Mitt Romney vs Lane Goodwin

Have you heard of Lane Goodwin? He’s an amazing kid in a tragic situation: he was diagnosed with Alveolar Rhabdomyosarcoma stage III in 2010. Since then he’s gone through dozens of weeks of chemo and radiation, at one point the cancer had cleared up, and more recently things relapsed when 13 tumors were found. While going through more treatment Lane has become something of an international celebrity. Around the world, people have been inspired by his indefatigable attitude and just as often by the other supporters;  Lane has an incredibly active facebook page and has even appeared on Ellen DeGeneres.

Maybe you already know this, but I’m a grouchy cynic who is skeptical of the idea that public outpourings and charities like this even have a net positive effect on outcomes. All the same, I can’t help but be overwhelmed by the shear number of heartfelt people willing to give their time and even money in support of someone they hardly even know. It’s seriously touching. Here’s what I want you to think about, though:

Let’s say (I have no insight into the finances or healthcare of the Goodwin family – this is hypothetical) that Lane had been diagnosed in 2007 with Alveolar Rhabdomyosarcoma stage III. Whether or not his parents had good health insurance, Lane and his family would have been in an extremely precarious situation. If Lane had hit his yearly cap on medical expenses, the money that many people would donate to Lane would have been the difference between life and death. Rather than deciding to promote Lane’s hopefulness and strength, Ellen DeGeneres would have decided to help raise funds so that Lane might actually survive (or, perversely, if she declined his appearance on her show, she would have declined to help his chances at surviving). Lane’s mother on his website says “We will do whatever we have to in order to save our sons life!!” And you know she means it. But in this situation, in the US in 2007, that might mean frantically raising money and making tough financial decisions about what they would be willing to sacrifice so that Lane could continue to receive care after his yearly cap had been reached. Would they have to tap into his college fund? The money they'd been saving for a new house once they have another kid? Their retirement fund? Which would they be willing to deplete first?

Of course, a number of other similar situations could have transpired: Lane could have reached his lifetime cap, his parents' insurance company could have found a flaw in their application (maybe an infection from a tick bite they forgot to mention) and thereby saved thousands or perhaps millions of dollars by rescinding coverage, or his parents could have lost their jobs and their access to health insurance (maybe they missed a payment during an especially rough month) so that no insurance provider would accept their family now that Lane had been diagnosed.

Every year, kids find themselves in a situation similar to Lane, except that their moms probably aren’t as good at building facebook campaigns and they probably aren’t as photogenic or inspiring. What happened to these kids and their families in 2007? Many were put in the exact situation I describe and those that weren't had to worry constantly about it. However, starting in 2010 when the Patient Protection and Affordable Care Act went into effect, annual limits, lifetime limits, rescinded coverage, and rejection for pre-existing conditions were all eliminated for children; those regulations will apply to all Americans in 2014. Yes PPACA is messy, but PPACA means that no family will ever have to raise funds for their life through charity so that someone they love might survive. This doesn’t mean that Lane’s parent’s have it easy. It doesn’t mean that his healthcare is cheap or free (remember, Republicans and ‘moderate’ Democrats rejected those options – single-payer, the public option, or other truly universal plans) but it does mean that the demands on Lane’s family are now significantly less extreme.

Yesterday, Nate Silver updated his presidential forecast model. His model, the prediction markets, and vegas now agree that there is roughly a 30% chance or better that Mitt Romney will be elected President. I’m pretty freaked out about this prospect and one of the reasons is that I’m concerned about kids like Lane. Romney and the Republicans in the House and Senate have sworn to repeal PPACA and literally none of them have offered a plan to restore these regulations. The Republicans even mounted a campaign against the constitutionality of the individual mandate, which allowed these regulations to exist without exploding healthcare costs. Let me make sure that is crystal clear: if the Republicans had gotten their way, the protections in PPACA would not just have been repealed but would have been virtually impossible to implement in the future – and 4 (all Republican appointed) out of 9 judges ruled in favor of this outcome.

What troubles me even more than the fact that Mitt Romney might win is why he might win. It seems like a huge fraction of Americans (maybe even a majority!) are okay with placing kids like Lane and their families in one the worst situations imaginable: where insurance companies would have to be fought and charity begged for in order to give a family member the chance to live.

I want everyone I know to wake up. I want everyone I know who has ever told me that it doesn’t make any difference who gets elected, that both candidates are the same, or that they just don’t trust Obama as much as Romney, to explain to me personally how those things could be consistent with the situation in which Romney and the Republican party would put Lane and his family.

Germany is Dead Wrong on Circumcision

Today, a German judge effectively outlawed the circumcision of german minors, ruling that the procedure amounted to "bodily harm" and "contravenes the right to choose religion later in life". The judge and his ruling are wrong on both accounts.

There are a variety of possible positions that a state might assume on this issue: ban the procedure outright, require parents to opt-in, require parents to opt-out, or to mandate the procedure. As A. M. Viens argues, generally but not always, it is appropriate to defer to parents on the issue of the well-being of their children. One notable exception is the issue of vaccination; the choice by a few parents to forgo their children's vaccination endagers the surrounding population while there is no significant risk involved in vaccination. For a ban on such a medical procedure to be justified, there would need to be compelling evidence that there is no medical benefit or that the medical risks outweighed the medical benefits. In the case where the medical outcome is unclear, the only moral policy is to defer to the wisdom of a child's parents.

I'm going to leave the medical details at the bottom in case you want to take my word for it or don't feel like reading about circumcision in detail. The conclusion about medical risks/benefits is pretty clear, though. There are cases in which male circumcision provides substantial medical benefits, most significantly where there is a high risk of HIV among the heterosexual male population. There are also cases where male circumcision involves significant risks, such as the circumcision of premature infants and older boys, and extreme risks, such as when the procedure is performed by someone other than a trained medical professional.

As far as religious choice goes, I am aware of no situations where someone has been denied admittance to a religion on the basis of that person's circumcision. So, unless I've overlooked something, it seems bizarre to suggest that circumcision contravenes ones right to choose religion later in life. However, due to the increased risk of undergoing the procedure later in life, in cases where the state forbids infant circumcision, the state actually creates a barrier to particular choices of religion, though I'm not sure this should effect legal consideration.

So, on balance, the only moral and just policies seem to be those policies that (A) carefully regulate the practice and ensure that it is performed safely by trained medical professionals with minimal risk; (B) encourage or make standard the procedure in situations where it is safe and there is a significant public health benefit; and (C) allow or require the wisdom of parents and medical professionals to intervene in cases where the procedure does not meet criteria (B).

The fact that this is a judicial precedent and that it regards the circumcision of a 4-year old boy means that it could very likely not result in a de facto ban on infant male circumcision, despite what we are hearing from the talking heads. But, to the extent to which the decision of this judge affects the circumcision of infant boys, it ignores strong medical and scientific results and contravenes, not the ability for adults to freely choose religion, but the moral duty of parents and doctors to decide in favor of the well-being of their children and patients.

Why liberals are scared of SCOTUS and you should be too.

I think campaign finance is of the highest importance, though it's also tedious and disappointing to analyze. One important thing to understand is how and when campaign contributions affect the outcomes of elections.


The common misunderstanding is that the function of democracy is exclusively proactive, that, individually or in aggregate, voters will make rational, informed decisions in their best interest. But elections also serve a reactive role, to modify the incentives for those who rule as they rule. The distinction is subtle but important. If I reduce the security of voters' property rights, I will be voted out of office, so I won't do that no matter to what party I belong or why I feel I was elected.

The same goes for campaign contributions. There is a proactive role: if I am a wealthy hedge fund manager and I am not burdened with generous intentions, I will contribute to exactly the politicians (or, more accurately the political institutions) I feel are most likely to give me the best outcomes. But there is also the reactive role: if I am a politician and I know that hedge fund managers are unlikely to buy ads for me after I raise taxes on the wealthy, then I'm going to be marginally less likely to do that relative to a world free of hedge fund managers.

So whether or not they ask for it, any politician who has ever received contributions from any interest, has had their incentives shifted by the campaign contributions they receive. This is why Wall-Street's heavy financial support of Obama during the 2008 crisis after which new regulation of Wall Street would be legislated, made my stomach turn.

Absent any campaign contributions, the interests of the voters are the primary source of incentives for politicians, both as politicians run for office and as they govern. Campaign contributions significantly alter these incentives because they come (at least disproportionately) from a very specific group of people, the economic elite.

As I understand it, the primary role of a political system is to control in whose interest the political elite govern. Or, to set up a network of incentives for the rulers. To the extent that we want the economic elite to be more empowered than the majority of americans, things like the Citizens United ruling are a good thing. But to the extent that we believe every american should be equally empowered, it is a failure. Even more so, it is a failure that results in a vicious circle of failure. As the economic elite are given more weight to affect the incentives of politicians, policy is more likely than before to solidify and augment the power of this very elite.

Just to take one example, Sheldon Adelson, whose annual income is roughly $7 billion*, has said he is willing to donate something like $100 million to the presidential race this year ( McCain/Palin's total 2008 direct budget was $85 million). As long as he is able to affect the political landscape such that whoever wins lowers his overall tax rate by 1.5% of his income, he gets a complete return on his investment in just one year. And this may be done by donating to someone who supports such a tax policy, or by incentivizing the opposition to do so in the hopes of getting his money the next time around.


Anyway, this is why liberals are scared. Because while deregulation and lower taxation may be painted in terms favorable to individual liberties in general, they disproportionately favor the liberties of individuals who have a whole lot already.


*In the original post, I referred to Adelson's net worth as being taxable and equal to $3.4 billion. That was incorrect on multiple levels. Thanks goes to Patrick for spotting the error.

A Statist Summer

This Summer I've been doing some research on broad strategies for positive societal progress.

In Robert Zubrin's Merchant's of Despair, Zubrin offers a critique of anti-humanism, or the institutions and philosophies that prioritize the well-being of humans below other goals such as environmentalism. Zubrin offers, to my eyes, a new form of humanism which is much more practical in its pursuit of human well-being at the expense of almost everything else (DDT may not be so bad after all if it eliminates major disease vectors and some of history's most vigorous diseases at the small cost of a few soft bird eggs).

Paul Krugman in End this Depression Now argues that empirical economic theory, including old-school Keynesianism, provides us with all the tools we need to get past the current economic depression, if only our Global elites weren't stuck on morality-based austerity. He also offers an outline of how the ruling elites might have gotten to be so misguided: inequality. Krugman argues that extreme inequality has thrown off the balance of political discourse between policy for the general population and policy for the very wealthy.

Where Krugman wrote a few passages on the causes of inequality and the negative outcomes that result from it, Chris Hayes has written a book on it: his debut, Twilight of the Elites. Hayes argues that meritocracy, for all of it's virtues, contains vicious circles which, if left unchecked, tend to create a ruling elite doomed to fail. This phenomenon of failure is caused primarily by an increase of social distance between the ruling elite, selected by meritocratic institutions, and those who are ruled. This increased social distance reduces the costs of failed policy and of rigging the system. Chris Hayes introduces the valuable ideas of the fail decade (2000-2010) and fractal inequality, wherein each fractionally smaller division of the US population, there is a similar distance between economic status.

Stephen Pinker's deep tome of optimism, Better Angels of Our Nature, is as valuable as it is large. Pinker's argument is that we are unequivocally better as a society now than we were at any time previously. Pinker's analysis might be called fractal progress, as each fractionally smaller span of time (The last 10 years, 100 years, 1000 years) tell the story of similar levels of societal benefit. Pinker argues that this phenomenon is the result of an expansion of the circle of concern and an the collectivisation of the enforcement of good behavior.

Finally, Daron Acemoglu and James Robinson seek to account for the stark contrast (and its relative persistance) between rich and poor nations with Why Nations Fail. Their thesis is both somewhat new and somewhat obvious: economic and political institutions (and not geography, culture, religion, or race) are the primary causes of the success and failure of nations. Many factors influence the development of such institutions, primarily, the two types of institutions, extractive and inclusive, tend to reinforce and magnify similar institutions in vicious (or virtuous) circles. But, also importantly, exogenous events have the capacity to create inflection points where institutional drift may change courses and inclusive institutions may begin to overcome the perverse incentives provided by extractive ones (or vice versa).

I have a few friends with whom I like to discuss things-that-seem-important-at-the-time. Somehow, all of them are either explicitly anarchists or at least have anarchist tendencies. If it wasn't obvious from my summaries, each of the books I've been reading more or less presuppose a state and then seeks to justify a vision of what sort of state works best or how a state might be improved. This makes conversations somewhat difficult. My project for the next little while will be to build (or find) an argument for statism.

Update on Religion

For the past 4 years, when I've been asked "why are you an atheist", I've responded along the lines of "because I think it is true".

This is changing, though.

Which of these two possible uses for religious belief–'to accurately represent the world' or 'broadly, to improve society'–is most important? I don't think it ever has been the first. Religious beliefs arise in people as a result of a variety of complicated factors but there must be straightforward reasons that the beliefs are held.

To hold a belief, it must be holdable, i.e. it must not conflict too strongly with any existing beliefs. But also, if one is to hold onto a belief in a sustained manner, one must be motivated to do so. Religious believers hold onto their beliefs because they consider the belief to be beneficial to them, their circle of family and friends, and society at large. Nearly every religious belief comes in a package that is sometimes referred to as 'life stance'. This package of beliefs must be considered holistically in order to see both how any religious life stance is a holdable belief and why one might be motivated to consider this the most beneficial of many mutually exclusive life stances.

And this is the sense in which I consider religious life stances (those that require an acceptance of the supernatural as opposed to secular life stances) to be failures. It can be demonstrated that, for instance, Christianity does not benefit individuals, their kith and kin, or society at large. (I need to demonstrate this)

PS This blog will not be exclusively about religion.