Somebody to blame

Jonathan Cohn — one of the best-informed voices on healthcare in American journalism — has a new article in The New Republic about the reductions in provider networks that insurers are imposing, due to constraints in the Affordable Care Act. Except, as he points out,

Even before Obamacare, employers and insurers were already moving in the direction of limiting networks and penalizing costly hospitals like Cedars. Kominski notes that his employer, the University of California system, aggressively restricted its provider network two years ago. The change affected thousands of employees—and was one of many such decisions employers made around the country. But it didn’t generate a national controversy. The city of Los Angeles just took Cedars off the network for one large plan in order to keep premiums for city employees low. And while it’s possible Obamacare accelerated a trend toward limited networks for direct consumers, it’s also possible that insurers would have made that switch anyway—and that they’re introducing these changes now, in one big wave, because Obamacare gives them a convenient excuse.

This is a genuine bias, particularly in American democracy, toward leaving problems unaddressed, because as soon as you start trying to deal with the problem, voters will hold you responsible for any remaining defects.

I remarked on this shortly after I came to the UK, that it seemed to me that the British underrate the NHS, because any health problem that occurs anywhere in the country, whether it’s unhygienic conditions in a hospital, or GP surgeries not being open at sufficiently convenient hours, is blamed on “the NHS”. That is a strength, but it’s also a temptation for politicians to offload the responsibility onto “the market”. The political culture hasn’t  gone that far in this country, but that’s why there’s a major US political party whose political philosophy is, conveniently, essentially “There’s nothing we can do”.

(Physicist David Deutsch has written a book-length quantum-utopian manifesto whose main lesson seems to be that the fundamental criterion for the progress potential of a political system is the extent to which it makes it clear, when things go wrong, who is to blame.)

This is a well-known problem in torts law — a public danger that has never been touched is nobody’s responsibility. If you try to make it safer, but cannot eliminate the danger entirely, suddenly it has become your responsibility if someone is injured. I first encountered this many years ago, when The Economist published a somewhat surprising plea for a planetwide defence against rogue asteroids. Like (I think) most people, on the rare occasions when I do think about asteroid strikes, I generally do not consider the legal implications. The article pointed out, though, that while an unmolested asteroid that obliterates London is an Act of God, as soon as some government tries to divert it, it becomes a legal liability.

This is an issue that I’ve never seen raised in the famous trolley problems that moral philosophers love to natter about. If you’re the trolley driver then you have a real moral dilemma. If you’re a bystander who happens to see a switch that could be thrown, you’d best call your lawyer first. She’ll tell you, under no circumstances should you touch anything. If 5 people die, that’s not your fault. If you save the 5 but kill one — if you even hurt the one’s finger — his family will sue you.

Einstein and the Quantum

I just saw an ad (in Blackwell’s Books) for a book titled Einstein and the Quantum, with a text that began

Einstein himself famously rejected quantum mechanics with his God does not play dice theory…

Putting aside the fact that “God does not play dice with the universe” is a quip, not a theory, I’m fascinated by this extreme statement of a calumny on Einstein that I knew as standard when I first learned about quantum mechanics from popular science in the 1970s, that the old man, despite his revolutionary past (and he was only in his late 40s) simply lacked the intellectual flexibility to keep up, rejected the new science, and was proved wrong by the march of progress.

In fact, that famous remark (from a 1926 letter to Max Born) acknowledged up front that the emerging probabilistic view of quantum mechanics was proving very useful. He simply rejected the willingness to deny a micro-level interpretation. (And the so-called Copenhagen “Interpretation” of quantum mechanics is really an anti-interpretation, a programmatic refusal to interpret. For more comments on the pedagogical function, see here.) The fact that this approach went from strength to strength as a calculating tool does not mean that its interpretive framework, the one that said that probabilities are the fundamental objects and there is no use going deeper, has been proved, any more than the success of Maxwell’s equations proved the existence of molecular vortices in the luminiferous aether. In particular, proponents of the Copenhagen Interpretation have tended to ignore the fact that they are helping themselves to a supposedly primitive concept, probability, that is actually complex, strange, and sorely in need of physical foundations.

Certainly one powerful strain of modern work on the foundations of physics — in particular, the Everett interpretation of quantum mechanics (cf. David Wallace’s The Emergent Multiverse) also rejects the notion that there is some randomness at the core of quantum mechanics, and takes as a point of departure the entanglement theory first proposed in the Einstein-Podolsky-Rosen thought experiment.

* Einstein wrote, “Die Theorie liefert viel, aber dem Geheimnis des Alten bringt sie uns kaum näher. Jedenfalls bin ich überzeugt, daß der nicht würfelt.“ Literally: “The theory gives us much, but it hardly brings us nearer to the Ancient One’s secret. In any case, I am convinced that he does not throw dice.”

On learning to play an instrument

I was intrigued by Mark Oppenheimer’s article in The New Republic “Stop Forcing Your Kids to Learn a Musical Instrument” when it appeared in September, and a reread it now that it has been reposted. Obviously, the “forcing” alluded to in the headline sounds pretty bad, and few people would advocate it. But the article is not about forcing; more like “strongly encouraging”. Oppenheimer is willing to continue financing his daughter’s violin and ballet lessons, but he won’t encourage it. And he does not believe that it is worthwhile, unlike the weekly Hebrew lessons, or more valuable than watching comedies on television. I can accept his feelings on this point, and I wonder myself sometimes what motivates some parents to push their children into certain activities, given attitudes that are little different from Oppenheimer’s.

But if this were merely confessional breastbeating it would have been a 50-word blog post, rather than an article in TNR that helps pay for those useless violin lessons. So Oppenheimer provides a few hundred words of explanation, and chaos ensues. The arguments are so badly tangled that they come out almost as an advocacy of music lessons once you’ve unknotted them. I find it hard to escape the impression that it irks him that his daughter is enjoying something that he doesn’t understand or appreciate.

He has two main arguments:

  1. To they extent that playing an instrument is a useful skill, it is not classical music that children should be learning.
  2. Learning to play an instrument has no value beyond itself. (Ditto for learning to dance.) The claims commonly put forward are spurious.

Let’s look at argument 2 first. Oppenheimer writes

Why are so many children taking ballet, violin, piano? Lately, I have been asking my fellow middle-class urbanite parents that question. About dance, they say things like, “Ballet teaches them poise,” or, “Ballet helps them be graceful.” And about violin or piano they say, “It will give them a lifelong skill,” or, “They’ll always enjoy listening to music more.”

It does not take a rocket scientist, or a Juilliard-trained cellist, to see the flaws in these assertions. First, as to ballet, I propose a test. Imagine we took ten girls (or boys) who had studied ballet from the ages of five to twelve, and then quit, and mixed them in with ten girls (or boys) who had never taken dance. Let’s say that we watched these twenty tweens move around their schools for a day… Does anyone really believe we could spot the ones who had spent seven years in weekly or biweekly ballet class?

Interesting thought experiment. Does anyone really believe…? Obviously the parents who told him this believe that, or something similar. (Maybe “poise” and “grace” aren’t quite so conspicuous, so they wouldn’t quite know what to predict.) Are they right? I don’t know. But it’s weird to present as proof that these other parents are wrong the results of a made-up experiment that no one actually did. Continue reading “On learning to play an instrument”

Lazy headline clichés: Obesity edition

Am I the only one who is briefly bemused when a Guardian homepage headline refers to obesity “leaping” in the developing world, or when the headline on the article tells us

Obesity soars to ‘alarming’ levels in developing countries

I understand the need for colourful imagery in headlines, but it shouldn’t clash. Thinking about obesity leaping and soaring makes my head hurt. We might imagine a headline about a “Healthy increase in measles cases”, or “New NHS rules allow GPs to make a killing”.

The striving after punchy language sometimes makes for weird effects when combined with the English language’s exceptional parts-of-speech ambiguity, as in this BBC headline from the time of the BP oil leak in the Gulf of Mexico:

BP caps shattered oil leak wellhead

At first I thought BP had put some caps on, which proved counterproductive because they shattered the wellhead. I forgot that headline writers like to put everything in the present tense (sounds more exciting that way, I guess), so what I thought was a noun (caps) was actually the verb, describing a success, and what looked like a past-tense verb describing the failed effort was actually a participle, referring to the state of affairs that started the whole story.