Thursday, September 29, 2011

Can—and Will—Mankind Survive?

When one stops long enough to consider existential questions about our societies and our civilization, thoughts usually drift to global warming and the gradual changes that ensue. John Terborgh has written an article for the New York Review of Books titled: Can Our Species Escape Destruction? His intention is to remind us that global warming is only one of our survival issues, and to make sure we realize that not all catastrophic change need be gradual.
The purpose of his commentary is to provide a review of a book by Tim Flannery, Here on Earth: A Natural History of the Planet. Terborgh recognizes Flannery’s skill at producing entertaining material, but he believes that the book is too optimistic about the future.

"By the end, one doesn’t know quite what to make of it. Does the book have a clear message other than that we humans have to cooperate with one another better than we have in the past? As the brief chapters fly by, punctuated with anecdotes and biographical snapshots, the answer to the question is not clear. Many books concerned with the earth’s future thunder doom and gloom on every page. Flannery handles the material with a lighter touch, buoyed by the soothing principle of Gaia, the earth’s propensity to maintain a stable environment congenial to life."

The idea that the planet is somehow tuned to be accommodating to life as we know it is a fantasy in Torborgh’s opinion. In his view the planet goes its own way and life forms either keep up or they die away and are replaced by other life forms. End of story.

"For roughly half of the earth’s history, the atmosphere lacked oxygen and was replete with noxious gases: carbon dioxide, ammonia, and methane. Still, life originated under these alien conditions. Oxygen appeared much later with the ascendancy of photosynthesis as the dominant process by which the energy of sunlight converts carbon dioxide into organic compounds."

"Early earth history includes a massive collision that liquefied the earth’s core and spun off the moon, a long period when the atmosphere was replete with greenhouse gases but lacked oxygen, and a time about a billion years ago when the entire earth froze over. Where was Gaia then? On a time scale of millions of years the earth’s geological processes can attain a dynamic quasi equilibrium that permits life to flourish and diversify; but on a scale of billions of years, the story becomes, from a human perspective, one of forbidding strangeness and intolerable conditions."

One way of assessing the survivability of a species is to observe that the species has been around for a long time. In that context, mankind has little reason to be optimistic. Our brief existence of 50-70,000 years provides us with small comfort. We have not been around long enough to demonstrate that we can come to equilibrium with the planet on which we reside. Indeed, that is the issue we face. Unique among the species we are capable of modifying not only our local environment, but that of the globe as a whole.

"It has been obvious for a long time—many decades—to legions of individual scientists, and to prestigious scientific organizations like the Union of Concerned Scientists and the National Academy of Sciences, that the global human enterprise is on a collision course with the physical and biological limits of the earth."

"Estimates of how bad the situation is, of course, differ, but various assessments agree that the global economy is consuming resources at a rate equivalent to 1.3 to 1.5 times the earth’s capacity to supply them sustainably. The only way this can happen is for us to be consuming the resource capital from which we should be harvesting only the interest. The consumption of resource capital is evident in the sluicing of millions of tons of topsoil into the oceans, the drawing down of underground aquifers, the salinization and desertification of erstwhile croplands, the depletion of fisheries stocks, the overharvest of forests, and on and on. We, the prodigal sons of the modern era, collectively seem powerless to stop any of this."

Global warming is in addition to all these environmental assaults. And while we think of our interaction with the earth as a slow continual process, that need not be the case.

"The earth maintains a stable environment because it is a dynamic system and dynamic systems possess stable equilibriums. Less widely recognized is that the earth is a complex dynamic system. A cardinal feature of complex dynamic systems is that they can attain multiple forms of equilibrium."

In other words: abrupt changes can come rather abruptly.

Interestingly, James Lovelock, the creator of the Gaia hypothesis, became the darkest of the gloom and doom authors a few years ago when he published a book: The Vanishing Face of Gaia: A Final Warning. His conclusions are described here.

"In his latest book....he argues that Earth’s system of self-regulation is being overwhelmed by greenhouse gas pollution and that Earth will soon jump from its current cool, stable state into a dramatically hotter one. All climatologists acknowledge the existence of such climatic jumps—as occurred for example at the end of the last ice age....A new climatic jump, he concludes, will occur within the next few years or decades, and will involve an abrupt increase in average global surface temperature of 9 degrees Celsius—from 15 to 24 degrees Celsius (59 to 75 degrees Fahrenheit). Such a shift, he contends, will trigger the collapse of our global civilization and the near extinction of humanity."

Torburgh does not comment directly on such predictions. He also provides his gloomy statistics merely in order to get our attention. His focus is not on the particulars of how mankind might mend its evil ways. Rather, and more interestingly, he asks whether mankind, given its short and focused evolution, is even capable of addressing the planet’s needs.

"Humans compete for resources, living space, mates, social status, and almost everything else. Each living human is at the apex of a lineage of successful competitors that extends back to the origin of life. We are nothing if not fine-tuned competitors. The compulsion to compete enters into nearly everything we do, whether we recognize it or not. And the best competitors among us are often the best rewarded. One needs to look no further than Wall Street for a flagrant example."

"It is becoming increasingly apparent that competition has a dark side, for a competitive system provides no rewards for restraint; to the contrary, lack of restraint is often rewarded. Being born into a competition-based society can be likened to entering a major marathon. Thousands surge forward at the starting gun and about two hours and ten minutes later, one person crosses the finish line. Most runners are far behind, not even within sight. Economic competition produces similar outcomes."

His analogy to a marathon race is compelling. The distribution of incomes within our societies tends to look like the exact inverse of finishing times in a marathon. If our societies are to survive as individual entities, a means will have to be found to restrain (not eliminate) this built-in desire on the part of individuals to compete and acquire ever more resources. Similarly, if our civilization is to survive it must find a way to restrain nations from their individual wills to compete and win the quest for resources.

"The human predicament of overpopulation and overexploitation of resources is fundamentally driven by the primordial impulses that drove our ancestors to achieve above-average reproductive success. In the contemporary world, these impulses form the self-interest of competitively driven entities, be they individuals, corporations, or nation-states. Will giving license to human greed bring us all down, or will the collective assert itself in time to tame the worst excesses of the few? This is the existential question that lurks in the background of every chapter of Flannery’s book."

"The world needs to impose collective restraints on many fronts, but so far self-interest and competitiveness have trumped most efforts to respond to the needs of the collective whole."

Individuals and nations have shown that when necessary they can work together, but never has the whole world collaborated on such a level. Unfortunately, by the time the necessity is sufficiently obvious to generate action, it may be too late. We don’t really know how much time we have.

Wednesday, September 28, 2011

Psychiatrists and Ethics: Medicating Children without Symptoms

There is a distinct difference between the practice of psychiatry and the practice of medicine. A medical doctor generally has a definable target involved when a medication is prescribed. There is a tumor, a bacterium, or an inflammation that is being combated. One can assess the effects of the medication. A doctor of psychiatry has the same ability to prescribe any medication he wants, and for any reason, but he gets no such physically measureable feedback.

Psychiatrists must depend on patient feedback to determine whether their prescriptions are having any effect—other than measureable side effects. Clinical tests of psychoactive drugs are notoriously difficult, and notoriously subject to manipulation. Most drugs are tested in double blind procedures against a placebo. Drug companies would not dare test their product against that of another company. The FDA will approve drugs that beat a placebo even if they are no better than existing drugs. Most such drugs have a sizeable placebo effect. If you tell a person who feels ill that you are giving him a pill that might make him feel better, he will tend to feel better. Some have concluded that essentially the entire effect of antidepressants like Prozac can be explained by this placebo effect. On the other hand, psychoactive drugs do modify brain function and can have observable negative effects on mental and physical function. An attempt to commit suicide does not have to be self-reported.

Psychiatrists who prescribe medication also have to face the uncertainty of not knowing whether the drug is actually addressing a medical issue. There is no physical definition for mental illness, so one never knows that the physical changes caused by the drug actually have anything to do with the illness. Psychiatrists tend to define mental illness as a collection of symptoms. They are provided a manual, written by a collection of psychiatrists, listing symptoms associated with a given condition. If some number, say five out of nine, of symptoms are observed in a patient, the psychiatrist can feel that he has made a defendable diagnosis. However, given that psychiatrists now recognize over 300 types of mental illness, it is often the case that several diagnoses are possible. It is somewhat arbitrary what is done in this case, but generally, one presumes, a judgment of the most relevant diagnosis will be made—somehow.

So a psychiatrist deals with symptoms, and chooses a drug that it is believed will alter those symptoms and create a set of other symptoms recognized as being more normal by society. There is no curing that can be assumed here, but most people will believe that this new set of symptoms is an indication that the drug is beneficial. But if there is no cure available, where does one go from here? In an ideal world, patients would use the reprieve provided by medication to find a way to cope with their problems, get off the drugs after a short time, and resume their lives. This is exactly what happens—occasionally. This benign exposure to drugs is not always the case. Other common outcomes include severe side effects that require either multiple drugs in order to counter each other’s side effects, drug dependency and addiction, or a worsening of symptoms after continued use of the drug. Perversely, psychiatrists interpret the inability of a patient to regain functionality after long exposures to drugs as evidence that conditions like depression have somehow switched from episodic to chronic. This of course explains and justifies a lifetime of drug dependence.

The real ethical issue with psychoactive drugs is that of long-term effects. My thoughts on the issue were influenced by two books: Unhinged: The Trouble with Psychiatry—A Doctors Revelations about a Profession in Crisis by Daniel J. Carlat, and Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker.

Whitaker asks the questions: If we are spending so much money on psychoactive drugs why is mental illness increasing rather than decreasing? Could the drugs used be actually worsening the patient outcomes and causing this increase? Whitaker spends his book building a quite convincing case by compiling data and studies that conclude that long-term exposure to these drugs can worsen symptoms, can cause brain damage, and can impair cognitive function.

Carlat is critical of the psychiatric profession for depending too greatly on drugs to the exclusion of other approaches, and he is also highly critical of the unseemly ties between drug manufacturers and their drug vendors (psychiatrists). Carlat believes drugs benefit his patients, but you will struggle to find any mention of long-term side effects. I could only recall one reference, as an aside, about drugs given to children for ADHD causing growth retardation. That may be an off-hand observation to him, but it is a tragedy for the children and parents involved. Especially since he hints that his own former colleagues at Harvard’s Massachusetts General Hospital were responsible for a gross over-diagnosis of ADHD within the profession. For Carlat, there does not seem to be a long term. Patients are looked upon as a problem that must be dealt with immediately, and if some combination of drugs can be found that will allow them to feel in control of their lives, the treatment has been a success. I would love to get Whitaker and Carlat in a room and have them duke it out.

The alliance between drug companies and psychiatrists is probably unique in the healthcare field. The two entities enable each other. There would be no sales without psychiatrists going out and proclaiming that each new generation of drug is the one that is finally the super-drug that will fix all. And psychiatrists could not exist if the drug companies did not keep them supplied with a constant flow of new drugs that can be used to cover up the shortcomings of the previous batches of drugs. This is not a healthy interaction. Carlat goes into great detail in explaining the various ways in which psychiatrists’ integrity can be purchased by drug companies. I was under the impression that the close financial ties between psychiatrists and drug companies provided the worst ethical issues to be dealt with. Unfortunately, I have found something worse.

In reading about these subjects, this collusion between psychiatrists and drug companies aroused the greatest emotion. Then I encountered Kiki Chang and the Stanford Pediatric Bipolar Disorder Program. An article in the San Francisco Chronicle by Julian Guthrie describes Chang and his program. Finding excuses to diagnose young children as suffering from bipolar disorder is no longer new and has gone beyond being controversial (although Whitaker goes to great lengths to demonstrate that bipolar symptoms can be caused by exposing children to antidepressants and the stimulants used for ADHD).

Chang has gone far beyond that stage by attempting to use these psychoactive drugs as a sort of preventive medicine to avoid potential future mental illness.

"’There is a window of time to have a healthy brain,’ said Chang, 43, who runs the Stanford Pediatric Bipolar Disorders Program. ‘Our hope is that if we can get in early, we can prevent it.’ Part of Chang's therapy is to put children at risk for bipolar on medication - something he acknowledges is controversial."

"’We are taking kids who don't yet have bipolar disorder and putting them on medication, something we know is serious,’ he said of the study participants, who range in age from 8 to 18."

"’We hope to find the right medication so the brain develops normally,’ Chang said."

The audacity! The arrogance! He is experimenting with dangerous drugs on children—children who have no signs of illness. Most of these drugs are not approved for use on sick children, let alone healthy ones. I am willing to bet that you could not perform these tests on monkeys without getting formal approval and having peer revues. But doctors can do anything they want to human patients.

To partake in such experimentation consists of (pick one): child endangerment, assault with a deadly weapon, extreme stupidity, mortal sin.... The punishment should be (pick one): lifetime injection with his own drugs, provision of a rope should he become suicidal, eternal damnation....

End of vent....

Monday, September 26, 2011

Europe and Its Radical Right

Whenever someone wishes to rail against the dangers of socialism, Sweden is usually the country mentioned as an example of a socialist nation. Consequently, many of us who were enthralled by Stieg Larsson’s Swedish trilogy might have been surprised by the focus on right-wing and neo-Nazi activities. Indeed, we learn that Larsson’s main employment was not writing thrillers.
"He was a Swedish journalist and anti-Nazi activist. He founded an organisation, the Swedish Expo Foundation, modelled on Searchlight, for keeping tabs on right-wing extremists."

It would seem there is more going on in Sweden than one might think. And then came the slaughter perpetrated by the Norwegian, Breivik. Again the question was prompted: "What’s going on here."

Andrea Mammone attempts to answer that question in an article in Foreign Affairs: The Future of Europe’s Radical Right.

"For years, commentators and citizens overlooked a worrying trend in European politics: growing right-wing extremism, including staunch nativism. Until its defeat in last week's election, Denmark's ruling center-right coalition was allied with the forceful extreme-right Danish People's Party. In government, they had imposed tough immigration legislation and border controls that ran the country afoul of the other Schengen states. The Freedom Party, which is Euroskeptical, overtly anti-Muslim, and against dual citizenship, is one of the strongest parties in the Netherlands. In Italy, the neo-Fascist granddaughter of Benito Mussolini is a popular parliamentarian and a founding member of Silvio Berlusconi's People of Freedom party. The Northern League party, known for its anti-Islamism, is powerful in Italy's wealthy north. In France, the extreme-right leader of the Front National party, Marine Le Pen, is a serious contender in upcoming 2012 presidential election."

Mammone claims a philosophical union between these parties.

"All of these parties share a common vision of a "pure" Europe that excludes immigrant populations from everywhere else in the world."

She tells us that even after Breivik’s attack, journalists and commentators were confused as to why a Norwegian nationalist would kill Norwegian citizens in the name of a greater Europe.

"In fact, Breivik represented an extreme form of pan-European rightism that has existed for decades. It harks back to the Nazis' quest to create a Euro-Fascist political order.’

"After 1945, as liberal Europeans started working together to create a new, and peaceful, supranational European entity, European rightists gathered in Rome and Malmö to develop their own version.... These former fascists and Nazis were highly respected, and some, such as Bardèche and Evola, are still read and praised by contemporary activists. They called their version of the union the European Social Movement. (Later, some split from the main group and created the New European Order.) If Europe was to be reborn, they believed, it should be fascistic, corporatist, and organic....This order would guarantee the proper functioning of the European continent (and its common market). It would also have been white-only."

The liberal view dominated, but the right-wingers never went away. Mammone says the movement broke up into several "networks" of adherents. These people are still united by a common view.

"....globalization, immigration, and Islam anywhere in Europe threaten the whole of it. Globalization destroys tradition, African immigrants assault European borders, and Muslims promote terrorism and hate. In sum, they are all enemies because they challenge the "pure" identity and culture of the old continent."

And how do Breivik’s convictions fit into this picture? It appears he was targeting Norwegian Social Democracy itself, viewing it as an appeaser in the struggle against multiculturalism and all the other things that he hated.

"He perceived himself to be a pure combatant on behalf of a community with a glorious and pure past. According to his logic, the war extends to citizens who betray the cause."

Mammone sees Europe as being at a critical juncture—if not a dangerous one—where many countries are struggling to accommodate an influx of immigrants with very different cultures.

"Those who believe that the contemporary extreme right is novel and comparatively unproblematic are wrong. And those who call the phenomenon populism are incorrect, too. The use of such a generic label indirectly, and perhaps unintended, legitimizes a manifestly undemocratic and racist ideology."

"Europe is now struggling with the integration of immigrants and the survival of its common currency. The EU was founded on the basis of promoting fraternity among its populations after the brutality of World War II -- integrating previously warring countries within a boundless and peaceful ideal. A European culture cannot exclude "others"; this would contradict the EU's very goal. The hope is that the continent will be ready to look, again, at itself and its inner values, and tackle this "pan-European" rightism once more."

Thanks to Mammone for providing needed context for what appears to be a much greater issue than I suspected.

Sunday, September 25, 2011

Refurbishing Our Schools: Can It Be Done Without Federal Help?

Senator Sherrod Brown has introduced a legislative initiative called FAST: Fix America’s Schools Today. The goal is to begin repairing and renewing our nation’s public schools. The needed upgrades are estimated to run between $270 billion and $500 billion. Brown is asking for $30 billion to initiate activity. The procedure appears to follow the standard process. Federal funds are granted to states for a targeted purpose and there will be mechanisms in place to determine accountability for how the money is spent. The cost of the program would be offset by revenue from closing tax loopholes. This sounds like a good idea. The need is there, and such an effort should be efficient at creating new jobs.

The amount of funding being requested is quite small given the scope of the project. Even so, the probability of getting any new initiative funded is quite small. This leads one to wonder if there are any nontraditional paths that could be followed to get this work done.

We reported here recently about an effort aimed at refurbishing old commercial buildings to make them more energy efficient. It seems that the anticipated energy savings are sufficiently high that everyone involved sees a sure return on investment. The potential profits are such that major investors see this as such a good opportunity that they will provide the seed money for the various projects rather than requiring some sort of government inducement.

There is an article in the New York Times by Justin Gillis, Tax Plan to Turn Old Buildings "Green" Finds Favor, that explains the concept. The idea is called PACE: Property Assessed Clean Energy. The goal is to allow owners of properties to upgrade their facilities to make them more energy efficient without incurring any upfront costs. The way this works is that a bank provides a loan to cover the cost of upgrades. The city or state agrees to be responsible for collecting payment on the loan through a property tax surcharge that could be spread out over as much as twenty years. A contractor comes in and does the work. When finished, the owner of the building covers his tax surcharge with the savings from the energy bill.

People believe the savings from lower energy consumption will be large enough that the loan risk is small. Rather, the belief seems to be that the return on investment will be quite large. In fact, the intention is to bundle these types of loans into, presumably, a CDO and offer them at 7% rate of return. One suspects the outfits like pension funds would jump at a safe 7% rate of return. There is talk of investors putting up hundreds of millions of dollars for these efforts. Environmentalists love the notion also, hoping the investments get into the billions.

How might this pertain to schools? First of all, consider the money. The biggest potential source of funding for any initiative has to be corporations. They are said to be sitting on around a trillion dollars in liquid funds, just waiting to find some good way to invest the money. One suspects that a safe 7% return would look rather enticing to them.

Making an analogy between schools and commercial buildings would put the school district in the place of the owner of the commercial building. Thinking just in terms of energy conservation, a similar process could work if the savings from lower consumption was in the same ballpark as that for commercial buildings. If so, the district would rebate savings back to the state to cover the loan expenses. If the savings exceed the cost of covering the loan, the excess can be used to finance other structural upgrades. Furthermore, if one was adept at predicting costs and savings, it would be prudent to include these additional upgrades in the initial contract if possible. Such a move would add to risk, but this suggests a role for the federal government to play by providing some sort of guarantee to the holders of the financial instruments.

I have no philosophical problem with having the government fund these types of activities. But it looks like it cannot happen. If one wishes to get action, the best way is to convince corporations with money that you can help them make more money.

If a variation on the PACE activities can be applied to the goals of the FAST initiative, do we then have something called FASTPACE—a logo that would be a lobbyist’s dream?

Saturday, September 24, 2011

A Promising Classroom of the Future

We recently discussed an article by Virginia Heffernan in which she proclaimed that today’s classroom needs a make-over.
"A classroom suited to today’s students should deemphasize solitary piecework. It should facilitate the kind of collaboration that helps individuals compensate for their blindnesses, instead of cultivating them....The new classroom should teach the huge array of complex skills that come under the heading of digital literacy. And it should make students accountable on the Web, where they should regularly be aiming, from grade-school on, to contribute to a wide range of wiki projects."

The counterargument was made that solitary piecework is really where learning takes place, not in group "engagement" exercises. Soon after came an article pointing out that one school system was deep into high-tech gimmickry and discovering that their test scores were not improving. That was particularly embarrassing because nearby school districts using traditional methods were showing improvement. One data point does not prove an hypothesis, but it was supportive.

The Economist has provided another instance in which new teaching approaches can be evaluated. It has provided an article titled: Flipping the classroom. It refers to schools in Los Altos, California that are employing computer-based lectures and teachers tools to invert the normal teaching procedure. The lessons and software are provided by KhanAcademy. The traditional process is for teachers to lecture and explain in class and give students homework to practice their skills. The article uses the term "flipping" to refer to the inversion of this process. Here, students are expected to watch the lectures at home, where they can view as many times as they feel necessary, and then come to school and try out there skills in the classroom. Each student has a computer where he/she works individually on computer-based exercises. Meanwhile, the teacher has access to software that allows he/she to monitor how each student is doing. If someone is making errors or just not progressing, the teacher can go and provide some assistance. This one-on-one tutoring should be a very effective use of the teacher’s time.

The system seems to be working—at least the teachers and students are satisfied with the method. No quantitative measures were provided.

"For although only a handful of classes in this public-school district tried the method in the last school year, many other schools, private and public, are now expressing interest, and the methodology is spreading."

"Indeed, philanthropists such as Bill Gates have such high hopes for the new method that they have given money to KhanAcademy, a tiny non-profit organisation based in Mountain View, next to Los Altos. This means that the more than 2,400 video lectures, on anything from arithmetic and finance to chemistry and history, will remain free for anybody."

This approach appears to be an ideal way to learn science and math. A visit to the KhanAcademy website provides a list of the lessons available. This list is clearly dominated by math and science, although economics and finance are well-represented. One criticism of the method is that it does not work as smoothly with other subjects. That could be a result of the initial emphasis rather than a long-term deficit. People have used digital tools to learn all sorts of things. That is not new. What is new is the systematic application in the classroom.

One has to find this type of approach encouraging. Although the article refers to "flipping" as if something revolutionary is taking place, it really is just a more efficient implementation of traditional methods. Teachers still teach, and students have to learn through solitary concentration and practice. Perhaps another data point in support of my hypothesis!

One should remember that it is still the students who have to do the learning. Los Altos may not be providing a typical sample. I would be thrilled to one day read that students in our worst performing school districts were now aglow with enthusiasm and making great strides using this approach.

Friday, September 23, 2011

Carbon Capture and Sequestration: Where is the All-Out Effort?

Given the continual reminders from scientists and journalists that global warming is not only happening, but its effects may be accelerating, and the realization that coal will be a significant source of energy for the foreseeable future, one might think that the world would be aggressively trying to clean up the coal consumption cycle in order to minimize carbon release per unit of energy. There are two ways this can be accomplished. First, one can consume the coal more efficiently, providing more energy per unit of carbon release. Second, one can capture and sequester the carbon produced (CCS) in order to keep it from entering the atmosphere. There are technologies available to address each goal, with the ideal situation being plants of the future that combine both approaches. 

Good intentions abound, with the US and most developed countries having at one point planned to aggressively pursue these technologies. Progress has been slowed by lack of political will and by economic effects stemming from the Great Recession. Two recent articles provide an update on the status of these efforts.

Ken Wells and Ben Elgin have an article in Businessweek titled: What’s Killing Carbon Capture? They present a picture in which an initial enthusiastic thrust on the part of both nations and industry appears to be dissipating.

"In 2010, President Barack Obama unveiled a goal to bring five to 10 commercial-size CCS demonstration plants on line in the U.S. by 2016. Leaders of the Group of Eight, a global consortium that includes the U.S., Russia, and Japan, embraced in 2008 a goal to launch 20 large-scale CCS demonstration projects by 2010 with "broad deployment" of the technology by 2020. All told, governments worldwide committed $22.5 billion to support CCS from 2008 to 2010, according to Bloomberg New Energy Finance. An MIT website that tracks worldwide CCS projects lists 68 scattered across 15 countries, 45 of them associated with coal-fired power plants."

"Yet since the beginning of the fourth quarter of 2010, at least five large-scale CCS projects have been canceled or postponed, while the fate of several others remains doubtful, according to interviews with a dozen project developers by Bloomberg Businessweek and research by Bloomberg New Energy Finance."

The power industry seems ambivalent about addressing future requirements. Many are open to development of energy and carbon efficient systems, but such efforts yield more expensive energy. Local controls will not allow them to raise rates to recover expenses, and federal subsidies are harder to come by, with economic and political difficulties anticipated for the near future. Those in the industry who would prepare for the future complain that without a carbon tax there is no way to recover their costs. Those in society who favor a carbon tax complain that the energy industry has successfully lobbied against it.

The authors are focused on providing a survey of the activities taking place in the United States, and detail some of the issues that have arisen. They point out that the carbon capture step is the most technically challenging, whereas storage sites seem to be plentiful. They include a hint of warning in recounting the story of a family in Canada who claims they are seeing seepage of carbon dioxide from an underground storage reservoir. High concentrations of the gas can be dangerous because the body’s breathing mechanism is triggered by buildup of the gas. A whiff of carbon dioxide tells the brain it is time to take a deep breath—exactly the wrong response.

The reader is left with the impression that the potential for carbon CCS is real and achievable—one only has to learn to live with higher energy costs. If one had a functioning government one could devise energy conserving strategies that could bring this closer to a zero sum game.

S. Julio Friedmann provides an article in Foreign Affairs titled: Carbon Capture and Green Technology. Friedmann’s article is more global in scope. He sees the ongoing efforts as being too small to change the world’s environmental trajectory.

"And even as some coal plants are decommissioned or slated for closure, others are built, and not only in developing countries. (In 2010, the United States commissioned ten new coal plants, which would put out 6000 megawatts.) Natural gas development, which also emits CO2, has continued apace. And although wind and solar power use have increased rapidly in both OECD and developing countries, electrical grid instability and average power costs have increased as well. On a global and national basis, the fossil-fuel fraction of energy supply has hardly changed and emissions have risen steeply, even with much more renewable supply."

The author is more disappointed than pessimistic. He indicates there is one country where activity is brisk and focused.

"The good news is that Chinese executives and politicians understand the risks posed by global climate change and the role that CO2 emissions play. Given that understanding and its reliance on coal, it is not surprising that China is investing substantively in CCS. The world's largest power company, Huaneng, has almost finished the GreenGen plant, soon to be the largest integrated gasification combined cycle plant on earth. It is being built to International Green Construction Code Standards with 80 percent indigenous technology -- and in less than three years. Moreover, the 250-megawatt plant will sequester 90 percent of GreenGen's emissions in the next three years, roughly one million tons per year. Huaneng also plans to undertake a large-scale CCS retrofit to a 600-megawatt plant near Shanghai, which will capture between two and four million tons of CO2 per year."

"Chinese state-owned enterprises are investing in indigenous capture technology of all kinds, including advanced pre- and post-combustion capture technology as well as oxygen-fired combustion. They are pursuing CCS at plants that convert coal to liquid fuels, chemicals, and natural gas, as well as new designs for ultra-high-efficiency coal conversion, all with major investments from China's National Energy Administration and the Ministry of Science and Technology. These projects will be large-scale enough to test and validate the safety and effectiveness of sequestration, as well as to provide insight into the real costs of these technologies. Not surprisingly, many Western companies have partnered with Chinese firms to develop and demonstrate novel CCS technology, including GE, Duke Energy Inc, Powerspan, Peabody, and others. These relationships are a pathway for advancing the technologies and lowering their costs."

James Fallows wrote an article for The Atlantic pointing out that the only way to stop global warming was by finding a way to provide clean energy from dirty coal. He also predicted that the only way this could be achieved is by depending on China to provide the laboratory where concepts could be tested and ultimately fed back to the developed nations. China’s massive building program, and its ability to put a project in operation within three years, has no counterpart elsewhere. We are fortunate that they seem to be fulfilling that role.

The events surrounding the Japanese tsunami have cast a shadow over any ambitious nuclear energy initiatives. That only makes the need to clean up energy production from coal more pressing. Unfortunately, momentum in this direction seems to have been lost—unless we can depend on China to be fabulously successful in their energy endeavors.

Wednesday, September 21, 2011

An Energy Initiative the Republicans Can’t Block

Consider a situation where you have billionaires, banks, defense contractors, and insurance companies proposing to state and local governments hundreds of millions of dollars worth of activity involving tax breaks and collateralized debt obligations. What could possibly go wrong here? 

Actually—it sounds like a fantastic idea!

There is an article in the New York Times by Justin Gillis titled: Tax Plan to Turn Old Buildings "Green" Finds Favor. The idea is called PACE: Property Assessed Clean Energy. There appear to be a number of initiatives around the country moving in this direction. The one referred to in the article seems to be the brainchild of a group called the Carbon War Room. Richard Branson (billionaire) set up this outfit to search for cost-effective ways to address climate and energy issues.

The focus at this point is on commercial properties. The idea is to allow owners of properties to upgrade their facilities to make them more energy efficient without incurring any upfront costs. The way this works is that a bank provides a loan to cover the cost of upgrades. The city or state agrees to be responsible for collecting payment on the loan through a property tax surcharge that could be spread out over as much as twenty years. A contractor comes in and does the work. When finished, the owner of the building covers his tax surcharge with the savings from the energy bill.

It all hangs together if the energy savings are greater than the project costs.

"Experts point out that, with modern techniques and equipment, a retrofit can typically cut a building’s energy use so much that the project pays for itself in as little as five years. The most famous recent example was the refurbishment of the Empire State Building, which cut energy use by nearly 40 percent, turning it into one of New York’s greenest buildings."

The consortium covered in the article was led by a company called Ygrene Energy Fund which already has exclusive contracts in place with a number of localities around Miami. It is expecting Miami and Sacramento California to jump on board soon. They have assembled a rather impressive team that is looking at as much as $650 million in investments over the next few years.

"Short-term loans provided by Barclays Capital will be used to pay for the upgrades. Contractors will offer a warranty that the utility savings they have promised will actually materialize, and an insurance underwriter, Energi, of Peabody, Mass., will back up that warranty. Those insurance contracts, in turn, will be backed by Hannover Re, one of the world’s largest reinsurance companies."

"As projects are completed, the upgrade loans, typically carrying interest rates of 7 percent, will be bundled into long-term bonds resembling those routinely issued by governmental taxing districts. Barclays will market the bonds. Retirement funds have expressed interest in buying these bonds, which will be repaid by tax surcharges on each property that undergoes a retrofit."

Lockheed Martin is also onboard to participate with its engineering expertise in the larger projects.

With potential energy savings that could exceed cost many times over, there is room for large profits for everyone. Even the environmentalists seem enthralled.

"’It’s a big deal,’ said James D. Marston head of energy programs for the Environmental Defense Fund, a group that has worked with Carbon War Room in developing the approach. Over the long haul, he said, ‘we’re talking about tens of billions of dollars in investments, and energy savings that are 10 times that amount. If you do this correctly, you would be able to shut down a third of the coal plants in the country’."

The concept has acquired wide spread acceptance.

"In the past three years, half the states have passed legislation permitting energy retrofits financed by property-tax surcharges, and hundreds of cities and counties are considering such programs. While the situation poses some risks, and programs aimed specifically at homeowners have run into a snag, many jurisdictions are moving forward with plans to focus on commercial properties."

The author attributes the notion of using this tax surcharge path to finance energy upgrades to Berkeley California. The observation that an idea originating in Berkeley, the liberalist of liberal bastions, is driving the capitalist engine to make large profits—and to make the world a better place to live—is something to savor. Berkeley and Lockheed Martin as collaborators—you gotta like that! I know that is a bit of a stretch, but the thought will help get me through the rest of the day.

Tuesday, September 20, 2011

Drug Supplies—Death-Causing: Plentiful, Disease-Fighting: Scarce

One of the problems with markets is that they do not always settle on the appropriate solution. Often the goals of making money and doing good are only loosely related. This has become clear in the pharmaceutical industry.
The Los Angeles Times provided us with a gloomy reminder of this when they published an article announcing that drug-related deaths in the United States now exceed deaths caused by traffic incidents.

"Fueling the surge in deaths are prescription pain and anxiety drugs that are potent, highly addictive and especially dangerous when combined with one another or with other drugs or alcohol. Among the most commonly abused are OxyContin, Vicodin, Xanax and Soma. One relative newcomer to the scene is Fentanyl, a painkiller that comes in the form of patches and lollipops and is 100 times more powerful than morphine."

"Such drugs now cause more deaths than heroin and cocaine combined."

This graphic is provided.





These are prescription drugs, but they seem suspiciously easy to acquire. On-line medical records, assuming doctors would update them, would put an end to "doctor-shopping" by addicts. However, easier ways to obtain them have arisen.

"Those prescriptions provide relief to pain sufferers but also fuel a thriving black market. Prescription drugs are traded on Internet chat rooms that buzz with offers of "vikes," "percs" and "oxys" for $10 to $80 a pill. They are sold on street corners along with heroin, marijuana and crack. An addiction to prescription drugs can be costly; a heavy OxyContin habit can run twice as much as a heroin addiction, authorities say."

There does seem to be more the medical profession could do to control access to these medications, and to control the quantities accessed.

"The rise in deaths corresponds with doctors prescribing more painkillers and anti-anxiety medications. The number of prescriptions for the strongest pain pills filled at California pharmacies, for instance, increased more than 43% since 2007 — and the doses grew by even more, nearly 50%, according to a review of prescribing data collected by the state."

While the market works just fine when it comes to providing drugs that are being used illegally, it seems to have a problem providing drugs that are needed to fight disease. We have an article in The Economist pointing out that there are serious shortages of critical medicines in the United States.

"In 2004 America had a shortage of 58 drugs. Last year it had 211 and this year 198 so far. As the problem has spread, so too has a sense of panic, with patients lacking essential medicines, doctors fretting over alternatives and hospitals navigating a ‘grey market’ for drugs."

"The shortage affects a variety of treatments, but most are generic, injected drugs. Some can be replaced by other medicines, often inferior in quality and more expensive. Others have few substitutes. Hospitals are desperate, for example, to have electrolytes that keep premature babies alive, explains Erin Fox, who tracks drug shortages at the University of Utah. Oncologists are anxious for cytarabine, a leukaemia drug."

The market issues seem to revolve around generics and the fact that competition is allowed. The Economist suggests no easy solutions, but it does make this disturbing observation.

"For now, the FDA and firms are scrounging for solutions. Eight times in the past two years the agency has allowed the import of drugs unapproved in America but used safely elsewhere. Some drugs with minor quality problems, meanwhile, are being shipped to pharmacies with warning letters. In such cases, the patient will at least receive the drug he needs. Others should be so lucky."

The only response for us is: don’t get sick, suffer through pain, and don’t be anxious. That last task is probably the toughest to pull off these days.

Monday, September 19, 2011

Mental Health and "The Three Christs of Ypsilanti"

Dealing with mental illness is something that society does not do well. First, there is the arbitrariness in the definition. Psychiatrists have at their disposal a manual that details hundreds of different states of mind that can be interpreted as illness, but this is only an attempt to relieve the practitioner from the guilt associated with making arbitrary decisions. 
Given that an individual has crossed whatever boundary exists between sanity and insanity, what does one do about it? One can be assured with physical sicknesses that a broken bone is really broken, or that a fever is caused by a virus, but with mental illness we are left with a system little better than calling the local witch doctor to come and cast out the evil spirit that has invaded the friend or family member. The good "doctor" will generally pull out a handful of colored stones from a pouch, pick the appropriate color while mumbling an incantation, and order the "sick" person to swallow the colored object.

But what if the "sick" person denies their sickness? A person can refuse treatment for medical treatment for a physical ailment and have their decision honored—or even applauded. Refusing treatment for a mental illness can be deemed as confirmation of being mentally ill—and mentally incompetent to boot. We discussed earlier Rachel Aviv’s article in The New Yorker describing Linda Bishop’s struggle with her demon. She suffered intermittently from delusions, was diagnosed as schizophrenic, and was provided medication. She did not like who she became under the influence of the medication and for the rest of her life refused to take any. Aviv presents a moving tale of her life and ultimate demise. Bishop chose a lonely and slow death by hunger rather than submitting to medication and the loss of the person she saw herself to be.

Some might call Linda bishop a sick fool. Others might view her as a heroine in a tragic tale.

Jenny Diski addresses some of these same issues in an article in the London Review of Books. Diski has some first-hand experience with mental illness and the associated issues. She tells us that at the age of sixteen, and after spending time in a psychiatric hospital, she came across a book that highly influenced her and confirmed observations she had made about the "mentally ill." The book was The Three Christs of Ypsilanti by Milton Rokeach.

Rokeach was a social psychologist who received a grant to perform an extended study of three institutionalized patients at Ypsilanti State Hospital in Michigan.

"Rokeach specialised in belief systems: how it is that people develop and keep (or change) their beliefs according to their needs and the requirements of the social world they inhabit."

The particular study he was to embark on promised to be exceptionally interesting. He was to bring together three individuals who all claimed that they were Jesus Christ. How would the three men, who all claimed to be the same person/God, react when placed in extended contact with others making the same claim?

Diski makes it clear that this was not an attempt at treatment. They were to be experimented on to try to understand the strength of their delusions and to determine if they could be manipulated in such a way as to alter them. Rokeach is quoted in order to define his approach.

"Because it is not feasible to study such phenomena with normal people, it seemed reasonable to focus on delusional systems of belief in the hope that, in subjecting them to strain, there would be little to lose and, hopefully, a great deal to gain."

Diski takes delight in recounting how the "mentally ill" were cleaver enough to keep a step ahead of Rokeach and his ploys. They each had no trouble dealing with any potential conflict when confronted by two others claiming to be the same person they were. After all, when dealing with individuals who are confined to a mental hospital it is rather easy to conclude that they might be insane. They basically sidestepped the issue and got along rather well together.

She views Rokeach’s attempts at manipulation as unworthy of the doctor, pointing out that the assumption implicit in his approach was that because these people did not lead "normal" lives, their lives and feelings were his to toy with.

"The three Christs themselves, however, were of the certain opinion that they had something valuable to lose and made truly heroic efforts, each in his own way, to resist, as well as to explain to Rokeach and his team that their lives had considerable meaning for them. All of them....had a very clear understanding of what it was to be deluded, why it might be a useful option to choose over normality, and who did and didn’t have the right to interfere in their self-selected delusions."

In fact the three were so persistent and persuasive in defense of their delusions that

"....Rokeach deduced that ‘a psychotic is a psychotic only to the extent that he has to be’."

Rokeach may not have attained the results he anticipated, but he must have written an excellent book. Diski writes:

"In 1964, having spent some time myself in a psychiatric hospital, I read The Three Christs....which confirmed what I had seen in it. It has made me very wary of reading ‘case histories’, written about the disturbed by those who believe themselves to know better. It also seemed to me, aged 16, that The Three Christs of Ypsilanti contained everything there was to know about the world. That’s not the case of course, but if resources were short, I’d still be inclined to salvage this book as a way of explaining the terror of the human condition, and the astonishing fact that people battle for their rights and dignity in the face of that terror, in order to establish their place in the world, whatever they decide it has to be."

Diski seems to be telling us that people can have illusions not because their brain is damaged, but because that is the only way they have found to cope with the world. Interestingly, she points out that Rokeach ultimately came to a similar conclusion. His book was reissued in the 1980’s and he appended some afterthoughts.

"Rokeach reread the book with regret. There were, he says, four people with delusional beliefs, not three. He failed to take himself into account, and the three Christs, not cured themselves, had cured him of his ‘God-like delusion that I could change them by omnipotently and omnisciently arranging and rearranging their daily lives’. He came to realise that he had no right to play God and interfere, and was increasingly uncomfortable about the ethics of his experiment. ‘I was cured when I was able to leave them in peace...."

As for what he may have learned from his study:

"The best Rokeach can manage is the acknowledgment that psychosis ‘may sometimes represent the best terms a person can come to with life’."

When Rokeach first started his study it was common practice to physically administer the equivalent to a whack up-side-the-head in hopes of jolting the person’s brain back to normality. Much time has gone by, but the only thing that has changed is that the hopeful jolt is administered with drugs. Both approaches have the same null scientific backing.  Perhaps, when possible, we should just leave these people alone.

When I first read of Linda Bishop’s story I concluded there was a bit of the heroine in her tale. I expect Diski would concur. Thanks go to Jenny Diski for providing some desperately needed perspective and insight into these matters.

Sunday, September 18, 2011

Xanax, the Perfect Drug: No Cure, Addiction, and a Lifetime of Sales

The history of the drug Xanax (alprazolam) provides a perfect example of how a drug company, Upjohn at the time, can foist a dangerous drug on an unsuspecting public and medical community. Upjohn had stumbled upon the perfect drug: it provides no cure, it is highly addictive, and it actually makes the condition it is presumed to treat worse if taken over time. This absolutely guarantees a supply of customers forever. This is a business model that the drug lords in Columbia know very well.


The New York Times carried an article titled: Abuse of Xanax Causes a Clinic to Halt Supply. It describes a community mental health center, Seven Counties Services, that was so overwhelmed by people demanding or pleading for Xanax that it had to turn off the spigot and say "no more."

Xanax is a member of a family of drugs called benzodiazepines. It is also now available in generic form under its chemical name alprazolam.

"While the patients at Seven Counties are mostly poor, experts say the appeal of Xanax cuts across socioeconomic lines. Alprazolam was the eighth most prescribed drug in the nation last year, according to SDI, a data firm that tracks drug sales. Even more than the figures suggest, Xanax has become part of the popular lexicon, as well known as a panic antidote as Prozac is for depression. "

"The Centers for Disease Control and Prevention last year reported an 89 percent increase in emergency room visits nationwide related to nonmedical benzodiazepine use between 2004 and 2008. And here in Kentucky, the combination of opiate painkillers and benzodiazepines, especially Xanax, is common in fatal overdoses, according to the state medical examiner."

The intention is to wean people off of Xanax by substituting a less addictive form of a benzodiazepine, and eventually weaning them off of that also.

"’The literature strongly suggests there are lots of really good ways to treat panic and anxiety disorders without using this particular medication,’ Dr. Hedges said. ‘And the risk to the community, if we continue to use this medication, is very high’."

"Xanax poses a particular risk for abuse and withdrawal, doctors say, because its effects are felt almost immediately, but last only a few hours. Users often quickly want more, experts say, and as their tolerance builds, they want increasingly higher doses.’

"Dr. Hedges said that while Seven Counties bore some blame for prescribing Xanax in the first place, many patients initially got it from primary care doctors. Alprazolam is one of the three most-prescribed controlled substances in Kentucky...."

Xanax has much the same response that narcotics provide, so it is not hard to see why people might succumb to it and why sales would skyrocket. Given what we know of the pharmaceutical industry, it is also easy to see why Upjohn would have worked so hard to bring this monster to market. What is astonishing is that the FDA was aware of all its potential for harm and approved it anyway.

Robert Whitaker writes extensively of Xanax in his book: The Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. He uses Xanax as an example of how drug companies, medical professionals, and the FDA conspire to make money from the suffering of the public.

Whitaker provides this graphic illustrating the known clinical response to Xanax before it was approved by the FDA.




One should be aware that Upjohn tried to bias these results by including within the placebo users those who were already suffering withdrawal symptoms from having used benzodiazepines. Even taking the data at face value, after taking medications for 8 weeks, the drug is no better than a placebo. The placebo takers have benefits that continue after drug or placebo are gradually removed, but those who have taken Xanax have symptoms that return and have become even worse than when they began the study. As Whitaker points out:

"In sum, at the end of fourteen weeks, the drug-exposed patients were worse off than the placebo group: they were more phobic, more anxious, more panic stricken, and doing worse on a ‘global scale’ that assessed overall well being. Forty-four percent had been unable to get off the drug, on their way to a lifetime of addiction."

This data predicts the exact result that is observed in the quoted article. Note the date when this data was published: 1988. Upjohn and those who purchased the rights to market this drug have had twenty years of enormous profits for selling something that is essentially a fraud.

One has come to expect unethical and criminal activity from drug companies. The saddest part of this sad tale is the complicity of the medical community and the FDA. For a few dollars it is easy to find medical "authorities" who will put their names on whatever the drug companies write. For a few dollars more they will roam the country convincing doctors that the drug is the greatest thing imaginable. The FDA often views its role as that of helping drug companies get their product to market in a timely manner. Such is the result of a non-regulatory mentality: the very agency that is supposed to protect us is aiding and abetting those who would harm us.

Saturday, September 17, 2011

Classrooms of the Future: Do They Have a Future?

We recently discussed an article by Virginia Heffernan in which she proclaimed that today’s classroom needs a make-over.
"A classroom suited to today’s students should deemphasize solitary piecework. It should facilitate the kind of collaboration that helps individuals compensate for their blindnesses, instead of cultivating them....The new classroom should teach the huge array of complex skills that come under the heading of digital literacy. And it should make students accountable on the Web, where they should regularly be aiming, from grade-school on, to contribute to a wide range of wiki projects."

Soon after encountering Heffernan’s article, another appeared in The New York Times, by Matt Richtel, that offered a preliminary report card for those "new" classrooms. It was pointedly titled: In Classroom of the Future, Stagnant Scores.

Richtel builds his story around the experience of the Kyrene School District which serves K-8 students from the area including Mesa, Phoenix, and Chandler Arizona. Kyrene has bought into the notion that new technology can be used to provide a better education. He presents this picture of a classroom in action.

"Amy Furman, a seventh-grade English teacher here, roams among 31 students sitting at their desks or in clumps on the floor. They’re studying Shakespeare’s "As You Like It" — but not in any traditional way."

"In this technology-centric classroom, students are bent over laptops, some blogging or building Facebook pages from the perspective of Shakespeare’s characters. One student compiles a song list from the Internet, picking a tune by the rapper Kanye West to express the emotions of Shakespeare’s lovelorn Silvius."
"The digital push here aims to go far beyond gadgets to transform the very nature of the classroom, turning the teacher into a guide instead of a lecturer, wandering among students who learn at their own pace on Internet-connected devices."

This is clearly not your typical classroom. These sorts of activities would appear to require significant skill in navigating and functioning in the current digital world. That should be a good thing. The school district has invested $33 million in advanced technologies since 2005, so that better be a good thing.

The world still demands that students perform well in tests of math and reading skills. One can argue about whether such tests are indicative, but one cannot escape the fact that without good reading comprehension skills a student is going to be limited in what he/she can accomplish throughout their lives. Based on standard metrics, how do the Kyrene students compare?

"Since 2005, scores in reading and math have stagnated in Kyrene, even as statewide scores have risen."

Richtel points out that there is no compelling evidence—pro or con—that sheds light on the efficacy of this approach. As with standard approaches to teaching, some obtain better results, some worse. Those who have chosen this path seem to have made a decision based on faith—if it ought to be good, then it must be good. There are also those who are unconcerned about stagnant scores.

"Karen Cator, director of the office of educational technology in the United States Department of Education, said standardized test scores were an inadequate measure of the value of technology in schools. Ms. Cator, a former executive at Apple Computer, said that better measurement tools were needed but, in the meantime, schools knew what students needed."

"’In places where we’ve had a large implementing of technology and scores are flat, I see that as great,’ she said. ‘Test scores are the same, but look at all the other things students are doing: learning to use the Internet to research, learning to organize their work, learning to use professional writing tools, learning to collaborate with others’."

Proponents speak enthusiastically of student "engagement," as if it were in itself a component of achievement.

"....engagement is a ‘fluffy term’ that can slide past critical analysis. And Professor Cuban at Stanford argues that keeping children engaged requires an environment of constant novelty, which cannot be sustained."

Whether or not these methods work better than traditional approaches is becoming as much an economic question as an academic one. Technology costs money and that money has to come from somewhere. At Kyrene, teachers’ salaries are stagnating as well as students’ scores. The only things that seem to be rising are the class sizes.

Proponents seem to believe that the technology investments will be proved cost effective and the tight education budgets will actually work in their favor. It is not clear how that happens unless one reduces the number of teachers—not a likely, or particularly wise path to follow.

One should not read too much in the Kyrene experience, but one should probably not expect tremendous gains to be made from the approach followed there either. The high-tech path is just another version of reform in which the assumption is made that our students would perform better if only they had better teachers. While better teachers would always be welcome, it is foolish to lay all the blame on that much maligned profession.

We recently discussed the paper that compared each state’s students’ scores against those of other countries. Our states spanned the performance spectrum. We had states that performed as well as the best countries, and we had states that compared with the poorest performing countries. We use essentially the same teaching methods, and train teachers in essentially the same way all over the country. It seems incredible that this vast disparity would be due to teachers and teaching methods.

People tend to forget that it is the students who must perform. Something is responsible, but it is likely a complex combination of a number of factors, including school systems, parents, culture, and economics. Getting consistently good performance across the nation may require eliminating poverty, discrimination, unemployment, and excessive income inequality—and that might just be the beginning.

Thursday, September 15, 2011

Does Education Need a Digital-Age Upgrade?

Virginia Heffernan provides an article in The New York Times that answers the question in the title with an enthusiastic "Yes!" Her thoughts on the matter seem to be derived from the work of Cathy N. Davidson who has written a book: Now You See It
Davidson believes that the classroom structure of the past is inappropriate for the age in which we are living.

"The contemporary American classroom, with its grades and deference to the clock, is an inheritance from the late 19th century. During that period of titanic change, machines suddenly needed to run on time. Individual workers needed to willingly perform discrete operations as opposed to whole jobs. The industrial-era classroom, as a training ground for future factory workers, was retooled to teach tasks, obedience, hierarchy and schedules."

Davidson appears to be open to almost any other approach to teaching on the assumption that it would have to be better than the one we inherited. She shares this view with us:

"A classroom suited to today’s students should deemphasize solitary piecework. It should facilitate the kind of collaboration that helps individuals compensate for their blindnesses, instead of cultivating them. That classroom needs new ways of measuring progress, tailored to digital times — rather than to the industrial age or to some artsy utopia where everyone gets an Awesome for effort."

The direction in which Davidson would like us to move becomes clearer with this revelation.

"Ms. Davidson herself was appalled not long ago when her students at Duke, who produced witty and incisive blogs for their peers, turned in disgraceful, unpublishable term papers. But instead of simply carping about students with colleagues in the great faculty-lounge tradition, Ms. Davidson questioned the whole form of the research paper. ‘What if bad writing is a product of the form of writing required in school — the term paper — and not necessarily intrinsic to a student’s natural writing style or thought process?’ She adds: "What if "research paper" is a category that invites, even requires, linguistic and syntactic gobbledygook’?"

Davidson seems to be saying the students do a good job when they are performing a task that is fun and easy, but when you ask them to do something hard, they fail—therefore we should stop asking them to do hard things? A research paper requires that one assemble a set of facts and assumptions into a coherent form that can be used to support a conclusion. The content of the paper must present a sustainable argument that will be convincing to the reader—a reader who is generally not a peer. If the student cannot write a coherent paper on a topic then he/she doesn’t understand the topic. She suggests the form invites "gobbledygook." If gobbledygook is what is turned in then blame it on the teachers not the form.

This suggestion that discipline in writing is somehow out of step with the "digital-age" segues to my major complaint with her outlook: the notion that "solitary piecework" should be deemphasized. Learning is a solitary exercise. You can introduce a subject to a student in a classroom setting, or in a small seminar setting, but the student has to go away and work with it over and over in order for the knowledge to be imprinted and become part of who he/she is. That is how math and science are learned. The language equivalent is the writing of the essay, or term paper, or research paper. If you cannot write a convincing essay on a topic, you do not understand the topic; if you cannot write a comprehendible essay on a topic, you, in addition, do not understand your language.

We should not forget that the ultimate aim of education is to learn how to learn—by definition, I maintain, a solitary process.

Davidson seems to suggest that group activities in schools are more consistent with the workplace of the future when, presumably, people will sit around and brainstorm all day. Such sessions are useful up to a point, but they are not the equivalent of a focused, concentrating individual.

Having spent a lot of time working in groups, I came to cherish a poster I stumbled across. It had the heading "Groups: No one of us is as dumb as all of us."

Wednesday, September 14, 2011

Higher Medicare Eligibility Age Increases Healthcare Burden on Economy

The Center on Budget and Policy Priorities (CBPP) has published a discussion of the issues associated with any attempt to curtail federal costs by raising the Medicare eligibility age to 67 years. Their conclusion is that it is a bad idea for the fiscal health of the country and for the individuals who would be affected.

The assumption is made that the higher Medicare eligibility age will come up as a means of reducing federal costs and thus the federal deficit. The argument is occasionally heard that this would merely make this age consistent with the Social Security full-retirement age which is approaching 67 years. CBPP points out that there is faulty logic in play here. Most people retire before 65 and take the lesser payments available starting at age 62. This creates an awkward situation in which retirees have to find some sort of coverage between the time they stop work and when they are eligible for Medicare. The two systems are already out of phase and the change in eligibility age would only make it worse.

CBPP refers to a study by the Kaiser Family Foundation for the fiscal implications of raising eligibility to age 67 in 2014. The conclusion is that very little federal money is actually saved, and the net effect is to distribute—and increase—healthcare costs throughout the economy. This summary chart is provided.





Why are the savings, $5.7 billion, so small? Actual Medicare spending would decrease by $24 billion in 2014, but that would be balanced by an additional $18 billion in expenses to cover the effect of the 65-67 year-olds on Medicaid and on the participants in the health insurance exchanges. Sending 65-67 year-olds with expensive healthcare needs out to get coverage will end up raising the cost of coverage for everyone.

If Congress should make such a move they would be passing the costs on to others and trading one form of healthcare for a more expensive form. As CBPP concludes: if your intent is to produce a healthier government and a healthier economy, you have done little for the government, and have contributed significant harm to the economy.

Tuesday, September 13, 2011

Will China Be the Dominant World Power? A Con Argument

China watching has become a full-time job for pundits, both professional and amateur. It is a country exceptionally rich in potential and uncertainty. Possible futures vary from world domination to chaos and revolution. Some view China as the world’s inevitable economic powerhouse, while others see a country and an economy that is "unconditionally unstable." Foreign Affairs features two articles that argue China’s future from different perspectives. One, the more positive, sees China’s economic and political dominance as inevitable. The second, the less positive, sees China’s future as resembling that of any other developing country: problems will arise, growth will slow and the future will be uncertain. We will discuss this latter article here today.

Salvatore Babones provides a document titled The Middling Kingdom: The Hype and the Reality of China’s Rise. Babones argues that China’s accomplishments, spectacular as they have been, cannot be extrapolated into the far distant future, as some are wont to do. He sees China as being the beneficiary of some circumstances that cannot continue.

"China's dramatic rise over the past 20 years was propelled by two one-time bonuses: the population's declining fertility rate and its increasing urbanization. Both factors have led to massive increases in economic productivity, but they are finite processes and cannot be counted on in the future."

Babones claims that the declining birthrate, coupled with the one-child policy and parents who were dying at an early age, freed up both men and women to focus almost entirely on their working careers. Now, however, life expectancies are rising and a relatively large number of elderly will have to be cared for.

"Of all the generations of Chinese throughout history, this one is uniquely positioned to pursue work and create wealth. Future generations of Chinese workers will be smaller and will be saddled with the care of ever more elderly relatives. Moreover, fertility rates can only rise going forward, meaning that these workers may have more children to care for as well."

The need to care for more dependents, the children and elderly, will mean that workers will have to be diverted from the high-productivity-producing areas like manufacturing, to low-productivity-growth service sectors.

Urbanization provides a productivity boost by taking workers who are often unpaid subsistence farmers and placing them in paid employment. This is a process with natural limits.

"China's level of urbanization is still well below that of the West, and urban expansion in China shows no signs of slowing down. (At current growth rates, urbanization in China will not catch up to urbanization in the West or Latin America until the 2040s.) But what form will this expansion take? Huge shantytowns are already forming on the edges of Beijing, Shanghai, and other Chinese megacities. The Chinese government bulldozes shanties by the hundreds of thousands every year, but it is unclear whether their residents are being relocated or just being made homeless. Whether or not the government wins its war against slum development, the days when urbanization was a boost to economic growth are gone."

He sees China, at best, following a path similar to that followed by South Korea.

"....economic models tend to downplay the fact that as countries grow, growth gets harder. When economies move up global value chains, graduating from the production of simple manufactured goods to a reliance on the creativity of their citizens to develop new industries, they rise less and less rapidly. It took South Korea 30 years, from 1960 to 1990, to raise its GDP per capita from one-thirtieth of U.S. GDP per capita to one-third -- but then it took another 20 years to nudge its way up from one-third to one-half. And South Korea today is still a long way from catching up with the United States."

He sees a more likely comparison with Brazil, Mexico, and Russia.

"At its current growth rates, China will likely catch up to Brazil, Mexico, and Russia around the year 2020 in terms of per capita GDP. At that point, all four states will have per capita national income levels between $10,000 and $15,000 (in today's dollars). All will also have similar levels of economic inequality -- levels far higher than those in the developed countries. Their people will not experience serious hunger or malnutrition, but they will know mass squalor. About 40 percent of these countries' populations will live in large cities, and about 20 percent will live in rural areas, with the rest in small cities and towns. Their fertility rates will have fallen somewhat under replacement levels, and about two-thirds of their populations will be between the ages of 16 and 65. In the face of rapid aging, these countries will need to shift their economies away from growth industries and toward slow-growth health-care services."
"All of which raises this question: If in 2020, China will almost certainly face structural conditions nearly identical to those in Brazil, Mexico, and Russia, why should anyone expect it to grow any faster than them?"

Babones lists a number of structural issues that china must overcome if it is to continue growing at a rapid rate. He says the nation’s schools and companies have not yet demonstrated the innovation needed to compete with countries like the US. He mentions the severe environmental issues that China will have to face. It is still far from being able to guarantee a secure water supply for all its citizens, let alone a healthy one. China has created for itself a legacy of early death, sickness, and birth defects that will have to be reckoned with, and the causes eliminated. Doing business in China will get much more expensive. The aging of its society will also act as a brake on the economy.

"Since 1960, life expectancy in China has risen from 47 years to 74 years, but the number of children per family has declined from more than five to fewer than two. Today's little emperors will spend their most productive years taking care of their parents. And as they do, China's economic activity will have to move away from high-productivity manufacturing and toward low-productivity health services."

Finally, he compares the political and geographic position of the US in the world with that of China.

"But given the United States' far greater alliance network and geostrategic position, U.S. hegemony is not threatened by the rise of China. The United States is encircled by long-standing allies (Canada and the countries of western Europe) or stable but weak noncompetitors (Latin America). China's neighbors are a rich and powerful Japan, rising South Korea and Vietnam, giant India and Russia, and a host of failed or failing states in Central and Southeast Asia. The United States reigns supreme over the oceans, the skies, and outer space; China struggles to maintain order within its own territory. China will, and legitimately should, play an increasing role in Asian and world politics, but it is in no position to dominate even Asia, never mind the world."

Of the two views we have presented, that of Babones seems the best grounded in reality. He provided us with a number of interesting facts and insights that will be helpful in putting what we observe in our "China watching" into context.

Monday, September 12, 2011

Will China Be the Dominant World Power? A Pro Argument

China watching has become a full-time job for pundits, both professional and amateur. It is a country exceptionally rich in potential and uncertainty. Possible futures vary from world domination to chaos and revolution. Some view China as the world’s inevitable economic powerhouse, while others see a country and an economy that is "unconditionally unstable." Foreign Affairs features two articles that argue China’s future from different perspectives. One, the more positive, sees China’s economic and political dominance as inevitable. The second, the less positive, sees China’s future as resembling that of any other developing country: problems will arise, growth will slow and the future will be uncertain. We will discuss the first article here today.

Arvind Subramanian has produced a document incautiously titled: The Inevitable Superpower: Why China’s Dominance Is a Sure Thing. He provides a very simple and blunt definition of dominance.

"Broadly speaking, economic dominance is the ability of a state to use economic means to get other countries to do what it wants or to prevent them from forcing it to do what it does not want."

He has developed an index that he claims allows him to tally the dominance of a country.

"....an index of dominance combining just three key factors: a country's GDP, its trade (measured as the sum of its exports and imports of goods), and the extent to which it is a net creditor to the rest of the world. GDP matters because it determines the overall resources that a country can muster to project power against potential rivals or otherwise have its way. Trade, and especially imports, determines how much leverage a country can get from offering or denying other countries access to its markets. And being a leading financier confers extraordinary influence over other countries that need funds, especially in times of crisis."

Subramanian projects China’s growth to slow, but still projects a 7% average over the next twenty years. By his index, China and the US are essentially equal in power now, and by 2030 China will be much stronger. To those who would disagree with this near equality at present, he argues that China has already demonstrated the power to intimidate.

"....China's exchange-rate policy has affected economies throughout the world, hurting developing countries as much as the United States: by keeping its currency cheap, China has managed to keep its exports more competitive than those from countries such as Bangladesh, India, Mexico, and Vietnam. Yet these countries have stood on the sidelines, leaving Washington to wage a crusade against Beijing on its own -- and for that reason, it has not done so very successfully. China, meanwhile, has been able to buy off the opposition. Although many countries chafe at seeing their competitiveness undermined by an undervalued yuan, they remain silent, either for fear of China's political muscle or because China offers them financial assistance or trading opportunities. Even within the United States, few groups have really been critical. China is a large market for U.S. companies, and so it is the liberal left, not the holders of U.S. capital, that has condemned China's exchange-rate policy, on behalf of U.S. workers."

Subramanian recognizes that his contention of inevitable dominance may have logical problems when he allows that in 2030 China will still have a per capita GDP that is still mid-range, and quite a bit smaller than that of the US, whereas dominant countries have normally been much wealthier than their competitors. He enumerates reasons why this would be a disadvantage in terms of having to extract from the economy in order to focus resources on things like military power projection when the excess wealth that usually enables that is lacking. Nevertheless, he believes China will have the "internal coherency" and "inspiring national ideals" that will allow it to maintain a path to dominance.

One supposes that if all goes well and the world waltzes slowly forward in time, a twenty year economic and political projection made today might actually happen. Currently, it would be difficult to produce a credible two-year projection for just about any country on earth.

While China has made tremendous progress, it still has a long way to go if it is to create a coherent society in which the extremes of wealth and poverty are subdued. Discounting the Mao years, it has really been a country for barely a generation. It is still learning how to govern itself—and this must be done in the face of enormous problems. If the price of food goes up too high, or if the economy slows and the jobs begin to disappear, the central government faces a billion or more unhappy people. One thinks of China as being ruled by a dictatorial regime that enforces discipline—violently if necessary. It is perhaps more accurate now to say that the government is more afraid of the people than the people are afraid of the government.

For the vaunted Chinese economy to continue to grow and lift hundreds of millions more out of poverty, it will require enormous amounts of resources. One can interpret all of China’s actions in the context of moves it believed were necessary to maintain its supply of the materials its economy needs. Does it keep its currency undervalued because it chooses to demonstrate its power, or because, given the state of its economy, there is no other choice? Does it build an aircraft carrier to project power and intimidate, or is it frightened that someone or something could hinder the flow of goods into and out of its ports. Does China "occupy" Tibet because it is an aggressor, or because it cannot survive without the resources to which the region provides access? Does it invest in Africa in return for natural resources as a modern-day colonial power, or just as a country that needs the materials and tries to get the best deal possible?

China has a difficult path to follow. It is a country where the environment was ravaged by overpopulation for centuries, and then it was ravaged again in order to carry out the rapid industrialization that provided its economic growth. It is accumulating enormous environmental bills that will one day have to be paid. That will have to come at the expense of economic growth.

One tends to forget at times that China has a neighbor who will become bigger and poorer than it. India will try to duplicate the growth that China has seen and it will have to compete with China for natural resources and for commercial ties. They have long shared an extensive armed border and a near state of war. The relationship seems destined to become even more contentious. It is difficult to foresee a happy ending here.

Subramanian seems to believe that China has considerable control over its own future, and therefore the future is theirs to lose. I have a hard time buying that. Let him make his twenty-year projections. I would be happy if in five years I can still recognize the world as being the same one I am living in now.

Sunday, September 11, 2011

Antidepressants and Autism

The incidence of autism in children has increased enormously over the past generation. The following plot provides the growth of reported cases per thousand children.





There is some question about the fraction of these cases that are derived from greater awareness and more accurate diagnoses, but most would agree that the occurrence is growing alarmingly. No precise cause is known, but most discussions include both genetic and environmental factors. A few recent studies have highlighted environmental effects. One is of particular interest because it identifies a specific risk factor.

A study be a Kaiser Permanente group on a collection of children indicated that the incidence of autism was significantly increased when mothers took antidepressant medications during pregnancy or within the year before birth. Specifically, they referred to selective serotonin reuptake inhibitors, the class that contains most of the common antidepressants.

"....we found a 2-fold increased risk of ASD [Autism Spectrum Disorders] associated with treatment with selective serotonin reuptake inhibitors by the mother during the year before delivery (adjusted odds ratio, 2.2 [95% confidence interval, 1.2-4.3]), with the strongest effect associated with treatment during the first trimester (adjusted odds ratio, 3.8 [95% confidence interval, 1.8-7.8]). No increase in risk was found for mothers with a history of mental health treatment in the absence of prenatal exposure to selective serotonin reuptake inhibitors."

In other words, taking this class of medication during the first three months of pregnancy leads to between 1.8 and 7.8 times increase in probability of producing an autistic child, with the most likely enhancement being 3.8 times. During the first trimester the fetus is busy constructing its brain and wiring its nervous system, it seems obvious that would be the time that it is most vulnerable to some form of chemical assault.

The authors of the study refer to their results as a modest effect. I find them frightening. The data provided above is approaching a one percent probability that a child born will suffer some level of autism. Now you find a common medication that, if taken during pregnancy, could make the risk from 2-8 times greater. Those are beginning to look like odds one might not want to bet against.

The Kaiser study has identified a risk factor, but there is no mechanism specified. How many molecules of this class of drug does it take to alter the development of a fetus? One? Trillions?

We discussed here the issue of pharmaceuticals and other drugs building up in our water supplies. There is a reference in Discover Magazine to a study performed to test the effect that observed levels of antidepressants might have on small fish

"Chemists have found that water downstream of water treatment plants holds a veritable medicine cabinet worth of antidepressants, including venlafaxine, bupropion (Wellbutrin), citalopram (Celexa), fluoxetine (Prozac) and sertraline (Zoloft)."

"The concentrations of antidepressants in the water—billionths of a gram per liter—aren’t enough to affect larger species, but they are enough to make small fish and fish babies feel woozy. Researcher Meghan McGee tested the effect of antidepressants on young minnows by exposing unhatched and newly-hatched minnows to levels of antidepressants commonly found downstream of water treatment plants. The drugged minnows appeared lethargic and took twice as long to react to stimulus, making them much more vulnerable to predators."

Remember that downstream from water treatment plants are often other towns that use the river as their water supply. Most treatment methods are not effective at eliminating these types of chemicals, so the problem gets passed on, and, to the degree that processed water gets recycled into the drinking water source, the chemicals can build up.

If the background level of antidepressants in rivers can be great enough to affect the performance of small fish, I think it is appropriate to re-ask the question: how many molecules does it take to affect a fetus less than three months in development? It may be time to start worrying more about what we are drinking.
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