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Archive for June, 2011

Truth

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Chuck Klosterman on latter-day Led Zeppelin

Entertaining and insightful, like he usually is:

‘In the Evening’: A second-by-second analysis of Led Zeppelin’s last stand

In August of 1979, Led Zeppelin played two concerts at the Knebworth Festival in Hertfordshire, England, headlining an event rumored to have been seen by some 218,000 people. This rumor is not true; in reality, the first show was seen by a crowd of about 104,000 while the second show (pummeled by day-long rain) had a crowd of fewer than 50,000. These are still massive numbers, certainly, but the difference between what the band’s management claimed and what was authentically happening illustrates the contradictory position Zeppelin was in by ’79: They were both the most popular and most criticized rock band in the world. Reviews for the Knebworth shows were mostly negative (especially for the second night, which even the band admits was subpar). At the time it had become trendy for other musicians to use Zeppelin as the example for everything they hated about the 1970s; Clash bassist Paul Simonon had recently said, “I don’t have to hear Led Zeppelin. Just looking at their album covers1 makes me want to throw up.” What Simonon was (actually) complaining about is what we see during the first 105 seconds of this Knebworth rendition of “In the Evening,” the first track off the widely panned (but 6x-platinum-selling) In Through the Out Door: conscious bloat. For almost two minutes, we get little more than a genius biker hitting the kettle drum while three superrich hippies prepare to be as awesome as they justifiably perceive themselves, lurking and droning beneath the same type of laser Patterson Hood saw at a BOC concert when he was 14.2 As is always the case with YouTube, time and circumstance have changed the meaning of those 105 seconds. But this was what the cool kids hated in 1979, despite the 104,000 Knebworthian kettledrum aficionados losing their hash-riddled minds.

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Health Care: It’s about delivering efficient outcomes

Megan McArdle is “freaking out a little bit”. She is really worried about the implications of the fact that Pharma isn’t spending as much money on R&D as it did the year before.

Here is the meat and potatoes of her argument:

While some drugs are simply an added expense (think chemotherapy prolonging the lives of people who would otherwise have died sooner), many of the real blockbusters substitute for labor-intensive treatment.  Statins instead of cardiac catheterizations or coronary bypasses.  Avandia instead of amputations.  Hydrochlorothiazide instead of nursing home care for your massive stroke.

Her analysis is logically correct, but I think she is missing the bigger picture. Pharmaceuticals are a tool to get a job done, as are “labor-intensive treatments”, and also preventive medicine, and holistic medicine… the point I am trying to make is that there are a number of substitutes for current medical treatments that do not involve pharmacology, unfortunately none of these other substitutes are as profitable as drugs (people like drugs because they don’t require much personal effort to be effective, as opposed to most preventive medicine, and usually when people are at the point where they need Lipitor, the spectre of death is hanging over their heads to remind them that they better take their Lipitor… he wasn’t there before to remind them to take their fish oil or order a salad instead of french fries). Each tool has a certain level of cost-to-benefit efficiency when it comes to delivering healthcare outcomes, and after decades of pharmaceuticals being the best “bang for your buck”, we have long since been at a point where our marginal American healthcare dollars are better spent on other things.

The fact that returns to pharmaceutical R&D have been falling isn’t surprising to me. Pharmacology has been one of the “low hanging fruits” described by Tyler Cowen in his “Great Stagnation” hypothesis, and within this context it would make sense that we might have reached a technological bottleneck that is preventing us from creating a blockbuster drug that will do for cancer or Alzheimer’s what statins did for arteriosclerosis. From an economic standpoint, generally all returns are diminishing over time. As competition increases and technological process forces changes to the ideal business model, firms are simply unable to do the same thing for decades upon decades and expect it to remain at the same level of profitability.

Where I think McArdle completely misses the point is in her assertions that reduced pharmaceutical R&D spending may lead to a situation where “health care expenses might actually rise faster than we expect”. Assuming she is not making the error of confusing costs with outcomes, and that she is referring to constant outcomes

Health care is not so much a consumable good as it is an outcome… not an end in and of itself, but instead a means towards longevity and quality of life. Today’s standard of whatever would constitute “world class healthcare” will assuredly be less expensive in the future than it will today. Whatever new discoveries or technologies that will improve healthcare outcomes above today’s benchmark will assuredly cost more, and that is because people will literally be paying for extra years to be added on to their lives or for those last years to be more peaceful and comfortable. It is these newer longevity and quality of life technologies that are the primary cost drivers (of course, that is to say nothing of the price distortions caused by government interference in the marketplace and cartelization/misregulation within the field of medical service providers… or of the irrational components of society’s demand, which are exacerbated by the Phrma complex and its army of marketers and lobbyists).

This distinction between costs and outcomes is very important to make, because it is a misunderstanding of outcomes that has driven medical costs as high as they are. Life expectancy is rising everyday, as is quality of life for the elderly, so you compare tomorrow’s costs with today’s costs because the outcomes are going to be different. Doctors (or at least the good ones) tell us to take preventive measures, such as exercising and eating right, because they are by far the most cost-efficient ways to deliver optimal medical outcomes (an example of an outcome would be: still being able to enjoy X quality of life level at the age of Y). Someone who doesn’t want to exercise or watch their diet can still live to be just as old as someone who does take these preventive measures, but they will most likely be taking thousands of dollars worth of drugs, and have had who-knows-how-many procedures, and even then, it is doubtful that their quality of life would objectively be at the same level as Mr. or Mrs. Preventive Medicine.

McArdle attempts to sequester the most common liberal sentiments into a neat opening paragraph:

Worried about me-too drugs?  The medicalization of human variability in order to medicate them into compliance and/or sell them quack cures of dubious value?  Ever-rising prices for brand name drugs pushing seniors into penury?

Well, you can breathe a (slight) sigh of relief.  For the first time ever last year, the global drug industry cut its R&D spending.  The trend is expected to continue, at least in the near term.

If you’ll excuse me, the rest of us will be over here in the corner, freaking out a little bit.

I actually am worried about all those things, except for the last one: seniors aren’t being pushed into penuary… they are just spending more money to squeeze every last bit they can from life. Today they have the option of taking expensive drugs and doing expensive treatments and procedures that weren’t even around 10 years ago. Having that option is a benefit, not a cost.

McArdle’s worry is unfounded unless you own pharmaceutical stocks or are skeptical of our society’s ability to recognize the efficacy of the many alternatives to pharmacology. I will give her the benefit of the doubt and assume McArdle is more firmly planted into the latter camp, although I betcha a 90-day supply of generic diazepam that she also relates with the former. I also suppose that we all, as taxpayers, have stake in this game since the government is the biggest buyer of healthcare, but this should be more reason for us to want to explore the more progressive modalities of medical treatment as individuals. My biggest fear is that someone will draw the conclusion that we should be subsidizing pharmaceutical R&D (maybe we do already? I wish we wouldn’t).

We need a way to measure the efficiency of every marginal dollar spent on health care, measured in terms of outcome. People have a complete disconnect from this concept; part of this is because of capitalism, and part of this is because of human nature. When it comes to life and death situations, we hardly ever do an actual cost-benefit analysis to see if it is worth it to give Grandma another round of chemotherapy so that she can see her next birthday… maybe the money would have been better spent sending Grandma on a trip to the place she always wanted to go, but was never able to: increasing the quality life side of the outcome equation rather than the life expectancy side. Maybe we need to reform our capitalist culture so that we don’t put such a high value on excess or quantification. Maybe it is a good thing that the drug companies aren’t spending as much money making new drugs for us to take, it might force us as a society to move away from pharmacology and towards other modalities of medical care that are more cost-efficient and, perhaps at our current position on the tech curve, more efficient at delivering the outcomes we really want.

Transcendent Man: Ray Kurzweil

I watched the documentary Transcendent Man tonight and it is a very interesting and educational film. I highly recommend it to anyone who has never heard of Ray Kurzweil or is unfamiliar with Moore’s Law. If you’ve already read Kurzweil’s book or seen him talk before, you will know what you are getting yourself into with this movie and might actually find it kind of boring (like I did) (but its still good).

Kurzweil is an inventor and engineer who holds a lot of patents on optical scanning technology (specifically OCR) and several musical instruments. He is pretty famous: in the film it seems like everyone from Colin Powell to Bill Gates is giving him props. Over the course of the last several decades, he has made a name for himself by making bold predictions about technology, most of which have kind of half-way or sorta all-the-way come true (sometimes not always exactly when Kurzweil predicts they will), although there is a lot of debate in the scientific community about the accuracy of his predictions. His Big Idea is the “Singularity”: a point in time where technological change will happen at such a fast rate that we will have to become cybernetic organism just to understand and comprehend it. Because of Moore’s Law, computer will be as small as blood cells by the year 2040 and we will be able to bioengineer ourselves into cyborgs that will live forever and be able to download information into our brains ala The Matrix. Most of the skeptics don’t so much disagree with the premise of his predictions as they do with when they will come true, and this is where things get interesting.

Kurzweil has been accused, and these accusations are somewhat supported by the seemingly candid view we get of him in Transcendent Man, of having a lot of fear-of-death driven hubris. The film brushes past the facts of Ray’s father’s illness and somewhat early death, Ray’s Type II diabetes, and his less than subtle obsession with immortality, to focus on the marvel of his predictions. In the film, he seems obsessed with the idea of his own genetic fragility, and also his ability to perhaps single handed invent a way to cheat death. Kurzweil definitely has a large emotional/spiritual/existential investment in his predictions coming to light.

Another criticism of Kurzweil’s extrapolations is that Moore’s Law has a limit (something freely admitted to by Gordon Moore himself). Computers can only become so small before they will have to actually be smaller than atoms (these subatomic computers are theoretically possible, and designing these types of computers is the objective of quantum computing). Also at a certain point, the speed of light and the gravitational constant come into play, although I am not versed enough in physics to explain the ramifications of these limits. Suffice it to say, the unlimited exponential growth that Kurzweil bases his theory from is dubious, although his predictions of cell sized computers may come to fruition before these limits are met.

Artificial intelligence also plays into Kurzweil’s view of the future world. He predicts that AI’s smarter than every single human brain on the planet combined will come into existence within the next 50 years. I personally find this hard to believe because we haven’t been able to build a machine that can pass the Turing Test yet. It is interesting to note the diverging opinions amongst some of the “experts” in this field. The kind of AI’s that some of Kurzweil’s peers describe in the film sound more like Skynet than the benevolent personalities imagined by Kurzweil himself. In any case, I am far from an expert on AI and the film doesn’t really try to explain the specifics of it, which is too bad because it is a fascinating and ill-understood subject.

Regardless of the accuracy of his predictions or the possible hubris behind his optimism, Ray Kurzweil is undeniably a genius and an inspiration. I personally hope that the predictions he makes come to be a reality within his lifetime so that he can see The Singularity happen and so I can live forever as a cyborg.

Good Reads

The Philosophy of Applied Mathematics : Very interesting article and accessible for people who, like myself, aren’t math geniuses.

Gender is Dead, Long Live Gender : It is kind of amazing that we live in the year 2011, but gender and sexuality are still essentially avant garde subjects. I think that most people aren’t really interested in the subject on an intellectual level because it is something that most of the privileged majority take for granted. As a straight male, I never really thought much about the subject until several years ago when I started dating a girl who identified as bisexual and who was very informed about issues relating to gender politics. It is very easy for the straight population to be tolerant of alternative sexualities without being 100% accepting; I know that I definitely was guilty of this before I began investigating the subject (and this type of tolerance without acceptance doesn’t end just with sexuality, it also extends to race as well, and within the marginalized groups there is also a fair share of “backlash” intolerance/nonacceptance against the normalized-value holding majority group). Regardless of your own personal identification, you probably owe it to yourself to read this article, if for nothing else than to understand a part of the social transformations taking place in the world today and also to further your understanding of yourself.

The History of Dialogue: Other People’s Papers : Fascinating dialogue between a professor and someone who helps students cheat by selling them papers.

Categories: Uncategorized

My bad… forgot I was supposed to also being writing about music

Tortoise are an awesome band. I honestly don’t know much about them besides what there music sounds like. As far as independent instrumental rock bands from the last 20 years go, they are the among the best, if not the best. Most of their songs are free-jazz jams based off one groove or melody, but it is definitely not simple music, and they aren’t afraid of getting all ambient and synthy on you, as if Brian Eno just happened to drop by for a minute. One friend of mine describes them as a faster and more jazz-influenced/less classical-influenced version of Mogwai.

Their albums TNT and Standards are what most hipster fanboys point to as their greatest, but I think they are one of those rare bands where you can jump into their catalogue anywhere and be not only rewarded, but also get an excellent impression of what the band is all about. There more recent stuff seems to rock a little harder. They also have done a lot of session work for indie bands and singers, or at least I think so… at the very least I know for sure that they did an album with Bonnie “Prince” Billy, so definitely check that out if you are into that type of stuff.

Categories: Rock

Looking Beyond a Society Based on Consumption or Why I Am Not A Randian or Objectivist

This post is inspired by, amongst many other things, this particular “piece of writing” that I saw on Google News Spotlight. It’s not very good but I am linking to anyway in hope of maybe getting some cross traffic or baiting some Randians to come argue with me.

I haven’t read Atlas Shrugged, so please don’t mistake this as some type of review or critique.

Imagine a world where, instead of the capital owning class going on strike, the lower and middle classes went on strike. They stopped buying durable goods, stopped eating out, stopped going on vacations, stopped investing in their 401Ks. What would happen to the economy and industry then? Granted, the working classes are generally unable to go on strike for prolonged periods. They are called the working class because they have to work. They don’t have nest eggs and investments from which they can draw an income. So they work. They aspire, they consume, and they keep the economy moving along because they have to: they have to feed and clothe and house themselves and their families.

But they don’t have to buy new TV’s and automobiles or overleveraged homes. These are cultural values, specifically consumer culture values. Partially they are the legacy of the “American Dream” that is itself rooted in the scientific revolutions of the Enlightenment and subsequently mankind’s gradual ascent from a Hobbesian existence towards the current level of comfort and physical security afforded to us today. Human beings are an aspirational animal. We are hardwired to accumulate material wealth because material wealth brings security. From an evolutionary perspective, this makes perfect sense. The only problem is that sometime thousands of years ago, mankind started to cultivate the land and form societies. These societies began to offer to human beings a way to escape the Darwinian struggle for survival, to a certain degree. Over time, it has brought us to a point today where natural selection is still in effect, although social processes have created an evolutionary environment in which it is not always the most adapted that survive and flourish. We have created a world of equal genetic opportunity, which is almost assuredly a great thing, but we still have these evolutionary impulses to conquer and acquire, to hoard what is scarce, and to have anxiety over our relative social position.

All of these impulses are putting us on a collision course towards collapse. I am not an expert on environmental science or population economics, but I believe it is fair to say that the scientific community, by and large, has seen the writing on the wall. The level of economic growth, as it is defined contemporarily by GDP growth, is unsustainable. The stock of natural resources on our planet is being diminished and the world’s population is continuing to grow, both at ever increasing rates. From the time of the Industrial Revolution to the end of the Second World War, the world’s population has grown from 1 billion to 3 billion people. Only a fraction of those people were lifted out of what we would consider poverty and into the ranks of the working consumer class. Today, the world’s population is near 7 billion and more than half of those people are currently playing “catch up” with the Western world in terms of industrialization and standards of living. Even though today’s industrial standards are more technologically sophisticated and efficient than what was used during the 19th and 20th centuries, the cost to the earth of giving 3 billion more people plasma screen displays and three bedroom houses will be tremendous.

The consumerist cultural values that are intrinsic to the operation of the current global capitalist system are unsustainable, and from an existential viewpoint, completely unnecessary in today’s world of abundant food and relative interregional security. Many recent studies have been done that conclude people do not gain any marginal happiness with income levels over a certain amount. I am not sure what that amount is, but the mere fact that it exists should tell us something about the end result of an aspirational consumerist society: it won’t end until the earth is dead or we change our values.

The middle classes can stop wanting to become the upper classes, and the lower classes can be assured of their own rights to be enfranchised as global citizens who are able to receive benefits from the technological and scientific progress that has been made over the last several centuries, we just have to want it and demand it, first as individuals, then as a society. We have to change our values.

Back to Atlas Shrugged: Atlas would be screwed without society at large. If the upper class really are the innovators, idea people, and heroes of society (which is a claim I am dubious of, but for the sake of argument I will let it stand), they still need a stock of workers to bring those ideas to life, and a marketplace full of consumers who are willing to purchase these ideas. Philosophically, the nobility of the capital owning classes lasts only as long as you give credence to consumption as an end in and of itself.