What Does Wealth Mean?

This passage from a recent essay by Robert Solow caught my eye, because it hits on a point that has always confused me:

When the implosion came in 2007, enormous amounts of what had been perceived as wealth—true, eventually spendable wealth—simply disappeared. According to data compiled by the Federal Reserve, household wealth in the US peaked at $64.4 trillion in mid-2007, and had plummeted to $51.5 trillion at the end of 2008. Something like $13 trillion of perceived wealth vanished in not much more than a year.

Nothing concrete had changed. Buildings still stood; factories were still just as capable of functioning; people had not lost their ability to work or their skills or their knowledge of technology. But a population that thought in 2007 that they had $64.4 trillion with which to plan their lives discovered in 2008 that they had lost 20 percent of that.

So, what does it really mean to say that 20% of that $64.4 trillion is gone? That's probably a dumb question. But as Solow himself points out, all of the wealth-building capacity is still there; it's not as if America got hit by a string of natural disasters or nuclear bombs that wiped out 20% of its population and territory. We're all still here.

What it means to say that trillions of "dollars" disappeared can only be that many or most of us are individually less willing to promise future payments of money for the stuff or services that other people have. But why are we all less willing to promise future payments of money to other people? Because we don't individually have enough productivity right now. And why? Because other people are less willing to promise future payments of money to us. And why are they less willing . . . well, you get the point.

So how is this not all rather circular?

Should You Be Reading This?

A good post from Keith Staples. He begins with a long quote from a book called "The Intellectual Life" (click through to read), and then offers these observations:

This is the passage to which I advert to explain my feelings of deep ambivalence toward the blogosphere. Whatever its advantages, I find that it feeds, instantly and abundantly, my uncontrolled appetite for fragmentary opinions, and images, weakens my powers of attention, and disturbs the “interior silence” that allows me to hear the truth. The pleasure of a two-hour blog-binge comes mostly from the sense of carnival: an orgy of various ideas and impressions in my mind. And, truth to tell, I also nurture my vanity, feeling self-satisfied as I reflect on the diversity of discourses in which I, in my glorious intellectual richness, take a lively and supposedly intelligent interest. A vague sense of exaltation attends the transition from an urbanist forum to a passionate discussion of divine transcendence.

But what, in the end, have I achieved? Nothing. Nothing at all. I cannot pretend to the expansive catholicity of a great mind like Goethe or a superior mind like Fr. Neuhaus. Their catholicity rounded out and gave context to expertise. I do not even have the dignity of a being a failure because I haven’t been able to settle on an objective long enough to fail. This ephemeral intellectual existence of mine can be explained almost entirely by spastic reading habits that I hereby vow to change. Amen.

Flannery O'Connor on Education

I loved this quote from an essay called "Total Effect and the Eighth Grade":

In other ages the attention of children was held by Homer and Virgil, among others, but, by the reverse evolutionary process, that is no longer possible; our children are too stupid now to enter the past imaginatively. No one asks the student if algebra pleases him or if he finds it satisfactory that some French verbs are irregular, but if he prefers Hersey to Hawthorne, his taste must prevail.

No child needs to be assigned Hersey or Steinbeck until he is familiar with a certain amount of the best work of Cooper, Hawthorne, Melville, the early James, and Crane [we can quibble with the names; I certainly quibble with Cooper’s inclusion], and he does not need to be assigned these until he has been introduced to some of the better English novelists of the eighteenth and nineteenth centuries.

The fact that these works do not present him with the realities of his own time is all to the good. He is surrounded by the realities of his own time, and he has no perspective whatever from which to view them. Like the college student who wrote in her paper on Lincoln that he went to the movies and got shot, many students go to college unaware that the world was not made yesterday; their studies began with the present and dipped backward occasionally when it seemed necessary or unavoidable.

The high-school English teacher will be fulfilling his responsibility if he furnishes the student a guided opportunity, through the best writing of the past, to come, in time, to an understanding of the best writing of the present. He will teach literature, not social studies or little lessons in democracy or the customs of many lands.

And if the student finds that this is not to his taste? Well, that is regrettable. Most regrettable. His taste should not be consulted; it is being formed.

Health Care in America

A few random quotations (OK, not entirely random):

1. From this month's report Beyond Health Care: New Directions to a Healthier America, from the Robert Wood Johnson Foundation:

Although medical care is essential for relieving suffering
and curing illness, only an estimated 10 to 15 percent of
preventable mortality has been attributed to medical care.

2. From an article entitled "Death by Medicine":

As shown in the following table, the estimated total number of iatrogenic deaths — that is, deaths induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures — in the US annually is 783,936. It is evident that the American medical system is itself the leading cause of death and injury in the US. By comparison, approximately 699,697 Americans died of heart in 2001, while 553,251 died of cancer.

3. From Barbara Starfield, "Is US Health Really the Best in the World?," JAMA 284 (2000):483-485.

The health care system also may contribute to poor health through its adverse effects. For example, US estimates8-10 of the combined effect of errors and adverse effects that occur because of iatrogenic damage not associated with recognizable error include:

* 12,000 deaths/year from unnecessary surgery
* 7000 deaths/year from medication errors in hospitals
* 20,000 deaths/year from other errors in hospitals
* 80,000 deaths/year from nosocomial infections in hospitals
* 106,000 deaths/year from nonerror, adverse effects of medications

These total to 225,000 deaths per year from iatrogenic causes. Three caveats should be noted. First, most of the data are derived from studies in hospitalized patients. Second, these estimates are for deaths only and do not include adverse effects that are associated with disability or discomfort. Third, the estimates of death due to error are lower than those in the IOM report.1 If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer.

4. From Jason Lazarou, Bruce Pomeranz, and Paul Corey, "Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies," JAMA 279 (1998): 1200-1205.

The overall incidence of serious [adverse drug reactions] was 6.7% (95% confidence interval [CI], 5.2%-8.2%) and of fatal [adverse drug reactions] was 0.32% (95% CI, 0.23%-0.41%) of hospitalized patients. We estimated that in 1994 overall 2216000 (1721000-2711000) hospitalized patients had serious [adverse drug reactions] and 106000 (76000-137000) had fatal [adverse drug reactions], making these reactions between the fourth and sixth leading cause of death.

Grim Fairy Tales

Following up on this gruesome fairy tale, I think I've found one that's even worse. I've still been periodically reading to my kids out of Grimm's Fairy Tales -- not the modern, sanitized versions -- and tonight came across The Robber Bridegroom, which happens to involve a band of cannibals. My kids are now of the firm opinion that I should read through a fairy tale by myself first before reading it aloud.

Random Thoughts

1. I really enjoyed Pascal-Emmanuel Gobry's argument for abolishing the concept of retirement, that is, the generic assumption that old people should sit around doing nothing.

2. I drink a lot of whole milk (probably a couple of gallons a week). Sometimes people comment, "Can you imagine what that's doing to your arteries?" Well, probably nothing. Via Conditioning Research, here's a recent systematic review of numerous dietary studies on heart disease. One of the conclusions: "Insufficient evidence (< or =2 criteria) of association is present for intake of supplementary vitamin E and ascorbic acid (vitamin C); saturated and polyunsaturated fatty acids; total fat; alpha-linolenic acid; meat; eggs; and milk." What you need to avoid: "intake of trans-fatty acids and foods with a high glycemic index or load," that is, most processed carbohydrates. I should start asking people who eat bagels, "Think about how that's going to clog your arteries."

The Problems of Goals

An interesting article from the Boston Globe on the pitfalls of setting goals. The primary problem with (some) goals, it seems to me, is the potential for distorting behavior, something that is more likely to occur if the goal is only a proxy for what you really want to happen. I'm not sure I buy the article's primary example of this, though:

IN THE EARLY years of this decade, General Motors had a goal, and it was 29. Determined to boost its flagging profits and reverse a long, steady fall from postwar dominance, the automotive giant did the natural thing: it set a goal. The company pledged to recapture 29 percent of the American market, the share it had ebbed past in 1999. The number 29 became a corporate mantra, and some GM executives took to wearing lapel pins with the number emblazoned on them.

It didn't work. GM never did regain 29 percent of the market, and today, facing the possibility of bankruptcy, it looks even less likely to do so. The lapel pins are gone, and that number isn't much heard from the company.

And while the causes of GM's woes are many - from poor design to high labor costs to a prostrate economy - industry analysts argue that one of the most damaging things the company did was to set that goal.

In clawing toward its number, GM offered deep discounts and no-interest car loans. The energy and time that might have been applied to the longer-term problem of designing better cars went instead toward selling more of its generally unloved vehicles. As a result, GM was less prepared for the future, and made less money on the cars it did sell. In other words, the world's largest car company - a title it lost to Toyota last year - fell victim to a goal.

Did GM fall victim to a goal, or did it fall victim to shortsighted means of achieving that goal? What would have happened if the executives at GM had decided that the best way to achieve a 29% market share was precisely to address the "longer-term problem of designing [and producing, I might add] better cars"?

Funny post

I laughed at this post by Paul Gowder, an old friend from law school: "Diary of a visit to a coffeehouse run by a madman."

Random Items

1. New band that I like: Your Vegas. A Brit-pop band with an 80s vibe and a soaring tenor vocalist.

2. Don't spend too much time sitting, as it is associated with increased mortality even if you work out.

3. Lots of people have cited Wesley Elementary in Houston as a good example of the success of Direct Instruction (see here and here). But it's not such a great example: The Dallas Morning News printed a story in 2004 giving several examples of cheating or apparent cheating at that school. Although an independent counsel found "no conclusive evidence" of cheating, the DMN story is fairly damning (for a related story, see here).

Sincerity in Moral Objections

If people claim to object to X as a general matter, but their objections to X are raised only when someone from the opposite political party can be blamed, and if they likewise ignore much more substantial instances of X, then I suspect that their objections to X are rooted more in political partisanship than in a sincere moral position.

Thus, for example, when many commentators were complaining about the Patriot Act provision allowing the FBI to subpoena a suspect's library records, my test for whether they were really that worried about privacy was whether they raised similar objections to the fact that all of us (not just terrorism suspects) have to file much more intrusive tax forms with the government every single year, providing numerous details that are overwhelmingly more private than anything that could conceivably be in a library record.

A similar test of sincerity could be raised about the torture issue. Consider a recent and persuasive New Yorker article by the always-worth-reading Atul Gawande:

“It’s an awful thing, solitary,” John McCain wrote of his five and a half years as a prisoner of war in Vietnam—more than two years of it spent in isolation in a fifteen-by-fifteen-foot cell, unable to communicate with other P.O.W.s except by tap code, secreted notes, or by speaking into an enamel cup pressed against the wall. “It crushes your spirit and weakens your resistance more effectively than any other form of mistreatment.” And this comes from a man who was beaten regularly; denied adequate medical treatment for two broken arms, a broken leg, and chronic dysentery; and tortured to the point of having an arm broken again. A U.S. military study of almost a hundred and fifty naval aviators returned from imprisonment in Vietnam, many of whom were treated even worse than McCain, reported that they found social isolation to be as torturous and agonizing as any physical abuse they suffered.

* * *

Most hostages survived their ordeal, Fletcher said, although relationships, marriages, and careers were often lost. Some found, as John McCain did, that the experience even strengthened them. Yet none saw solitary confinement as anything less than torture. This presents us with an awkward question: If prolonged isolation is—as research and experience have confirmed for decades—so objectively horrifying, so intrinsically cruel, how did we end up with a prison system that may subject more of our own citizens to it than any other country in history has?

* * *

Whether in Walpole or Beirut or Hanoi, all human beings experience isolation as torture.

* * *

The number of prisoners in these facilities has since risen to extraordinary levels. America now holds at least twenty-five thousand inmates in isolation in supermax prisons. An additional fifty to eighty thousand are kept in restrictive segregation units, many of them in isolation, too, although the government does not release these figures.

Douglas Berman of "Sentencing Law and Policy" points out that "while a few hundred accused terrorists and murderers have lots and lots of constitutional lawyers and activists running to court on their behalf, many thousands of lesser criminals confined to the hellhole of supermax prisons languish with very few persons even thinking about their plight, let alone fighting in court on their behalf."

The answer is not to be less concerned about the handful of people tortured by the CIA. The answer is to show a proportionate amount of concern about what is effectively torture elsewhere, even if there's no partisan gain to be had. That is, someone who is sincerely concerned about torture should spend MUCH more effort writing and agitating about things done in America's prisons every day. Solitary confinement is one thing to oppose; here's another cause.

Spinal Tap and 110%

It just occurred to me that the sports cliche about "giving 110% out there on the field" is mathematically equivalent to the great scene from Spinal Tap about turning the volume up to 11: