Saturday, September 27, 2008

"News" coverage about political campaigns

The way the media cover political campaigns in the US is absurd. At best it reduces the role to entertainment, but I believe it is actively harmful to the process and thus the country. In whole, political campaigns have radically changed (I would say "devolved") over the past 30 years.

What do voters need in order to make an informed decision?

You need to know there view on a variety of views. You need some indication of how they operate under pressure. You need to know their views on governance. You need to see the sorts of people they surround themselves with, as these are the people who are likely advising them and will continue to advise them in office; as such you need to know the views of those people as well (which we don't hear nearly enough about).

Do we get that from the news. "A little." Very little. What do we get? We find out what the candidate did each day. We get their most compelling sound bite. And vastly we get information analyzing the latest polling data, campaign strategies, whether said strategies seem to be working or not, etc. Let's look at each group of information more closely.

Polling data. Really? Why could this be "news"? It is "new", but is it important for people to know? Who would need to know this? The campaigns need to know this, because they can then tell what is working and what isn't, how they may need to act. It may encourage people to join a flagging campaign if a person is passionate and the polls show it the candidate slipping (so that would be recruiting for the campaign, so that isn't really news-worthy either). It could help those who don't understand issues to see what others think so they can follow suit -- but I would argue that is not a valid way to vote (and thus it calls into question the role of yard signs, who's intention is to drive it as a popularity contest, create name recognition, and try to create peer influence via neighbors, none of which involve understanding candidate positions, and thus I would say actually are a negative as well, but I digress).

Last, polling data allows us to talk about who is ahead. "Wow, did you see that last maneuver on Saturday? After it that team went up by 6 points!" Hmm. Sounds a lot like you're talking about a killer deke in a college football game. But they could be talking about the latest attack ad for a candidate. 90% of "news" coverage about elections seems to be an attempt to treat it like a sporting event. To make it entertainment -- which is no surprise: since the rise of cable television news has felt it has had to entertain to maintain the viewership needed for advertising (when there were 6 stations in a local market, 3 of them were network affiliates broadcasting news at the same times, so their competition was other newscasts, PBS broadcasting something it would probably broadcast again, a couple of indepenedents possibly showing news themselves, or more likely showing reruns).

What is wrong with covering an election like a sporting event? Nothing if you are watching the events in another country. That is to say "if you are a non-participant". But elections are driven by the voters, and the "news" is aimed at the voters. So this is all giving voters entertainment and treating them as non-participants, rather than giving them the information on which to base a vote.

This provides a lens with which to look at the other favorite topics.

Next let's take "campaign strategies". First, how could this benefit a voter? It could help show how the campaigns are attempting to influence (nice version) or manipulate (nasty version) the voters. But when you couple it with "what strategies are working and what aren't" frequently coupled with called in experts opining on what the campaign should do, we are firmly back to the sporting event. There is another group who should look at this: political scientists; of course I'm skeptical that the CBS Evening News really is the latest Jounal of Political Science. So the net is that all of the talk about strategies are more an attempt to follow the format of the "Monday Night Football" broadcast than to enable voters to make an informed vote.

Last we have "What the candidate did each day, and a key sound bite." This is at least news. It allows you to find out who they are talking to and what they are talking about. But the campaigns know this, know that there is a "fairness doctrine" that requires most newscasts to spend equal time on both candidates, and we have for many campaign cycles had controlled access and creation of one "sound bite" to carefully control the message the news will report on.

So I am clearly arguing the current system is broken. What would fix it?

STOP reporting polling data. Report it once a week, period. Describe whether it has gone up or done, but don't speculate on why.

Quit reporting on the mechaniations of the campaigns, unless they are doing something deemed to be highly manipulative.

Continue to cover what the candidates are talking about. Use the time freed up from not doing the sportscast to go deeper: fact check the statements and report the good and bad; show how past behavior supports or refutes the assertions, and if there is past behavior that seems contrary, show if there was a point of change of heart and discuss it; explain where positions are coming from: expose the supporting cast and describe their views

Create a roster of topics to be covered, and cycle through them. There will be various aspects of: economic policy, national security, international relations, the role of government in education, labor, science, space, the role of the US military in the world, healthcare, Social Security, civil rights and liberties, etc, etc. I suspect we could list 100 topics. There will also be topical issues that arise (at the time of this writing we've recently had Russian/Georgian hostilities, and the proposed government bail out of financial institutions).

On one hand, candidates positions don't change often, so they aren't news. But on the other hand, nobody understands in detail what any of the candidates positions on more than a couple of issues, so while it may not have developed in the past 24 hours, it is new to the audience, it helps them understand a key aspect of the world around them (who they can vote for), and thus is certainly News.

In the age of the internet, it also means you can create a site documenting all of these positions. Campaigns now run for a year or more. Assuming 5 day a week coverage, that would allow you to cover 250 topics in depth, and catalog the positions in writing. I can think of no more valuable role for the news than to create such insight into the candidates in the interest in creating and enabling an informed populace.

While the founding fathers may have believed that we have a right to the pursuit of happiness, an entertained populace wasn't declared a linchpin of Democracy.

Tuesday, May 6, 2008

Leaving health on the table

There is a saying that someone "left money on the table" -- they could have gotten more from their financial dealings.

Well, as a society I believe we are leaving health on the table, and doing it in some pretty concrete ways. Unfortunately the ways are pretty well entrenched, so I'm not sure how easy it is to go back and "renegotiate".

All of them revolve around the body's ability to heal itself. Perhaps they are just symptoms of the same thing. But there are three distinct things to think about.

We all know the anecdotes of phenomena like cancer patients who Western Medicine deems "untreatable" mysteriously go into remission. A simple example is the knee jerk reaction to take antibiotics to fend off a sinus infection while the body in the vast majority of cases could do this on its own. (In fact, medical best practice now recommends that antibiotics not be prescribed for routine sinus infections.)

So that brings us to the topic of ways of encouraging the body to heal itself faster or better. There is an aspect to medical research that is so routine that nearly everyone has forgotten its importance. Medical tests can consist of three groups: control (no treatment -- what can the body do on its own), placebo (a treatment with no "therapeutic" value), and the treatment in question.

As already discussed, some percentage of a control group will handle a condition, so when looking for the efficacy of a treatment, we want to show that patients with the treatment do better than without. However there is a phrase "more effective than placebo" used in reporting results. There is an interesting truth in that construct: placebos are effective in treating conditions.

Placebos are sugar pills, so there is little likelihood that there is some complex biochemical chain of reactions leading to the outcome. The outcome is psychological -- we have triggered our internal mending system to better results.

So the first way in which we leave health on the table is by having structured the system such that we cannot leverage the simple truth that people can heal themselves better if someone simply tells them they are helping. (Which is all prescribing a placebo is.)

How to overcome that? It's tough. In the age of reason, we have developed the culture of doubt and an expectation of everyone needing to be an expert. Since everyone is encouraged to read about drugs themselves, it is impractical to prescribe a placebo -- a large percentage of patients would discover that is what they have. To conceal the fact would legally constitute fraud. For that matter, simply prescribing a placebo may break laws or codes of ethics.

We also insist on proof of anything in medicine. If something seems to work, we must prove it works. Preferably we must also understand how it works. That leads to questioning means of treatment older than Western Medicine.

Acupuncture, shamanism, rural apothecaries. Western science has scoffed at these. Interestingly, acupuncture is now accepted at least in some circles.

Do they work? If the receiver of care believes they will help, then they will help. Looking at placebos confirms this. Of course that still runs into our societal constraints on medicine.

For some reason if someone says they will help someone heal and the effect of healing is only to help the person believe they can heal, that is a fraud. We refute the psychological effect as valid treatment, and by doing so, we all suffer. There are probably practitioners in bad faith -- who are looking for a buck and don't really care about the patients. Most are caring people, looking to help, who offer treatments that they don't know how work, but sincerely believe do work.

So if we know placebos help, why prohibit these claims to help? Partly to protect people from the true shams. Partly because we don't believe it is valid to claim to have done something that you didn't mechanically cause. And partly because those that profit from specialized treatment have an interest, conscious or unconscious, to prevent competition from simple sources.

So we have made it impossible to use placebos. We throw roadblocks to treatments that may be just the effect mechanism of a placebo.

The question also remains of "if we don't understand how something works, could it be working?" Obviously the answer is yes, but it triggers our skepticism.

We are capable of many things we don't really understand. Recent books like "Blink" note that we can process huge amounts of information, very, very quickly.

What got me thinking are questions like "how did anyone think to try _____?" In particular this applies to having found medicinal herbs. Is it possible that when we quiet our overactive intellects that our bodies can sense things in their environment that will help them?

I know of an anecdote that could be random, or could be enlightening. It involves the patient of a chiropractor.

Chiropractors are an interesting lot. They perform services that are clearly efficacious. Through physical manipulation you leave the office feeling better than when you walked in. At a minimum we're talking a benefit similar to massage. But there are chiropractors that believe chiropractic medicine can help treat illness. Some are also interested in other forms of alternative medicine. But all of them have a skill so few are probably outright shams on the other fronts -- it is probably always out of a sincere desire to help rather than just to make a buck. But I digress.

The anecdote involves a patient that was having recurring issues that the chiropractor didn't think skeletal manipulation was going to correct. They had a notion that there could be a mineral deficiency. That much isn't interesting -- what is interesting is how they went about determining what the deficiency was.

The patient stood with an arm held out in front of them. The chiropractor then held up a series of bottles of multi-vitamins in front of the chest of the patient, label away from the patient. As each was held up, they would press down on the arm to see how much resistance was provided to having the arm pushed down. While one of the middle bottles in the series was held up, the resistance was much higher -- the body/mind were creating a positive reinforcement from having those vitamins nearby.

I've seen the arm resistance measurement used in a pop psych experiment before. If before testing resistance you state something you believe (I want to live), it is much stronger than if you first say something you don't (I want to be broke).

So two questions come to mind looking at the anecdote. Was there a real effect observed? And if so, how did it work. I wasn't in the room, but I'm more inclined to believe the story than not. Perhaps just because it fits observations that we seem to be able to perceive things that there is no way currently to explain. Which brings us to the question of how might the patient have done that? My curiosity is interested in that question, a much more pragmatic voice says "who cares?"

The general sentiment in science and thus in Western society is that ancient humans must have spent lots of time experimenting to find the herbs and plants that help medicinally may be fundamentally flawed. It may be that they innately knew what would help. It certainly is a simpler answer even though we don't understand how people can do this.

So in addition to not letting others "coach" us into healing ourselves, we also refute and deny treatments that may be truly effective because they can't be confirmed nor explained within a scientific framework. Should you be able to show the efficacy of the above example of the body "sensing" what it needs? Perhaps, but it may be that simply participating in an experiment tends to key our mind to "thought" rather than "feel" and thus suppress the effect if it was ever there. I don't buy that science has proven these things don't work -- I think that by how they ask the questions they exclude a lot of truths.

Shamans that have spoken frankly have acknowledged that some of the ceremonial pomp and circumstance is solely to get the patient to believe that great magic is occurring which will cause them to be in the frame of mind for healing. That part is a placebo effect, and they'll admit it. However they believe they do more that is directly helpful. Scientific skepticism may say it is mystical gobbledygook. Some of it may be, but some of it may work via a mechanism that science will discover (and exploit for our good) in a hundred years, or three hundred, or a thousand.

Ultimately we have bought so thoroughly into the "Western Medical Expertise" model that we leave many opportunities for health on the table. There is the potential for abuse in the other direction, and for mutual self-deception (sometimes to good effect, sometimes to simply an exchange of money). Might the good outweigh the bad? It may be a long time before we can tell.

Tuesday, March 25, 2008

On "Fair" Taxation

It seems that all of the topics kicking around at the top of my list are economic. Not what I would expect, but let's have at one of them.

When it comes to taxation there are two perfectly valid points of view on what is "fair". Unfortunately, they are incompatible. Isn't that the way of things?

Let's start out be saying that I don't believe there are many reasonable people who are willing to argue that the current tax system in the US couldn't be improved. Nobody seems to feel the system treats them fairly, and it contains lobbied-for loop holes for a variety of special interests.

With that said there are two basic versions of "fair" people cite:
  • Everybody pays the same (say as a percentage of income)
  • Everybody pays based on their ability to pay

If you believe everyone should pay the same percentage, then having a graduated tax rate scale imposed on you feels very unjust. After all, you work hard for the money you earn (presumably), so that hard work shouldn't be punished by forcing you to pay "more than your fair share".

If you look at things from the so called "ability to pay" point of view, then you probably look at pay in terms of the degree of negative impact. If you live at or below the poverty line, you have no disposable income, and a tax rate of 5% will dramitically impact your quality of life -- it will sap your ability to procure things most of us would consider "essential". Even if you are making it in the middle class and 10% of your pay you can count as "disposible income" -- that 5% tax rate has trimmed your quality of life by significantly decreasing your ability to spend on "perks". The impact to your quality of life is still much less than the person who is subsisting. Now let's take someone who is well off -- say they make twice as much as our previous person, but have higher fixed costs so we won't count 50% is disposible, but perhaps 25%. The 5% tax decreases their ability to have the nice things in life far less than it impacts our middle class example -- only one fifth of their disposible income is affected rather than half. Now look at that in dollars. Say our middle class example makes $60,000 and of that $6,000 is fun money of which we take $3,000. Our well off example would then be at $120,000 in salary and of that $30,000 would be discretionary of which we would tax out $6,000. Even though the rate of impact is %20 instead of 50% in total dollars, so 2 1/2 times, the remaining pool of money is $24,000 compared to $3,000, or a whopping 8 times.

So with that lens a person would say you should tax the person subsisting little, if any, and that you can fairly tax the person making $120,000 a higher percentage than you tax the person making $60,000. "Fair" would be measured not in the relative dollars taxed, nor in the relative percentage taxed, but in the relative impact on quality of life. (Such a person might posit that money is a means to a comfortable life and not an end in itself.)

There are terms applied to taxation systems: progressive, flat, and regressive. Progressive systems tend to ask more of those to whom this impacts their life less. Flat systems would tax everyone at the same rate. Regressive systems end up drawing a higher percentage of income from those who make less.

You might think we would never levy a regressive tax, but in fact we have two today. One is a sales tax (or Value Added Tax aka VAT, which has other names as well), and the other is property tax.

Why is sales tax regressive? Because the less you make, the higher percentage of your income you must spend just to get by. Below the poverty line, saving money is rarely even an option and thus you spend every dollar you take in. As you become more and more well off, you have more discretionary income, and a higher and higher percentage gets saved (hopefully). So a sales tax tends to tax the poor at a higher percentage rate (of income) than the middle class, and the middle class higher than the upper class.

There are variants that avoid taxing "essentials" (groceries and shelter for example). These help spare the poor, but are still regressive between the middle and upper classes.

Property tax works similarly. The less you make, the higher percentage of your income tends to go towards housing -- the primary item taxed. Even if you don't own your home, the landlord is taxed on the value of where you live and your rent will be adjusted over time to recoup this expense of the owner.

So calls for a national sales tax are destined to hurt the poor and provide a windfall to the rich. Got a way to make the masses understand that? Polls show an awful lot of people who would be hurt by such a plan support it. I believe this is because there is resentment of a handful of folks and businesses who can take advantage of tax loopholes to pay very little -- much less than "their fair share" under either of the above interpretations.

Whether you think graduated tax rates or flat tax rates are what represent "fair", I urge you to reject sales, consumption, value add, and property taxes. All of these are in fact regressive and hurt those least able to afford it.

- K

Afterword:

As an aside, I find it interesting that Europe has taken this model despite being seen as largely Socialist -- of course that may mean there are better safety nets at the bottom at least, but it still stings a middle class. And Socialism actually involves the degree of public/private ownership of assets and funding of necessities, despite what campaign ads might teach you, and so perhaps it isn't so contrary after all.