Never let a crisis go to waste: covid-19 and democracy (Guest post from Luke Slawomirski)

Dear Troppodillians, please welcome Luke Slawomirski to Troppo. I first met Luke at the OECD where I gave a paper on public-private digital partnerships with a particular focus on health policy. Luke was an Australian health economist working there and he’s recently returned to COVID free Perth. Anyway, I said I’d welcome a guest post from him and here it is. Nicholas

A few years ago, I had the opportunity to observe several groups of citizens deliberate on how their local health services should be managed in terms of provision and access. This approach could help policymakers navigate some upcoming challenges of COVID-19 crisis.

At the time, I was sceptical that a citizens’ jury could produce more than a wish-list of costly services and interventions. I was wrong. The 20-or-so jurors, randomly selected from the electoral roll and led by a strong, well-versed facilitator, quickly grasped the economic concepts at play: resource scarcity, opportunity cost, diminishing returns and even vertical equity – the unequal but equitable treatment of unequals.

In this way, the jury helped local policymakers define concepts such as health ‘need’, provided guidance for setting priorities that require value judgements and inevitable trade-offs when trying to do the most with limited resources.

Citizens’ juries date back to the ancient Athenian practice of sortition, a practice that involved citizens in the executive functions of government.  More recently, they have gained traction in health and other areas of public policy.

The unique challenges of covid-19 illustrate its potential advantage and signals that perhaps their time may have truly arrived.

A SARS-Cov-2 vaccine is uncharted policy territory Continue reading

Posted in Democracy, Economics and public policy, Health | 8 Comments

What works: getting to the land of ‘how’: Part One

Cross posted from The Mandarin Premium. Government leaders understanding what they need to do when faced with impending issues is one thing. But here, in the first of a three-part series, Nicholas Gruen gets into the nitty-gritty of coming to terms with the ‘how’ of what needs to be done. 

It is impossible to remember, until one gets in the country … that they care about their experiment more than about making things work.”

John Maynard Keynes on Soviet Russia, to Lady Ottoline Morrell, May 2, 1928.

The land of ‘what’ and the land of ‘how’

From at least the years of the ‘third way’ in the 1990s under Blair and Clinton, we’ve been hearing what governments need to do to address our various social problems. Again and again, ‘thought leaders’ tell us what we must do – move beyond one-size-fits-all services to ‘joined up government’ to ensuring that programs do things ‘with’ people rather than ‘to’ them. Plausible as they are, these ideas have barely been tested. Because if they tell us what we have to do, we’ve scarcely learned how.

At the outset there seemed to be a seductive straightforwardness to getting to how. As Bill Clinton put it “nearly every problem has been solved by someone, somewhere”. The challenge was “to find out what works and scale it up”. For me these words stand as a creation myth of the problem I want to address. They even show us original sin, because if you pay close attention there it is! Clinton suggests we learn how to solve our problems by learning a ‘what’ – what works – and then scaling it.

Yet here we are nearly three decades on and despite numerous promising innovations in small scale programs, they all share the same fate. It’s hard to think of a single example of action to address social problems that’s started small and been ‘‘scaled’ as Clinton proposed. Yet despite endless inquiries into our failure to address social problems – for instance aboriginal or multi-generational disadvantage and endless restructurings and resettings of policy in response, we’ve never got far. Peter Shergold lamented the problem in 2005.[1] Yet despite a term as the nation’s chief public servant, he conceded in 2013 that the problem remains.[2]

This is the first instalment of a three-part essay which itself is part of a larger project. In this article, I’ll set the stage showing the subtlety and depth of the problem. For, when it’s pointed out, we all understand that there’s a difference between ‘knowing what’ the rules of tennis or chess are and ‘knowing how’ to play. My claim is that in all kinds of ways we insensibly confuse the two and so substitute ‘knowing what’ (or ‘knowing that’) and knowing-how. In this first part of this essay, I’ll show how this happens in our universities and the professions they teach. In the second, I’ll show how this occurs in government agencies and programs. The third part concludes with a look at recent initiatives like nudge units and What Works Centres that seek to foster greater ‘knowing how’ and innovation in government. The key to their success so far has been the way they bolt on to business-as-usual and, in so doing, improve it. This essay is written to try to articulate how they might envisage a more ambitious future.

From the foundations to the commanding heights

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Posted in Cultural Critique, Economics and public policy, Education, Philosophy, Science | Leave a comment

Markets as ‘causal spread’: How the early neoliberals anticipated embodied cognition: Fragment one – Hayek

My essay on the Ghost of Descartes was written by cannibalising a longer, not quite finished essay entitled “Cartesian vices, Copernican moments”. In writing something else, I find myself wanting to refer to another part of it, so I’m hastily topping and tailing the relevant section and posting it here. I’ll follow it up with another fragment on Michael Polanyi who was an all-round better neoliberal guy than Hayek for reasons I’ll elaborate when I publish it.

Hayek’s markets as embodied cognition

The ideas of embodied cognition help vivify economists’ appreciation of markets. The issues were brought to life most fully in the ‘socialist calculation debate’ of the 1920s. It was already well understood that administrative mechanisms could blunt market incentives for self-interest to drive economic improvement.1 But Ludwig von Mises, and then his fellow Austrian, Friedrich Hayek observed that even if the incentive problem could be overcome, in a centrally planned economy, decision-makers could not obtain the information they needed to make economically rational decisions.

How would the centre determine the value of different commodities if they weren’t traded in a market? It seems intuitively clear that it would be massively more complex to run such information from all corners of the market to some central brain to make production and allocation decisions. Yet, socialist economists, Lange and Lerner proposed just such a scheme. To simplify it somewhat, consumers would pay prices and producers would be paid to produce with the central planner sitting between them receiving and paying each appropriately. Where production surpluses and deficits appeared, the central controller would change its instructions, the prices it set and/or the payment producers received in a ‘trial and error’ process just as markets mutually adjust demand and supply within the market.

(As an aside on re-reading this, the ‘socialist’ side of this debate is as classic a case as one can imagine of an intellectual pathology in which the scientist imagines their own construct as part of the world itself, rather than a construct of it. The neoclassical construct Lange and Lerner are seeing in markets has been built from one particular intellectual mapping of what goes on in a market. The neoliberals are right that that’s for deeper reasons. Nassim Taleb often tackles something similar when he critiques neoclassical theorists of risk for imagining that the world is the casino of risk they imagine it is, when most of the risk people must manage in the world is a very different thing – uncertainty. There’s a similar split between Kahnemann’s work which is quick to assume that naïve decision making has ‘biases’ when compared with ‘optimal’ decision theory, when Gigerenza and the embodied cognition crowd more generally think that those heuristics we can discover are the building blocks of ecological rationality.)

Continue reading

  1. Murray N. Rothbard, 1991. “The End of Socialism and the Calculation Debate Revisited”, The Review of Austrian Economics, Vol. 5, No. 2 (1991): 51-76.
Posted in Economics and public policy, Philosophy, Political theory | 2 Comments

From being to seeming: why empirical scientists failed in times of Covid.

There have long been scientists who were celebrities in their own time. Galileo, Keppler, Goodall, Linneus, Cousteau, Darwin, Smith, Leeuwenhoek, Da Vinci, Ibn Khaldhun, Curie, and many others in the last 800 years were followed and admired. They in many ways performed their science, as when medics performed autopsies in theaters, astronomers performed their experiments and claims in large observatories in major towns, and geologists and botanists had whole populations bring them samples to put on display. The paleontologists displaying the bones of dinosaurs in Western museums were as much performance artists as Kayne West is today.

And yet, nowadays, the business of performing science has gone a level deeper, both inside the halls of academia and outside. Nicholas Gruen has written many times about how governments and other large organisations “perform expertise”, at the cost of actually having much expertise or valuing its application. Not only do I think he is totally right, but the need to be seen to perform has taken over much of science itself. Like Oscar Wilde’s Dorian Gray, whose picture shows the degrading real character of a master of pretense, so has the whole of empirical science been sliding for decades into seeming over being.

The Picture of Dorian Gray - WikipediaI suspect this slide towards “seeming over being” is why empirical science so spectacularly failed us during the covid-19 pandemic. It lead to a loss of independence from group think, a loss of awareness of basic rules of thumb, and it lead to poverty in reasoning.

In this long piece, I want to sketch the content of that slide and the deeper reasons for them. Importantly, I don’t think any individual or group is clearly to blame, making it hard to see how we get out of the trap it has put us in.

Government budget performances

Take government budgets as an example of a science-like modern performance. They once were sober affairs wherein governments would put in some state-run newspaper some general information as to how the state finances were going and which taxes were going up or down.

Nowadays, almost everywhere in the Western world, budgets are annual performances. As Nicholas Gruen termed it nicely, governments engage in accountability theater. Someone official announces budgets in an important place. It is televised and podcast. Lots of dressed-up people talking gravely, getting equally grave “responses to the budget”. Snippets are leaked to the media beforehand to get attention for something or to diffuse attention away from something. Continue reading

Posted in Coronavirus crisis, Cultural Critique, Democracy, Economics and public policy, Education, Geeky Musings, Health, Life, Philosophy, Politics - national, Religion, Science, Social Policy, Society, Theatre | 15 Comments

Public servants and political partisanship

Every now and again I’m asked to contribute to The Mandarin as part of their Brains Trust. Here’s my latest contribution in seeking to answer this question:

Where is the boundary between their designated public duty and the apparent expectation by some ministers that it’s ok for public funds to be spent on political objectives like garnering votes for pre-selections or funding programs skewed to marginal seats?

“The principles are fairly straightforward at least in principle. Political staffers act for the minister and the minister should be accountable for staffers’ actions. This follows from the basic common law principle that principals are responsible for those who act as their agents. Sadly, for decades now, there’s been a tacit bipartisan agreement to leave things as they are. This effectively prevents any effective accountability regime being established over staffers. And over time this is increasingly degrading the accountability of ministers who are increasingly using their staff as deniable ministerial proxies.

“Regarding public servants, they should assist their political masters administer programs including exercising their ministerial discretion according to law. They should obviously not be drawn into assisting them to exercise that discretion in politically partisan ways, and it is likely that this would be beyond ministers’ power under the legislation they administer.

“The problem, however, is one of interpretation. Ministers will deny acting improperly. Public servants should not assist or coach them in making disingenuous claims, but if ministers can figure out how to cover their tracks and assert their probity unless a public servant has clear evidence that they are acting improperly, it is difficult for them to do anything other than assist their ministers in their work.

“If it seems highly likely the minister is acting improperly, the next step according to the book is for the public servant to write to the minister: informing them that, in the department’s professional view, the proposed action is ultra-vires or beyond the minister’s power; and seek a formal written direction from the minister in response. One can see an exemplary letter of this kind written by a senior British civil servant recently at this link.

“Unfortunately, however, after the widespread sackings that cleared the public service decks on the ascension of new governments in 1996 and 2013, and the summary removal of Paul Barrett and Paul Grimes each for giving unwanted advice, these values are imperilled. It would be nice to be bipartisan in offering such admonitions. But the fact is that it’s the Coalition that has perpetrated virtually all these heavy blows against our Westminster heritage which evolved in England and then Australia over centuries. It’s ironic that such people call themselves ‘conservatives’.”

Posted in Cultural Critique, Democracy, Economics and public policy | 1 Comment

May the farce be with you: Dyson Heydon (or is that Heydon Dyson?) edition

Heydon Dyson Dyson Heydon is hard at work.

A quick follow up on my “May the farce be with you” article on how the oligarchy got George Pell off on charges of sexual molestation. One that Graham Young rated thus:

One of your worst posts Nicholas. You show a complete disregard and contempt for the legal system. It’s not meant to convict people of crimes they didn’t commit.

Jeremy Gans has a fascinating write up of His Honour and Groper and Sexual Harasser Du Jour Dyson Heydon and how Heydon, (or is that Dyson, no it’s Heydon),  was the only High Court judge who saw the obvious sense in admitting similar fact evidence in cases like this. He argued it on slightly different grounds to those I’ve argued it on, but similar fact evidence in these cases is highly probative in circumstances where one does want some corroboration and by the very private nature of the offence will be difficult to come by.

The legal system should have handled Pell in the way that only Heydon Dyson (OK – Dyson Heydon) said they should. From the article:

Heydon was somewhat ahead of the public on whether to believe an allegation of professional predation. He bemoaned that such an allegation’s1 seeming bizarreness meant that a prosecution based on it alone “may easily falter, no matter how truthful,” even when — as Stubley’s patient testified — the allegation was of years of persistent indecent assaults and rapes perpetrated in a psychiatrist’s office, her sobbing throughout. That’s why, he said, such claims of predation shouldn’t be heard on their own. Quoting Western Australia’s evidence law statute, he declared that “fair-minded people would think that that the public interest” would favour hearing “similar testimony about the tendency of the accused.” … Regardless, he was alone on the High Court in 2011. The other four judges who heard Stubley’s case  [including] Susan Kiefel and Virginia Bell [!!] — all allowed the psychiatrist’s appeal. …

These judges’ words, in sharp contrast to Heydon’s own, could be music to the ears of any barrister asked to defend the former judge if he is prosecuted for crimes against some of the people whose accounts have emerged this week. If Heydon admits doing the particular acts he is accused of — say, touching a woman’s thighs or hugging or kissing her — but says that the woman consented to those acts, then the majority’s ruling on Stubley’s appeal would bar the prosecution from using others’ accounts of his misconduct, no matter how similar or non-consensual or well-established, to convict him. In short, the majority’s judgement takes the “too” out of #metoo.

I am long on the record as saying that the High Court’s approach to such cases is seriously wrong. Six years previously, the national court had unanimously allowed the appeal of a different alleged predator, a teenager convicted of the rapes or attempted rapes of six different teenagers, by ruling that he should have been tried separately for each. Why? Because he had testified that each of the six consented to sex with him, only to later accuse him of rape. (Remarkably, the sixth instance occurred while he was on bail on charges of raping the other five.) The national court ruled that, as a result, their testimony could not establish any pattern about the accused, but only cast light on their own, separate, decisions not to consent to sex with him.

  1. Of a psychiatrist’s having sex with his patients.
Posted in Cultural Critique, Law | 10 Comments

“Living with Covid” Interesting paper on tradeoffs

Here is a new paper from Imperial College, this time by a team with David Miles, Mike Stedman, and Adrian Heald, looking into the implicit cost per QALY that the UK spent via lock downs and other repression policies. They use a somewhat different methodology from mine, estimating marginal effects of policies from cross-country variation rather than with some notion of the previous status quo, but they end up with almost the exact same answer that “The lowest estimate for lockdown costs incurred was 50% higher than highest benefits from avoiding the worst mortality case scenario at full life expectancy tariff and in more realistic estimation they were over 50 times higher“. In other words, they estimate that for every life-year saved by restrictions, an estimated 50 will be lost down the line whom we can no longer afford to save. And that’s just solely within the UK. They hence say it was all a huge mistake that we should undo as fast as possible. Here’s their full abstract:

The COVID-19 pandemic has transformed lives across the world. In the UK there has been a public health driven policy of population ‘lockdown’ that had enormous personal and economic impact. We compare UK response/outcomes including excess deaths with European countries with similar levels of income/healthcare resources. We calibrate estimates of the economic costs as different %loss in GDP against possible benefits of avoiding life years lost, for different scenarios where local COVID-19 mortality/comorbidity rates were used to calculate the loss in life expectancy. We apply quality-adjusted life years (QALY) value of £30,000 (maximum under NICE guidelines). The implications for future lockdown easing policy in the UK are also evaluated. The spread of cases across European countries was extremely rapid. There was significant variation both in severity and timing of both implementation and subsequent reductions in social restrictions. There was less variation in the trajectory of mortality rates and excess deaths, which have fallen across all countries during May/June 2020. The average age at death and life expectancy loss for non-COVID-19 was 79.1 and 11.4years respectively while COVID-19 were 80.4 and 10.1years; including for life-shortening comorbidities and quality of life reduced this to 5QALY for each COVID-19 death. The lowest estimate for lockdown costs incurred was 50% higher than highest benefits from avoiding the worst mortality case scenario at full life expectancy tariff and in more realistic estimation they were over 50 times higher. Application to potential future scenarios showed in the best case a QALY value of £220k (7xNICE guideline) and in the worst-case £3.7m (125xNICE guideline) was needed to justify the continuation of the lockdown. The evidence suggests that the costs of continuing severe restrictions in the UK are so great relative to likely benefits in numbers of lives saved so that a substantial easing in restrictions is now warranted.

 

Posted in Coronavirus crisis, Health, Libertarian Musings, Medical, Science, Social Policy | 51 Comments