Month: November 2022
How good are on-line reviews for physicians?
We compare the online reviews of 221 “Questionable” Illinois and Indiana physicians with multiple paid medical malpractice claims and disciplinary sanctions with matched control physicians with clean records. Across five prominent online rating services, we find small, mostly insignificant differences in star ratings and written reviews for Questionable versus control physicians. Only one rating service (Healthgrades) reports on paid medical malpractice claims and disciplinary actions and it misses more than 90% of these actions. We also evaluate the online ratings of 171 Illinois hospitals and find that their ratings are largely uncorrelated with the share of hospital-affiliated physicians with paid medical malpractice claims and disciplinary sanctions. Online ratings have limited utility in helping patients avoid physicians with troubled medical malpractice and disciplinary records, and steering patients away from hospitals at which more physicians have paid medical malpractice claims and disciplinary sanctions.
That is from a new paper by David A. Hyman, Jing Liu, and Bernard S. Black. Via the excellent Kevin Lewis.
Sunday assorted links
1. U.S. restrictions on GPU sales to China.
2. Inside (one part of) the pro-natalist movement.
3. What is going on in Quebec’s health care system?
4. Annie Lowery on women in the economics profession.
5. Intentional, or was there a trickster (or Straussian) involved in this one?
6. Thread on the Chinese protests. And ChinaTalk on the China protests.
Speeding up Inhaled Vaccines
After Operation Warp Speed was disbanded by the Biden administration, vaccine development slowed from warp speed to impulse power. The rest of the world now has some innovative vaccines not yet available in the United States. China, for example, has an inhaled vaccine. We don’t yet know how good the vaccine is and China, of course, has its own problems. In my view, however, the Chinese vaccines have been incorrectly discounted, due in part to chauvinism and propaganda as well as the initial impression that mRNA vaccines had higher efficacy. That advantage, however, his diminished over time. There is something to be said for a tried and true inactivated vaccine that delivers the whole virus and not just the spike protein which is one reason I advocated in 2020 for including an inactivated vaccine in the Operation Warp Speed portfolio. It’s not just China either, as the NYTimes reports Russia, India and Iran all have a nasal vaccine. But in the United States it’s back to business as usual.
NYTimes: In the United States, nasal sprays have been held back by the same funding constraints and logistical hassles that, before the pandemic, often made developing vaccines a decade-long ordeal. The delay could not only weaken the country’s defenses against a more lethal coronavirus variant but also hurt preparations for a future pandemic, depriving the world of an oven-ready nasal vaccine platform that could be adapted to a new pathogen.
“It went back to the prepandemic speed of vaccine development,” said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai. His team’s nasal vaccine has undergone its most advanced testing in Mexico; collaborating with a pharmaceutical company there offered the fastest path to clinical trial funding. In the United States, he said, “The funding situation is pretty dire.”
See also my post on an Operation Warp Speed for Nasal Vaccines.
What I listened to in 2022
I am listing only new releases:
Bach, Johann Sebastian, complete Sonatas and Partitas for violin, Fabio Biondi. Perhaps the only recording I like as much as the older (stereo) Milstein performance?
Bach, Johann Sebastian, The Art of Life, Daniil Trifonov, The Art of the Fugue (favorite of Thomas Schelling!) is the main work here. Schelling, by the way, was especially fond of the Grigory Sokolov recording of this work.
van Baerle Trio, Beethoven complete piano trios
Beethoven, Kreuzer sonata for violin and piano, Clara-Jumi Kang and Sunwook Kim
William Byrd, John Bull, The Visionaries of Piano Music, played by Kit Armstrong
Handel, George Frideric, Eight Great Suites and Overtures, by Francesco Corti on harpischord
Matthias Kirschnereit plays Mozart, the complete piano concerti, and two Rondos
Mozart, La flûte enchantée (yes in French), conducted by Hervé Niquet
Shostakovich/Stevenson, mostly Op.87, piano music, by Igor Levit
Szymanowski, Karol, Piano Works, by Krystian Zimerman
By far my biggest discovery was Benjamin Alard playing the complete keyboard works of Bach, mostly on organ and clavichord. These are some of the best recordings of the best music I have heard, ever.
There is much more, but those were the highlights. I listened to plenty of so-called “popular music” too, but I don’t think anything you would need me to tell you about.
Wealth and income inequality have been falling
And that is bad! (Never reason from an income inequality decline.) Despite a recent rebound, equity prices are still down considerably from their peaks, and of course that in percentage terms is a larger loss for wealthier people. Here is one part of my latest Bloomberg column:
And it’s not as if people on the lower end of the income scale feel happier or more healthy because the wealthiest are now poorer. For most Americans, life goes on; their main economic concern is that high inflation will eat into potential wage gains.
Nor is it the case that the proletariat have taken hold of the reins of power and a new populist utopia is nigh. The very wealthy might make fewer political donations, but the influence of money on politics was overrated in the first place. It hardly seems like a new era of egalitarian redistribution. Instead, Western government budgets are fairly tight, and in the US in particular the set of plausible policy alternatives is likely to get more narrow.
For at least two decades, the attention given to rising income and wealth inequality was huge, among both policymakers and academics. Over the last decade, the attention given to falling income and wealth inequality has been tiny.
Perhaps our views end up biased, can you imagine that? And to close:
I am by no means convinced that this reduction in inequality will continue. Forthcoming technological advances will have unpredictable effects. But if the last decade proves to be an interlude, there is still a lesson: Maybe inequality wasn’t the problem in the first place. That’s why I’m not cheering at its decline, and why I suspect not everyone else is, either. The real challenge isn’t how to reduce the difference in wealth between the rich and the poor. It’s how to reduce poverty.
I thank Brian Chau and Matt Yglesias for relevant pointers, without implicating either one in my take.
The polity that is German
Yes the expenditures had prior approval, but that does not always lead to productive results:
Nine months ago, in the wake of Russia’s full-scale invasion of Ukraine, Olaf Scholz declared a Zeitenwende — a turning point — for Germany’s military and its place in the world. But since then, barely any of the €100bn in extra funding the German chancellor pledged has made its way to the armed forces.
The parliamentary body set up in the spring to allocate money to modernisation and reform programmes has met once. The defence ministry had no procurement proposals to submit to it. Its next sitting will not be until February.
Now opposition lawmakers, and some of the country’s leading security experts, are beginning to ask whether Germany’s commitment to a leading role in European defence is anything more than rhetoric.
“Mr Chancellor — I can’t call it anything else, you are breaking your promise to the parliament and especially to the Bundeswehr [federal army],” opposition leader Friedrich Merz said in an attack on Scholz in the Bundestag on Wednesday morning.
Far from rising, the 2023 defence budget, Merz noted, was set to shrink by €300mn based on current government plans. The lack of German action was “[giving] rise to considerable distrust” at Nato and in allied capitals, he claimed. Germany has long fallen short of its Nato-set obligation of spending the equivalent of 2 per cent of GDP on defence.
Here is the full FT story. Via a loyal MR reader.
Saturday assorted links
1. Private market exchange putting Americans in touch with Ukrainians they wish to aid (WSJ).
2. Fabio Rojas is now on Substack.
3. Data on the sex lives on Cambridge (UK) students, including by major. Selection bias, but still…and why aren’t there more philosophy majors?
One reason why TFR problems are hard to fix
Perhaps much larger birth subsidies would help to raise birth rates. But the world with much larger birth subsidies might also coincide with a world where the social pressures to have (more) children are higher than under the status quo. Many women would be worse off with such pressures, or at least they feel they would be. In principle, these women might prefer a mixed regime of “strong pecuniary incentives, weak social incentives,” but they don’t feel they can get to that mix. The expressive function of the law is strong, and the social pressures to have more children would become strong too. These women therefore end up opposed or indifferent to the pecuniary incentives, even though on paper they might appear to be a “free lunch.”
The difficulty of separating pecuniary and social incentives therefore may be one reason why TFR problems are hard to fix.
Poland projection of the day
If the UK continues with the same level of growth it has seen for the last decade,” writes Sam Ashworth-Hayes, “Poland will be richer than Britain in about 12 years’ time”:
It sounds like an absurd idea that in 2040 we might see complaints in the Polish press about a flood of British plumbers undercutting wages, or Brytyjski Skleps lining the rougher areas of Warsaw, but it isn’t beyond the realms of possibility.
This talking point has also appeared in the Telegraph, the Express and the Financial Times. It often comes with a sense of vague alarm and bewilderment. Poland? The post-communist place? Don’t they live entirely off vodka and potatoes? Don’t they have horses clippety-cloppeting down the streets selling women’s underwear pinched off a truck in Germany? Poland?
A lot can change in nine years, in Britain and in Poland
Having lived in Poland for nine years, I can say that I am not at all surprised by these projections. To be clear, that is all they are — projections. A lot can change in nine years, in Britain and in Poland.
Still, I think a lot of British people would be surprised by how much better things can be in the land of Lech Wałęsa and John Paul II.
That is by Ben Sixsmith. Poland remains a underrated nation.
Friday assorted links
1. Law in the Bahamas. At least at times. And impact of the FTX collapse on the Bahamas (FT). And WSJ on the Bahamas.
2. How physics can improve the urinal.
3. “During the 1920s, the EBR [Eastern Bengal Railway] continued to grow by merger and amalgamation, and also began to convert sections of metre and narrow gauge to eliminate rail bottlenecks.” Link here.
4. Stewart Brand praises Shantaram, the best bad book ever.
5. Generalized tendency to make extreme trait judgements from faces. Funny how no one seems to mind this, perhaps it is too hard-wired? How much is it that this tendency serves the interest of the media class overall? After all, most stories about people have photos of those same people.
6. Mises and Hayek on federalism, European and otherwise.
More on the nominal strength of the dollar
Adrián Lucardi writes to me, addressing yesterday’s question of why more currencies are not nominally stronger than the USD:
Short answer: costly to implement; few direct (political or macroeconomic) benefits if things go well; but politically costly if things turn sour.
Long answer: Suppose you’re the dictator of a non-serious country who wants a “strong” local currency for propaganda reasons. The dollar is probably more valuable (nominally) than the local currency, so you will have to start with a massive currency reform. This is costly (bad) but will increase the salience of the issue (good, you’re doing it for propaganda reasons). But then, you make the exchange rate focal: you publicly commit to it as a signal of your government’s performance. Since you’re unlikely to keep your currency more “valuable” than the dollar in the medium term, this can be disastrous.
Furthermore, since your commitment to a “strong” exchange rate is not credible, people may use the local currency to buy dollars. This may not be rational in the sense that the local currency is only “strong” in nominal terms, but if everybody believes that everybody will do it, the logic becomes self-fulfilling.
PS. Non-serious governments have long used exchange controls to benefit cronies and politically valuable constituencies. But if you’re doing that, you don’t want the exchange rate to be in the public imagination.
Our own Alex T. writes:
Detective Wanted
Nat Friedman is seeking a full-time solo technical leader to go on a modern day Indiana Jones-style treasure hunt. You will be responsible for starting and running a crowdsourced effort to crack an archaeological puzzle of great historical significance. Success would be global news, could rewrite large chunks of history, and is guaranteed to be a story you will tell your grandchildren.
This is a full-time position for a 3-6 month period (which is about how long we think it will take to crack the puzzle, or at least to set it on a course to be solved). Pay range is $120-250k/yr. Think of this as an adventurous interlude between your more lucrative commercial gigs.
You will act as a mini-CTO, making appropriate technical decisions, staying responsive, and allocating time and resources effectively. This role will require highly effective communication, the ability to make complex code understandable, the ability to write clear technical documentation, the ability to foster and grow an online community, coupled with solid software engineering knowledge.
The ideal candidate will have experience in creating, managing, maintaining, and contributing to open source software projects. A background in working with custom software and data pipelines for scientific research is desirable. Comfort with PyTorch, C++, and OpenCV is a big plus.
More here.
AI and language learning
Rob asks:
I would love to see you write on how AI changes the value of language learning, at the margin.
Two thoughts:
The value of learning languages in order to “get” a culture more deeply probably doesn’t change much.
On the other hand, international students probably have much less incentive to learn English — they are mostly interacting with other non-native speakers anyway, there is little cultural knowledge to be gleaned from it.
What else?
(I’m thinking of this because I just moved to Paris with my French wife . . . and thinking about the value of improving my French)
Let’s say that soon we have universal translators as good as on Star Trek, except the words are spoken first in the foreign language and then repeated/translated by the AI (i.e., the AI can’t just make “Romulans speak perfect TV English”). There is then one obvious reason not to learn foreign languages, especially for short interactions and travel interactions. For short interactions, the doubling time for the verbal exchange isn’t a big deal. So instead of learning the foreign language, the AI does the work for you.
But under which conditions does this not hold?
Alternatively, let us say you wanted to be “matched” to the most appropriate person in the entire world on some topic. It could be a marriage match, a friendship match, or simply a “I need to spend many hours discussing Tibetan traditional music with this person” match. The doubling time for the exchange now is a big deal. “Yes we are married, but it is not so bad that everything is repeated by the AI — it limits the amount of time we have to talk to each other and it also slows down our arguments” –no, that just doesn’t cut it, perhaps only for Tyrone.
These ideal matches still will provide a robust reason to learn foreign languages, at least provided you know the language you wish to match into, or perhaps you simply wish to match into something. If the people you wish to match to speak decent English, however, that is again a reason not to learn.
You also might value the “perspectival” benefits of a foreign language more in a world with AI. Perhaps the humanities and multi-perspectival approaches will rise in value, given the ability of the AI to execute very well on technical tasks. Under those assumptions, AI increases the returns to learning the appropriate foreign languages.
Plus AI itself will make languages easier to learn — imagine having a companion to practice with, at any level of desired difficulty, all the time.
Since the short, travel-based interactions were never the main reason to learn foreign languages anyway, perhaps the demand to learn other languages will prove more robust than many are expecting?
Why aren’t more currencies more valuable than the U.S. dollar?
The currencies from Kuwait and Bahrain and Grand Cayman are more valuable than the U.S. dollar, the British pound, and the euro usually if not always as of late. Why aren’t more currencies greater in nominal value?
True, nominal variables should not matter past the short run, but that does not answer the question. Why don’t some countries denominate above USD, and then boast to their misled citizenries about having created “stronger” currencies? Is that what a few possibly status-hungry smaller nations have done? Or is the status quo merely an accident of history?
Or is there some structural reason why the USD is relatively strong? Was not the Indian rupee once at par? Maybe part of the mystery is that we Americans have, by global standards, a lower than average inflation rate. But why is it (currently) about 140 Japanese Yen to the dollar?
Might it be that other countries are wiser, opting for finer gradations in their nominal schemes, just as Fahrenheit is a better temperature system than Centigrade for the same reason?
What other reasons might there be? Inquiring minds wish to know.
Assorted links
1. Does quantum entanglement enable mechanisms that guarantee PD cooperation?
2. Building the Empire State Building.
3. Enter Inspector Gadget, and Wilkie Collins.
4. FT dialogue with Brad DeLong.
5. The other AEA — Actors’ Equity Association — lifted mask mandates some while ago. It is not too late for our AEA — American Economics Association — to follow suit and avoid embarrassment. Isn’t part of science being able to admit you were wrong? Who exactly is still doing a mask mandate right now? I’ve been to plenty of events and plenty of other countries.
6. Additional things to be thankful for. Large and small.
Both points are of interest for those who have been paying attention to the difference between real and nominal currency values.