Open Thread, 11/12/2017

One of the major insights of contemporary cognitive psychology is that a lot of human mental processes emerge from the intersection of lower level intuitions/models/instincts. The key is to remember that a lot of mental operations occur implicitly and rapidly, and we often construct ad hoc rationalizations after the fact (see The Enigma of Reason).

Because rationality is such a good talker many of us have deluded ourselves into thinking that instead of being a mouthpiece and a lawyer that gets us out of sticky situations, it’s actually calling the shots. No.

Anyone interested in these topics should check out Paul Bloom’s Descartes’ Baby: How the Science of Child Development Explains What Makes Us Human (or his other books).

This comes to mind when thinking about issues that have been bubbling up in our society. A friend on Facebook who is an evolutionary anthropologist wondered about the context of Harvey Weinstein’s serial rapes. I think A Natural History of Rape: Biological Bases of Sexual Coercion get’s a bad rap because of the incendiary topic, but in this case, I think cognitive psychology yields a quicker and clearer answer. Weinstein is a very wealthy man, so if it was sex with nubile women he could have paid for high-priced escorts (and it seems he did on occasion). But cognitive psychology suggests that people crave “authenticity.” Weinstein’s targeting and abuse of women he knew professionally and personally clearly provided for him an addictive frisson that paying for sex wouldn’t have given him.

Today people are passing around this “shock poll,” Poll: 37 percent of Alabama evangelicals more likely to vote for Moore after allegations. Probably most of these people think this is a politically motivated hit. That being said, it brought to mind a passage from In Gods We Trust where respondents asserted that disconfirming evidence in regards to their beliefs actually made them stronger in their beliefs.

In other words, when it comes to deeply held beliefs people aren’t going to react in a straightforward manner to reason and logic. Don’t be surprised if they behave irrationally. If the irrationality is consistent across individuals there’s probably some deeper psychology you aren’t accounting for.

The problem of doctors’ salaries. The AMA licensing cartel is keeping the supply of medical services constrained. Yes, we need more doctors. But we need more non-doctors to be able to do things that only doctors can do right now.

On the other hand, medical doctors have on average $200,000 of educational debt when they graduate. The high debt load is probably in part because there is the assumption that they will be making between $200,000 and $400,000 per year (though with income tax rates, as well as malpractice insurance, remember their net take home is considerably less).

These sorts of structural features are why we can’t have nice things. I suspect most people agree that the American tax code should be reformed…but peoples’ choices have been made with deductions in mind!

We’re rolling out more shirts for DNAGeeks. Eight people have bough GNXP t-shirts. Would be curious to post a picture of someone wearing one of those. A little surprised, but the Evo-Devo t-shirts are selling well. Anyone have any ideas for something more pop-gen related?

I love maps [THE MAP IS FAKE!] which have more granularity than country vs. country comparisons. I really hate when people compare the USA to European countries. California alone is nearly as populous as Spain, which isn’t even a small European country.

The map to the left shows the areas of high GDP in South Asia, though resizing region by the size of the population would help give a better sense. The distinction between urban and rural is very stark in Bangladesh.

I predict Twitter will be clearly in a death spiral in a year. The proportion of highly polarized political chatter on my timeline keeps increasing, even though I’m not following anyone different. The vibrant years of “genomics twitter” seem to be a thing of the past.

The above tweet has gone somewhat viral. What did I mean above? The sort of thing in The End of History and the Last Man, that the terminal stable state of humanity would be post-materialist secular individualist liberalism. Though secularism seems to remain ascendant in the West, for now, the post-materialist individualism liberal project seems to be fraying. Instead of Western culture being a stand-in for global culture, it may be in the near future it will again be just another culture among cultures.

31 thoughts on “Open Thread, 11/12/2017

  1. Re “I predict Twitter will be clearly in a death spiral in a year”. This prediction is definitely wrong, even though the insight is correct.

    A good analogy is myspace and facebook. Myspace was clearly flawed and suffering many problems, but it could’ve muddled along for a long long time. But instead facebook killed it. See the chart in this post, in particular the time around 2006-2008.
    http://www.slate.com/articles/business/moneybox/2014/01/facebook_s_decline_in_popularity_a_viral_research_paper_doesn_t_prove_its.html

    The reason twitter is still muddling along is it’s a brilliant idea to have an social interest graph, in which you can post short notes/links to those who follow your interests.

    There’s nothing currently like facebook was to myspace, in regards to twitter. Networks are hard to ramp up, hard to kill. And when something does, twitter is still capable of a management pivot to not being horrible. It just needs to be managed well enough to kill off the next version of itself. Myspace couldn’t do that. But twitter might. Hard to know. But since nothing is on the horizon for doing the jobs-to-be-done that twitter does right now, it’s got a few more years of muddling along at least.

  2. speaking of “In Gods We Trust”:

    The study – published in Scientific Reports—was the first to challenge a growing trend among cognitive psychologists over the past 20 years that has attempted to show that believing in the supernatural is something that comes to us ‘naturally’ or intuitively.

    https://phys.org/news/2017-11-religious-belief-linked-intuition-rational.html

    twitter is still nice but i’ve become a Pocket evangelist. i found over 80 longreads in less than half an hour of searching. it’s basically is a one stop shop for good links.

    i can recommend “A Ghost Story” starring Casey Affleck. a highly original film that also left me feeling totally depressed about…existence, i guess. a film that makes you think

  3. “The AMA licensing cartel is keeping the supply of medical services constrained.”

    Its not the licensing per se, the real choke points are the med schools and residency system. I am too lazy to get the links, but:

    The US med school system graduates about 20K sprogs per year. There are slots for about 25K residents per year filled by the 20K grads and about 5K foreign grads.

    Both the number and size of the med schools and the residencies are controlled by the Federal government. I am sure the AMA lobbies the hell out of that, but the final say is not theirs.

    The result is that there are about 1 million docs in the US, or about 3 per thousand pop. Other major industrialized countries, France, Germany, etc. are above 4. To get to that level would require a 25 to 35% increase in trainees.

    The Federal Government is pursuing one of its classic policy formations that cannot end well. On one hand it is subsidizing demand via Obamacare, medicare, medicaid. On the other side it is choking supply. The spiraling costs are the predictable result.

    “On the other hand, medical doctors have on average $200,000 of educational debt when they graduate.”

    And who is the lender? That is right the Federal government.

  4. “Yes, we need more doctors. But we need more non-doctors to be able to do things that only doctors can do right now.”

    We now have doctors spending more time with computer screens and drop down menus than patients. Perhaps we could figure out how to get less expensive people to relieve physicians from clerical work.

    There is little doubt that less highly trained people can do well baby visits and treat runny noses. The minute clinics at CVS are staffed by nurse practitioners. And in some states there are practices where the patients are seen by NPs, and there is one doctor on site as a supervisor, QC officer, and guru. So it is starting to happen.

  5. The map to the left shows the areas of high GDP in South Asia

    Even anyone with a very cursory knowledge of South Asia knows that the wealth-poor disparity is enormous, but the map you link really paints a stark picture about the interregional disparity of wealth in South Asia.

  6. Twitter is claiming they’ll be profitable next quarter. We’ll see, although survival of the service doesn’t mean it will be a particularly good or useful one for intellectual discussions.

    I love maps which have more granularity than country vs. country comparisons.

    That India data is remarkable. I remember being shocked when I looked up GDP per capita for Mexican states after seeing a humorous map comparing them to various countries in economy size. The highest state had a GDP per capita nearly five times as high as the lowest state (not counting the Federal District containing Mexico City), compared to a roughly two-times disparity here in the US between the richest and poorest states.

    But that’s nothing compared to those Indian disparities.

  7. A final note is that we need to restructure medical training. Now kids get a BA in any old subject that won’t lower their GPA. They are required to take about 10 science course and the rest can be art history and French literature. Student at some of the tougher universities (like my nephew who went to an ivy) take their really hard science courses (organic) during the summer at municipal college. The BA wastes 3 years and costs a boat load of money.

    Then they go to med school where they take science courses and labs for two years. The final 2 years are where they start going to clinics and tagging around the hospital.

    There is another admissions process to get them into a residency. Specialist training follows that.

    Here is what we can do to make it cheaper and faster. Abolish the BA requirement. Allow students to pursue a three or four year program that will cover the UG science, and med school science, without the French Lit and Art History. They would get a BS in Human Physiology and Anatomy.

    The science courses can be taught via remote lectures and and computer labs. Instead of dissecting cadavers, they could use VR to explore anatomy. It could be a fairly cheap process.

    Then they would go to a program that combined the last two years of medical school and the internship year. That would be followed by a three year residency program where there could be specialization.

    It could turn a 12 year path into an eight or nine year path at a considerable saving.

  8. Both the number and size of the med schools and the residencies are controlled by the Federal government.

    You are right on the money, especially about the residencies. What’s worse is that American medical school graduates are NOT the only ones admitted into American residency programs. There is now an increasing admission of foreign medical graduates (FMGs) into residency.

    On one hand it is subsidizing demand via Obamacare, medicare, medicaid. On the other side it is choking supply. The spiraling costs are the predictable result.

    Excellent and concise point. Add to that the fact that our medical insurance system does not work like ordinary insurance (low premiums to spread exposure to catastrophic, but low probability risk), but acts as a guaranteed payout system for chronic services. The total cost can only go up higher than it would organically without these administrative layers (which encourage demand).

    We now have doctors spending more time with computer screens and drop down menus than patients. Perhaps we could figure out how to get less expensive people to relieve physicians from clerical work.

    Do you really want further bureaucratization of medicine? What about reducing the amount of clerical work? After all, do we really want for medicine the university/academia model of the past 50 years, in which the administrative staffing and costs have mushroomed enormously while the numbers of the customers served (i.e. students) and the providers (i.e. professors) have remained flat essentially?

    If there is one industry that is ripe for de-regulation, it is medicine!

    My wife and I sit on the board of a large (multi-regional) medical system, and I always froth in frustration at the mouth like a rabid dog after each board meeting, because of 1) the incredible amount of bureaucracy that adds no value to the provision of medical care as well as the gross inefficiency in the administration of medicine (paper files? What is this, the 1950’s?) and 2) the shockingly low level of competence among the managerial staff of medical facilities (my wife calls people in medical management “the bottom 10% of the graduates of the bottom 10% of business schools”). But I suppose that’s what the “non-profit” model gets you.

  9. “Yemen’s Shia provinces are now completely blockaded. There’s mass starvation and a cholera epidemic. The Anglosphere could stop this if it cared.”

    5000 years most warfare was siege warfare. The rules were that if you didn’t have enough supplies and were starving, you put up the white flag and surrendered. If you were very lucky, the winner did not massacre the men and sell the women and children into slavery.

    In the 21st century we have people with the goofy idea that we should prolong wars by resupplying the loosing side. They are not humanitarians, they are like little boys who torture grasshoppers.

    What we should do is to use our good offices to ensure that a swift surrender is followed by a humane aftermath without enslavement and massacres. The only alternative is to continue to mind our own business.

    Oh yes, and the Yemeni shia are Iranian stooges and the stronger side is our allies the Saudis. The Iranians are our enemies, in case you have forgotten. Another reason to not get more involved than we are.

  10. I am not sure about the data behind the India GDP map, but a few things stand out.

    1. Population density is an issue since some South Indian low GDP areas (near South west) are rain forests of Western ghats and unlikely to have many people. Same issue with central-east region, north of Hyderabad city. It is historically under-developed due to being a forest region.

    2. The map is clearly at district level since “Nellore” district (just north of Chennai economic zone along the east coast) is clearly a darker colour than the surrounding. It is historically rich with Pennar river delta and rice farming. Similarly, two other river deltas along the east coast (Krishna and Godavari) are historically rich due to fertile land for rice farming. It is hard to believe the light colour just south of Vishakapatnam along the coast. There must be a data error to say West Godavari district is lower GDP than Nellore…

    3. The lightest colour in Deccan between Hyderabad, Bangalore and Chennai was historically called “Rayalaseema” (supposedly rich during Vijayanagara empire ~16 century). But is a rain-shadow region due to Eastern Ghats and red sandy soils that are not good for farming. Hence, low GDP. There is extensive mining in the region, but I guess most of it is illegal, and perhaps didn’t make it to data?

    Other than metropolitan areas, it is unbelievable how much relative GDP maps directly to farming yields to this day.

  11. Something is off about that South Asia map.

    Rural Sindh is NOT one of the richest parts of Pakistan. And rural Sindh and backwoods Baluchistan are not richer than rural Punjab.

    I know it’s supposedly sourced from the world bank, bit intuitively, it looks wrong.

  12. Ok. This map is “fake”, in that it is not a map of GDP per capita.

    It is actually a map of _predicted_ GDP district based on night light intensity.

    Tha map originally appears in a World Bank paper on using light intensity from space to predict GDP.

    https://www.worldbank.org/en/news/press-release/2017/10/08/right-policies-south-asia-potential-growth-lead-saef

    It was then published in a blogpost, where the figure was clearly labelled in a caption. The paper notes that light intensity has drawbacks as a GDP proxy (and is particularly bad at measuring agricultural GDP in South Asia – maybe because farmers use power on water pumps, not light) but could have use in remote areas or during natural disaster.

    http://blogs.worldbank.org/endpovertyinsouthasia/measuring-south-asia-s-economy-outer-space

    Whoever lifted it from the blogpost (I suspect a McKinsey consultant) failed to include the clarifying caption.

    It was then passed around by twitter users, all of whom are credulous and lazy.

    Razib, this is a great example of why Twitter is worse than useless. Even when you think you are learning something, you are being misinformed and getting dumber.

    (Imagine how much other misinformation you have been victim to, where I have not been around to fact check)

  13. Lots of women now go to medical school and they are far more likely to work part time or stop work entirely because of raising children and/or husbands that make more money than even their high doctor salaries. Thus 20K medical school graduates doesn’t translate into 20K more doctors taking care of people.

    Given how much the government spends to train doctors (residency slots are heavily subsidized) maybe favoring people that will work for 40 years would be a good idea.

    No, I don’t think this is actually possible to do.

  14. “But we need more non-doctors to be able to do things that only doctors can do right now.” That is actually what is happening now. But it is not humans, who are the aforementioned non-doctors but technology.

    For example: there are multiple Artificial Intelligence projects designed to detect dieseases. Cancer being the most popular. They do detection better than humans.

  15. re Moore, reason, and logic: Moore’s supporters, perhaps, are acting according to reason and logic… for their own interests.

    Moore’s base sees their champion assailed by others who have posed as the enemies of Alabama folkways for two centuries or more. They look into the allegations against Moore, and see little here that could not be levelled against Democratic and, indeed, against mainstream Republican candidates. (Denny Hastert, anyone?)

    Alabamians know a concern-troll when they see one.

  16. As far the Iranians being our enemies: I’d prefer they weren’t, but they did declare war on the US in the 1970s, occupy American sovereign territory (the embassy), and abuse American citizens.

    If the Iranian government decides to sign a treaty with America acknowledging this – and, yes, the Americans should for their part discuss and apologise for their own meddling – then, fine, hooray. But until then I have no sympathy for the Islamic Republic nor for those armed militias abroad who foolishly throw in their lot with said Republic.

    Especially not for the Houthis. I’ve read their slogan. It has some pungent comments about the Jews – not just about Israel. They are avowedly racist. If they want to disavow that and reach an agreement, we can talk. Otherwise this is the bed they have made for themselves.

  17. Intentional starvation of civilians is a war crime:
    https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_rul_rule53
    Regarding blockades:
    “Likewise, the prohibition of starvation as a method of warfare does not prohibit the imposition of a naval blockade as long as the purpose is to achieve a military objective and not to starve a civilian population. This principle is set forth in the San Remo Manual on Naval Warfare and in several military manuals which further specify that if the civilian population is inadequately provided for, the blockading party must provide for free passage of humanitarian relief supplies.”

    Since the Saudis are tightening their blockade (out of frustration about their military failure), it seems increasingly like this is deliberately aiming at some collective punishment of the Yemeni population. And the US is enabling this appalling behaviour through its support (logistic and diplomatic) for Saudi-Arabia.
    Will end badly, and wouldn’t surprise me if this will come back to haunt Western powers in one way or another.

  18. A Progressive Muslim Candidate Wants to Flip a Florida District. He’ll Have to Beat Both Parties to Do It.

    https://theintercept.com/2017/11/13/ahmad-saadaldin-florida-muslim-candidate/

    “Vote for the brown guy with the weird name.”

    re: saudis and other nasty bedfellows. the more i read about our ongoing relationship with Saudi and nearly every other “bad” foreign policy “on the wrong side of history” I feel like Zbigniew Brzezinski’s attitude about the Afghan/Russia policy a few decades ago sums it up. he didn’t care about a few angry muslim militants since he got what he wanted re: Russia. it’s just cost/benefit – you’re in the long game and simply can’t afford to worry about the little guy. same reason our gov’t didn’t really care about who was really responsible for 9/11 – they’re focused on the long game (at least, they think they are.) mistakes will be made since you don’t know what the best move is at any given point. there’s a chance all of those neocons are right (though i think their cynicism is too expansive.) i mean, you need look no further than stuff like this:
    https://www.theatlantic.com/international/archive/2017/11/al-qaeda-iran-cia/545576/
    i think the Saudis ended their blockade so maybe that’s our way of being on *both* right sides of history:)

  19. “i think the Saudis ended their blockade so maybe that’s our way of being on *both* right sides of history:)”

    They’re apparently still keeping the port of Hodeidah blockaded though which is pretty important if I understand correctly.
    Regarding support for Islamist Saudi-Arabia and the militants it sponsors, probably a bad idea even back in the 1980s. At least there are claims which seem credible to me that the Soviets’ war in Afghanistan had very little impact on the break-up of the Soviet Union (e.g. that argument is made in Rodric Braithwaite’s “Afgantsy: The Russians in Afghanistan”). So probably not worth it given the anti-Western militancy this helped bring about. Seems even dumber as a policy today.

  20. At least there are claims which seem credible to me that the Soviets’ war in Afghanistan had very little impact on the break-up of the Soviet Union

    Materially, probably not. But even in the relatively opaque Soviet Union, dead bodies of their young coming back was a severe moral blow, on top of the failing economic system.

    probably a bad idea even back in the 1980s.

    This is only in retrospect. The Soviet Union was a mortal, existential threat back then. Terrorism was usually state-sponsored in proxy wars and was seen to be relatively benign (in the sense that it was limited; the usual acts of terrorism such as airplane hijackings usually led to demands being made and the passengers being used as hostages and bargaining chips, rather than being decapitated on TV).

  21. @Ikram, Thanks for the blog post link. It all makes perfect sense now. Night time street life is insane in Nellore compared to other districts of similar wealth. Kurnool is under-performing than expected due to inclusion of Nallamala forests within its boundaries.

    It is so strange that the band of darkness along western coast of Karnataka, showing the rain forests of Western ghats, didn’t translate to similar light colored band in western Karnataka. I think that district boundaries that don’t coincide with physical geography are introducing the prediction errors.

  22. I missed this earlier:

    On the other hand, medical doctors have on average $200,000 of educational debt when they graduate. The high debt load is probably in part because there is the assumption that they will be making between $200,000 and $400,000 per year (though with income tax rates, as well as malpractice insurance, remember their net take home is considerably less).

    Note that there is a bit of bifurcation in physician compensation between primary care docs and specialists. Your link states:

    A 2015 survey of salaries for specialist physicians reported the median starting salaries of various specialties. Median salaries ranged from $167,012 for general pediatrics to $680,000 for neurological surgery. Other high-paying specialties were general orthopedic surgery ($450,000), gastroenterology ($377,500), cardiology ($360,000) and sports medicine orthopedic surgery ($350,000). Specialties other than pediatrics that paid less than $200,000 were internal medicine and nephrology.

    Furthermore, the median numbers above are also a bit deceptive, because type of employment and payer mix greatly alters the compensation. So, combining these factors, physicians doing general pediatrics or OB/GYN as employees in a bad payer mix area might make, say, $100,000 a year while doctors who are partners/shareholders* at good payer mix ENT or anesthesia practice might earn $500,000-1 million+ a year.

    However, I should point out that such practices are increasingly being sold to large national medical companies as consolidation continues, and entries to such partnerships are growing extremely scarce, especially in desirable areas.

  23. @Zimriel

    re Moore, reason, and logic: Moore’s supporters, perhaps, are acting according to reason and logic… for their own interests.

    Yes. People have different understandings of what loyalty to the group entails.

  24. A correction on the blog but not twitter? Different norms in different platforms?

    Looking at a few of your twitter posts, another item is dubiously sourced. The New Yorker has only hearsay on Moore being banned from the local mall. Your tweets treat it as closer to fact (eg the word “busted”).

  25. no one uses twitter to search. archive is worthless.

    re: moore, where there’s smoke there’s fire. the veracity of that specific fact is less relevant than the ‘constellation’ of facts/accusations.

  26. Best case scenario: Moore is elected and then expelled from the Senate by Republicans with help from Democrats.

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