Friday, October 21, 2005

Here are some interesting posts on the general insanity of America's health policy.

Let's start with this one, briefly summarized here, as follows:

For the relatively modest cost of about $25 billion annually, the U.S. Gov could finance the same volume of drug research currently done under the aegis of private companies, and by virtue of that expenditure, be able to place all discoveries in the public domain, thereby reducing the price of drugs for consumers to zilch. All the discussion about the necessity of patents (with prohibitively high prices and short supply) being essential incentives for research is a giant pile of avian doo-doo.

The summary is inaccurate. It neglects to mention, as the longer post does, that doing this would save most of the $125 billion that the government currently spends on drug benefits, resulting in a nearly net $100 billion saving, as just about all drugs (save for the very, very rare cases which are genuinely tricky to manufacture) go generic. It also neglects to mention the many perverse incentives the patent system sets up:

  • Researching "copycat" drugs
  • Monetary incentives to fraud in research
  • Prioritizing the annoyances of the rich over the desperate needs of the poor, because, like, they have more money.

It's worth noting that the last of these is just the market working the way the market is supposed to work. The freshman economics canard is that a free market guarantees you an optimal allocation of resources. What it really gives you is what's called "Pareto optimality" --- that is, that there's no trade you could arrange that makes both parties better off. (Because, duh, if it's a free market, the parties would make that trade). But Pareto optimality is sometimes a far cry from social justice.

For more on how our political rhetoric around these issues is as screwed up as the health care system itself, look here, as George Will echoes the conventional wisdom:

Miller bluntly says that the social contract written after 1945 is being -- must be -- repealed because, given globalization, unskilled manual labor cannot be paid $65 an hour, with the cost passed on to consumers. "When you buy a Hyundai you get a satellite radio as your option, but if you buy a Chevrolet you get social welfare as an option. Long term, the customer is going to desert you if you try to price for your social-welfare costs."

The main social welfare you get with your Chevy is, of course, the workers' health care. And so Matt Yglesias flays the bow-tied SOB, after surveying how major car exporters do things:

In every major car-making country, auto workers get health care. The difference is that in every major car-making country besides the United States there's a systematic government policy in place trying to make sure that everyone gets health care. This is good policy. Those other countries feature better health outcomes and lower per capita expenditures than does the USA. They also have more competitive car industries than we have.

America's private sector welfare state is, indeed, breaking down. But our public sector one isn't breaking down. It's being bankrupted as a matter of deliberate public policy by officials who want to wreck it in order to better afford tax cuts for extremely wealthy individuals. This is also destroying our car industry and it's all very outrageous. But to pretend that nefarious "globalization" is responsible for it all is absurd. Universal health care is a staple of much more trade-dependent countries than the United States. Nothing is stopping us from doing it except the George Wills of the world.

And a political culture dominated by the groupthink of well-heeled, blindered acolytes of The God That Sucked.

Wednesday, October 19, 2005

Ray Kurzweil is known, these days, for predicting that before his biological frame expires, he'll be able to upgrade to a newer, high-tech silicon substrate. But in the meantime, he's apparently worried that someone may be constructing a virus to subject his current biological support systems to a denial-of-service attack. The particular virus that has him worried is the 1918 avian flu virus, which caused the epidemic that killed more people than World War I. And what has him upset is that the source code for the virus --- its full DNA sequence --- was recently released on the internet. Open source, as it were.

Of course, the compilers needed to take this source code and recast it into executable form are expensive, and the expertise required to operate them somewhat rare. But the result is a real, bona fide weapon of mass destruction. Really mass destruction --- far wider than you could achieve with any chemical attack. More perhaps, even, in a worst-case scenario than a "mere" isolated tac nuke. Of course, these are less discriminate weapons than nukes, which don't stay around for months killing people thousands of miles from the point of initial release. No matter who releases this, they would be killing their friends. But serious young men driven by some wild ideology might not let that stop them, any more than the Sept. 11th hijackers were bothered much by all the Muslims working in the World Trade Center. So, he has a legitimate concern.

Now, to make a nuke, you need specialized knowledge and equipment --- and highly enriched uranium or plutonium which takes billions of dollars worth of infrastructure to create. (Before World War II, physicist Niels Bohr said that it was impossible to make a uranium bomb because you'd need to cover an entire country with enrichment plants. Later, on his first visit to Los Alamos, he claimed vindication: "I told you it couldn't be done without turning the whole country into a factory. You have done just that."). To create the virus, you need specialized knowledge and equipment made of cheap materials, which fits in a building that doesn't look all that much different from a well-equipped medical lab. And the genomic equipment has plenty of legitimate uses (unlike bomb tooling), and it's getting cheaper all the time, while the expertise gets ever more widely distributed. So Kurzweil (and his co-author, Bill Joy) argue that the source code for the virus --- its DNA sequence --- should be kept secret.

But that tactic has its limits too. Techie blog BoingBoing titled its post on the Kurzweil/Joy opEd, "Kurzweil and Joy call for genomic Manhattan Project". An odd title --- most of the time, when people call for a "new Manhattan project", they're talking about throwing massive resources at a problem. But plenty of money is being thrown at genomics anyway. What Kurzweil and Joy are thinking of is the secrecy. And the real Manhattan project shows the limits of what can be achieved in that field. Obsessive as the Manhattan Engineering District was about security, their innermost sanctum, the section doing the most sensitive parts of warhead design, let in a serious young man driven by a wild ideology --- Klaus Fuchs.

Bohr's quip is reported in ch. 15 of Richard Rhodes's "The Making of the Atomic Bomb" --- by way of Edward Teller, of all people, on p.500 of my edition. As for Fuchs, the best account I know of is in Rhodes's follow-up book, Dark Sun.

Tuesday, October 18, 2005

As evidence that I am not dead, I offer more wisdom from Times Select. Today's installment, which lucky non-subscribers can't read, comes from their new conservative, John Tierney:

For now, it looks as if the outing of Valerie Wilson was done by officials who didn't think it was illegal and believed they were replying truthfully to a partisan who had smeared them. Hardball politics isn't pretty, but it's not criminal, either.

They were replying to Joe Wilson's report about Niger, that is, by talking about his wife. Republican logic at work.

Why is Tierney so sure that this was mere hardball politics? Well, for one thing

This case, if you can remember that far back, began with accusations that White House officials violated a law protecting undercover agents who could be harmed or killed if their identities were revealed. But it now seems doubtful that there was a violation of that law, much less any danger to the outed agent, Valerie Wilson.

There wasn't much danger to Wilson because she was back home when her cover was blown. But blowing her cover also blew the CIA front company she was working under, and exposed colleagues still in the field. Which might be one reason the law in question applies whether Wilson herself was endangered or not. Perhaps you can imagine others. (Imagine how her former contacts would react. And their soon-to-be-former contacts and colleagues). But Tierney can't --- at least not when Republicans are wriggling on the hook.


The case originally aroused indignation because the White House appeared to be outing Wilson as part of a campaign to unfairly discredit her husband, Joseph Wilson, who accused the administration of ignoring his 2002 report debunking evidence that Iraq was trying to acquire material for nuclear weapons. But a Senate investigation found that his report not only failed to reach the White House but also failed to debunk the nuclear-material evidence - in fact, most analysts concluded the report added to the evidence.

So, if the middlemen the White House put between themselves and Wilson suppressed his report, then by Republican ethics, the White House itself gets none of the blame. And Tierney's last claim --- that the report "added to the evidence" --- is true, in so far as there was more evidence once he finished writing a report. But that report refuted the charges. If Tierney thinks it didn't, what on earth does he believe the "hardball politicians" in the White House were retaliating for?

Tierney does also say that the Republicans' perjury charges against Clinton were bogus --- but he's wrong about so much else that it's hard to give him much credit (update --- particularly as I may have been giving him too much even for this; see comments....)