Happy Thanksgiving

It has been a good year for OE (the default abbreviation of the blog title). We started in March 2009 as an experiment. The addition of Mark to the blog list has been a big improvement in the quantity and quality of posts. In 2010 we have months with more blog posts than the 2009 total.

So I hope that you all have a safe and Happy Thanksgiving!

Dental Care

So it looks like I am getting my second root canal next week due to a filling that went too deep. It is, sadly, one of my front top teeth (which makes the "just pull it" option unappealing).

There has been a lot of talk of health care, per se, at sites like the Incidental Economist and Marginal Revolution. But I am finding dental care to be shockingly expensive even with good dental insurance and a reasonable salary. Having experienced severe tooth pain (repeatedly), I wonder what happens to people who cannot afford care.

I will also say that free market options are limited when you are in blinding pain with a tooth abscess. One is willing to pay almost anything to make the pain stop and worry about things like rent later. Certainly it is a poor time for comparison shopping. Nor does the fact that many patients pay for most of their care seem to do anything to control prices.

These episodes have made me increasingly tough on my dental hygiene (flossing, brushing, ultrasonic toothbrush, prescription tooth paste). But I fear that some aspect of my diet or lifestyle still seems to be out of whack because dental decay appears to be accelerating at an alarming pace.

But it does make me wonder why dental care is treated differently than, for example, back pain.

Industrial Policy

I am a huge believer in mixed economies. But it is hard to prove that they are the best option for exactly the reasons that Ms. McArdle is skeptical about industrial planning in China:

It's not that I didn't understand that the government did this; it's that I didn't understand how pervasive it would be, or how popular this would be, at least with the folks we interview. Everyone--including most of the economists and NGOs--seems to think this is swell. No fiddling around with archaic, unplanned systems; just figure out what the country needs and do it!


Perhaps it is just my ideological blindness that makes me believe that this cannot, in the long run, turn out well. But there's a plausible story that the early boom was mostly a matter of removing distortions (and taking advantage of capital, human and otherwise, accumulated in Hong Kong and China). Now the government is much more directly picking winners and losers. They're not trying to manage growth; they're trying to cause it in places where it shows little sign of happening organically.


It's not that I think that no form of industrial policy can ever have good effect. Can government build infrastructure to good effect? Yes, certainly. Can they manage growth? Can it occasionally pick industrial winners? They have in the past--though on average, I'd say it's abundantly clear that governments have more often picked, and sustained, losers. And the more comprehensive the industrial policy, the worse the economic losses have generally been.

The issue here is that successes can be explained by a lot of different factors (as can failures). And it is pretty clear that people have strong "priors" (in the Bayesian sense) for the approach that they favor. This makes it hard to use the (limited in scope) data to decide between approaches. Add in confounding factors and it gets harder. Add in changes in technology and you guarantee issues.

Just consider, for example, stock market returns. What is the relevant period of interest? Some people claim you can consider returns on stock from 1800 to today based on what records are available. But clearly the information available to stock analysts is different today than in 1960. Now consider that you want to look at long term returns (i.e. saving for retirement) and suddenly the noise threatens to overwhelm the data -- as you really have only a very few (tightly correlated) time trends.

How much worse is that for looking at economic growth?

No wonder these arguments are difficult to make . . .

Another argument for parenting as an addiction

And unlike the one demolished here, the sitcom version actually makes some sense in terms of reinforcement schedules.



Of course, this story refers to actions parents take in pursuit of specific rewards, not to the decision to become parents.

Impact Factors

Frances Woolley makes a great point in Impact Factors and how they vary by field and by sub-field. This issue comes up in medical research all of the time. If I try and be really methodological, a statistics or epidemiology journal has a much smaller imapct factor than a medical journal. On the other hand, if I focus on the drugs and go to a pharmacy journal then impact factors are even lower.

So it is a constant dilemma about how to focus one's research. I would like to think that tenure and promotion committees are sophisticated about such issues but one does worry . . .

I suspect that the same issues are replicated with grant funding.

Airline Security

This is a nice point from Megan McArdle on the current value of airline security procedures:

Somehow, this seems like a questionable reaction to two attacks that failed. Especially since they failed for the same reason that any similar attack is likely to fail: the amount of explosives you can smuggle in your underwear or shoes is necessarily small, meaning that you need to be in the cabin to detonate them if you want to be sure that you'll bring the plane down. And it's really hard to set your underwear, or your shoes, on fire without your fellow passengers noticing. In Asia, I've never been required to have my shoes scanned--not even to get on a US bound flight. And yet, we have not been confronted with a rash of exploding planes out of Taipei or Saigon.

I am forced to fly a lot for work and I have the misfortune of living far away from family. Yet I would gladly never fly again if I could arrange it. It's really become a miserable process. At some point one really would like to avoid the whole mess.

History question of the day

This excellent column by Steven Pearlstein got me thinking, is hard-currency populism a new phenomena? I realize a lot separates Bryan and Palin/Beck/etc. but this would seem to be 180.

Maybe this is making outcomes worse?

From an interesting interview with a (formerly) obese cardiologist:

In 2003, Gary Foster, now director of the Center for Obesity Research and Education at Temple University, conducted a survey of primary-care doctors about obesity. More than half viewed obese patients as ugly and noncompliant. A third saw them as weak-willed and lazy.

and

He understands that doctors can be frustrated by their patients' failure to lose weight, but he sees it as no worse than many other difficult-to-treat diseases. "My fellow colleagues are understanding of cancer even when it recurs and recurs, and they'll say, 'Well, that's the disease,' " he said.

I think that this might have some serious ramifications for the treatment of obesity by the medical profession. Patients seem as noncompliant are less likely to receive treatment which can make the health risk associated with obesity more difficult to treat.

It's true that there is some factor that is driving the current obesity epidemic (and the even mroe cocnerning diabetes epidemic) that is, my definition, modifiable. But perhaps we should focus on what that factor is? After all, our grandparents were much less obese (on average) and that suggests that the focus shouldn't necessary be at the level of the patient but rather at how we have changed our culture.

Seniors in space

From 1996:

Now here are two seemingly unrelated facts.

Fact One: 30% of Medicare expenditures are incurred by people in the last years of their lives.

Fact Two: NASA spends billions per year on astronaut safety.

Maybe you see where I am going....

Why not shoot the elderly into space? Stay with me. Because I'm not just thinking about the budget here. I'm talking about science. Just think how many more manned space operations NASA could undertake if they didn't have to worry about getting the astronauts back.

Now, I'm not saying we don't try to get them back. We just don't make such a big deal about it. That way we don't have to use the shuttle every time, which is very expensive. Put an old Mercury capsule on top of a Saturn rocket, fire it up, and see what happens. And if the "Houston, we've got a problem" call comes, Mission Control can simply reply, "Best of luck. We're rooting for you."

-- Al Franken, in "Rush Limbaugh is a Big Fat Idiot"




From the AP:

Two scientists are suggesting that colonization of the red planet could happen faster and more economically if astronauts behaved like the first settlers to come to North America — not expecting to go home....

"You would send a little bit older folks, around 60 or something like that," Schulze-Makuch said, bringing to mind the aging heroes who saved the day in the movie "Space Cowboys."

You can read the actual proposal here but be warned, it does not improve under close scrutiny.

Things you can do if you're a charter school

Make demands of parents:

Parent involvement has been a surprisingly central feature of many of the proposals for new and restructured charter schools in California. State legislation mandates that parents be involved in the governance of charter schools, but broader kinds of parental involvement seem to be contemplated by those who are designing these new schools. In many of these schools, parent involvement is much more than simply a requirement to volunteer assistance or to help with their children's homework. Parents are seen as central adults in a more inclusive school community--participants who share time and expertise with the school's students as a whole. For example, a majority of the first chartered schools were planning to have parents and other community members as instructors in the school building, and several expected to sponsor training in tutoring methods and parenting techniques for use at home. In fact, a survey of thirty-four of the first forty-four schools chartered by the state found that in more than 50 percent parents are required to sign contracts and to participate in certain activities (Dianda & Corwin, 1994). One recently approved charter school, for example, intends to require parents "to volunteer a minimum of three hours per month at the school." Another stated in its charter: "Parents, by signing their child's registration form, commit themselves to at least 2 hours of school service per month.... Any student accepted on an above mentioned agreement will meet a prescribed written contract and will understand, if the contract is broken, said agreement will be revoked and the student will be disenrolled."

In many ways this is a good thing and I'm not saying that charter schools should stop, but it does provide another example of the near impossibility of making meaningful comparisons between schools that have the option of easily 'disenrolling' students and those that don't.

Is it too late tonight to write a post on the card game Eleusis?

Yes.

Something you have to post immediately if you see it at two a.m.

I'm generally not that impressed with this sort of thing but obviously I have to post this.

From Psychology Today:

There is thus no indication in any of the ethnographic evidence that any sustained nocturnal activities occur in traditional societies, other than occasional conversations and singing, in these tribes. It is therefore reasonable to infer that our ancestors must also have limited their daily activities to daylight, and sustained nocturnal activities are largely evolutionarily novel. The Hypothesis would therefore predict that more intelligent individuals are more likely to be nocturnal than less intelligent individuals.

Not much time for blogging...

... or even reading other people's blogs. I've been busy and based on the conversations I've had recently, Joseph is inundated.

Regular blogging will resume soon. Till then you can kill some time with the only popular board game I know of* that has imperfect information but no random elements.


* And no, I wouldn't call this a popular board game.

More wheelbarrows

I suggested in a previous post that the surreal images and anecdotes of hyper-inflation (particularly in early Twenties Germany) have a more powerful hold on the imagination than do the deceptively benign images of deflation.

Today I learned (via Media Matters by way of Krugman) that hyper-inflation warnings are showing up on Glenn Beck's show:

As I told you at the beginning I'm not an expert. I am not a guy to listen to for financial advice. I'm an American with an opinion. Period. I don't know that the Weimar republic isn't going to happen here. I don't know if it is going to happen here. But I will tell you this: Those same damn experts told me two years ago that the Fed wouldn't do what they did yesterday. those same damn experts told me four years ago the housing market was fine. When will these experts lose a little bit of credibility? When will we start listening to our own guts, and to common sense?

While on another Fox show the host is calling for a return to gold not only to back the dollar but as an alternative currency.

Observational Research

Andrew Gelman quotes a discussion the design of clinical trials by John Langford. It's based on work by Amy Harmon on people who fail to get the drug in the active arm of a randomized controlled trial.

The case that she begins with:

But when Mr. Ryan, 22, was admitted to the trial in May, he was assigned by a computer lottery to what is known as the control arm. Instead of the pills, he was to get infusions of the chemotherapy drug that has been the notoriously ineffective recourse in treating melanoma for 30 years.

The question is:

With reasonable record keeping of existing outcomes for the standard treatments, there is no need to explicitly assign people to a control group with the standard treatment, as that approach is effectively explored with great certainty.

I see this as an argument for Observational (instead of experimental) research. The reason that experimental research is valuable is that you can rule out confounding and estimating quantities like the counter-factual outcomes is a lot easier (as counterfactuals have the nice properties of being missing completely at random).

If you only test the novel drug in the trial then you are assuming that there are not other changes (in population composition, in other forms of care) that do not explain some or all of the variability. You can use statistical adjustment to reduce differences but then things hinge on model specification and whether there are unmeasured differences.

I worry that we are some distance from trusting data where two analysts can get two different answers making different sets of assumptions (which years are the control years? who is included? which covariates are included?).

That being said, many key breakthroughs are entirely observational in nature and it would be good to see more use of this study design. But it is also clear that there are a lot of blind alleys that occur when non-randomized data is used (statins and cancer, anyone?).

[In a larger sense, I think that this is the danger of outside experts. Sometimes they point out that the Emperor has no clothes. However, they may not realize that is because it is currently bath-time . . . ]