Innovation Versus Time and Culture Bound Normality

Scott Alexander at SlateStarCodex riffs off my post on how we laugh at Oregonians afraid to pump their own gas while not looking at our own absurd restrictions on cutting hair, for example, and adds a few of his own:

There are way too many discrepancies in approved medications between countries to discuss every one of them, but did you know melatonin is banned in most of Europe? (Europeans: did you know melatonin is sold like candy in the United States?) Did you know most European countries have no such thing as “medical school”, but just have college students major in medicine, and then become doctors once they graduate from college? (Europeans: did you know Americans have to major in some random subject in college, and then go to a separate place called “medical school” for four years to even start learning medicine?) Did you know that in Puerto Rico, you can just walk into a pharmacy and get any non-scheduled drug you want without a doctor’s prescription? (source: my father; I have never heard anyone else talk about this, and nobody else even seems to think it is interesting enough to be worth noting).

Scott then strikes at the heart of the issue:

So maybe the scary thing about Oregon is how strongly we rely on intuitions about absurdity. If something doesn’t immediately strike us as absurd, then we have to go through the same plodding motions of debate that we do with everything else – and over short time scales, debate is interminable and doesn’t work. Having a notion strike us as absurd short-circuits that and gets the job done – but the Oregon/everyone-else divide shows that intuitions about absurdity are artificial and don’t even survive state borders, let alone genuinely different cultures and value systems.

This is part of what I meant by collective action kills innovation. I wasn’t saying that DARPA can’t work but rather that by subjecting everything to collective action we subject it to debate. discussion and legislation and that slows down innovation, in part because our notions of what is normal are so time and culture bound.


Absurdism: the teleological suspension of the rational.

Since “more risk more capital - less risk less capital”, sounds far from being absurd, it keeps the following question from being asked:

Why do regulators want banks to hold more capital against what has been made innocous by being perceived risky, than against what is dangerous because it is perceived safe?

Tabarrok makes the mistake of treating all government regulations as absurd. It's a mistake because by not separating the wheat from the chaff he is inadvertently protecting the chaff. Mockery and derision have their place; usually, it's on the far side of the air lock. But I digress. The U.S. is a federation, which arguably produces more chaff than wheat as the states and national government seem to be in competition for the chaff. I like to remind readers that the Founders were not revolutionaries but conservative elites whose main concern in Philadelphia was to reign in the states that were adopting their own currencies and debt forgiveness laws (among other things that alarmed the Founders); the states seemed to be a coalition of anarchists and special interests, the worst of both worlds. Oregon proves that the states are not the libertarians' ally. Tabarrok may get all tingly at the prospect of shutting down the FDA, but would 50 different regulatory schemes be better than one? If Tabarrok believes the national government is subject to regulatory capture, what does he think goes on at the state level? Of course, the irony of the Trump Administration is that regulatory capture is its overriding policy.

I think that the reverse is the greater danger. Too many people treat the absence of bureaucratic administration as absurd, assuming government regulation as the wheat until the democratic process changes things. Anyone over college age should now that's not a nimble machine.

Among those who favor consumer-driven markets over politically driven ones, Oregon's gas pump regulation has been a joke for *decades*. I think that Tabarrok rightly suggests that bad regulation is too resistant to change.

I found Alexander's essay a bit of a wander, but isn't the answer to have neither "regulations are good/bad" biases, and to ask to see the data?

In an adjacent thread a commentator suggests that suspicions against people who want handwashing signs us somehow justified by their very demand for signs. This presumes some kind of knowledgeable cynicism about their motives, I guess.

It seems to me that the way to cut through that is to remove both biases and cynicism from the equation, and look as closely as possible at the data.

Does having a sign reduce infection? Does having attendant reduce accident? (I suspect that you would get a yes for one and a no for the other, but the trick is to be evidence driven, rather than assumption driven.)

The classical Hayek argument against government regulation is not that it is good or bad, ex post, but that ex ante it's impossible to know if it's good or bad, so better to let the invisible hand work.

AlexT's subsequent post is good clarification and/or goal post shifting, depending on your point of view. It's a riff on the classic book 'Diffusion of Innovations' by Everett Rogers.

Bonus trivia: what is the elasticity of supply for innovation? That's the 64--like a chess board--k $ question on whether you believe in Ray's "we need to reward inventors more" or TC's "just pat inventors on the back, inventors will invent, no need to compensate them more" stance.

Perhaps if you think of the FDA as a place that does RCTs, rather than a place that thinks up regulations..

" subjecting everything to collective action we subject it to debate. discussion and legislation..."

no, we've ceded EVERYTHING to oligarchic government action. average citizens have NO say in the hundreds of thousands of laws/regulations imposed upon them -- and there is NO aspect of American life that government considers off-limits to its direct rule. This "collective action" assertion is fantasy.

I just don't understand where "innovation" is involved in any of the discussion.

Remembering the shift to self service, I do not find it innovative for gas stations to terminate the facilities for "making a pit stop". Yet, with no place to make a pit stop, with a worker in the weather keeping you cozy inside your car, it is innovative to force the customer to do the work in bad weather, and do the bidding of a guy behind glass, locked in a box. Where is the innovation in getting out of your car and giving cash or credit card to an attendant in a box, then doing the work of filling up plus cleaning windshields, then going back to the box to get your change and receipt.

Yes, innovation put the credit card reader in the pump eventually, but it doesn't always work, so you still need to go to the attendant.

Seriously, the only innovation was in fighting gas station robberies. That was the biggest driver of the change to self service. People were driving more hours of the day while cars required less service. No longer was a mechanic or tech working at the service station, helped by someone around the pumps, or breaking off from his work to pump gas. While gas companies had credit cards, lots of people paid cash, so busy stations would have a lot of cash late in the evening, so the station owner of his low wage employee has a wad of cash in his pockets that was easy picking.

The regulations that were made law were conservative, fighting change that was driven by anonymous distant faceless Wall Street MBAs that harmed local people, the customer and the workers.

How about "innovation" of the same sort at the meat counter. You go pick a part of the cow or an entire bird, ring it up, then go to the butcher block and cut your meat? Then the meat counter can be run by someone who knows nothing about meat.

So is that what we have become? A giant Oregon. Is there no end for our fall fro grace?

At least we're not Brazil.

Most Americans are not. So what? Is it what we are good at? Not being from Brazil? Wil it raise our children's standards of living?

"Europeans: did you know melatonin is sold like candy in the United States?"
no but we know how powerful drug companies are in US and that american life expectancy is dropping for second year in a row, so better not to copy your medicine and food standard ( chlorine washed chicken ?)

And not just washed with chlorine, but dihydrogen monoxide as well!

Any idea how to spend a trillion dollars a year more on health care and obtain worse average results?

Melatonin appears as an exception to the absurdities.

Not "obtain worse average results". Very good results, just expensive.

By worse average results, I mean that on average results are worse.

I, for one, am glad that at least some medicines require a doctors prescription to obtain. Imagine how much worse antibiotic resistance would be if anyone could buy antibiotics whenever they had a cold!

In some South American countries, you can buy antibiotics over the counter -- do they have worse problems with antibiotic resistance? - "Antimicrobial-resistant bacteria are common in communities with frequent non-prescription use. In a few settings, control efforts that included regulation decreased antimicrobial use and resistance."

I am for antibiotics requiring a prescription but this ( makes me have a little time bit of doubt.

In countries enforcing the requirement, infectious disease mortality is no lower and poisoning mortality is higher than in those not enforcing the requirement.

When I was young, we had something called responsibility.

Perhaps there is a deeper issue here: Innovation that is allowed to flourish at will is potentially damaging to societies. So, well-established polities develop rules of thumb that may be somewhat rational in the aggregate but irrational or inefficient at narrow micro margins.
Unfettered liberalism may seem to increase output in the short run but often leads to outcomes that damage cohesiveness, civilizational support, and the abilty to engage in informal collective action. This of course becomes harder to do sensibly as the polity becomes more diverse and heterogeneous and formal rules must inefficiently substitute for norms. Think daily life in Japan vs. USA or South America. Or even consider the economics literature on how bureaucratic rules are micro inefficient but can be macro stabilizing.
Think of Hayek but about societal norms not just prices.

We need more mockery and truculence with a smile!

More "Irish democracy"!

"Anybody can be dissatisfied; it requires no real expenditure of effort."
Kevin Williamson

“The government is huge, stupid, greedy and makes nosy, officious and dangerous intrusions into the smallest corners of life….”
P.J. O’Rourke

“Why do you people love the state so much? It doesn’t love you.”
Michael Munger

"More regimes have been brought, piecemeal, to their knees by what was once called 'Irish Democracy,' the silent, dogged resistance, withdrawal, and truculence of millions of ordinary people, than by revolutionary vanguards or rioting mobs."
James Scott

The amusing thing is how strongly we rely on intuitions concerning what is currently called evolutionary psychology. Especially considering how Kipling's Just So Stories is much better written, and often just as factual, as most of the output associated with evolutionary psychology.

You do not know what you are talking about if you think that a 30 year old criticism by Lewontin discredits all subsequent Ev Psych.

"Europeans: did you know Americans have to major in some random subject in college, and then go to a separate place called “medical school” for four years to even start learning medicine?"

Beyond false. Try getting into med school having studied some random subject in college. Then after you go back to undergrad and get your pre-med requirements met with a very good GPA, attempt to get into med school without any time spent shadowing/scribing/or otherwise proving some familiarity with medicine.

Unless you are going to med school in the Caribbean the requirements begin long before arrival at med school.

The standard disclaimers apply (legacy or victimology).

if you want to compare the quality of doctors the different systems produce, that would be interesting. Just saying "there are rules; I hate rules", isn't very convincing. Especially when you get the basic facts wrong.

"Just saying “there are rules; I hate rules"
Evidently there are no rules in Europe.

Former Surgeon General Vivek Hallegere Murthy got, according Wikipedia, a bachelor's degree in Biochemical Sciences (Harvard). Not bad and not random, I admit. But is there any good reason to teach all that biochemistry (plus all the other pre-Med requirements to get in Harvard) to someone who was to spend his carreer practicing Internal Medicine and then spend another four years teaching him real Medicine many countries think they need five or six years to teach instead of starting teaching Anatomy? Why waste a slot on someone who h no intention of working with biochemestry. It is like making the Fermat's solution obligatory for Engineering tudent who should be learning Calculus II.

Europe has rules; they are just different from the US.

I'm not claiming the US system is the best, just that Alex's portrayal is not correct. I'd also say that he hasn't done a very good job of making his case.

I'd argue that greater than 51% of what is taught in the US from pre-K through PhD is without merit to either the student or society. But that's a separate rant.

All the way through the education process until grad school we explicitly force the concept of a well-rounded student and doctors haven't gotten a free pass. Neither have lawyers, engineers, etc.

This isn't absurdity per say. It's an option, one that I think is inefficient, but an option none the less. We teach all sorts of things in grade school to expand people's knowledge. We also teach these things to the professional class in hopes that they will be erudite members of the upper crust.

All sorts of things happen in society around me that I don't think are net benefits, but it doesn't follow that they are absurd.

Oh, and biochemical sciences does relate to med school.

"Oh, and biochemical sciences does relate to med school."
Four year? You know what four years of Biochemetry relates to? Biochemestry. Come on, those were wasted years, he could have learned Anatomy, Phisiology, real Medicine stuff.

"Beyond false. Try getting into med school having studied some random subject in college. Then after you go back to undergrad and get your pre-med requirements met with a very good GPA, attempt to get into med school without any time spent shadowing/scribing/or otherwise proving some familiarity with medicine."

If anything, this makes the point of Alex Tabarrok even more relevant (that in the US the requirements are much more restrictive than in Europe)

The requirements to become a medical doctor, I mean.

Alex's point was that innovation is retarded by regulations that we can't respond appropriately to in public debate since our culture blinds us to logic.

His argument (relative to med school) is that:

1. There is a rule that prospective med school students just get a random degree prior to attending med school. Which is false.

2. That studying of medicine doesn't begin until med school. Which is false.

Alex is claiming that the prep prior to med school is without relevance to the end goal of being a doctor. It may be inefficient and he could argue that. He however is claiming absurdity since the work is completely separated from medicine, which is entirely incorrect.

Personally, if one were to drop four years of work, I'd drop the average high school.

The requirements for MIT are higher than my state uni. This does not mean that by default MIT is absurd. That the US has different standards from Europe does not, in of itself, make it absurd.

Studying biochemestry while you do a few pre-Med requirements (more than a few would make a farce out of the bachelor's degree onemis earning) is not "studying Medicine" umder any meaningful definition.

"That the US has different standards from Europe does not, in of itself, make it absurd."
Care to defend the specific standard. Has MIT demanded all candidates to a Physics spot to get a mechanical engineering degree before trying to become physicists?

Pre-med is effectively a second major. I don't see why this makes anything a farce, or how you arrived to that conclusion. As I noted above, the studying of medicine is both in and out of the classroom. Decent programs will expect time spent in medicine (such as scribing), a good MCAT, and a good GPA.

No, I'm not interested in defending the standards either way. Which should be obvious by now since I've made it clear that my objection is the incorrect statements followed by an unsupported conclusion.

It doesn't follow that because MIT has different standards than my local uni that MIT would make it's physics undergrads earn a mechanical engineering undergrad.

However, I'd suspect that both require some form of humanities for both physics and engineering. I'd also suspect that the students had to take classes unrelated to physics or eng between k-12.

I'd also guess that both will let someone with a BSME apply for a MS in Physics.

The debate isn't around absurdity; it is where the line is drawn between specialization an general education.

"Decent programs will expect time spent in medicine (such as scribing), a good MCAT, and a good GPA."
A GPA in Biochemestry, or worse, History? Come on. Why not a year of Anatomy, Phisiology, etc . Scribing? Seriously, I know the system is a product of America's special educational path, but it looks more and more as a weird attempt of being original... and wasting four years teaching major level Biochmetry (again, for the guy who wants to work in Internal Medicine) to someone who could be learning four years of Medicine courses and then will have to cram six years of real Medicine in Med School's four. Again, it is like demanding an Astronomy major for every would-be engineer. Why?
"The debate isn’t around absurdity; it is where the line is drawn between specialization an general education."
The guy studying Biochemestry as a major to learn Internal Medicine is the general educarion guy or the specialization guy? I lost the track here. Again, the guy was brilliant (Harvard and Yale material) and I doubt Biochemestry dumbed him down, but again why such an awkward path?

There are plenty of English and other humanities majors that make it into med school. Yes, they ALSO had to pass typical pre-med classes of cell biology, organic chemistry, etc.

Challenge accepted. I studied philosophy in undergrad and got into med school.

Notice me senpai!!!!!

There are medical schools that have no premed requirements and are considered good (e.g. Cincinnati). There are medical schools that require only three years of studying medicine (e.g. NYU). There are medical schools that let you go from high to school to MD in just six years (e.g. Howard University).

Getting into medical school does require some work, and it takes more work if you want to go some idiosyncratic route, but you basically can get there from anywhere in most any way you like with enough effort. Some schools will round file your application if you lack organic chem, some will round file if you lack shadowing, and some will round file if you cannot get an above average MCAT.

Given all the permutations currently in use in the US, it is an utter waste of time to require the "get a BA first" or take 8 years to become a full MD - plenty of US schools don't and show no dramatic deficiency in quality relative to peer schools that make the students suffer through eight years. Howard vs Moorehouse, Cincinnati vs OSU ... there really is no need for half of the typical requirements, many students do not have all of them and do fine (legacies appear to fail out no more or less often than other students).

Frankly, it was obvious in my class which medical students had taken their prereqs last year and which had taken them four (or more years ago). In spite of having people who barely passed calc or gen bio due to freshman drunkness, they all became average or above doctors. Med schools know this, they know that everyone will have gaps from the "ideal" medical student and will teach to cover all the gaps any ways, so why bother doing biochem, biophysics, or biomechanical engineering first? You are going to have to cover the relevant material for the other two regardless.

In short: we already do all of this at some medical schools. We already have to reteach prereqs and we already let people with no prereqs become docs. Just define the relevant skills, make a test (after all you are going to be taking ACT/SAT, MCAT, USMLE, and boards so it is not like another test will hurt), and then let anyone start in medical school. It is pure credentialing to require a BA before starting on the MD.

I do know someone who just recently got into med school. She majored in history because she said it was easy to get A's and then took enough of the bio, etc. premed requirements for med school. So this is one random, but relevant anecdote, about the possibility of gaming med schools' preferences for a clean GPA over a spottier GPA from a tougher program (such as physics or math).

This usually has to be accompanied by a stellar MCAT.

For Matriculants to U.S. Medical Schools by Primary Undergraduate Major, 2017-2018, out of 21,338 there were 888 humanities majors, 2204 social sciences.

Well, sure. The professors are quick to tell us that to be "educated", and a good citizen, one must have studied the Liberal Arts and not those icky "vocational" majors like biology or chemistry.

I'd never trust one of those automobiles, they go too fast and are loud. I'll just ride a horse.

I'd never get in an airplane, it is too dangerous.

The world will collapse if we end Prohibition.

People want to be in the same room when they talk. The telephone will never work.

No one will ever trust putting their credit card information into the Internet.

The world will end if we legalize medical marijuana.

No one will ever get into a car of a complete stranger that they ordered on the Internet.

The world will end if we legalize recreational marijuana.

When things need government approval before being permitted:

"The reaction of Senator Smith of Indiana after a demonstration of the telegraph by Morse for members of Congress in 1842, as reported in the 1915 book "A History of Travel in America":

"I watched his countenance closely, to see if he was not deranged … and I was assured by other senators after we left the room that they had no confidence in it.""

But things worked in the favor of innovation in the 19th century. When Morse offered to sell the telegraph to the US government for $100,000, the Postmaster General declined.

"… the operation of the telegraph between Washington and Baltimore had not satisfied him that under any rate of postage that could be adopted, its revenues could be made equal to its expenditures."

"...while not looking at our own absurd restrictions on cutting hair, for example."

I'm not sure why that's thought to be a comeback here. Doesn't Oregon have all of these other absurd restrictions PLUS the restriction on pumping gas?

"All mankind’s progress has been achieved as a result of the initiative of a small minority that began to deviate from the ideas and customs of the majority until their example finally moved the others to accept the innovation themselves. To give the majority the right to dictate to the minority what it is to think, to read, and to do is to put a stop to progress once and for all."

Mises, Ludwig von (1927). Liberalism (p. 54)

Just found this on government driven innovation from a commenter on another site

"In comments, ExpatNJ quips:

Reminds me of the cold-war of the 55mph speed limit:
First, the Traffic G*ds gave us Radar Guns.
Then, the radio engineers gave us Radar Detectors.
Then, the Traffic G*ds gave us Radar Detector Detectors.
Then, the radio engineers gave us Radar Detector Detector Detectors.
Ultimately, vehicles could become so heavy, they would not go over 55mph anyway"

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