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Covid-19: lies, damn lies and statistics

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Brazilian President Bolsonaro, explaining how government mismanagement and corruption is a good thing

Canto: So Russia is being described as a ‘late arriver’ with regard to Covid-19. It now has the second-highest number of cases, as everyone knows. Yet the mortality figure is astonishingly low. It’s only natural to be suspicious as there’s surely no obvious epidemiological explanation. It’s worth comparing Russia to Germany, whose figures few would quibble with, given its reputation for efficiency. It’s been treated as the European outlier in terms of its response, but nobody appears to be praising Russia for its tiny mortality rate. Why would that be?

Jacinta: Just looking at some reporting, various reasons have been given. Take this one from Dr. Elena Malinnikova, the chief of infectious diseases in the Russian Ministry of Health:

The low mortality is due to timely detection of infection as well as the fact that that Russians tend to see their doctor soon after symptoms appear.

Canto: Hmmm. Other nationalities don’t see their doctor, when there’s a killer pandemic on the loose? And ‘timely detection of infection’ sounds overly vague to me.

Jacinta: Let’s try another one. ‘Russian journalists have reported that more than 60% of all cases diagnosed in the country have been in Moscow, which has a younger and healthier population than rural areas’.

Canto: Yeah, but in the USA it’s the richer, more heavily populated regions of the north-east that have been hardest hit. The rural regions much less so.

Jacinta: Okay. In the article linked to above, Kent Sepkowicz, a physician and infection control specialist, provides good reasons why Russia’s mortality figures don’t make much sense on their face. And before I report on that, let’s look at rough reported mortality rates of a few countries, for comparison. I’ve just looked at total reported deaths as a percentage of total cases. As of May 20, the USA’s mortality rate is around 6%, the UK’s a horrendous 14%, Germany’s has gradually risen to 4.6%, and Brazil, another latecomer like Russia, and now with the fourth largest number of cases, is at 6.5%. Russia, on the other hand, is at 0.95% mortality. That’s a huge disparity, which we might call ‘Russia’s miracle’. But, as Sepkowicz points out, despite reports that Russia is doing well on testing (more than ten times that of Brazil, and somewhat more than the USA, and they might’ve started earlier too), Russia scores poorly on the comorbidity front, otherwise known as ‘pre-existing conditions’, such as heart disease, chronic lung disease, diabetes and obesity. It has an ageing population, and smoking is far more prevalent there than in European countries and Brazil. The testing regime is definitely not so much better than other countries to account for Russia’s apparent success – both Spain and Italy have done more tests per population.

Canto: Hello, are you saying there’s something shifty in the works? Vlad and and his charming circle would never lie to us, surely?

Jacinta: I don’t know that they’d gain much from fudging the figures…

Canto: Are you kidding? Isn’t that like saying Vlad wouldn’t gain much from rigging his election results? What he loses in international credibility, he might gain on the national scene, and that’s more important for him. But maybe there’s some less nefarious reason for the low mortality – I know they’re counting the numbers differently in some way. But the deaths from Covid-19 are the deaths from Covid-19. It should be a straightforward matter.

Jacinta: What about the deaths from x, y or z, exacerbated by Covid-19 infection?

Canto: I think that’s what they’re doing in Russia. Unless they’re certain that it was Covid-19 directly, they’re not counting it, even if they’ve tested positive for the virus, and then they die. They might be arguing that they were going to die anyway, Covid-19 just hastened the end.

Jacinta: Very dodgy if true. You could say that about anyone who’s a bit peely-wally.

Canto: Anyway let’s look at another country in this very complicated trans-national battle against the virus. Brazil’s an interesting one. I’m noting that countries with right-wing laissez-faire governments tend to be killing their citizens at a faster clip than leftist or centrist governments. Whadyareckon?

Jacinta: That’s a bit crude, but let’s look again at the reported figures and give number of deaths per number of cases as percentages. I’m going to leave out Russia and China, as I don’t trust what they’re reporting – which isn’t to say I entirely trust the other nations, but you have to draw the line somewhere. Britain, as mentioned, is very high at 16%, and has a conservative government. A very interesting country to look at is Belgium, which has the highest death rate per million of population of any major country in Europe. It’s death-to cases percentage is also high, at just over 16%. The country’s political situation is horrendously complex. They’ve had a caretaker PM for a year or so, and there’s basically a caretaker government after messy election results in March, in the middle of the Covid-19 crisis. This interim government is supposedly in place just to manage the crisis. Clearly it’s not going well. It would be reasonable to put their problems down to no strong central government, à la the US. Now, Brazil has a notoriously extreme-right government at present, and I’ve already given its deaths-to-cases ratio, but the number of cases is rising rapidly, as are the number of deaths. Now, let’s have a look at Scandinavian countries, often glorified as models of good government. I’ll include in that vague grouping, in order of population: the Netherlands (17m), Sweden (10m), Denmark (5.8m), Finland (5.5m) and Norway (5.4m), and I’ll exclude Iceland, which has all the advantages of a distant island re isolation (it’s 87th in the world for cases). On deaths-to-cases: The Netherlands 13%, Sweden 12%, Denmark 5%, Finland 4.7% and Norway 2.8%. On those statistics, it seems that the smaller the country, population-wise, the better managed it has been in terms of preventing mortality, which does make some sense.

Canto: Okay so I’ll look at their current governments. the Netherlands is clearly hard-hit, Covid-19-wise. It has a multi-multi-party system (that’s not a typo) and is currently governed by a centre-right or conservative-liberal party, VVD, presumably supported by the next largest party, PVV a right-wing nationalist group. The left appears to be divided amongst a number of smaller parties, and the current government has been in power for ten years. Sweden, also faring badly under Covid-19, currently has a minority government with a social democrat PM after a controversial and inconclusive election in 2018. So it’s a centre-left government relying on centre-right parties. The social democrats have been in power, mostly as a majority, since 1917, but there has been a movement towards the right in recent years. Denmark, doing better than the previous two, but faring much worse than we are here in Australia, where we have a death-to-case ratio of 1.4%, has again a multi-party system – and by the way, all of these Scandinavian countries, except Finland which is a republic, are constitutional monarchies practising parliamentary democracy like Britain, and, in a weird way, Australia, New Zealand and Canada. The leftist social democrats are currently in power in Denmark, and they have a far tougher position on physical distancing than the Swedish government. Finland Has both a President and a Prime Minister, somewhat like France. The Prime Minister, Sanna Marin, made news worldwide as the youngest PM in the world when elected late last year. She’s a social democrat and heads a coalition government, which seems to be the case with most Scandinavian governments.

Jacinta: Yes, They seem designed that way so the parliament is more or less forced to collaborate in order to get things done. It seems a much better way to run a country, a far superior system to that of the USA, much more team-based. Anyway, statistics seem to suggest that, overall, strong central governments that can co-ordinate efforts effectively, and have the support of the people, are doing better at saving lives. It’s not a conclusive finding though, and no doubt each country has its confounding factors.

Canto: Norway, finally, has handled things in much the way you would expect of the nation rated first in the world by the OECD. On March 19 this year, their federal government was granted emergency powers by parliament until December. That’s one way of creating strong central government, albeit temporarily. The current government is essentially right-centrist, within a multiparty system where the balance is usually held by left-centre parties. Clearly, though, this is a nation where people place more faith in government than, say, in the USA. And speaking of libertarianism and such, it’s interesting to look at Brazil more closely. When we began this post a couple of days, ago, Brazil was fourth in the world in terms of confirmed cases. Now it’s up to second, that’s how fast-moving things are.

Jacinta: And it’ll never reach top spot, surely – the USA is way way ahead of the rest of the world.

Canto: So Brazil is a republic, and currently has an extreme right-wing government under Jair Bolsonaro, who, according to this very recent New Yorker report, seems to be doing everything he can to exacerbate the situation. Brazil’s rise in cases has been more recent than most, and the death toll is now rising rapidly, now up to sixth in the world.Bolsonaro is shrugging it off and encouraging defiance of state restrictions in much the manner of Trump, whom he idolises. So it seems that when you get extreme anti-government government – negligence mixed with incompetence – as in the case of Trump and Bolsonaro, the death toll will likely be devastating, and will impact mainly the poor, elderly and disadvantaged. Who would’ve thunk it?

References

https://www.worldometers.info/coronavirus/

https://edition.cnn.com/2020/05/13/opinions/russia-low-covid-19-mortality-rate-sepkowitz/index.html

https://www.washingtonpost.com/world/europe/without-a-government-for-a-year-belgium-shows-what-happens-to-politics-without-politicians/2019/12/19/5c13cb48-20de-11ea-b034-de7dc2b5199b_story.html

https://www.nationsencyclopedia.com/economies/Europe/Belgium-POLITICS-GOVERNMENT-AND-TAXATION.html

https://en.wikipedia.org/wiki/Politics_of_the_Netherlands

https://en.wikipedia.org/wiki/Politics_of_Sweden

https://en.wikipedia.org/wiki/Politics_of_Denmark

https://en.wikipedia.org/wiki/Politics_of_Norway

https://www.forbes.com/sites/carmenniethammer/2019/12/12/finlands-new-government-is-young-and-led-by-women-heres-what-the-country-does-to-promote-diversity/#28236f8835aa

https://www.newyorker.com/news/daily-comment/the-coronavirus-hits-brazil-hard-but-jair-bolsonaro-is-unrepentant


Written by stewart henderson

May 23, 2020 at 10:47 am

Empress Dowager Cixi: tradition and reform

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Canto: So we’ve written a piece on Cixi (to save time I won’t keep referring to her by full title), touting her as a reformer, within strict limits, but without actually mentioning and discussing any of her reforms.

Jacinta: Yes, there’s so much to write, to put her in context, that a few blog posts wouldn’t be enough. But before we begin I want to express my annoyance at the Wikipedia article on Cixi. It ends with this on Jung Chang’s book:

In 2013, Jung Chang’s biography, Empress Dowager Cixi: The Concubine Who Launched Modern China, portrays Cixi as the most capable ruler and administrator that China could have had at the time. Pamela Kyle Crossley said in the London Review of Books that Chang’s claims “seem to be minted from her own musings, and have little to do with what we know was actually going in China”. Although Crossley was sympathetic to restoring women’s place in Chinese history, she found “rewriting Cixi as Catherine the Great or Margaret Thatcher is a poor bargain: the gain of an illusory icon at the expense of historical sense”.

Canto: Yes, this is a travesty of the book, which at no point makes comparisons with the other leaders mentioned, or ever hints at such comparisons. Having said that, Chang’s book was a biography, not a history of China during this period, which of course would’ve been a far more monumental task. The book focuses particularly on the court and the Forbidden City, and the struggles and machinations there, and only occasionally, but effectively, expands outward to the nationwide repercussions. As to being ‘minted from her own musings’, the book is clearly massively researched, with primary sources linked to almost every page of the book. Of course some decisions and actions require speculation, all of which, it seems to me, fits with a coherent description of Cixi’s character – that of a proud and often ruthless, baggage-laden Manchu aristocrat with progressive tendencies in keeping with her love of knowledge and innovation, struggling to make sense of and keep abreast of a wave of progress, internationalism and foreign encroachment without precedent in Chinese history. And also of course that of a powerful 19th century woman in a part of the world even more repressive of powerful women than that of ‘the west’.

Jacinta: Yes, it’s particularly disappointing that Wikipedia ends with this hatchet-job, leaving the unwary reader with a very wrong impression of the book, IMHO. Anyway, to the reforms. Chang highlights most of them in the epilogue to her book, and the list is well worth presenting here:

Under her leadership the country began to acquire virtually all the attributes of a modern state: railways, electricity, telegraph, telephones, western medicine, a modern-style army and navy, and modern ways of conducting foreign trade and diplomacy. The restrictive millennium-old educational system was discarded and replaced by western-style schools and universities. The press blossomed, enjoying a freedom that was unprecedented and arguably unsurpassed since. She unlocked the door to political participation: for the first time in China’s long history, people were to become ‘citizens’. It was Cixi who championed women’s liberation in a culture that had for centuries imposed foot-binding on the female population – a practice to which she put an end. The fact that her last enterprise before her untimely death was to introduce the vote testifies to her courage and vision Above all, her transformation of China was carried out without her engaging in violence and with relatively little upheaval.

Canto: Yes, all this is true, and it largely came from her, or more accurately from her complex response to the massive changes going on in the outer world, and that world’s growing impact on China. I’m sure Chang wrote this partly as a corrective to the propaganda surrounding Cixi, that she was an obstacle to progress and, in contradiction, a figurehead manipulated by powerful aristocrats and factions.

Jacinta: And also a cruel and lascivious harridan. And I must say, in response to Crossley’s review, she does bear comparison to other major female power-wielders. To Thatcher perhaps, if only for her formidable ‘she who must be obeyed’ presence, to which many eye-witnesses throughout the book testify, and also perhaps to Elizabeth I (I don’t know enough about Catherine the Great), for her concern for stability and moderation, and for the Chinese people.

Canto: And yet she could be ruthless and cruel, though I put this partly down to the absolute power wielded by the throne, and the history of imperial and aristocratic cruelty she was born into – the eunuch system, lingchi (death by a thousand cuts), the bastinado and so forth. Reforms to the Qing Legal Code, late in Cixi’s lifetime, banned many of these cruelties, though certainly this was under pressure from other nations.

Jacinta: Yes, she has to be seen in the context of China’s long isolation from the ‘enlightenment’ ideas of the west, which was coming to an end just as she gained total power. And her experience, for example, of the wanton destruction of the Old Summer Palace – regarded as ‘the garden of gardens’, an apparently wondrous complex of outstanding architecture, floral designs and historical treasures – by the British in the 1860s would hardly have warmed her to any ideas of western superiority. In fact I think her early sympathy for the Boxer Rebellion well captures her sympathy for so many of the ordinary people who felt threatened by the many changes wrought by foreigners and the arrogance with which some of those went about their ‘mission’. And I’m thinking about Christians in particular.

Canto: The cruelties and the despotism of mid-nineteenth century China bear comparison to the different cruelties of pre-enlightenment Europe, with its burnings by fire, its trials by ordeal, its divine rights and so forth. Reforms came to China almost too quickly, and the path from that nineteenth-century ‘opening up’ to the extremely repressive and unrepresentative government of modern China is no doubt as complex as it is depressing. Cixi was bowing to the inevitable towards the end of her life, it seems, acknowledging, or hoping, that a constitutional monarchy, with popular representation in some kind of parliament, would be the eventual result of all the pressures being brought to bear on the system she’d been accustomed to manipulating. Certainly she was a traditionalist in many ways, full of superstitions that seem bizarre to us, overly loyal to her heritage, the Manchu minority (though she appointed more Han people to positions of authority and power than any previous Qing ruler), and keen to uphold court ceremonial (though flexible when it suited her). It seems to me that if she was twenty or thirty years younger at the turn of the century, with the same hold on power, she would’ve had a better chance than anyone else of effecting a peaceful transition in China, from an absolute monarchy – one of the last – to some kind of more democratic system. But that wasn’t to be, and the rest, sadly, is history.

References

Jung Chang, Empress Dowager Cixi: the concubine who launched Modern China, 2013

https://en.wikipedia.org/wiki/Old_Summer_Palace

https://www.britannica.com/event/Boxer-Rebellion

Written by stewart henderson

May 19, 2020 at 12:11 pm

progressivism: the no-alternative philosophy

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Canto: So here’s the thing – I’ve occasionally been asked about my politics and I’ve been a little discomfited about having to describe them in a few words, and I’ve even wondered if I could describe them effectively to myself.

Jacinta: Yes I find it easier to be sure of what I’m opposed to, such as bullies or authoritarians, which to me are much the same thing. So that means authoritarian governments, controlling governments and so forth. But I also learned early on that the world was unfair, that some kids were richer than others, smarter than others, better-looking than others, through no fault or effort of their own. I was even able to think through this enough to realise that even the kind kids and the nasty ones, the bullies and the scaredy-cats, didn’t have too much choice in the matter. So I often wondered about a government role in making things a bit fairer for those who lost out in exactly where, or into whose hands, they were thrown into the world.

Canto: Well you could say there’s a natural diversity in all those things, intelligence, appearance, wealth, capability and so forth… I’m not sure if it’s a good thing or a bad thing, it just is. I remember once answering that question, about my politics, by describing myself as a pluralist, and then later being disappointed at my self-description. Of course, I wouldn’t want to favour the opposite – what’s that, singularism? But clearly not all differences are beneficial – extreme poverty for example, or its opposite…

Jacinta: You wouldn’t want to be extremely wealthy?

Canto; Well okay I’ve sometimes fantasised, but mainly in terms of then having more power to make changes in the world. But I’m thinking of the differences that disadvantage us as a group, as a political entity. And here’s one thing I do know about politics. We can’t live without it. We owe our success as a species, for what it’s worth, to our socio-political organisation, something many libertarians seem to be in denial about.

Jacinta: Yes, humans are political animals, if I may improve upon Aristotle. But differences that disadvantage us. Remember eugenics? Perhaps in some ways it’s still with us. Prospective parents might be able to abort their child if they can find out early on that it’s – defective in some way.

Canto: Oh dear, that’s a real can of worms, but those weren’t the kind of differences I was thinking about. Since you raise the subject though, I would say this is a matter of individual choice, but that, overall, ridding the world of those kinds of differences – intellectual disability, dwarfism, intersex, blindness, deafness and so on – wouldn’t be a good thing. But of course that would require a sociopolitical world that would agree with me on that and be supportive of those differences.

Jacinta: So you’re talking about political differences. Or maybe cultural differences?

Canto: Yes but that’s another can of worms. It’s true that multiculturalism can expand our thinking in many ways, but you must admit that there are some heavy cultures, that have attitudes about the ‘place of women’ for example, or about necessary belief in their god…

Jacinta: Or that taurans make better lovers than geminis haha.

Canto: Haha, maybe. Some false beliefs have more serious consequences than others. So multiculturalism has its positives and negatives, but you want the dominant culture, or the mix of cultures that ultimately forms a new kind of ‘creole’ overarching culture, to be positive and open. To be progressive. That’s the key word. There’s no valid alternative to a progressive culture. It’s what has gotten us where we are, and that’s not such a bad place, though it’s far from perfect, and always will be.

Jacinta: So progressiveness good, conservativism bad? Is that it?

Canto: Nothing is ever so simple, but you’re on the right track. Progress is a movement forward. Sometimes it’s a little zigzaggy, sometimes two forward one back. I’m taking my cue from David Deutsch’s book The beginning of infinity, which is crystallising much I’ve thought about politics and culture over the years, and of the role and meaning of science, which as you know has long preoccupied me. Anyway, the opposite of progress is essentially stasis – no change at all. Our former conservative Prime Minister John Howard was fond of sagely saying ‘if it ain’t broke, don’t fix it’, as a way of avoiding the prospect of change. But it isn’t just about fixing, it’s rather more about improving, or transcending. Landline phones didn’t need fixing, they were a functional, functioning technology. But a new technology came along that improved upon it, and kept improving and added internet technology to its portability. We took a step back in our progress many decades ago, methinks, when we abandoned the promise of electrified modes of travel for the infernal combustion engine, and it’s taking us too long to get back on track, but I’m confident we’ll get there eventually. ..

Jacinta: I get you. Stasis is this safe option, but in fact it doesn’t lead anywhere. We’d be sticking with the ‘old’ way of doing things, which takes us back much further than just the days of landlines, but before any recognisable technology at all. Before using woven cloth, before even using animal skins and fire to improve our chances of survival.

Canto: So it’s not even a safe option. It’s not a viable option at all. You know how there was a drastic drop in the numbers of Homo sapiens some 70,000 years ago – we’ll probably never know how close we came to extinction. I’d bet my life it was some innovation that only our species could have thought of that enabled us to come out of it alive and breeding.

Jacinta: And some of our ancestors would’ve been dragged kicking and screaming towards accepting that innovation. I used to spend time on a forum of topical essays where the comments were dominated by an ‘anti-Enlightenment’ crowd, characters who thought the Enlightenment – presumably the eighteenth century European one (but probably also the British seventeenth century one, the Scottish one, and maybe even the Renaissance to boot) – was the greatest disaster ever suffered by humanity. Needless to say, I soon lost interest. But that’s an extreme example (I think they were religious nutters).

Canto: Deutsch, in a central chapter of The beginning of infinity, compares ancient Athens and Sparta, even employing a Socratic dialogue for local colour. The contrast isn’t just between Athens’ embracing of progress and Sparta’s determination to maintain stasis, but between openness and its opposite. Athens, at its all-too-brief flowering, encouraged philosophical debate and reasoning, rule-breaking artistry, experimentation and general questioning, in the process producing famous dialogues, plays and extraordinary monuments such as the Parthenon. Sparta on the other hand left no legacy to build on or rediscover, and all that we know of its politico-social system comes from non-Spartans, so that if it has been misrepresented it only has itself to blame!

Jacinta: Yet it didn’t last.

Canto: Many instances of that sort of thing. In the case of Athens, its disastrous Syracusan adventure, its ravagement by the plague, or a plague, or a series of plagues, and the Peloponnesian war, all combined to permanently arrest its development. Contingent events. Think too of the Islamic Golden Age, a long period of innovation in mathematics, physics, astronomy, medicine, architecture and much else, brought to an end largely by the Mongol invasions, and the collapse of the Abbasid caliphate but also by a political backlash towards stasis, anti-intellectualism and religiosity, most often associated with the 12th century theologian Abu Hamid al-Ghazali.

Jacinta: Very tragic for our modern world. So how do we guard against the apostles of stasis? By the interminable application of reason? By somehow keeping them off the reins of power, since those apostles will always be with us?

Canto: Not by coercion, no. It has to be a battle of ideas, or maybe I shouldn’t use that sort of male lingo. A demonstration of ideas, in the open market. A demonstration of their effectiveness for improving our world, which means comprehending that world at an ever-deeper, more comprehensive level.

Jacinta: Comprehensively comprehending, that seems commendably comprehensible. But will this improve the world for us all – lift all boats, as Sam Harris likes to say?

Canto: Well, since you mention Harris, I totally agree with him that reason, and science which is so clearly founded on reason, is just as applicable to the moral world, to pointing the way to and developing the best and richest life we all can live, as it is to technology and our deepest understanding of the universe, the multiverse or whatever our fundamental reality happens to be. So we need to keep on developing and building on that science, and communicating it and applying it to the human world and all that it depends upon and influences.

References

The beginning of infinity, by David Deutsch, 2012

https://en.wikipedia.org/wiki/Parthenon

https://www.thenewatlantis.com/publications/why-the-arabic-world-turned-away-from-science

Written by stewart henderson

May 3, 2020 at 4:36 pm

Covid 19: hopes, failures, solutions

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under pressure

Covid-19 continues to be devastating, especially in the USA, where there are vastly more cases than anywhere else, and vastly more deaths, though the picture there is complex. The hardest-hit region, the New York area, is seeing devastation in poorer districts such as Queens, where the Elmhurst public hospital is inundated with uninsured, critically ill patients. New York has suffered almost half of US deaths. Some other states and regions, especially physical outliers such as Alaska, Hawaii and the Virgin Islands, have very low numbers, and it would be hard to explain why the spread of cases across the mainland has been so uneven. Of course it’s obvious that there has been no federal leadership on the pandemic.

Here in Australia, where the numbers seem to be improving (we’re 33rd on the list of total cases, down from 18th when I first started paying attention to the list about three weeks ago, and 52nd on the list of total deaths), our conservative federal government is keen to open up the country again, and has released modelling to the effect that the virus will be eliminated from the mainland if we maintain current physical distancing measures, though it’s likely to take weeks rather than months:

The model suggests that every 10 people infected currently spread the virus to five more people, on average. At that level, the virus would eventually be unable to circulate and would die out within Australia.

Sydney Morning Herald, ‘Australia in course to eliminate Covid-19, modelling shows’

Australia’s current reproduction number (R0) is just a little over .5. A maintained R0 of 1 or less will eventually eliminate the virus. Of course, there will be fluctuations in that number, so it will be difficult to project a time when things are ‘all clear’. Another difficulty with modelling is that the number of infected but asymptomatic people is unknown and difficult to estimate. For example, recent Covid-19 testing of the entire crew of the aircraft carrier Theodore Roosevelt found that a substantial majority of those who tested positive were asymptomatic, casting doubt on previous estimates (already worrying for transmission) of one in four cases being asymptomatic.

The asymptomatic/presymptomatic transmission issue was addressed by Bill Gates in this article back in February. It’s what makes SARS-CoV-2 a much more serious threat than the previous SARS and MERS viruses. Gates, in this very important article, also provides an outline of what needs to be done globally to fight this pandemic and to prepare for inevitable future ones. If only…

It’s worth comparing Gates’ call for national and global co-ordination, and more expenditure, in the fields of epidemiology and disease prevention, with another more recent article, also published in the New England Journal of Medicine, which tells a tale of Britain and its NHS, gutted by years, in fact decades of ‘reforms’ and budget cuts:

Thanks to government “reforms” of the NHS, it has become highly decentralized, with over 200 commissioning groups in England that can make independent decisions about staffing and procurement of equipment — far from the monolithic “socialist” health care system it is often assumed to be. The devolved governments in Wales, Scotland, and Northern Ireland have substantial health system autonomy. At a time when central management of staff and resources might be most helpful, the decentralized decision-making structure leads to competition for resources and inconsistent policies.

One can hope that the travesty of this virus, especially in places like the US and the UK, will lead to a rethinking of the importance of a well-funded, centralised, co-ordinating and interventionist government in modern states, with particular emphasis on the healthcare system. But I suspect that, in the USA at least, things will go the other way, and the government-hating and government-blaming will only intensify. I’d love to leave this topic and look at solutions – that’s to say I’d love to focus more on the science, but I’m barely equipped to do so. Still, I like to have a go. A very technical and comprehensive review review of pharmacological treatments has been posted recently on the JAMA website, which includes an account of how SARS-CoV-2 enters host cells and utilises those cells for reproduction.

The review claims that currently the most promising therapy is the antiviral drug remdesivir. So what is it and how does it work? I’ll try to answer that question next time.

References

https://www.news.com.au/world/coronavirus/global/epicentre-of-the-epicentre-this-queens-ny-hospital-is-coronavirus-ground-zero/news-story/6d0213ab9d5dd82fa12339f551be99ce

https://www.theguardian.com/world/ng-interactive/2020/apr/16/coronavirus-map-of-the-us-latest-cases-state-by-state

https://www.smh.com.au/national/australia-on-course-to-eliminate-covid-19-modelling-shows-20200416-p54kjh.html

https://www.nejm.org/doi/full/10.1056/NEJMp2005755?query=recirc_artType_railA_article

https://www.nejm.org/doi/full/10.1056/NEJMp2003762

https://jamanetwork.com/journals/jama/fullarticle/2764727

Written by stewart henderson

April 18, 2020 at 1:18 pm

Represent Us and ‘US democracy’, part 2

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Wall Street owns the country. It is no longer a government of the people, by the people, and for the people, but a government of Wall Street, by Wall Street, and for Wall Street.
― Mary Ellen Lease

So the next issue the Represent Us video raises is partisan gerrymandering, an issue here in Australia too. It’s extraordinary to think that gerrymandering has been a problem in the USA since 1788 (the term refers to a salamander-shaped redistricting map created by a governor Gerry of Massachusetts in 1812), with still no solid solution found. So, although this isn’t a new problem, the clearly political, anti-democratic motives involved should make it obvious that it needs to be dealt with apolitically, such as through the justice system or a thoroughly independent, regulated authority. The idea should be that boundaries, which may need to be redrawn from time to time, considering, for example, the general human movement from rural to urban neighbourhoods, should be drawn so as to best assure that all individual votes are of equal value in deciding representation. This would clearly mean taking redistricting out of the hands of partisan politicians and making it a function of independent bodies armed, nowadays, with computer-based maps and up-to-date statistics on human movement. Or am I missing something? Apparently. Here’s what Wikipedia says about the US problem:

Through the 20th century and since then, the US Court system has deemed extreme cases of gerrymandering to be unconstitutional, but has struggled with how to define the types of gerrymandering and standards to be used to determine when redistricting maps are unconstitutional. 

… the Supreme Court has struggled as to when partisan gerrymandering occurs (Vieth v. Jubelirer (2004) and Gill v. Whitford (2018)), and in a landmark decision in 2019 in Rucho v. Common Cause, ultimately decided that questions of partisan gerrymandering represents a nonjusticiable political question that cannot be dealt with by the federal court system.

I’m not sure if this 2019 decision is due to the conservative stacking of the Supreme Court (Republicans have more financial clout but less popular support than Democrats), but it seems reasonable to my naive self that legislation can be created to ban incumbent governors etc from redrawing the boundaries of their own districts. They should be the last people allowed to do so.

So the video goes on to claim that, due to gerrymandering, ‘only 14% of House campaigns are actually competitive’. As a non-American, I’m not sure if that means just House of Reps campaigns or Congressional campaigns. In any case a USA Today article from late 2016, with the telling title ‘Fewer and fewer US House seats have any competition’. However, the author argues that it’s not just about gerrymandering. He quotes a political scientist who talks of ‘self-sorting of the population’, where citizens move around to be with the ideologically like-minded. The Washington Post has an article from mid 2017 on the trend, which, I have to say, favours my fantasy of having the USA split into two nations, on red and blue lines, and seeing how each one fares. But nothing is so simple. Interestingly, on the gerrymandering question the WaPo has this:

Some states have moved to take the redistricting process out of the hands of the legislature, turning the duty over to special commissions that in many cases are told to ignore political outcomes. Results have been mixed.

A bit vague, unfortunately. Are they talking about the results of the attempt to form special commissions, or the results of redistricting by the commissions? The point should be that redistricting by partisan actors should be banned as intrinsically a bad thing.

So let’s look at other claims in the video – 1) trillions of dollars spent annually ‘on fraud and abuse in government’ (does this mean on fighting it, or just by the fraudsters and abusers?) – 2) one in five children live in poverty – 3) the most expensive healthcare in the world – 4) more people in prison per capita than any other country. Other claims are perhaps less quantifiable – the US is losing jobs to the rest of the world, and isn’t doing enough re air and water pollution. I’ll look more closely at those first four.

On point one, the evidence is plentiful. This Medical Economics article cites a study showing nearly a trillion dollars annually in healthcare waste, most of it due to administrative complexity and over-pricing. Forbes reports here on massive waste and fraud by federal agencies, and – most egregious but least surprising – the Pentagon’s accounts are in such a mess that multiple firms of auditors have given up on auditing them. There’s no doubt that waste, fraud and abuse in this massively over-indulged sector dwarfs all others.

As to point two, poverty is of course defined differently in different parts of the world. The US website Debt.org has a section titled How is poverty defined in America?, but what follows fails signally to answer the question. Nevertheless, according to their vague criteria 22% of Americans under 18 live in poverty. With its limited government-based safety net and its massively-paid business and banking sectors, there is surely no other ‘open society’ nation that has such a rich v poor disparity.

On the third point, according to Investopedia, the USA does indeed spend more per capita on healthcare than any other nation, but without the best outcomes. Also, unlike most European nations which also spend heavily on healthcare, the USA spends vastly more on expensive private health insurance rather than subsidised government healthcare.

Point four – Wikipedia doesn’t seem to have reliable figures on incarceration rates beyond 2013, but it does state that ‘in the last forty years, incarceration has increased with rates upwards of 500% despite crime rates decreasing nationally’. It’s an outrageous and shameful statistic, but they might argue that it’s the price they’re willing to pay for their libertarianism (!). The rate of incarceration of women in recent decades has been double that of men. The price to pay for women’s liberation?

So there you go – the greatest country in the world, according to that country.

So the Represent Us argument is that this mess can be cleared up, or begin to be cleared up, if the nation is given back to the people, who are currently unrepresented, mostly. Fix the system, and you can fix everything else. According to Silver and Lawrence, and the constitutional scholars (again, that worshipped constitution) and other experts they consulted, a law (but presumably more than one) that would wrest power from the established economic elites and so move, via the people, to end gerrymandering (using independent redistricting commissions), to create ranked-choice voting (we have this in Australia, where it’s called preferential voting), which will give more scope for new parties and independents, and to automate voter registration.

As to the issue of bribery and financial corruption in the political system, here’s what’s hoped to happen once they, the people are in control. They’ll overhaul lobbying and ethics laws, so that politicians can’t be bribed, say, by promises of cushy sinecures after leaving office; they’ll mandate transparency of political spending, for obvious reasons; ‘give every voter a tax voucher so politicians spend time fundraising from their constituents rather than the [economic elites]’ (this is a strange one I’ll have to look into).

All of these reforms can be wrapped up in an American Anti-Corruption Act, which 87% of Americans already support, enthuses Josh Silver.

So the model American Anti-Corruption Act (AACA), co-authored by Silver and other luminaries, was first unveiled in 2012. I gather from the Wikipedia article on it that it does have a lot of electoral support, though 87% might be a bit exaggerated. I just don’t have that much faith in they, the people.

In any case, Silver himself has little faith in a Congress captured by the economic elites. Congress, he feels, will never turn such an act into law. So what’s the solution? I’ll look at that in my next post. Keep well!

Written by stewart henderson

April 1, 2020 at 6:44 pm

On politics and states – some opening remarks

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‘It takes a village to raise a child’ – Andaman Island girls

One of my abiding interests in life is how to organise society effectively for the benefits of its members. It’s so easy to criticise corrupt and incompetent governments and states, but it seems clear to me that, given the crooked timber of humanity, there’s no ideal form of state or anything close to it. In any case I’m a pragmatist rather than an idealogue, so I’m guessing that the posts I write on this topic will be more about what to avoid rather than what constitutes best practice.

Governments can and should play many roles in trying to provide for an effective society, and these roles often seem to be in conflict. For example, I’ve always been keen on government’s regulatory role in protecting the potentially exploited from would-be or actual exploiters. This would seem to conflict with government’s role in promoting economic success and well-being, in which, for example, traders and producers seek to sell products of highly contested worth. 

Of course one popular view of government is that it should play a minimal role, allowing markets to flow as freely as possible. However the claim that government is ‘always the problem, never the solution’ strikes me as easily refuted. The hands-off approach from government led to the global financial crisis of 2007, in the minds of all but the most hardened libertarians, and in Australia, a recent Royal Commission into the banking sector, which was fought against vigorously by then Federal Treasurer (and now Prime Minister) Scott Morrison, has revealed banking corruption on a massive scale by all of the major banks in the country. Why would anyone think that self-regulation works, given the lessons of history and what we know of human nature?

So I believe that states – that’s to say governments – should have a major role to play in protecting their citizens from exploitation, while providing incentives for industry and capital enterprises to develop and thrive – with certain provisos. It shouldn’t come as a surprise, for example, that I feel that good science, in industrial and other capital enterprises, should be encouraged by government. So good government necessarily entails scientifically literate government. In this respect I believe that good government should be more interventionist than, say, government is expected to be in the USA, where, apparently, pharmaceutical products of highly dubious efficacy can be advertised. Truth in advertising appears not to be a major concern of government in that country, and I thank that’s a mistake.


Looking around the world and reading history, I find the worst governments, in terms of corruption and disastrous consequences for the governed, are those that have managed to avoid being held to account for their actions by those affected. That’s why democracy, bolstered by a free and informed fourth estate, and of course an independent judicial system, has proved to be more effective than its alternatives. But of course democracy is practiced in many different ways in many different states, and it too has its failings.


There’s also the complex role of culture in many states or governing systems. Nationalists tend to exaggerate or manufacture cultural traits, while humanists like myself tend to underplay them or wish them away, but I think the significant increase in globalisation in recent decades has been a benefit overall. Isolationism sees its most extreme examples in North Korea and the Andaman Islands, two very different cases, requiring us to think of culture, its manipulation or otherwise, in complex ways.

I’m not sure where all this is going, but I’ve been wanting to write about this sort of stuff for a long time. I’m currently reading a political history of Korea (north and south) and Russia, in the lead-up to the Putin dictatorship, and of course I’ve learned a lot about the problematic US presidential system over the past three years or so, so there’s plenty to reflect upon…

Written by stewart henderson

January 24, 2020 at 10:43 am

Laws are more important than constitutions, get it?

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not entirely relevant to this piece, but worth considering…

Watching proceedings from afar against Trump and his blundering bovver boys, I become more agitated than I probably need to, but I quite often find my frustration directed more at the prosecutors than at Trump’s mostly contemptible allies. For example, MSNBC commentators and many of their guests, not to mention Nancy Pelosi, are still claiming that the crime here is bribery, when it’s clearly extortion, which is generally considered a more serious crime.

So what’s the difference? It should be obvious. A bribe generally involves appealing to a person’s venality. It’s usually presented in positive terms, as in ‘I’ll make you rich beyond the dreams of avarice if you just do this dirty job for me’. Extortion however is presented in more menacingly negative terms – ‘if you don’t do this dirty job for me, you’ll really really regret it’. Now, it’s notable that the infamous phone call from Trump was relatively polite, which is why he’s trying to characterise it as ‘perfect’. After all, by his boorishly bullying standards, it probably was. The near-polite asking of a favour, then, might be characterised as a bribe, but what was happening behind the scenes, directed by Trump, was definitely extortionate. That’s why focussing on the phone call as the main incident is definitely a mistake, and that’s why Giuliani, Mulvaney and Trump himself need to testify, and should of course be made to, and jailed immediately if they refuse, as should happen in any nation worthy of respect.

But this would only happen if the matter was being dealt with in court – where of course it should be dealt with.

Americans are profoundly worshipful of their constitution and their founding fathers. Indeed they seem to have been fine, upstanding, as well as colourful fellows. It’s my view, though, that given current circumstances, they’d have been the first to realise that the constitutional provisions for dealing with a law-breaking, rogue President were wholly inadequate. This isn’t surprising – experience is the best teacher in these matters, and the US experience has been mostly of Presidents priding themselves on being ‘gentlemen’. This is the only silver lining of this presidency, that it has exposed manifold inadequacies of the constitutional presidency system. 

Constitutions are guides to how governments are to be constituted. I don’t think the framers of this or any other constitution ever imagined that later followers would expect that it constituted the entire law under which the head of state operated. That, to me, is virtually proven by the vague and minimalist treatment of the legal liabilities of the President in the US Constitution. Surely the founding fathers took it for granted that the President would be subject to all the laws of the land that any other citizen would be subject to. How could it be otherwise for someone in leadership, someone expected to set an example? Even minor infractions would be seen as ‘the thin end of the wedge’, and generally this is the case under the Westminster system. 

The worst argument that could possibly be given for the kind of immunity granted to the US President is that he’s too powerful to be charged with a crime. You might call this the Putin argument (or the Stalin, Ghengis Khan or Ramses II argument, or name your favourite dictator). The argument hasn’t improved over the last 3000 years. 

Written by stewart henderson

November 21, 2019 at 4:32 pm