Friday, March 26, 2010

Healthcare Hyperventilating

Growing up, my parents and teachers stressed the importance of personal responsibility. Over and over I heard the mantra that my life would be what I would make of it – positive or negative outcomes depended upon my decisions, my preparation, my effort. The outcome was under my control.

Presumably, this holds true for everyone.

But as I've lived, I've seen individual outcomes that don't appear to flow from individual decisions. I've seen enormous effort go unrewarded, meticulous preparation end in naught. A vegetarian athlete succumb to an early heart attack – an unapologetic chain-smoker live into his 80's. I've seen cancer strike a very young friend – and a good family flirt with poverty when their spouse and father died, leaving behind no life insurance because of a heart defect uncovered when he was 17.

The Health Arbiter of the Universe metes out health and illness in only a broadly discernible pattern – but it would be rare for us to be able to say of a stricken individual: “She surely deserves her cancer with the way she's lived her life!” Yes, some things, like smoking, do have a stronger correlation, but even so, you have to remember that for our parents' generation and before, medical doctors actually recommended smoking! So, making a seemingly good decision based upon available evidence turned out bad...

As a result, I'm loathe to pass judgment on an individual about their deservedness, about their future potential. Receiving preventative and restorative medical care, regardless, gives people the ability to engage in society and provide the best they can. I certainly believe that a wealthy nation like ours (for we certainly, and by all standards, are an extremely wealthy nation) should ensure that health care is available and affordable by all members, without distinction. Perhaps all employers provide it, and we share the cost by paying slightly more for goods and services at the checkout. Perhaps the government provides it for the unemployed, and we all share the cost through a small tax. Perhaps....we could come up with many options, and there are many countries around the world that already do it: We could shop around for the best, and produce an amalgamation better than any other.

Sadly, from the information that I've heard and read, that's not what we've gotten. There are provisions in the new Health Care Law that my education and experience flag. I'm particularly distressed over the emphasis on Corporate Welfare, and the strict avoidance of any countervailing publicly administered provision. I am concerned that while expanding Health Care Affordability, we've also expanded the Health Care monopoly, and that monopoly will work to undermine what has been done.

Perhaps your experiences and education flag similar or different portions of this law. That you, too, were hoping that we could provide for all, but that there are portions that need some re-work.

Which historically, is almost a given with any legislation. There are portions that work as intended, portions that work better than intended, and portions that miss their mark, having unintended consequences, some good, and some decidedly bad. The causes of the bad consequences will have to be determined and revised. We have yet to make a 'final' law. I'm certain that we both foresee such an outcome for this specific piece of legislation also.

But there is nothing in this law that advocates or authorizes violence; nothing that reduces or restricts our ability to participate in government through democracy; nothing that eliminates our presumption of innocence before the law (the provisions prohibiting the use of pre-existing conditions and rescission perhaps strengthen this); nothing that decreases our freedom to make decisions about how to live our life: What to do, where to live, what to eat, how to play, etc.

So screams of 'tyranny' are just hyperbole, the fear-mongering of a 'descent into submission and slavery' just hyperventilating, and the name calling just meanness.

The act of providing health care to those members of society who formerly could not have it is not an act of fear, greed, or hate, but an act of compassion. And so far, countries have not fallen because they were too compassionate towards their own people – it is hatred, fear, and greed that do in empires.

Providing Health Care is one of those endeavors where compassion and greed collide and co-exist. It is the greed woven into this law that concerns me most, that makes me fearful that instead of just providing a little more equality in our society, a little more financial security, it will also be a net transfer of wealth to the already wealthy.

But it is the compassion inherent in this legislation that encourages me. It bolsters my desire to see Health Care provided to all, and stokes my enthusiasm that we are at least moving in that direction. Taking care of each other, even at some cost to ourselves, is one of those 'Good Things' that makes living in human society special and rewarding. Yes, when we show compassion towards another, we do open ourselves up to being taken advantage of. However, the majority of people reciprocate – and as I opened this essay by observing that most of those on the medical down and out aren't lazy or foolish, I think that we can expect for many lives, this act will make a difference, reducing fear and insecurity, and improving health. Their gain will be society's gain, our gain, and the hand-wringing will look small and selfish.

So take a deep breath. There's no need to damage your health with undue agitation over the passage of this law, no need to infect your mind with hatred, no need to lower your morals by considering others unworthy.

Who knows? You might live longer and happier as a result!

Sunday, March 21, 2010

Too Big To Fail

Remember Animal Farm?

In his dystopian allegory, George Orwell takes us on a journey to another land where the pigs rule, the other animals work, and gradually, through trickery and force, the pigs re-write history and take unearned rewards to cushion their lives. The remaining animals suffer, but somehow continue their allegiance to both the pigs and the ideology they spout. Even as they die, broken, they somehow believe that they inhabit the best of possible societies, and the changes that would improve their lot, so readily seen by an outside observer, go unrealized.

When we read the tale, we were certain that it referred to communist Russia. It was a cautionary tale, but we always took it as caution against communism, for the evils portrayed in Animal Farm were seen as a direct (and unavoidable) consequence.

Perhaps we were wrong, or too narrow minded.

For along has come Andrew Ross Sorkin, and he has retold the tale in his latest book. The setting has moved to a modern democratic capitalist nation, but the pigs still rule, still write history. Sorkin has spiced it up with the feel of a modern spy novel, with multiple parallel threads racing towards some convergence – as we read, we get swept up in the contributory actions of the characters, fearful of the outcome.

The story traces the trajectory of an impending financial collapse – the industry in which pigs are employed. As the pigs gather and take actions to stave off banking failures, we see the Animal Farm rubric of 'All animals are equal, but some are more equal' replaced with 'All corporations are equal under the law, but some are Too Big To Fail' – from which Sorkin titles his book.

Money is transferred from the workers (equines) to the bankers (pigs) under the guise that all will suffer if it isn't done. As they decry the horror that has potentially befallen them, the pigs line their pockets with bonuses and golden parachutes, and all across the country, the equines, instead of dropping dead from overwork, are sent home without jobs, to lose their homes, possessions, and dignity.

To illustrate how much control the pigs have, in one memorable sequence, a candidate for major public office (for this nation apparently has open, democratic elections), suspends his campaign to rush to the capital to do the pig's bidding, to insure that sufficient money is transferred from the workers to the bankers. Imagine!

Such is the pig's control that in the end of the book, the government itself is used as a major transfer mechanism to undermine the country's underpinnings of meritocracy and equality. As the book closes, the pigs are shaken, but unrepentant, and Sorkin has updated a major allegory to demonstrate how greed and unearned privilege are dangers that tear and subvert the well functioning of society.

What is most disquieting in Sorkin's retelling is that it leaves a reader with the sense that, like the original, the events are not the outcome of a fertile imagination, but rather they are a close approximation of real events in a real nation. This nation, too, not unlike our own, is decidedly uncommunist, and yet the outcome was the same as in Animal Farm. So, we must honestly confront the question:

Could It Happen Here?

Saturday, March 20, 2010

Influential Books

I was going to do a post on Orwell, but it will have to wait. As too frequently happens, I stumbled upon something tonight that ended up taking a fair amount of my time, and I have precious little left for serious writing.

It was this post by Matthew Yglesias on the 10 books that influenced him most. Not necessarily his 10 favorite, or the 10 best that he's read, but the 10 that influenced his future thinking the greatest amount.

Seeing Nietszche, Dennett, Dostoevsky, Rorty, and Kuhn in his list made me read on. And On, through the comments, where quite a lively (and uncommonly civilized) discussion of the relevance of various philosophers and writers is occurring.

There are interesting references in there, too: Julian Jaynes, Wittgenstein, Quine, Chomsky, Rawls. Foder, Davidson, and Nagel make the list, also, as the various commenters reveal different influences, and discuss why.

It was refreshing to see an actual exchange - and others putting up their lists. More books, more ideas to meet and digest! I'm often disappointed in what I run across on the web (or, more accurately, the blogosphere) - I imagine that with blogging, people putting up ideas, discussing, proposing, etc. that it could be a wonderful re-creation of the free-for-all discussions that took place in the common room during my college days as we grappled to understand the information pouring at us. Too frequently, however, it's a reasonable post by someone positing or proposing an idea (or attempting to back one up), and a lot of name calling and ad hominem attacks following.

There's an interesting question here, too: Will the next generation provide a list of their 10 most influential books, or will digital media change it to their 10 most influential sites? Or, in the hopeful words of Yglesias, "...I hope and think digital media will mostly crowd out relatively low-value book-reading experiences and still leave room for some of the big deal reads."

I still can find no substitute for the reward that comes from engaging for a serious time an author's ideas by grappling with a large-scale book of ideas, and so, I'm inclined to suspect that he is correct.

Saturday, March 13, 2010

Hypothesis Testing

I've often wondered if the changes in the size of government could really be attributable to the party in power. Said another way: Could an outside observer use data over our history to accurately discern which party was in power by looking at the changes in the size of government?

To test this, we need a hypothesis. I submit the null hypothesis:

There is no statistical difference between the growth in government dependent upon the party in power.

Mathematically, if we sum the changes in government size and compute the averages when the Republicans are in power, and the average when the Democrats are in power, we have:

Average Republican Growth – Average Democratic Growth = 0.

I gathered the following information: Yearly GDP, Yearly Federal Government Outlays, and who holds the office of the President, and the majority of each house of Congress, all for the past 40 years.

For purposes of government size, I divided Yearly Fed Gov Outlays by Yearly GDP. This normalizes the size and removes changes due to inflation (and presumable, population growth). Interestingly, The size of our Federal government has been relatively constant, moving between 18.84% in 1970, 22.86% in 1983, 19.78% in 2000, and back to 20.66% in 2008.

For Party in power, I decided that it would be two out of three: Whichever party held at least two of: Majority of Senate, Majority of House, and Presidency, would be tagged as the party in power.
Also, since budgets (hence Federal outlays) are done for the following year, I imposed a one year lag between when a party rises to power and when they effect the size of government. So, we have the following:
1970 – 1981: Democratic
1982 – 1987: Republican
1988 – 1995: Democratic
1996 – 2007: Republican
2008 – on: Democratic

What we are going to do then is compute the averages, the standard deviations, and run a standard double tailed hypothesis test, to see if we can reject the null hypothesis (i.e., that instead Average Republican Growth – Average Democratic Growth is NOT equal to zero.) We'll use a 95% confidence interval, which will answer the question: Can we say with 95% certainty that the difference is not zero?

Computed Data:
Republican: Average – 99.62%; Median – 99.32%, Standard Deviation: .0307
Democratic: Average – 101.86%; Median – 99.92%, Standard Deviation: .0557

(Interestingly, more than half the time, government decreases under either party, hence the medians below 100%. For the Republicans, 11 of 18, for the Democrats, 12 of 22)

To reject the null hypothesis at 95% confidence, the normal distribution table says we need a value of greater than 1.96 after we compute the answer to the equation:

Ave D – Ave R / SQRT((R stddev squared / 18) + (D stddev squared / 22))

And we get?

1.61.

Since 1.61 < 1.96, we cannot reject the null hypothesis at 95% confidence that the two are indeed different. So, my hypothesis withstands statistical analysis. An outside observer cannot discern the party in power by looking at changes in the size of the Federal government, because there is not enough evidence that the underlying distributions are different.

What about relaxing the statistical standards? For instance, could we reject the null hypothesis at 90%?

No. Although it is really close – we would need a value greater than 1.64.

So – What does this say? Basically, we cannot determine, with certainty, that the difference between the averages reveals an actual underlying difference between the two distributions. The two overlap almost entirely – and that there is a slight difference today between the averages may very well be an aberration. Or maybe not. We would need more data covering the time frame in question. However, there is no more data – we've got all 40 years. Data from previous to 40 years ago may help answer the question: In the past, was there a difference, that is gone today? But it doesn't directly help us today.

There is something interesting here, too. The computed value doesn't meet the requirements for a 90% confidence, but it is really close. You might be tempted to think that there is an actual difference – and that perhaps the inclusion of state government data would push it over. And that may be true. But what I find intriguing is that it was an outcome of a very similar nature that had everyone saying that the Global Warming hypothesis was null. If you recall, one of the scientists revealed that the near-term data (last 15 years), just missed the mark for the 95% confidence interval, and so he couldn't reject the null hypothesis on that data alone.

Perhaps you agree. Perhaps you'd like to declare Global Warming dead. But understand this: There is statistically more evidence for Global Warming than there is that Republicans and Democrats influence the overall size of government differently.


Footnote: I did not expect this outcome. Like almost everyone I know, I really expected that the data would damn the Democrats, and that our conventional wisdom would be upheld. I had started to suspect that it may not be fully true during the last decade, and especially recently. I will have to gather more data – I suspect now that the source of our conventional wisdom was planted during the 1930's – that government did grow, but its size appears to have stabilized.
I was tempted too to not include the past two years. 2009 was the only year during the 40 I looked at were GDP fell – which if used as a yardstick imposes an enormous growth on government even if it maintains the same dollar outlays – which it didn't, due to the stimulus bills. But that reveals even more that differences in size are more likely due to other causes than the party in power: 2009's 19% growth goes against the Democrats, and if the underlying distribution can absorb a value that far off the average without pushing it past the 90% confidence interval, then the null hypothesis is very, very solid.

Monday, March 1, 2010

Article V

The other day we were discussing whether or not populist democracy was allowed in America. We all know that our government properly labeled is a representative democracy. Most of the time, that is what we want, too: Let our elected officials design and debate the laws that will govern. The majority of us lack the training, expertise, (and often the interest!) to really consider a law, its potential ramifications, and think outside our own self-interest to determine if it may be good for society.

However, Colorado's Constitution has been used in recent years to promulgate a kind of popular democracy. A friend had heard that someone was going to bring a lawsuit against that behavior under the grounds that we are not a populist democracy, and that such lawmaking by the people was unconstitutional.

As he pointed out, too, such lawmaking has the flavor of lawmaking by coin-toss: The resultant laws seem almost random, unconsidered. Might it be better to let our elected officials make the laws, and defer to a representational form of government?

As a side project, I'm working my way through Akhil Reed Amar's "America's Constitution: A Biography". In one of those wonderful coincidences, I was to the section that discusses Article V - Which outlines the manners in which the Constitution should be amended.

So, I read with great interest Amar's recounting of the facts of Article V's Text, the history the surrounded it, and even more, as he delved into exactly this topic!

Article V sets out that amending the National Constitution can be done by a two-thirds convention of Congress, which must then be approved by three-fourths of the states. And here's where a little ambiguity and interest sets in. Although it would indicate that the approval process would be done by the elected officials, it doesn't exclusively say that must be so. And, Amar points out: The Constitution itself was ratified by popular vote. Would it not be reasonable for the people to retain and return to popular democracy when the need arose?

Contemporary arguments at the Nation's founding by James Wilson would also back that up. Wilson argued that "The people may change the constitution whenever and however they please. This is a right of which no positive institution can ever deprive them." "A majority of society is sufficient for this purpose." Furthermore, Wilson's arguments where supported by the actions of many state legislatures as they re-wrote and subsequently amended their constitutions after the ratification of our new, National Constitution. Populist Democracy was in the air.

It would be unfortunate if a ruling was made that we couldn't alter our laws by popular vote: It would give a monopoly to lawmakers, who could then alter the underlying structures of government to give themselves new, greater powers - perhaps even to post-pone elections, change voting requirements, so that they could no longer be held accountable through regular elections and removed when we grew tired of them, or determined that we wanted society (and its laws) to proceed in a new direction.

So, although I agree that in general we (as in the general populace) shouldn't be making our laws, I fully believe that we need to retain the power and the possibility of full popular, or direct, democracy.

The matter is hardly settled, either. Amar indicates that James Madison's opinion is currently more popular: That Article V supplants our right to direct democracy (rather than supplements and implements it). But, as he says, there is still a lot of constitutional history to be written. And, Amar points out that interpreting the Constitution by looking at contemporary laws, both those that fed into its drafting and those that were not considered, shows us that our Founders had a different, and in many ways, much more populist idea of how democracy should be.

References: Amar, Akhil Reed. America's Constitution - A Biography. Random House, 2005. Pages 302-305. Quote page 303.