun regulations but I know them when I see them. Generally speaking I was swayed by Scalia's argument in part 1 that in the absence of sensible regulation guns are always legal. There was no dissent to part 2 (there is such a thing as sensible regulation) so that obviously represents the unanimous opinion of the court. I was swayed by Justice Bryer's dissent in part 3. I am convinced that the DC regulation was sensible and, therefore, constitutional. But the majority disagreed.
Since the Heller case came down with the exception of the case I mentioned above there have not been any big gun rights cases argued in front of the Supreme Court. I think the reason is similar to the reason there have been no big pornography cases argued for many years now. In the case of pornography the Court came to see that it all boiled down to personal opinion and decided they were tired of playing that game. So they stopped taking cases. In the gun situation I think the analysis is the same, it's just coming from the other end. Instead of the court turning cases down plaintiffs are not filing them. They are just not comfortable risking that the court will disagree with whatever side of the "reasonable gun law" argument they are on. And this "not comfortable" position applies to both "pro" and "anti" sides.
Now I want to get into some more detail about what Justice Scalia had to say about what he thought was "reasonable". There are some surprises. He is in favor of "prohibitions on carrying concealed weapons". He also says "nothing in our opinion should be taken to cast doubt on longstanding prohibitions on the possession of firearms by felons and the mentally ill, or laws forbidding the carrying of firearms in sensitive places such as schools and government buildings, or laws imposing conditions and qualifications on the commercial sale of arms." He also is OK with the ban on "M-16 rifles and the like".
This last item is particularly interesting. A large portion of his opinion is devoted to militias. The U.S. military adopted the M-16 during the Vietnam War ('60s). They have recently replaced it with the M-4. But the M-4 is an "M-16 and the like" weapon. It is an M-16 with a shorter barrel, a modified stock (the part you put to your shoulder), and a few other minor changes to make it easier to carry around. Militias in the form of state National Guard units are typically equipped with the same weapon the military uses. This means M-16s and now M-4s. Militia members at some times and in some places have been responsible for providing their own weapon. Applied in the modern context this means that they would be required to provide an M-16 or M-4. The obvious argument sounds reasonable to me (if you adopt Scalia's analysis) and would justify the Second Amendment requiring that it be legal for ordinary citizens to purchase M-16s then and M-4s now. But Justice Scalia explicitly rejects that argument by unequivocally stating that is is constitutional to regulate the sale and possession of M-16s (and by extension M-4s) by ordinary civilians.
Justice Scalia also says 'We think that limitation is fairly supported by historical tradition of prohibiting the carrying of "dangerous and unusual weapons"'. What is a "dangerous and unusual weapon"? I have absolutely no idea. I could possibly come up with a definition. But I have no way of knowing whether the Supreme Court would agree with me. If I had to put money down I would bet that the court would come up with a different definition than I would. And I have no idea how the Court's decision would differ from mine. Also, like pornography, what constitutes "dangerous and unusual" is likely to change with time. Something like say a Thompson submachine gun (see any thirties gangster movie if you are not sure what I am talking about) has now been around for something like 80 years. I think most people would have characterized it as "dangerous and unusual" in the '20s and '30s. But would they now?
I am confident that pro-gun types would be shocked to find out what Justice Scalia thinks (or at least thought in 2008) are appropriate gun regulations. And certainly many anti-gun people would be pleasantly surprised to find out how much cover Justice Scalia provides to them. But I think everyone who has studied the actual situation carefully is in the same position I am. They do not know with any kind of confidence what the state of play is on the "gun law" front. Polls on people's positions on various gun regulation ideas have been static for a couple of decades. But they seem to be changing very quickly in our post Sandy Hook world. This adds even more confusion and uncertainty to the situation. It is too soon to predict that any new laws will actually make it through at the Federal level given our political environment. And who knows what the Supreme Court will think of what might come out? All I know for sure is that I don't know.
Monday, January 7, 2013
A Modest Proposal for Guns
Johnathan Swift wrote a satirical piece in 1729. The piece had a long title, which is usually shortened to "A Modest Proposal". In it he proposed to solve the problem of the Famine that was then affecting Ireland by having Irish peasants eat their children. There is a nice article in Wikipedia, if you are interested in learning more about the original Swift piece. The article includes a link to a "Project Gutenberg" entry (see note 1 in the Wikipedia article), if you want to read the whole thing. It is pretty short. The proposal I outline here is not satirical but it is modest. Hence the title.
In the U.S. we have what are often referred to as "sin taxes". We tax items that some people think of as sinful as a source of revenue. Taxes are unpopular so, since these things are "sinful", it is easier to get a tax on these items passed through the legislature than than it is to get a tax passed on more mundane or useful ones. The taxes have two purposes. They are supposed to modestly depress demand for the taxed items and to raise revenue. There is no question that these taxes are legal. And the two "poster child" products that are subject to sin taxes are alcohol and tobacco. Both are subject to federal taxes.
Alcohol and tobacco are both regulated by the Federal ATF department, the Department of Alcohol, Tobacco, and Firearms. I propose to impose a federal sin tax on the third category of items regulated by the ATF, namely firearms or guns, for short. The tax certainly would not outlaw guns. And, since I propose a modest rate of tax, it would do only a little to discourage them. I propose that an annual tax of $10 be imposed on most guns. If the gun had a serial number it would be taxed at this rate. If the gun was an old "antique or collectible" gun that did not have a serial number then it would be taxed at the rate of $15 per year. It would have to have been made before 1960 (roughly 50 years ago) to qualify for this category.
In the case of other guns that did not fall into this antique and collectible category and lacked a serial number, including guns where the serial number had been defaced or otherwise rendered illegible, an ATF issued serial number would have to be affixed to the weapon. A one time $50 "registration" fee would have to be paid in these situations. And the gun owner would have 6 months to get the serial number affixed, say by a gunsmith. Antique and collectible guns would also be subject to the one time registration fee but would be exempted from the serial number requirement. They could, of course, voluntarily put an ATF serial number on the gun. In this case the gun would be be taxed at the lower rate. Included in this registration process would be a detailed description of the gun. That's why an additional fee would be required.
Paying the tax would involve identifying a "registered owner". In the same way that a Social Security card is "not to be used for identification", this registered owner would "not be used for purposes of identifying the legal owner". It would only identify the person responsible for paying the tax. Every time the registered owner changed, an additional $10 "transfer fee" would be required. This is for transactions involving the transfer of ownership between private parties. In the case of manufacturers, dealers, or importers (hereafter referred to as wholesalers), a $1 transfer fee ("wholesale" fee) would be required. Each time the gun was transferred to a different wholesaler the wholesale fee would be again assessed. The $10 ($15 for a classic or antique gun) "retail" fee would be due when the gun was sold at retail. If a wholesaler bought a gun from a private party the "wholesale" fee would be assessed at the time of the transaction. Subsequently selling the gun to a new private party would necessitate payment of the "retail" fee. The retail fee would cover the tax due that year on the gun, if the gun had not already been taxed in the current year. But the full "retail" fee would be due even if the gun had already been taxed in the current year.
In the case of lost or stolen guns the gun and tax would continue to be the responsibility of the registered owner until a "lost or stolen" report was filed. In the case of guns imported or exported the gun would have to be reported to customs. In the case of importation the appropriate registration and fees would be required at the time of the importation.
The penalties for failure to comply with the law would be civil, not criminal. It would be like getting a parking ticket not a speeding ticket. The point is to raise revenue, not to make people into criminals. There are many details to be worked out including penalties for failing to pay required fees. I leave it to the ATF to work these details out. I simply note that a simple failure to pay the fee would result in an additional larger civil penalty. If the issue goes beyond a simple failure to pay a fee, e.g. if an unregistered or improperly registered gun is used to commit a crime then criminal penalties might be appropriate. I leave it to the ATF, and perhaps subsequent legislation, to address these issues.
All guns should be registered as their ownership may eventually devolve to civilian hands. But the ATF may, at its discretion, exempt the military, law enforcement, etc. from the fees. It may also exempt artillery pieces and other purely military guns at its discretion. But in borderline cases, e.g. heavy machine guns, I would recommend that the ATF err on the side of requiring registration even if they choose to waive the fee requirements. I suspect that many of these items contain a manufacturer provided serial number so modern computer systems make it easy to add these items to the registry.
There are supposedly about 300 million guns in the U.S. If each gun generated $10 per year this would amount to $3 billion per year in additional Federal revenue. Budgetary matters are often calculated over a ten year period. In this case the ten year revenue forecast would be for $30 billion in additional revenue. This would definitely not close the current budget deficit. It would, however, improve the situation in a modest way. Of course, the actual number of guns in circulation may be far less. Or efforts to impose the tax on all guns could be only partially successful. In either case the revenues forecast might be much less than I have forecast. Still, the additional funds should help, if only in a modest way.
In the U.S. we have what are often referred to as "sin taxes". We tax items that some people think of as sinful as a source of revenue. Taxes are unpopular so, since these things are "sinful", it is easier to get a tax on these items passed through the legislature than than it is to get a tax passed on more mundane or useful ones. The taxes have two purposes. They are supposed to modestly depress demand for the taxed items and to raise revenue. There is no question that these taxes are legal. And the two "poster child" products that are subject to sin taxes are alcohol and tobacco. Both are subject to federal taxes.
Alcohol and tobacco are both regulated by the Federal ATF department, the Department of Alcohol, Tobacco, and Firearms. I propose to impose a federal sin tax on the third category of items regulated by the ATF, namely firearms or guns, for short. The tax certainly would not outlaw guns. And, since I propose a modest rate of tax, it would do only a little to discourage them. I propose that an annual tax of $10 be imposed on most guns. If the gun had a serial number it would be taxed at this rate. If the gun was an old "antique or collectible" gun that did not have a serial number then it would be taxed at the rate of $15 per year. It would have to have been made before 1960 (roughly 50 years ago) to qualify for this category.
In the case of other guns that did not fall into this antique and collectible category and lacked a serial number, including guns where the serial number had been defaced or otherwise rendered illegible, an ATF issued serial number would have to be affixed to the weapon. A one time $50 "registration" fee would have to be paid in these situations. And the gun owner would have 6 months to get the serial number affixed, say by a gunsmith. Antique and collectible guns would also be subject to the one time registration fee but would be exempted from the serial number requirement. They could, of course, voluntarily put an ATF serial number on the gun. In this case the gun would be be taxed at the lower rate. Included in this registration process would be a detailed description of the gun. That's why an additional fee would be required.
Paying the tax would involve identifying a "registered owner". In the same way that a Social Security card is "not to be used for identification", this registered owner would "not be used for purposes of identifying the legal owner". It would only identify the person responsible for paying the tax. Every time the registered owner changed, an additional $10 "transfer fee" would be required. This is for transactions involving the transfer of ownership between private parties. In the case of manufacturers, dealers, or importers (hereafter referred to as wholesalers), a $1 transfer fee ("wholesale" fee) would be required. Each time the gun was transferred to a different wholesaler the wholesale fee would be again assessed. The $10 ($15 for a classic or antique gun) "retail" fee would be due when the gun was sold at retail. If a wholesaler bought a gun from a private party the "wholesale" fee would be assessed at the time of the transaction. Subsequently selling the gun to a new private party would necessitate payment of the "retail" fee. The retail fee would cover the tax due that year on the gun, if the gun had not already been taxed in the current year. But the full "retail" fee would be due even if the gun had already been taxed in the current year.
In the case of lost or stolen guns the gun and tax would continue to be the responsibility of the registered owner until a "lost or stolen" report was filed. In the case of guns imported or exported the gun would have to be reported to customs. In the case of importation the appropriate registration and fees would be required at the time of the importation.
The penalties for failure to comply with the law would be civil, not criminal. It would be like getting a parking ticket not a speeding ticket. The point is to raise revenue, not to make people into criminals. There are many details to be worked out including penalties for failing to pay required fees. I leave it to the ATF to work these details out. I simply note that a simple failure to pay the fee would result in an additional larger civil penalty. If the issue goes beyond a simple failure to pay a fee, e.g. if an unregistered or improperly registered gun is used to commit a crime then criminal penalties might be appropriate. I leave it to the ATF, and perhaps subsequent legislation, to address these issues.
All guns should be registered as their ownership may eventually devolve to civilian hands. But the ATF may, at its discretion, exempt the military, law enforcement, etc. from the fees. It may also exempt artillery pieces and other purely military guns at its discretion. But in borderline cases, e.g. heavy machine guns, I would recommend that the ATF err on the side of requiring registration even if they choose to waive the fee requirements. I suspect that many of these items contain a manufacturer provided serial number so modern computer systems make it easy to add these items to the registry.
There are supposedly about 300 million guns in the U.S. If each gun generated $10 per year this would amount to $3 billion per year in additional Federal revenue. Budgetary matters are often calculated over a ten year period. In this case the ten year revenue forecast would be for $30 billion in additional revenue. This would definitely not close the current budget deficit. It would, however, improve the situation in a modest way. Of course, the actual number of guns in circulation may be far less. Or efforts to impose the tax on all guns could be only partially successful. In either case the revenues forecast might be much less than I have forecast. Still, the additional funds should help, if only in a modest way.
Saturday, December 22, 2012
Political Catastrophe Theory
Catastrophe Theory is the cute name for a branch of mathematics developed about 50 years ago. It's not just about catastrophes but the name was too precious not to stick. I think that the insights that come from this branch of mathematics might shed some light on the evolving current political scene. But, as is my wont, it's time for a digression. In order to shed light on catastrophe theory let me first talk about linear analysis.
What does it mean to say in the mathematical sense that something is linear. A classic example is the famous equation in physics that comes from Sir Isaac Newton: F = ma. In words, this is "Force equals mass times acceleration". In this case the equal sign is literally true. Take the mass of an object and multiply it by its acceleration and you get exactly the amount of force applied. For those of you whose physics is weak let me take this a step at a time. If you are in a car and you mash on the gas pedal the car speeds up. This change in speed is called acceleration. Mass is the same as weight in every day situations. It's that number that is displayed on your bathroom scale. There is a technical difference between weight and mass but I am going to skip over that. That leaves force. Force is how hard you push on something. So when you mash on the gas pedal the engine revs up and pushes harder on the wheels. The car speeds up. If it is a big engine (lots of force) and a light car (not so much mass) then the car speeds up (accelerates) a lot.
What "F=ma" tells us is that there is a "linear" relationship between force and acceleration. If you push twice as hard you will get exactly twice as much acceleration. And the relationship works backwards. If you want the car to accelerate half as fast then apply exactly half as much force. "F=-ma" is a simple equation. The whole thing has only 4 letters in it. So linear relationships are about as simple as you can get in physics. Now, a lot of things are not linear. But mathematicians and physicists have come up with a lot of tricks to handle various situations.
Maybe in some situations you have to apply a little more than twice the force to get twice the acceleration, for instance. The Einstein "relativity" version of "F=ma" requires just these kinds of adjustments. I'm not going to get into them because I want to keep things simple. But even though a lot of situations in physics may not be strictly linear the basic insight often holds. If you want more of one thing provide more of something else. If you want less of something then provide less of something else. These situations are technically called "monotonic relationships". And monotonic relationships are common and intuitive. They seem like how a lot of the world works.
We can see this playing out all the time in politics. The relationship may not be strictly linear but we naturally assume that more gets more and less gets less. Generally, for an issue it is common to assume that there are a verity of positions held. These positions can be laid out on a scale going from "more of this" to "more of that". Commonly we will have a scale going from more conservative to more liberal. And it also seems like we can place say Senators on this scale. So we place everyone in their proper place on the scale. To get something done we need to pass a bill. The idea is to structure a bill so that has the right mix of liberal and conservative components. What we want to do is to get a majority of the Senate to be in favor of the bill. So we put the mix of components that will garner the support of a majority. Let's say we start with a very conservative version of the bill. We will start with only a few Senators supporting it, those whose position is as conservative as or more conservative than the bill in its current form. Then to get more support we add liberal components. As the bill slides down the scale toward the liberal side it will pick up more and more supporters. If we do this correctly then we will end up with a majority supporting the bill and we can pass it out of the Senate. The same approach can be used where we start with a very liberal bill and keep modifying it to add more and more conservative supporters.
This process is not strictly linear. Making the bill 1% more liberal is not going to always get you exactly one more Senator. And the scale might not be a liberal - conservative one. And we can talk about the House instead of the Senate or an election or many other political processes. But this whole "add sweeteners till you get a majority" process is how things are supposed to work in politics. Here a "sweetener" is a component that will get you one or more additional votes, hopefully without losing any current supporters.
We can see this all the time. The stimulus package that President Obama proposed shortly after he first got into the White House is a typical example. The bill had "infrastructure" spending to appeal to Democrats. It had tax cuts to appeal to Republicans. It was designed to be a classic "something for everyone" bill. Health Care Reform was the same kind of thing. It had components designed to appeal to Democrats (expanded coverage) and components designed to appeal to Republicans (individual mandate - originally a Republican idea). It also had components designed to make various pressure groups happy: the pharmaceutical industry, doctors, hospitals, insurance companies, others. The whole idea was if you are a few votes short, add the right sweeteners and you can pick up those votes and pass the bill. This is linear thinking applied to politics. Push a little harder here and you will get a little more of there.
The same thing applies to elections. Voters are presumed to lie along a scale, usually assumed to be the liberal - conservative scale. If you don't have a majority then move a little right (or left) and pick up a few more votes. The key to success is supposed to be putting yourself close to the center. Depending on the specifics of the electorate you may actually want to be center-left or center-right. If it looks like you are a little behind in the race then you just need to adjust your positions to move you a little to the left or to the right. This will pick up enough centrist votes to put you over the top.
That's the model most people use to analyze politics. The idea is that a small change that moves you in the correct direction on the appropriate scale will turn defeat into victory. This is definitely how the media analyzes and covers politics. They pick the scale. They lay out voters or politicians (or whatever) on the scale. They then decide who is winning. They then determine which direction the loosing side needs to move in. They pick actions they think will move the losers in that direction then watch to see if they do it. Since the media does not exist to pursue truth but instead to pursue eyeballs (readers, listeners, viewers) that can be delivered up to advertisers the media does not worry about whether this "analysis" is correct. They only worry whether it attracts eyeballs. For the media, winning is not serving up accurate information. It consists of winning the admiration of advertisers. And admiration is measured in terms of ad revenue. The shorthand for this behavior by the media is "covering the horse race".
So lets get back to catastrophe theory. The key idea behind linear analysis is that small changes result in small changes. But there is something more. If a relationship is linear (or can be massaged to behave like a linear relationship with the proper mathematics) then you can always get back to where you started with. In our "F=ma" example, suppose we decide that we have too much "a". Then we can dial back the "F" by the right amount and "a" will settle back to where we want it. It may be complicated to figure out the right amount to dial back the "F" by but the proper mathematics will allow us to calculate the correct value. But can we always get back to where we were? Catastrophe theory says no!
Put a Popsicle stick on the edge of a table so that about half of it is sticking over the edge. Now push down on the end of the stick that is sticking over the edge. That's the "F". Now observe what happens to the end of the stick. It bends down. That's the equivalent of the "a" in our example even though it is not really acceleration. If we push down a little the stick bends a little. If we push down harder it bends down more. And it we stop pushing it returns to sticking straight out. In other words, it is a classic linear system. A little push results in a little bend. More push results in more bend. If we stop pushing it goes back to where it started. The actual amount of bend you get for a specific amount of push may be mathematically very complicated. But the general idea is simple. And the way most people think of politics involves the exact same ideas as our Popsicle stick analysis.
But now lets push really hard on the end of the stick. What happens? The stick breaks. Now if we stop pushing the stick does not go back to being straight. It stays bent because the stick is broken. This is the key idea behind catastrophe theory. The actual analysis can be quite complex. But catastrophe theory says that there are systems that change behavior radically if a threshold is exceeded. The best way to explain what mathematicians are talking about is to talk about catastrophes and that's where the name comes from. In our simple case the catastrophe is the stick breaking. But consider Superstorm Sandy. After you have washed away a bunch of buildings things do not go back to the way they were after the wind and the waves die down.
All this media analysis and a lot of the thinking done by many political experts is well modeled by linear analysis. For instance, the assumption is that the U.S. electorate lays out nicely along a liberal-conservative scale. Democrats are successful when a little over half of the electorate is feeling liberal. Conservatives do well when a little more than half of the electorate is feeling conservative. The expectation is that opinions will change slowly and in a liner manner over time. The electorate will slowly become more liberal or more conservative. This will result in a slow change from Democratic success to Republican success as this slow incremental change takes place. But what does the historical record say?
For decades the electorate was conservative and Republicans were successful. Then the Great Depression took place and all of a sudden (the 1932 election) Democrats became successful. This continued with some exceptions until the 1980 election. Reagan swept in and for the most part Republicans have been successful since. This behavior fits a catastrophe model better than a linear model. As late as 1928 the Republicans were doing very well. But in 1932 Democrats got in and for the most part stayed in until 1980. Then the Reagan Revolution happened. The Democrats were kicked out and the Republicans swept in and they have pretty much stayed there since. In other words some "catastrophic event" happened and the electorate switched pretty much immediately from one kind of behavior (say favoring the Democratic party) to another kind of behavior (favoring the Republican party).
We did not see a series of elections where one party does less well by a fairly small amount in each subsequent election until they lose control. This is followed by a number of elections where the new winning party improves their margin by a small amount until they peak and a swing back starts. Instead we see a series of elections where generally speaking one party prevails. Then a catastrophic event (politically speaking) happens and all of a sudden the other party starts generally prevailing. So I contend that I have proven that catastrophe theory is a better model for how politics works that linear analysis. Assuming I am right, who cares?
Well, I think we are now in the middle of one of those catastrophic events. It will take a few years to see if I am right. But trends are always obvious after the fact. What is interesting is figuring out what's going on before the trend becomes obvious to everyone. So what do I see and why does it make a difference?
The way elections work, in my opinion, is that they are about two competing narratives. Each side constructs a narrative. If you buy into the narrative you buy into the candidate. And that candidate and his party (assuming the narrative is part of a broader narrative) wins. If you look at either narrative it seems compelling. But only one narrative works because only one candidate can win. So generally voters come to have more faith that one narrative is more correct than the other one. At its simplest, voters believe one candidate more than another.
Now many attributes of these narratives can be analyzed to see if they are correct. It would be nice if the media and others did this. But they don't. They have decided that "horse race" is much more fun and easier to do. So voters are pretty much on their own for figuring out who is more right. And the Republicans have an awesome messaging machine. Dave Frum, a long time conservative activist, recently called it the "Conservative Entertainment Complex". For more on this see my recent post http://sigma5.blogspot.com/2012/12/how-obama-won.html. But my point in this post is that the Republican messaging machine has been very successful for a long time in convincing voters that the Republican narrative is more true than the Democratic narrative. As a result, Republicans have won a lot of elections between 1980 and now.
The messaging machine is still there. But if voters decide it is not credible then Democrats are more likely to win the narrative wars and, therefore, elections. As I pointed out in the "How Obama Won" post, Republicans have been pushing a number of unpopular positions. People who should vote Democratic (old white people on Social Security and Medicare) voted heavily Republican in the last election. But Obama in particular and Democrats in general won anyhow. If voters decide that Republicans are dishonest or are not working on their behalf then they will switch allegiance and, according to catastrophe theory, do it quickly and stay switched for a long time. Recently we have seen a number of reliable Republican narratives being rejected.
Historically, Republicans have been seen as being better at things military. But the Obama position of getting out of Iraq and Afghanistan are now very popular. In fact, most people would like to move faster than Obama wants to. The public has generally sided with Republicans on abortion/birth control. This actually makes sense. Old white people are past their child bearing years. So being against abortion/birth control carries no personal cost. People that are more directly affected, younger women, oppose Republican positions by large majorities. Another long time Republican narrative that has been successful is that Republicans are fiscally conservative and Democrats are spendthrifts. I wrote a blog post on this subject over two years ago that argued that this was exactly backward. Here's a link: http://sigma5.blogspot.com/2010/10/there-are-no-fiscally-conservative.html. Until recently the media and the majority of voters, however, have disagreed with me and agreed with Republicans. But voters now generally believe that Obama is better on the economy than Mitt Romney. And polls indicate that the public is siding with Obama on the Fiscal Cliff negotiations. I have argued in http://sigma5.blogspot.com/2012/11/off-cliff.html that it would be not that bad to go off the cliff. As of today (December 22, 2012) it looks like I may get my wish. Anyhow, the point is that sentiment seems to have shifted away from Republicans on the issue of "who is a better steward of the economy".
Finally, there is Gun Control. I have been around the block a lot on Gun Control. I am for it. But I have been losing badly on this issue for a long time. In his first term President Clinton pushed through a couple of what I would consider to be pretty wimpy anti-gun laws. One of them banned assault weapons and some other things. But before it passed the NRA and its allies applied the Swiss Cheese strategy. They got a lot of specific language inserted that built many loop holes into the law. So a simple effective and easy to enforce law was turned into a complicated and hard to enforce law that was much less effective. The other law was a background check law. Again the NRA was able to Swiss Cheese it. The major loop hole is the "gun show exception". This and other exceptions means that 40% of all legal gun sales (and all illegal gun sales) do not involve a background check. We have had a number of massacres that involved people with mental problems. NRA Swiss Cheese provisions have made it difficult to prevent people with mental problems from getting guns. Another loop home is the one that allows people on the terrorist watch list to legally buy guns. I think you can now see why I think both of these laws are wimpy. And, by the way, the assault weapon law had a 10 year "sunset" provision. When it came up in Bush's first term it was not renewed.
So a couple of wimpy anti-gun laws were passed in front of the 1994 elections. And several people who voted for these laws lost their re-election bids. It was generally agreed that being anti-gun was the key factor in a number of these losses. Now the case could be made that elections are complex. So it is unfair to blame the NRA for these losses, the argument goes. But let's look at the record since. There are no cases in the roughly two decades since then where it is generally agreed that a candidate lost because he was too pro-gun. A lot of wildly pro-gun people have run and won. This is the track record that generates the fear politicians have of the political power of the NRA. Interestingly, in the recent election Obama had a better pro-gun record than Romney. But the NRA endorsed Romney and trashed Obama anyhow. So politicians have had good reason to run away from anti-gun legislation.
Then we had the Newtown massacre in which 20 young children were killed. I don't know why all the other massacres had no effect but this one seems to be having a large one. All of a sudden the public seems to have changed its mind. And it seems to have specifically changed its mind on the NRA. The NRA has had something to say after all of the massacres we have had in the last few years. Their statements follow a pattern. The NRA feels bad for the victims. They opine that there are lots of reasons for these massacres (I'm not going to list them all) but none of those reasons involves the ready availability of guns or the lack of regulation of guns or gun owners. This nonsense has worked just fine every time they have done it before. But it seems to be not working this time. There is shock and outrage over the NRA statement all over the place this time. Let me be very clear here. The NRA nonsense this time is exactly the same nonsense as it was every other time. What is different this time around is that the general consensus this time is that it is nonsense. In other words the messaging is not working this time.
That's my case for why we are going through a catastrophic event. And here I am talking about an event that is catastrophic in the mathematical sense and that is a political event. If I am right then this event will drastically rearrange the political landscape. As I said above, a lot of political conflicts are a war of narratives. Generally speaking the Republican narrative has prevailed over the Democratic narrative. This has resulted in the Republican narrative being taken as the foundation and only legitimate way of selecting issues that warrant coverage and the Republican narrative has framed how issues are presented.
A simple example of this is the current budget negotiations. The problem is a big deficit (Republican narrative) rather than a weak economy that needs stimulus (Democratic narrative). I could easily cite a half dozen situations where various problems are framed from a Republican perspective. The Democratic perspective is ignored to a great extent. And, if Republicans don't want to talk about an issue (e.g. the total dysfunction of the Republican caucus in the House, or the cost to the economy of Republican Senate filibusters), the issue becomes invisible. We have seen a massive change in the narrative surrounding the NRA. The beltway media has been slow to move off the Republican perspective on budget negotiation talks. Boehner pulling the "plan B" alternative to negotiating with Obama on the Fiscal Cliff may result in additional change. We'll see. If I am right then the narrative will change. And it will change on a broad range of issues, not just a few.
Given that Republican positions on many positions are wildly unpopular, electoral success could change dramatically too. The messaging machine has been successfully providing cover for Republicans on these issues. If people start distrusting Republican messaging and the media starts properly covering actual Republican positions and actions on these issues, Republicans could become deeply unpopular very quickly. And they are likely to stay unpopular because there are powerful forces that have driven them to take these unpopular positions. Those forces are unlikely to back off. For instance, raising taxes on the wealthy is broadly popular. But House Republicans could not even agree to raise taxes on millionaires (the key provision in plan B). The millionaires that are critical to Republican fund raising efforts are unlikely to change their position on this. The religious conservatives that are behind the Republican hostility to abortion and birth control are unlikely to change their mind. The gun lobby that favors an open market on all things gun is unlikely to change its position. The list goes on and on. And, if the Republicans lose any of these constituencies, they are in trouble. They need the money to fund the message machine. They need the activists in the other camps to do the grunt work in campaigns. So they are pretty much stuck with these peositions for now.
The reaction that most people expect, and here I agree with the consensus, is centered on the likely Republican reaction to electoral losses. The two most recent Republican presidential candidates (McCain and Romney) have been viewed as centrists from within the Republican tent. Many Republicans have concluded that the reason for their failure is that they weren't conservative enough. If this is true then the obvious correction is to put up a true conservative next time. Now people outside the Republican party think that both candidates ran campaigns that were too conservative and not moderate enough. But it is now possible to live within the conservative bubble all the time. So opinions from outside the party and even from outside the hard core conservative movement are unimportant. If the Republicans run candidates that are even more conservative than the current batch then these candidates should lose and by wide margins.
But that's for the future. In the short run watch for the general response to Republican actions. The response to the Newtown massacre and the NRA statement are new territory. So far, the media is continuing to provide at least some cover to the Republican "plan B" fiasco. The more important response is the one of the general public. If the opinion that going over the Fiscal Cliff is a bad thing and is the fault of the Republicans hardens then the media will eventually come around. This will weaken the Republican message machine that is so critical to Republicans. This in turn will further erode support for Republicans. This will first show up in negotiations after the first of the year about how to clean up the Fiscal Cliff mess after the fact. Then we are looking at debt ceiling negotiations in a couple of months. If the response by the public to any Republican hanky panky (anything but a clean bill to raise the ceiling) is immediate and harshly negative then we will know that the contours of the political landscape have changed in a Superstorm Sandy manner. I live in hope.
What does it mean to say in the mathematical sense that something is linear. A classic example is the famous equation in physics that comes from Sir Isaac Newton: F = ma. In words, this is "Force equals mass times acceleration". In this case the equal sign is literally true. Take the mass of an object and multiply it by its acceleration and you get exactly the amount of force applied. For those of you whose physics is weak let me take this a step at a time. If you are in a car and you mash on the gas pedal the car speeds up. This change in speed is called acceleration. Mass is the same as weight in every day situations. It's that number that is displayed on your bathroom scale. There is a technical difference between weight and mass but I am going to skip over that. That leaves force. Force is how hard you push on something. So when you mash on the gas pedal the engine revs up and pushes harder on the wheels. The car speeds up. If it is a big engine (lots of force) and a light car (not so much mass) then the car speeds up (accelerates) a lot.
What "F=ma" tells us is that there is a "linear" relationship between force and acceleration. If you push twice as hard you will get exactly twice as much acceleration. And the relationship works backwards. If you want the car to accelerate half as fast then apply exactly half as much force. "F=-ma" is a simple equation. The whole thing has only 4 letters in it. So linear relationships are about as simple as you can get in physics. Now, a lot of things are not linear. But mathematicians and physicists have come up with a lot of tricks to handle various situations.
Maybe in some situations you have to apply a little more than twice the force to get twice the acceleration, for instance. The Einstein "relativity" version of "F=ma" requires just these kinds of adjustments. I'm not going to get into them because I want to keep things simple. But even though a lot of situations in physics may not be strictly linear the basic insight often holds. If you want more of one thing provide more of something else. If you want less of something then provide less of something else. These situations are technically called "monotonic relationships". And monotonic relationships are common and intuitive. They seem like how a lot of the world works.
We can see this playing out all the time in politics. The relationship may not be strictly linear but we naturally assume that more gets more and less gets less. Generally, for an issue it is common to assume that there are a verity of positions held. These positions can be laid out on a scale going from "more of this" to "more of that". Commonly we will have a scale going from more conservative to more liberal. And it also seems like we can place say Senators on this scale. So we place everyone in their proper place on the scale. To get something done we need to pass a bill. The idea is to structure a bill so that has the right mix of liberal and conservative components. What we want to do is to get a majority of the Senate to be in favor of the bill. So we put the mix of components that will garner the support of a majority. Let's say we start with a very conservative version of the bill. We will start with only a few Senators supporting it, those whose position is as conservative as or more conservative than the bill in its current form. Then to get more support we add liberal components. As the bill slides down the scale toward the liberal side it will pick up more and more supporters. If we do this correctly then we will end up with a majority supporting the bill and we can pass it out of the Senate. The same approach can be used where we start with a very liberal bill and keep modifying it to add more and more conservative supporters.
This process is not strictly linear. Making the bill 1% more liberal is not going to always get you exactly one more Senator. And the scale might not be a liberal - conservative one. And we can talk about the House instead of the Senate or an election or many other political processes. But this whole "add sweeteners till you get a majority" process is how things are supposed to work in politics. Here a "sweetener" is a component that will get you one or more additional votes, hopefully without losing any current supporters.
We can see this all the time. The stimulus package that President Obama proposed shortly after he first got into the White House is a typical example. The bill had "infrastructure" spending to appeal to Democrats. It had tax cuts to appeal to Republicans. It was designed to be a classic "something for everyone" bill. Health Care Reform was the same kind of thing. It had components designed to appeal to Democrats (expanded coverage) and components designed to appeal to Republicans (individual mandate - originally a Republican idea). It also had components designed to make various pressure groups happy: the pharmaceutical industry, doctors, hospitals, insurance companies, others. The whole idea was if you are a few votes short, add the right sweeteners and you can pick up those votes and pass the bill. This is linear thinking applied to politics. Push a little harder here and you will get a little more of there.
The same thing applies to elections. Voters are presumed to lie along a scale, usually assumed to be the liberal - conservative scale. If you don't have a majority then move a little right (or left) and pick up a few more votes. The key to success is supposed to be putting yourself close to the center. Depending on the specifics of the electorate you may actually want to be center-left or center-right. If it looks like you are a little behind in the race then you just need to adjust your positions to move you a little to the left or to the right. This will pick up enough centrist votes to put you over the top.
That's the model most people use to analyze politics. The idea is that a small change that moves you in the correct direction on the appropriate scale will turn defeat into victory. This is definitely how the media analyzes and covers politics. They pick the scale. They lay out voters or politicians (or whatever) on the scale. They then decide who is winning. They then determine which direction the loosing side needs to move in. They pick actions they think will move the losers in that direction then watch to see if they do it. Since the media does not exist to pursue truth but instead to pursue eyeballs (readers, listeners, viewers) that can be delivered up to advertisers the media does not worry about whether this "analysis" is correct. They only worry whether it attracts eyeballs. For the media, winning is not serving up accurate information. It consists of winning the admiration of advertisers. And admiration is measured in terms of ad revenue. The shorthand for this behavior by the media is "covering the horse race".
So lets get back to catastrophe theory. The key idea behind linear analysis is that small changes result in small changes. But there is something more. If a relationship is linear (or can be massaged to behave like a linear relationship with the proper mathematics) then you can always get back to where you started with. In our "F=ma" example, suppose we decide that we have too much "a". Then we can dial back the "F" by the right amount and "a" will settle back to where we want it. It may be complicated to figure out the right amount to dial back the "F" by but the proper mathematics will allow us to calculate the correct value. But can we always get back to where we were? Catastrophe theory says no!
Put a Popsicle stick on the edge of a table so that about half of it is sticking over the edge. Now push down on the end of the stick that is sticking over the edge. That's the "F". Now observe what happens to the end of the stick. It bends down. That's the equivalent of the "a" in our example even though it is not really acceleration. If we push down a little the stick bends a little. If we push down harder it bends down more. And it we stop pushing it returns to sticking straight out. In other words, it is a classic linear system. A little push results in a little bend. More push results in more bend. If we stop pushing it goes back to where it started. The actual amount of bend you get for a specific amount of push may be mathematically very complicated. But the general idea is simple. And the way most people think of politics involves the exact same ideas as our Popsicle stick analysis.
But now lets push really hard on the end of the stick. What happens? The stick breaks. Now if we stop pushing the stick does not go back to being straight. It stays bent because the stick is broken. This is the key idea behind catastrophe theory. The actual analysis can be quite complex. But catastrophe theory says that there are systems that change behavior radically if a threshold is exceeded. The best way to explain what mathematicians are talking about is to talk about catastrophes and that's where the name comes from. In our simple case the catastrophe is the stick breaking. But consider Superstorm Sandy. After you have washed away a bunch of buildings things do not go back to the way they were after the wind and the waves die down.
All this media analysis and a lot of the thinking done by many political experts is well modeled by linear analysis. For instance, the assumption is that the U.S. electorate lays out nicely along a liberal-conservative scale. Democrats are successful when a little over half of the electorate is feeling liberal. Conservatives do well when a little more than half of the electorate is feeling conservative. The expectation is that opinions will change slowly and in a liner manner over time. The electorate will slowly become more liberal or more conservative. This will result in a slow change from Democratic success to Republican success as this slow incremental change takes place. But what does the historical record say?
For decades the electorate was conservative and Republicans were successful. Then the Great Depression took place and all of a sudden (the 1932 election) Democrats became successful. This continued with some exceptions until the 1980 election. Reagan swept in and for the most part Republicans have been successful since. This behavior fits a catastrophe model better than a linear model. As late as 1928 the Republicans were doing very well. But in 1932 Democrats got in and for the most part stayed in until 1980. Then the Reagan Revolution happened. The Democrats were kicked out and the Republicans swept in and they have pretty much stayed there since. In other words some "catastrophic event" happened and the electorate switched pretty much immediately from one kind of behavior (say favoring the Democratic party) to another kind of behavior (favoring the Republican party).
We did not see a series of elections where one party does less well by a fairly small amount in each subsequent election until they lose control. This is followed by a number of elections where the new winning party improves their margin by a small amount until they peak and a swing back starts. Instead we see a series of elections where generally speaking one party prevails. Then a catastrophic event (politically speaking) happens and all of a sudden the other party starts generally prevailing. So I contend that I have proven that catastrophe theory is a better model for how politics works that linear analysis. Assuming I am right, who cares?
Well, I think we are now in the middle of one of those catastrophic events. It will take a few years to see if I am right. But trends are always obvious after the fact. What is interesting is figuring out what's going on before the trend becomes obvious to everyone. So what do I see and why does it make a difference?
The way elections work, in my opinion, is that they are about two competing narratives. Each side constructs a narrative. If you buy into the narrative you buy into the candidate. And that candidate and his party (assuming the narrative is part of a broader narrative) wins. If you look at either narrative it seems compelling. But only one narrative works because only one candidate can win. So generally voters come to have more faith that one narrative is more correct than the other one. At its simplest, voters believe one candidate more than another.
Now many attributes of these narratives can be analyzed to see if they are correct. It would be nice if the media and others did this. But they don't. They have decided that "horse race" is much more fun and easier to do. So voters are pretty much on their own for figuring out who is more right. And the Republicans have an awesome messaging machine. Dave Frum, a long time conservative activist, recently called it the "Conservative Entertainment Complex". For more on this see my recent post http://sigma5.blogspot.com/2012/12/how-obama-won.html. But my point in this post is that the Republican messaging machine has been very successful for a long time in convincing voters that the Republican narrative is more true than the Democratic narrative. As a result, Republicans have won a lot of elections between 1980 and now.
The messaging machine is still there. But if voters decide it is not credible then Democrats are more likely to win the narrative wars and, therefore, elections. As I pointed out in the "How Obama Won" post, Republicans have been pushing a number of unpopular positions. People who should vote Democratic (old white people on Social Security and Medicare) voted heavily Republican in the last election. But Obama in particular and Democrats in general won anyhow. If voters decide that Republicans are dishonest or are not working on their behalf then they will switch allegiance and, according to catastrophe theory, do it quickly and stay switched for a long time. Recently we have seen a number of reliable Republican narratives being rejected.
Historically, Republicans have been seen as being better at things military. But the Obama position of getting out of Iraq and Afghanistan are now very popular. In fact, most people would like to move faster than Obama wants to. The public has generally sided with Republicans on abortion/birth control. This actually makes sense. Old white people are past their child bearing years. So being against abortion/birth control carries no personal cost. People that are more directly affected, younger women, oppose Republican positions by large majorities. Another long time Republican narrative that has been successful is that Republicans are fiscally conservative and Democrats are spendthrifts. I wrote a blog post on this subject over two years ago that argued that this was exactly backward. Here's a link: http://sigma5.blogspot.com/2010/10/there-are-no-fiscally-conservative.html. Until recently the media and the majority of voters, however, have disagreed with me and agreed with Republicans. But voters now generally believe that Obama is better on the economy than Mitt Romney. And polls indicate that the public is siding with Obama on the Fiscal Cliff negotiations. I have argued in http://sigma5.blogspot.com/2012/11/off-cliff.html that it would be not that bad to go off the cliff. As of today (December 22, 2012) it looks like I may get my wish. Anyhow, the point is that sentiment seems to have shifted away from Republicans on the issue of "who is a better steward of the economy".
Finally, there is Gun Control. I have been around the block a lot on Gun Control. I am for it. But I have been losing badly on this issue for a long time. In his first term President Clinton pushed through a couple of what I would consider to be pretty wimpy anti-gun laws. One of them banned assault weapons and some other things. But before it passed the NRA and its allies applied the Swiss Cheese strategy. They got a lot of specific language inserted that built many loop holes into the law. So a simple effective and easy to enforce law was turned into a complicated and hard to enforce law that was much less effective. The other law was a background check law. Again the NRA was able to Swiss Cheese it. The major loop hole is the "gun show exception". This and other exceptions means that 40% of all legal gun sales (and all illegal gun sales) do not involve a background check. We have had a number of massacres that involved people with mental problems. NRA Swiss Cheese provisions have made it difficult to prevent people with mental problems from getting guns. Another loop home is the one that allows people on the terrorist watch list to legally buy guns. I think you can now see why I think both of these laws are wimpy. And, by the way, the assault weapon law had a 10 year "sunset" provision. When it came up in Bush's first term it was not renewed.
So a couple of wimpy anti-gun laws were passed in front of the 1994 elections. And several people who voted for these laws lost their re-election bids. It was generally agreed that being anti-gun was the key factor in a number of these losses. Now the case could be made that elections are complex. So it is unfair to blame the NRA for these losses, the argument goes. But let's look at the record since. There are no cases in the roughly two decades since then where it is generally agreed that a candidate lost because he was too pro-gun. A lot of wildly pro-gun people have run and won. This is the track record that generates the fear politicians have of the political power of the NRA. Interestingly, in the recent election Obama had a better pro-gun record than Romney. But the NRA endorsed Romney and trashed Obama anyhow. So politicians have had good reason to run away from anti-gun legislation.
Then we had the Newtown massacre in which 20 young children were killed. I don't know why all the other massacres had no effect but this one seems to be having a large one. All of a sudden the public seems to have changed its mind. And it seems to have specifically changed its mind on the NRA. The NRA has had something to say after all of the massacres we have had in the last few years. Their statements follow a pattern. The NRA feels bad for the victims. They opine that there are lots of reasons for these massacres (I'm not going to list them all) but none of those reasons involves the ready availability of guns or the lack of regulation of guns or gun owners. This nonsense has worked just fine every time they have done it before. But it seems to be not working this time. There is shock and outrage over the NRA statement all over the place this time. Let me be very clear here. The NRA nonsense this time is exactly the same nonsense as it was every other time. What is different this time around is that the general consensus this time is that it is nonsense. In other words the messaging is not working this time.
That's my case for why we are going through a catastrophic event. And here I am talking about an event that is catastrophic in the mathematical sense and that is a political event. If I am right then this event will drastically rearrange the political landscape. As I said above, a lot of political conflicts are a war of narratives. Generally speaking the Republican narrative has prevailed over the Democratic narrative. This has resulted in the Republican narrative being taken as the foundation and only legitimate way of selecting issues that warrant coverage and the Republican narrative has framed how issues are presented.
A simple example of this is the current budget negotiations. The problem is a big deficit (Republican narrative) rather than a weak economy that needs stimulus (Democratic narrative). I could easily cite a half dozen situations where various problems are framed from a Republican perspective. The Democratic perspective is ignored to a great extent. And, if Republicans don't want to talk about an issue (e.g. the total dysfunction of the Republican caucus in the House, or the cost to the economy of Republican Senate filibusters), the issue becomes invisible. We have seen a massive change in the narrative surrounding the NRA. The beltway media has been slow to move off the Republican perspective on budget negotiation talks. Boehner pulling the "plan B" alternative to negotiating with Obama on the Fiscal Cliff may result in additional change. We'll see. If I am right then the narrative will change. And it will change on a broad range of issues, not just a few.
Given that Republican positions on many positions are wildly unpopular, electoral success could change dramatically too. The messaging machine has been successfully providing cover for Republicans on these issues. If people start distrusting Republican messaging and the media starts properly covering actual Republican positions and actions on these issues, Republicans could become deeply unpopular very quickly. And they are likely to stay unpopular because there are powerful forces that have driven them to take these unpopular positions. Those forces are unlikely to back off. For instance, raising taxes on the wealthy is broadly popular. But House Republicans could not even agree to raise taxes on millionaires (the key provision in plan B). The millionaires that are critical to Republican fund raising efforts are unlikely to change their position on this. The religious conservatives that are behind the Republican hostility to abortion and birth control are unlikely to change their mind. The gun lobby that favors an open market on all things gun is unlikely to change its position. The list goes on and on. And, if the Republicans lose any of these constituencies, they are in trouble. They need the money to fund the message machine. They need the activists in the other camps to do the grunt work in campaigns. So they are pretty much stuck with these peositions for now.
The reaction that most people expect, and here I agree with the consensus, is centered on the likely Republican reaction to electoral losses. The two most recent Republican presidential candidates (McCain and Romney) have been viewed as centrists from within the Republican tent. Many Republicans have concluded that the reason for their failure is that they weren't conservative enough. If this is true then the obvious correction is to put up a true conservative next time. Now people outside the Republican party think that both candidates ran campaigns that were too conservative and not moderate enough. But it is now possible to live within the conservative bubble all the time. So opinions from outside the party and even from outside the hard core conservative movement are unimportant. If the Republicans run candidates that are even more conservative than the current batch then these candidates should lose and by wide margins.
But that's for the future. In the short run watch for the general response to Republican actions. The response to the Newtown massacre and the NRA statement are new territory. So far, the media is continuing to provide at least some cover to the Republican "plan B" fiasco. The more important response is the one of the general public. If the opinion that going over the Fiscal Cliff is a bad thing and is the fault of the Republicans hardens then the media will eventually come around. This will weaken the Republican message machine that is so critical to Republicans. This in turn will further erode support for Republicans. This will first show up in negotiations after the first of the year about how to clean up the Fiscal Cliff mess after the fact. Then we are looking at debt ceiling negotiations in a couple of months. If the response by the public to any Republican hanky panky (anything but a clean bill to raise the ceiling) is immediate and harshly negative then we will know that the contours of the political landscape have changed in a Superstorm Sandy manner. I live in hope.
Subscribe to:
Posts (Atom)