Where quack medicine meets political corruption meets pyramid schemes

This piece from the LA Times' indispensable Michael Hiltzik this excellent New Yorker article by Rachel Monroe

Orrin Hatch is leaving the Senate, but his deadliest law will live on – LA Times

Sen. Orrin Hatch (R-Utah) last made a public splash during the debate over the GOP's tax cut bill in December, when he threw a conniption over the suggestion that the bill would favor the wealthy (who will reap about 80% of its benefits by 2027).

Hatch subsequently announced his retirement from the Senate as of the end of this term, writing finis to his 40 years of service. In that time, he has shown himself to be a master of the down-is-up, wrong-is-right method of obfuscating his favors to rich patrons. That was especially the case with his sedulous defense for 20 years of his deadliest legislative achievement.

We're talking about the Dietary Supplement Health and Education Act of 1994, or DSHEA (pronounced "D-shay"). Hatch introduced DSHEA in collaboration with then-Sen. Tom Harkin (D-Iowa), but there was no doubt that it was chiefly his baby. The act all but eliminated government regulation of the dietary and herbal supplements industry. Henceforth, the Food and Drug Administration could not block a supplement from reaching market; the agency could only take action if it learned of health and safety problems with the product after the fact.

DSHEA, as it was written and as it was intended, facilitates the legal marketing of quackery.
...

The Government Accountability Office found the marketing of herbal supplements, especially to the elderly, to be rife with deceptive and dangerous advice; marketers were heard assuring customers that their products could cure disease and recommending combinations that were medically hazardous. The FDA told the GAO that, yes, those marketers shouldn't be saying these things, and they'd get right on it.
...

But one didn't have to drill down too deeply in the speech to discern what really drove the law's enactment. It wasn't the desire for "rational regulation," but that most common political drug of all, money. The dietary supplement industry had set up shop in Hatch's home state and plied him with pantsfuls of campaign cash; in 2010, for instance, Utah-based Xango LLC, which markets dietary supplements among other products, was Hatch's second-biggest contributor. (Herbalife ranked third.) Hatch's son, Scott, has worked as a lobbyist for the industry.

Thanks to DSHEA, the supplements industry grew from $9 billion in 1994 to more than $50 billion today. In Utah alone, it's worth more than $7 billion.

And the consumers often aren't the only victims.

The Grandiosity/Contribution Ratio

From Gizmodo [emphasis added]

Zuck and Priscilla laid out the schematics for this effort on Facebook Live. The plan will be part of the Chan Zuckerberg Initiative and will be called simply “Chan Zuckerberg Science.” The goal, Zuck said, is to “cure, prevent, or manage all diseases in our children’s lifetime.” The project will bring together a bunch of scientists, engineers, doctors, and other experts in an attempt to rid the world of disease.

“We want to dramatically improve every life in [our daughter] Max’s generation and make sure we don’t miss a single soul,” Chan said.

Zuck explained that the Chan Zuckerberg Initiative will work in three ways: bring scientists and engineers together; build tools to “empower” people around the world; and promote a “movement” to fund science globally. The shiny new venture will receive $3 billion in funds over the next decade.
...

“Can we cure prevent or manage all diseases in our children’s lifetime?” Zuck asked at one point. “This is a big goal,” he said soon after, perhaps answering his own question.

Obviously, any time we can get some billionaire to commit hundreds of millions of dollars a year to important basic research, that's a good thing. This money will undoubtedly do a tremendous amount of good and it's difficult to see a major downside.

In terms of the rhetoric, however, it's useful to step back and put this into perspective. In absolute terms $3 billion, even spaced out over a decade, is a great deal of money, but in relative terms is it enough to move us significantly closer to Zuckerberg's "the big goal"? Consider that the annual budget of the NIH alone is around $35 billion. This means that Zuckerberg's initiative is promising to match a little bit less than 1% of NIH funding over the next 10 years.

From a research perspective, this is still a wonderful thing, but from a sociological perspective, it's yet another example of the hype-driven culture of Silicon Valley and what I've been calling the magical heuristics associated with it. Two of the heuristics we've mentioned before were the magic of language and the magic of will. When a billionaire, particularly a tech billionaire, says something obviously, even absurdly exaggerated, the statement is often given more rather than less weight. The unbelievable claims are treated less as descriptions of the world as it is and more incantations to help the billionaires will a new world into existence.

Perhaps the most interesting part of Zuckerberg's language here is that it reminds us just how much the Titans of the Valley have bought into their own bullshit.

Arthur C Clarke and the futurist's inflection point

Clarke circa 1964:

Trying to predict the future is a discouraging and hazardous occupation because the prophet invariably falls between two stools. If his predictions sound at all reasonable, you can be quite sure that within 20 or, at most, 50 years, the progress of science and technology has made him seem ridiculously conservative. On the other hand, if by some miracle a prophet could describe the future exactly as it was going to take place, his predictions would sound so absurd, so far-fetched, that everybody would laugh him to scorn. This has proved to be true in the past, and it will inevitably be true, even more so, of the century to come.

The only thing we can be sure of about the future is that it will be absolutely fantastic.

So, if what I say to you now seems to be very reasonable, then I'll have failed completely. Only if what I tell you appears absolutely unbelievable, have we any chance of visualizing the future as it really will happen.

I can't quite recommend Paul Collins' recent New Yorker piece about the book Toward the Year 2018. Collins doesn't bring a lot of fresh insight to the subject (if you want a deeper understanding of how people in the past looked at what was formerly the future, stick with Gizmodo's Paleofuture), but it did turn me on to what appears to be a fascinating book (I'll let you know in a few days) which provides a great jumping off point for a discussion I've been meaning to have for a while.

If you wanted to hear the future in late May, 1968, you might have gone to Abbey Road to hear the Beatles record a new song of John Lennon’s—something called “Revolution.” Or you could have gone to the decidedly less fab midtown Hilton in Manhattan, where a thousand “leaders and future leaders,” ranging from the economist John Kenneth Galbraith to the peace activist Arthur Waskow, were invited to a conference by the Foreign Policy Association. For its fiftieth anniversary, the F.P.A. scheduled a three-day gathering of experts, asking them to gaze fifty years ahead. An accompanying book shared the conference’s far-off title: “Toward the Year 2018.”
…

“MORE AMAZING THAN SCIENCE FICTION,” proclaims the cover, with jacket copy envisioning how “on a summer day in the year 2018, the three-dimensional television screen in your living room” flashes news of “anti-gravity belts,” “a man-made hurricane, launched at an enemy fleet, [that] devastates a neutral country,” and a “citizen’s pocket computer” that averts an air crash. “Will our children in 2018 still be wrestling,” it asks, “with racial problems, economic depressions, other Vietnams?”

Much of “Toward the Year 2018” might as well be science fiction today. With fourteen contributors, ranging from the weapons theorist Herman Kahn to the I.B.M. automation director Charles DeCarlo, penning essays on everything from “Space” to “Behavioral Technologies,” it’s not hard to find wild misses. The Stanford wonk Charles Scarlott predicts, exactly incorrectly, that nuclear breeder reactors will move to the fore of U.S. energy production while natural gas fades. (He concedes that natural gas might make a comeback—through atom-bomb-powered fracking.) The M.I.T. professor Ithiel de Sola Pool foresees an era of outright control of economies by nations—“They will select their levels of employment, of industrialization, of increase in GNP”—and then, for good measure, predicts “a massive loosening of inhibitions on all human impulses save that toward violence.” From the influential meteorologist Thomas F. Malone, we get the intriguing forecast of “the suppression of lightning”—most likely, he figures, “by the late 1980s.”

But for every amusingly wrong prediction, there’s one unnervingly close to the mark. It’s the same Thomas Malone who, amid predictions of weaponized hurricanes, wonders aloud whether “large-scale climate modification will be effected inadvertently” from rising levels of carbon dioxide. Such global warming, he predicts, might require the creation of an international climate body with “policing powers”—an undertaking, he adds, heartbreakingly, that should be “as nonpolitical as possible.” Gordon F. MacDonald, a fellow early advocate on climate change, writes a chapter on space that largely shrugs at manned interplanetary travel—a near-heresy in 1968—by cannily observing that while the Apollo missions would soon exhaust their political usefulness, weather and communications satellites would not. “A global communication system . . . would permit the use of giant computer complexes,” he adds, noting the revolutionary potential of a data bank that “could be queried at any time.”

[Though it's a bit off-topic, I have to take a moment to push back against the "near-heresy" comment. Though most people probably assumed manned space exploration would have more of a future after '68, and it certainly would've gone farther had LBJ run for and won a second term (Johnson had been space exploration's biggest champion dating back to his days in the Senate), but the program had always been controversial. "Can't we find better ways to spend that money here on earth?" was a common refrain from both the left and the right.]

As you go through the predictions listed here, you'll notice that they range from the reasonably accurate to the wildly overoptimistic or, perhaps overly pessimistic, depending on your feelings toward weaponized hurricanes (let's just go with ambitious). This matches up fairly closely to what you find in Arthur C Clarke's video essay of a few years earlier, parts that seem prescient while others come off as something from that months issue of Galaxy Magazine.

It's important to step back and remember that it didn't used to be like that. If you had gone back 20, 50, one hundred years, and asked experts to predict what was coming and how soon we get here, you almost certainly would have gotten many answers that seriously underestimated upcoming technological developments. If anything, the overly conservative would probably have outweighed the overly ambitious.

The 60s seemed to be the point when our expectations started exceeding our future. I have some theories as to why Clarke's advice for prognostication stopped working, but they'll have to wait till another post.

Removing the senate

This is Joseph

I normally have great respect for Ezra Klein.  His stuff is awesome and I always click on his articles.  Which is why this article annoyed me. 

Consider the proposal:

Bennet has introduced the “Shutdown Accountability Resolution.” The effect would be that from the moment a shutdown starts, most members of the Senate would be forced to remain in the Senate chambers from 8 am to midnight, all day, every day. No weekends. No fundraisers. No trips home to see their families or constituents.

The proposal would not, itself, resolve the DREAMer debate that’s driving the federal government toward shutdown. But it would give the senators involved a powerful incentive to find a solution. This is a body that typically comes together in Washington a few days a week for only part of the year. The last thing they want is to be tied to the Senate floor day after day, for weeks or months on end.

Here’s how the resolution works: It would change Senate rules so that following a lapse in funding for one or more federal agencies — the technical meaning of a shutdown — the Senate must convene at 8 am the next day. Upon convening, the presiding officer forces a quorum call to see who’s present.

In the absence of a quorum, the Senate moves to a roll call vote demanding the attendance of absent senators. If a sufficient number are absent, the sergeant at arms will be asked to arrest them. This process is repeated every hour between 8 am and midnight until a bill passes reopening the government.

The result is that senators need to remain on or near the Senate floor for the duration of the shutdown. They can’t go wait it out in the comfort of their own home.

Perhaps they omitted the piece where the house of representatives is also penalized.  But a budget needs to be passed by both the House and the Senate, right?  So how does this prevent the strategy of the House passing a budget and then leaving for six weeks?  They aren't required to be present 8 am to midnight every day.  I read the whole thing and it seems awfully specific to senators.

So if the house passes something then the senate can rubber stamp it, or being sitting around until they do.  House members can be on the golf course. 

After all, if the senators make an agreement on a budget, doesn't it have to pass the house as well? 

It also hides the real story, which is that budget reconciliation would let a budget be passed with 50 votes.  There was a decision here to put a priority on tax cuts without working out a budget at the same time.  The idea that they would need to compromise now was baked into using the previous strategy for a tax cut.  But it doesn't help to then make the senate a hostage of the house. 

Similarily, what happens if a president vetoes the budget?  Punishing senators for other people's actions seems to result in a stable outcome of making the senate impotent.  Now this could be the goal, but that seems like a different conversation (should there be a senate). 

Feel kind of bad about making fun of Soylent now

Remind me to throw in some raw water jokes next time I write something about the culture of Silicon Valley.

Double blind peer review

This is Joseph

I was reading this piece by Andrew Gelman and this led me to this other article in the comments.  The discussion was a journal being annoyed by preprints, and one reason that people wondered if it might be so was double blind peer review.  So the comments on the challenges of double blind peer review are well worth thinking about:

A related problem with mandatory DBPR, if the journal wants to actually attempt to enforce it (in my experience, many problems in any form of professional life start when someone creates a rule and then tries to be consistent in enforcing it, despite the messiness of the world), is that in addition to the assumption that the manuscript is not available through Google, it also assumes, more completely, that it has not previously been seen by the reviewers in an unblinded state.  That seems like a rather untenable assumption, especially in specialised fields.  PSPB is a well-respected journal by any measure, but like any journal ("Cell wouldn't take it? Let's try Nature!") it may not always be the first port of call for the authors who submit there.  Should the reviewer who has already seen the manuscript unblinded on behalf of another journal recuse herself because she knows who the author is, thus depriving the editor of an expert opinion (which, as a bonus, could presumably be provided very quickly

I am actually pretty good at guessing who the authors are when I review a double blinded paper, even if I am not specifically trying.  Part of it is that some pieces are informative -- a paper on the Framingham Heart Study has a limited pool of typical authors.  Journals ask people to include notes about ethical review (gives the institution).  And the citations are a pretty big clue if there is any building upon previous work.

Does this mean that I shouldn't review in areas where I know the field well?

It is not a trivial problem.  But I think I might err on the side of free information above strict blinding if I had to make a call.  But it's definitely an issue I want to think more about.  

Montclair SocioBlog makes a good point

This is Joseph

I don't completely agree with this sentiment, but I think it is worth deconstructing the underlying thinking pattern that the author identifies:

Last week, a New York Times op-ed about Medicare had a title that characterized the Republican approach: “You’re Sick. Whose Fault Is That?” The same idea applied to abortion would give us “You’re Pregnant. Whose Fault Is That?” It’s a great question if you are interested in assessing blame. The payoff comes in the currency of feelings – guilt (for those with illness or unwanted pregnancy), pride or righteousness for the healthy and virtuous. But if you’re interested in effective policy to improve people’s health or reduce abortion, “whose fault?” is the wrong question.Why not ask, “How can we help?”

There is a question about whether the question"how can we help?" is the best approach.  I think that it is terribly unhelpful to focus on judging others for their struggles, misfortunes, and challenges.  Everyone has a moment when they are down or require help.  If you don't believe that then ask how many infants are completely self-sufficient and don't require at least some degree of assistance.

Focusing on judging is a barrier to solving problems, both social and in in terms of public health.  It is a good thing to remember.

Infrastructure thoughts of the day

This is Joseph

Some thoughts on transportation and infrastructure.

Duncan Black points out a new proposal to create dedicated lanes for driverless cars.  I think it goes without saying that creating dedicated lanes will make any transportation system look good and that it says a lot that we are thinking about this for expensive cars but not buses.

In parallel, there is a nice article on how high speed trains can replace airplanes for medium distance trips.  To some extent this advantage comes from us deliberately making air travel inefficient.  Whether or not we need TSA screening, do we need long queues?  I like trains, I wish we had more of them, but I think the real barrier is the will to create efficient infrastructure projects. Should Paris be more efficient than New York?  

Mark Palko and Andrew Gelman are grappling with this inefficiency in the comments to this post.  Mark is assuming the stifling world of Los Angeles where even small improvements in density require huge amounts of political capital to change restrictive zoning and to reach out to the impacted communities.  Andrew asks the obvious question of why we can't just let construction companies fix these issues without central planning getting involved (via changing the zoning).  It's a good question.  My pet theory is that we've let house prices get so high that even small changes in value equal huge gains and losses, making local homeowners resistant to improved zoning.    

Too busy for a real post...

... but not too busy to give you a flying machine fix

Looks almost too pretty to fly, but it did.

Scientific American June 17, 1905. “It traveled at a high speed for over a mile, and then came slowly and steadily to the ground ... The experiment was attended with complete success, and testified to the efficiency of the design.”

When the YIMBYs don't have the answer

This is a bit LA specific but you can probably generalize the conclusions to other areas.

While there are certainly cases where simple solutions work with complex problems, you should always beware when the appeal rests disproportionately on that simplicity, particularly when combined with ideology and vested interests.

Recently in Los Angeles, we've seen a powerful alliance between utopian urbanists, free market advocates, and real estate developers. The rhetoric has been lofty, framing their initiatives as a battle against climate change, congestion, and urban decay. A look at the details, however, raises serious questions and perhaps reveals the fundamental flaw of the alliance, that utopianists who depend on market forces and business self-interests are perhaps bound to be disappointed.

Before we get into cases, let's review a few general principles. Building housing so that residents have access to good public transportation is generally a great idea, but it is important to define what constitutes "good" here. Since the objective is to reduce or even eliminate the need for cars, the public transportation options need to be reasonably competitive in terms of range of destinations, speed, convenience, and pleasantness, roughly in that order.

The first is particularly important in terms of jobs and commuting. The main problem with the naïve live-where-you-work model is that people often live in multi-income households and frequently change jobs. This also brings up an aspect of public transportation that is frequently forgotten by people who write about buses and trains but don't actually use them. While as-the-crow-flies distance is usually a pretty good indicator of travel time if you have a car or a bike, it can be almost meaningless when you are relying on other forms of transportation. In a place like Los Angeles, it is easy to find examples where one 10 mile trip will take 20 minutes while another will take two hours.

A good (albeit arbitrary) metric for evaluating public transportation as a commuting option would be to count the number of destinations that can be reached by bus, train, and bicycle within a half hour (maybe 45 minutes). Based on that metric and other factors such as available land and demand for middle and lower income housing, there are a number of spots in LA that would be ideal for development.

Chinatown would be perfect. In addition to having its own train station, it's within walking distance of Union Station, the major transportation hub for the county. Between the different bus and rail lines, you have a reasonable commute to much of greater LA. Another excellent candidate would be the section of the Green Line that connects the silver line in the blue line in South LA.

On the other end of the spectrum, if you were to look at the map of the LA train system and try to find the worst possible place for building housing around stations, you would very probably end up picking the Expo line to Santa Monica. While overall a good addition to the system and certainly better than nothing, the Expo line is a slow and exceptionally badly connected train. The commuter relying on it would have either a very small list of destinations or would face daunting travel times.

You can probably guess where this is going. The one place where everyone's talking about this new urban vision is the one place it's least likely to work, Santa Monica. There are vacant lots used for parking within walking distance of Union Station and a desperate need for good affordable housing in places like Watts. Train station housing developments in those areas make far, far more sense from a public transportation standard and from an economic development standard, but given the choice between a trendy, upscale beach neighborhood and Compton, where do you think the real estate the money is going to flow?

(Yes, I do realize that there's a trickle-down argument, but LA's a big place and the idea that lowering prices in fashionable beach communities will have a noticeable effect on the market in East LA seems unlikely.)

 At the risk of pounding home the obvious,bad housing regulations and zoning laws have done a lot of damage and NIMBYs bear a great deal of the blame. Under the right circumstances, intelligent deregulation and selective application of market forces could help alleviate some serious problems, but blind faith in those forces and in the enlightened self-interest of developers is foolish and dangerous.

Another satisfied Comcast customer

From XKCD

Linking health insurance and employment: does the saga ever end?

This is Joseph

Yesterday, I wrote about Matt Reed talking about unions.  He had an earlier post on how an aging work force was doing bad things to the health insurance costs at his institution.  His solution is pretty obvious from a policy perspective -- linking health insurance to employment is looking like less and less of a good idea over time.  Among other things, it reduces job mobility and insulates customers from directly seeing the relevant costs (a second payer causes problems).  But it also reduces the quality of life for older adults.

One of the commentators on the post had an excellent point about how it discourages things like early retirement for burnt out staff:

Here is how we think Matt: Retiring before 65 is economic suicide. Even if you have a decent pension and some serious savings, a quick look at the private health insurance market will dissuade you from even thinking about it. This is doubly the case if you have any known health problems. Those $2,000 a month premiums, $5,000 deductibles and $7,500 out-of-pocket maximums mean you are $30,000-some a year in the hole the day you walk out the door. If you become disabled and don't have private disability insurance that you bought when you were 20 it is even worse. I have known people who have been fired before age 65, but I don't know any that went out the door on their own. (Oh, and your chances of finding another job? Zero! Unless you like driving Uber.)

It's astonishing that costs of health insurance exceed that of many people's pensions.   It is also likely that we've long since hit the point of diminishing returns on trying to get people to pay more in deductibles.

Now I am not unaware of the risks and costs of transitioning to a single payer style of system, especially when health care costs are already high.  But it isn't absolutely clear to me that these high costs are necessarily helping improve health, overall, which is an issue.  But it is also clear that suddenly radically reducing compensation for a huge segment of the economy is likely to cause . . . disruption.

But it is a problem worth thinking about and it would likely pay large dividends to have a good policy plan for improvement.  I mean it isn't like there are nearby functional models that work in decentralized and diverse English speaking countries with a large immigrant population that manage to have a decent life expectancy.  Right?

Colleges and unions

This is Joseph

Matt Reed is worried about unions in discussions of the financial stability of colleges:

Internally, for instance, many public colleges (including my own) are unionized. Collective bargaining agreements, and sometimes state laws, can greatly narrow the strike zone for any prospective downsizing. When you have to do layoffs by seniority, and your salaries are mostly determined by seniority, the most expensive employees are the most protected. That makes the math harder.

While I get that this creates problems, there are bigger issues that everyone wants to ignore.  I want to talk later about health insurance costs, and how that creates a relatively large crisis.

But the idea that job security is a problem suggests that there is already an assumption of neoliberal ideals of a lack of security in life.  Keep in mind that wealth provides options and people with lots of money have an implicit security -- you have options if working is optional or if you can cover a gap without problems. Why have we evolved from seeing people as resources to liabilities?  Why would you not want to keep your most experienced employees?

It is also worth noting that institutional loyalty is much harder to develop if senior managers are constantly worried about high seniority employees.  How can you be loyal to a place that sees you as a barrier to efficient lay-offs.

Now I do get the main point -- that colleges are meant to be grown and shrunk in slow and organic ways.  It is not a style of organization that works well with either fast growth or fast shrinking.  This suggests that maybe stabilization of finding (both directions) should be a piece of the conversation.  After all, doesn't it make sense to be able to plan?

It took Coke a while to escape its patent medicine origins

As this July 6, 1907 issue of Scientific American demonstrates.

Self-driving cars would be wonderful

This is Joseph

Another new year topic seems to be that of self driving cars.  This is a nice piece on the subject, with a smart take on the problems of having a human driver ready to take over: 

First, as one might infer, the human who is suddenly asked to intervene is going to have to quickly asses the situation. The handoff delay means a slower response than if a human had been driving the entire time. Second, and even worse, the human suddenly asked to take control might not even see what the emergency need is. Third, the car itself might not recognize that it is about to get into trouble. Recall that Uber tried to blame a car accident when its self driving car was making a left turn on the oncoming driver, when if you parsed the story carefully, it was the Uber car that was in the wrong.

This is exactly correct.  Problems that can be foreseen well in advance really don't typically need a human driver.  It is the moment that things go wrong that you need a sense of judgment.  And I can't think of a more boring thing to be doing than constantly watching the car drive.  I would much rather either check out and do something else (e.g. read) or be accumulating information on issues like road surface slipperiness. 

Remotely located drivers are even worse (imagine a bad cellular connection during the driving emergency). 

If we have a way to make a self-driving vehicle work than I am an enthusiast, but I want to make sure that the new option is better than the current technology.  We might get there, but it is during an emergency that I want the enhanced reflexes of a computer the most.