Category: Uncategorized
Medical markets in everything?
Or will they be thwarted?
To Nina McCollum, Cleveland Clinic’s decision to begin billing for some email correspondence between patients and doctors “was a slap in the face.”
She has relied on electronic communications to help care for her ailing 80-year-old mother, Penny Cooke, who is in need of specialized psychiatric treatment from the clinic. “Every 15 or 20 dollars matters, because her money is running out,” she said.
Electronic health communications and telemedicine have exploded in recent years, fueled by the coronavirus pandemic and relaxed federal rules on billing for these types of care. In turn, a growing number of health care organizations, including some of the nation’s major hospital systems like Cleveland Clinic, doctors’ practices and other groups, have begun charging fees for some responses to more time-intensive patient queries via secure electronic portals like MyChart.
…a new study shows that the fees, which some institutions say range from a co-payment of as little as $3 to a charge of $35 to $100, may be discouraging at least a small percentage of patients from getting medical advice via email. Some doctors say they are caught in the middle of the debate over the fees, and others raised concerns about the effects that the charges might have on health equity and access to care.
Demand curves do slope downward. And yet:
But a recent study led by Dr. Holmgren of data from Epic, a dominant electronic health records company, showed that the rate of patient emails to providers had increased by more than 50 percent in the last three years.
Perhaps there is a smidgen of room for AI here? But not under the current legal regime, I suspect. Here is the full Benjamin Ryan NYT article.
*Professor of Apocalypse: The Many Lives of Jacob Taubes*
The author is Jerry Z. Muller, and I am sorry I did not have the chance to read this book last year when it came out. Taubes is one of the most underrated deep thinkers, and this is the definitive biography of him. Think of Taubes as a mid-twentieth century Germanic-Jewish but also partly Christian thinker who tried to integrate philosophy, theology, and science, yet without ever committing to a serious enough level of written investigation to have a chance of pulling that off. He nonetheless was capable of depth, and pearls of insight, that few other thinkers can pull off. From the biography, here is one of the more personal excerpts:
Some of Margherita’s friends wondered at the pairing. Some thought her more attracted to women than to men. The partners seemed so different. She had a fashion sense that Jacob lacked. She drove a white Alfa Romeo, while after his move to Berlin, Jacob did not drive at all. She was proper and reserved. Jacob was neither. Jacob was ironic, skeptical, and witty; Margherita more strict and earnest. Jacob had a mind that was explorative and associative, while Margherita did not. She was a dog lover, a not unusual taste among Germans of her background, but foreign to Jacob’s. She owned a small house in the Black Forest, to which she withdrew from time to time, a practice Jacob scorned as “Heideggerei.”
I had not known Susan Sontag was his research assistant. I am less surprised that he hung out with Cioran and Hans Blumenberg (both insufficiently read in the English-speaking world as well). This book is not for everyone (500 + pp. about a thinker you probably have not read), but it is for some people.
Saturday assorted links
1. Forthcoming Netflix movie: “They Cloned Tyrone.”
2. “The Great Automatic Grammatizator,” by Roald Dahl 1954.
3. One account of how GPTs hallucinate.
4. More on MusicLM from Google. Yet Google won’t release the model.
5. An AI-generated image? This one is marginally not safe for work, though not at the very extreme.
6. In which Peter Thiel speaks to the Oxford Union and calls Greta Thunberg “complacent.” Good Q&A.
Text-to-4D dynamic scene generation
Find it here, via Ryan Watkins. Further improvement is required, but the pace of current breakthroughs is remarkable.
The educational culture that is New Jersey
For four days, a 29-year-old woman pretended to be a student at a New Jersey public high school. She attended classes, spent time in the guidance office and collected phone numbers from teenagers who helped her find her way through the maze of hallways, according to students and a school official.
She continued to text former classmates days after the ruse was discovered last week, students said.
The woman, identified by the police as Hyejeong Shin, was arrested Tuesday and charged with providing documents that falsified her age to officials at New Brunswick Public Schools, a district with nearly 10,000 students in central New Jersey.
The incident, first reported by New Brunswick Today, has raised concerns about the safety protocols in place to verify student identities — and the woman’s reason for sneaking into a school that enrolls children as young as 15 in the first place.
Aubrey A. Johnson, the school superintendent, told board members Tuesday night that the district would be evaluating “how to better look for fake documentation and other things,” according to a video of the meeting shared on Twitter. Neither school nor police officials offered any information about a possible motive for her behavior.
Here is the full story, via tekl.
Friday assorted links
1. How much can economics explain medieval warfare?
2. Will India lose its oldest Chinatown?
3. What if you could talk to the Bible? (What again does the first Commandment say?)
5. An argument for Effective Altruism, maybe the best one?
6. Generating music from text commands? I know there is a lot of this b.s. going around, but this one is receiving positive reviews.
What should I ask Jess Wade?
I will be doing a Conversation with her, and here is her work:
Wade, a research fellow at Imperial College London, centers her work on Raman spectroscopy, a technique often employed in chemistry to identify molecules, among other uses. She has received several awards for her scientific contributions, and her Wikipedia page is robust with her many achievements.
Here is a good interview with her. And from The Washington Post:
Since 2017, Wade has written more than 1,750 Wikipedia pages for female and minority scientists and engineers whose accomplishments were not documented on the site.
Here is her own Wikipedia page. So what should I ask her?
Are macroeconomic models true only “locally”?
That is the theme of my latest Bloomberg column, here is one excerpt:
It is possible, contrary to the predictions of most economists, that the US will get through this disinflationary period and make the proverbial “soft landing.” This should prompt a more general reconsideration of macroeconomic forecasts.
The lesson is that they have a disturbing tendency to go wrong. It is striking that Larry Summers was right two years ago to warn about pending inflationary pressures in the US economy, when most of his colleagues were wrong. Yet Summers may yet prove to be wrong about his current warning about the looming threat of a recession. The point is that both his inflation and recession predictions stem from the same underlying aggregate demand model.
You will note that yesterday’s gdp report came in at 2.9%, hardly a poor performance. And more:
It is understandable when a model is wrong because of some big and unexpected shock, such as the war in Ukraine. But that is not the case here. The US might sidestep a recession for mysterious reasons specific to the aggregate demand model. The Federal Reserve’s monetary policy has indeed been tighter, and disinflations usually bring high economic costs.
It gets more curious yet. Maybe Summers will turn out to be right about a recession. When recessions arrive, it is often quite suddenly. Consulting every possible macroeconomic theory may be of no help.
Or consider the 1990s. President Bill Clinton believed that federal deficits were too high and were crowding out private investment. The Treasury Department worked with a Republican Congress on a package of fiscal consolidation. Real interest rates fell, and the economy boomed — but that is only the observed correlation. The true causal story remains murky.
Two of the economists behind the Clinton package, Summers and Bradford DeLong, later argued against fiscal consolidation, even during the years of full employment under President Donald Trump [and much higher national debt]. The new worry instead was secular stagnation based on insufficient demand, even though the latter years of the Trump presidency saw debt and deficits well beyond Clinton-era levels.
The point here is not to criticize Summers and DeLong as inconsistent. Rather, it is to note they might have been right both times.
And what about that idea of secular stagnation — the notion that the world is headed for a period of little to no economic growth? The theory was based in part on the premise that global savings were high relative to investment opportunities. Have all those savings gone away? In most places, measured savings rose during the pandemic. Yet the problem of insufficient demand has vanished, and so secular stagnation theories no longer seem to apply.
To be clear, the theory of secular stagnation might have been true pre-pandemic. And it may yet return as a valid concern if inflation and interest rates return to pre-pandemic levels. The simple answer is that no one knows.
Note that Olivier Blanchard just wrote a piece “Secular Stagnation is Not Over,” well-argued as usual. Summers, however, has opined: “we’ll not return to the era of secular stagnation.” I was not present, but I can assume this too was well-argued as usual!
Erika Fatland’s *High*
The subtitle is A Journey Across the Himalaya Through Pakistan, India, Bhutan, Nepal, and China. This is the first great book of 2023, at least that I have seen. Bravo! Travel books are hard to summarize, but I will note that most of them are bad or at best mediocre. They assume you care about the author’s adjectives, or that the interesting nature of experienced events will translate automatically to the page. This work, in contrast, is a wonderful blend of fact, history, political observation, and narrative. I read every page, and it would likely make my list of my favorite thirty travel books of all time. Here is the author’s home page, she is by background a Norwegian anthropologist who speaks eight languages.
Thursday assorted links
1. ChatGPT taking U. Minnesota law exams.
2. The story and background of Scholz.
3. What is going on with PredictIt, and the legal case against them.
4. Macca reviews from 45s from 1967. Lennon does the same from 1965. Both are a bit harsh, but right on, and ruthless with those who will not innovate and progress with their styles.
5. Why is East Asia less happy?
6. Construction Physics on Goolsbee and Syverson on construction productivity. And commentary on some recent gender gap results.
My excellent Conversation with Paul Salopek
Here is the transcript and audio, here is the summary:
Paul Salopek is a Pulitzer Prize-winning journalist and National Geographic fellow who, at the age of 50, set out on foot to retrace the steps of the first human migrations out of Africa. The project, dubbed the “Out of Eden Walk,” began in Ethiopia in 2012 and will eventually take him to Tierra Del Fuego, a distance of some 24,000 miles.
Calling in just as he was about to arrive in Xi’an, he and Tyler discussed his very localized supply chain, why women make for better walking partners, the key to crossing deserts, the most difficult terrain to traverse, what he does for exercise, his information prep for each new region, how he’s kept the project funded, why India is such a good for walkers, which cuisines he’s found most and least palatable, what he learned working the crime beat in Roswell, New Mexico, how this project challenges conventional journalism, his thoughts on the changing understanding of early human migration, and more.
Here is one excerpt:
COWEN: What’s true is true. How is it that you crossed the desert? You’ve been through some of the Gulf States, I think.
SALOPEK: Yes, I’ve been through several deserts. The first was the Afar Desert in north Ethiopia, one of the hottest deserts in the world, and then the Hejaz in western Saudi Arabia, and then some big deserts in Central Asia, the Kyzyl Kum in Uzbekistan.
You cross deserts with a great attentiveness. You seem to want to speed up to get through them as quickly as possible, but often, they require slowing down, and that seems counterintuitive. You have to walk when the temperatures are congenial to your survival. Sometimes that means walking at night as opposed to the day. It means maybe not covering the distances that you would in more moderate climates.
Deserts are like a prickly friend. You approach them with care, but if you invest the time, they’re pretty inspiring and remarkable. There are reasons why old hermits go out into the deserts to seek visions. I was born in a desert. I was born in the Mojave Desert of Southern California, so I’m partial to them, maybe even by birth.
COWEN: Do you find deserts to be the most difficult terrain to cross?
SALOPEK: No, I find alpine mountains to be far trickier. Deserts can be fickle. Deserts can kill you if you’re not careful. Of course, water is the most limiting factor for survival.
But alpine mountain weather is so unpredictable, and a very sunny afternoon can turn into a very stormy late afternoon in a very quick time period. Threats like rock falls, like avalanches, blizzards — those, for me, are far more difficult to navigate than deserts. Also, I guess having been born in the subtropics, I don’t weather the cold as well, so there’s that bias thrown in.
COWEN: What do you do for exercise?
Recommended, interesting throughout.
Wednesday assorted links
1. Is there objective evidence for democratic backsliding?
2. Bryan Caplan chats with Tucker Carlson.
3. The growing bureaucratiation of job interviews.
4. Fairfax elementary school temporarily bans sports.
6. Noah on changes in Japan (also a Substack you should subscribe to).
AI Is Improving Faster Than Most Humans Realize
That is the topic of my latest Bloomberg column, here is one excerpt:
I have a story for you, about chess and a neural net project called AlphaZero at DeepMind. AlphaZero was set up in late 2017. Almost immediately, it began training by playing hundreds of millions of games of chess against itself. After about four hours, it was the best chess-playing entity that ever had been created. The lesson of this story: Under the right conditions, AI can improve very, very quickly.
LLMs cannot match that pace, as they are dealing with more open and more complex systems, and they also require ongoing corporate investment. Still, the recent advances have been impressive.
I was not wowed by GPT-2, an LLM from 2019. I was intrigued by GPT-3 (2020) and am very impressed by ChatGPT, which is sometimes labeled GPT-3.5 and was released late last year. GPT-4 is on its way, possibly in the first half of this year. In only a few years, these models have gone from being curiosities to being integral to the work routines of many people I know. This semester I’ll be teaching my students how to write a paper using LLMs.
We are now at or close to the point where LLMs can read and accurately evaluate the work of…LLms. That will accelerate progress considerably.
And to close I wrote this:
I’ve started dividing the people I know into three camps: those who are not yet aware of LLMs; those who complain about their current LLMs; and those who have some inkling of the startling future before us. The intriguing thing about LLMs is that they do not follow smooth, continuous rules of development. Rather they are like a larva due to sprout into a butterfly.
It is only human, if I may use that word, to be anxious about this future. But we should also be ready for it.
Recommended. Remember my old Wilson Quarterly piece about “invisible competition”?