Map of life expectancy at birth from Global Education Project.

Thursday, January 30, 2020

Hagiography

Proposed headline: "Rapist who played a children's game for a living dies flying a fucking helicopter to his daughter's basketball game."

Think about this. Routinely getting around town in a helicopter is absurdly self-indulgent and environmentally irresponsible, as the LA Times kind of hints at but doesn't exactly want to say, because you know, a WaPo reporter got suspended for linking to a perfectly legitimate news article about the time Kobe Bryant raped a 19 year old hotel clerk. The helicopter Bryant was riding in costs about $5,000 an hour, so let's say he spends 2 hours at the basketball game, we're talking $20,000. Can you think of anything else to do with $20,000? And could an unemployed guy find the time to spend an hour driving each way in a minivan instead? Maybe.

Actually dying in private plane and helicopter crashes is one of the few occupational hazards of being obscenely rich. Golfer Payne Stewart died when his Learjet depressurized and flew on autopilot full of dead people before running out of fuel. The carnage among the plutocracy is substantial, actually, more than 300 deaths a year. Commercial aviation is far safer, by a couple of orders of magnitude. But I guess it's worth the risk to separate yourself from the little people.


Wednesday, January 29, 2020

The hard problems

I've said before that in the view of many, there are three profound questions that pose a fundamental challenge to scientific inference. I think that only two of them really count however.

The first I discussed last time. We've been able to deduce approximately when the universe came into existence and how it has evolved since. But it is not apparent what path of scientific inquiry could explain why that happened when it did (if "when" even means anything before there was time), and why it has the observed laws and physical parameters, To put the problem in an epistemological nutshell, the answer to these questions must lie outside the universe, and by definition the universe consists of what we can directly observe or deduce from observation. Again, saying "God did it" is the intellectual equivalent of saying "OogaBooga!" It's completely meaningless. Nevertheless this is frustrating.

Note that deep mysteries we just haven't solved yet, such as the nature of the Dark Matter and Dark Energy (if it exists, which has been called into question) are not in this category. They are answerable in principle, we just haven't done it yet.

The second hard question, and probably the hardest, is the nature and origin of consciousness. Something is going on inside our heads that no-one else can directly observe. We can only assume that other people experience something roughly like it, though certainly not exactly the same, but how do we really know that? Maybe everyone else in the world is a zombie. And how about dogs, lizards, fish and octopi and earthworms? How does the physical system of neurons give rise to this thing we call experience, which apparently exists outside the physical world and is as far as we can tell undetectable and immeasurable by any material means. We just have to take each other's word for it that we all have it. This is the one so far irreducible challenge to scientific materialism.

Many people have intuitive ideas about this, which I won't go into, but that's all they are. So far no way to test any of them.

The third question I do not personally consider to be in the hard category at all. That is the origin of life -- that is life on earth, which is the only place we know it to have happened so far. It happened so long ago that the evidence needed to figure out exactly how it happened is may just be lost, and no investigation, even with as yet undiscovered technology, will ever suffice to answer it. But in principle it's pretty simple. At some time from 3.6 to maybe 4.3 billion years ago, a molecule or assemblage of molecules happened to appear that could catalyze its own reproduction, but not always perfectly. That's all you need. It only had to happen once, and given the vastness of the oceans and the uncountable chemical entities that existed within them, it doesn't seem improbable, it seems inevitable.

Once that happened, quickly there were 2 of them and then 8 and 16 and soon enough 4,294,967,296 (minus however many fell apart along the way). At some point some of them were slightly different, because replication wasn't always perfect, and then you had various kinds of which some may have lasted longer and reproduced more often than others, and we were off to the evolutionary races. I personally don't consider this difficult to understand. We've had more than 3.6 billion years of the process and in that amount of time it has produced an extraordinary diversity of complicated products, each of which may seem improbable in and of themselves but the existence of which as a whole -- however different it might have been in the specific -- is inevitable. That it all derives from a single ancestor (known as the Last Common Ancestor, LCA) is evident because it all uses the same basic machinery of DNA, RNA, and amino acids. (DNA probably came along last.)

However unsatisfying it may seem, there is no need whatsoever for God in this story.

Update: If hundreds of people with many years each of hard-won expertise have spent their careers thinking about a difficult question, and you don't understand the answer they come up with, the most likely conclusion is not "they are really stupid because what they say doesn't make sense to me." The likely conclusion is that you need to work hard and study to try to understand them, and if you don't want to do that, go and argue about something else.

The basic molecular building blocks for life evidently existed in the oceans of early earth. Biochemists have a number of hypothesis about how the first self-replicating system may have arisen, although they can't prove any one of them. But none of their hypotheses consist of "yadda yadda," the actual meaning of which is "I'm not listening."

Monday, January 27, 2020

Cosmology

For most of our maybe 250,000 years as a species, people were aware only of their local environment. Eventually, as trade networks grew, they started to gain a dim awareness of distant lands, and by the time of classical Greece they knew that the earth is roughly spherical, although they were largely unaware of what lay beyond the Middle East and the steppes of Asia. (Alexander of course expanded their knowledge and drew the central Asian empires into the orbit of Greece.)

But it was not until Galileo's time, in the late Middle Ages, that some people began to believe that the earth was not at the center of the universe. Nevertheless, even if the earth does orbit the sun, people continued to believe that the universe was purposely designed to provide a habitat for humans, by a God who continued to be intimately concerned with our affairs.

The truly radical disruption happened when Edwin Hubble discovered the reality of the universe -- uncountable billions of galaxies, each containing hundreds of billions of stars, racing away from each other into an unimaginable void. Continuing observations and calculations, combined with deepening understanding of the underlying structure of reality through physics, eventually led to the calculation that about 13.8 billion years ago, the universe was compressed into a point of infinite density and temperature, which then suddenly started to expand and cool. Once it had cooled enough for atoms to form, the only elements that existed were hydrogen, helium, and a small amount of lithium, hence life was impossible. But the primordial gas contracted under the weight of gravity into stars, in which nuclear fusion ignited when their cores became hot enough, and heavier elements were forged. When some of the first generation of stars ultimately exploded in Novae, star systems of the second generation contained these heavier elements. Our solar system is of the third generation, and so our planet has enough carbon, oxygen, and other elements necessary to life.

This is a very brief sketch, but it's enough for our purposes. I recall the words of one cosmologist to the effect that the more we learn, the more pointless it seems. And from the human standpoint it is indeed pointless. This story is unsatisfying to many people. The though of us as just a momentary bag of chemicals in a thin layer of slime on a grain of dust in that vast, cold emptiness of time and space just doesn't work. But cosmologists are quite sure that the story they have discerned is broadly correct.

However, they most definitely do not claim to know everything, or even a tiny part of all there is to know. They do not claim to know why this happened, why the history and laws of the universe are what they are, or even why there is something rather than nothing. They think about these questions, and they propose possible pathways to answers, but they are far humbler than preachers who claim to know everything that matters, even though they have no evidence for their beliefs whatever.

It doesn't work to say that God made the Big Bang happen. In the first place, you would still have to explain where God came from. More to the point, whatever you mean by God in this context it is very definitely not the God of the Old Testament, the New Testament, the Koran, the Book of Mormon, the Upanishads, or any other religion. Just making up a silly story to explain what we don't know is no answer. For now, we just have to live with the mystery.

Sunday, January 26, 2020

Sunday Sermonette: Air Pollution Warning

The Skeptics Annotated Bible introduction to Leviticus begins, "I wouldn't read Leviticus if I were you. No one else does." That's probably good advice, but we're committed to this project so off we go. One of the key reasons I'm doing this is to prove that people who claim that the Bible is the literal, inerrant word of God a) must have a very low opinion of God and b) don't pay any attention to 99% of what he says.

Leviticus begins with detailed, specific instructions for dismembering and burning animals. And that is a good percentage of the entire book, actually, along with several other categories of bizarre instructions. Orthodox Jews nowadays pay attention to an item here and there, as do fundamentalist Christians, but they ignore most of it.  To the extent that the Bible is foundational to any religious sect, Jewish or Christian, it is by selecting a few nuggets here and there and ignoring the rest. Here we go. God really loves the smell of burning flesh but I warn you, breathing the smoke is very bad for your health.

The Lord summoned Moses and spoke to him from the tent of meeting, saying: Speak to the people of Israel and say to them: When any of you bring an offering of livestock to the Lord, you shall bring your offering from the herd or from the flock.
If the offering is a burnt offering from the herd, you shall offer a male without blemish; you shall bring it to the entrance of the tent of meeting, for acceptance in your behalf before the Lord. You shall lay your hand on the head of the burnt offering, and it shall be acceptable in your behalf as atonement for you. The bull shall be slaughtered before the Lord; and Aaron’s sons the priests shall offer the blood, dashing the blood against all sides of the altar that is at the entrance of the tent of meeting. The burnt offering shall be flayed and cut up into its parts. The sons of the priest Aaron shall put fire on the altar and arrange wood on the fire. Aaron’s sons the priests shall arrange the parts, with the head and the suet, on the wood that is on the fire on the altar; but its entrails and its legs shall be washed with water. Then the priest shall turn the whole into smoke on the altar as a burnt offering, an offering by fire of pleasing odor to the Lord.
10 If your gift for a burnt offering is from the flock, from the sheep or goats, your offering shall be a male without blemish. 11 It shall be slaughtered on the north side of the altar before the Lord, and Aaron’s sons the priests shall dash its blood against all sides of the altar. 12 It shall be cut up into its parts, with its head and its suet, and the priest shall arrange them on the wood that is on the fire on the altar; 13 but the entrails and the legs shall be washed with water. Then the priest shall offer the whole and turn it into smoke on the altar; it is a burnt offering, an offering by fire of pleasing odor to the Lord.
14 If your offering to the Lord is a burnt offering of birds, you shall choose your offering from turtledoves or pigeons. 15 The priest shall bring it to the altar and wring off its head, and turn it into smoke on the altar; and its blood shall be drained out against the side of the altar. 16 He shall remove its crop with its contents[a] and throw it at the east side of the altar, in the place for ashes. 17 He shall tear it open by its wings without severing it. Then the priest shall turn it into smoke on the altar, on the wood that is on the fire; it is a burnt offering, an offering by fire of pleasing odor to the Lord.

Footnotes:

  1. Leviticus 1:16 Meaning of Heb uncertain

Saturday, January 25, 2020

Wuhan Ban

By now you probably know that the Chinese authorities have taken drastic measures to isolate Wuhan and other cities, shutting down all transportation services from the city. They have also started building hospitals to quarantine infected people. The U.S. is evacuating its diplomats from Wuhan, and offering to evacuate other Americans who want to leave China. No doubt similar measures will be taken elsewhere in China and in other countries where the virus appears. The economic cost of these measures will be at least many tens of billions of dollars, probably in the hundreds of billions. And of course isolation and quarantine have public health costs of their own, and may cause death and disease themselves.

So should we all panic? If they are taking such extreme and costly measures this must be a really dangerous situation, right? Well, I dunno about that. As the latest update from CDC makes clear, we really don't know how virulent this virus is. Generally speaking, coronaviruses are among the innumerable viruses that cause what we call the common cold. We take it for granted that these viruses circulate all the time, and sometimes people get colds. Rarely, colds lead to pneumonia and even more rarely, pneumonia leads to death, usually among people who are already debilitated and mostly that means very old people. That's commonly how a long life ends. It's a fact of life that we accept.

So why all the hoopla about what may just be another of 100 viruses that cause colds? Well, the problem is that we don't really know. Novel pathogens are concerning because people don't have immunity to them, so they might cause particularly serious problems. That's what happened to the indigenous population of North America when they suddenly encountered diseases that Europeans had been living with for centuries. They're also concerning because we just don't know. Maybe this is generally a lot worse than the commonest of colds, and maybe it isn't. So the Chinese don't want the worst to happen, and they don't want to be blamed for not doing enough if it does. On the other hand, maybe the only real disaster will turn out to be the response.

I tend to be on the side of more conservative reaction to outbreaks. The 2010 flu pandemic hoax -- and that's what it was -- is a case in point. We had what turned out actually to be a comparatively mild flu season around the world, but the panicked overreaction was immeasurably costly and damaging. But I wouldn't want to be the person responsible for underreacting either. So that's where we find ourselves. 

Friday, January 24, 2020

White collar crime

John Kapoor, CEO of Insys Therapeutics, was sentenced yesterday to 5 1/2 years in prison. That's a pretty stiff sentence, right?

Well let's see now. What did he do exactly?

His company sold fentanyl under the brand name Subsys. As you probably know, fentanyl is an extremely powerful synthetic opioid that is responsible for a high percentage of the overdose deaths in the current epidemic of opioid addiction. As a prescription drug, it was approved by the FDA only for so-called breakthrough pain in cancer patients. But Insys literally bribed doctors to prescribe it inappropriately, resulting in 8,000 known deaths and countless more ruined lives.

I ask you to consider the comparable case of an organized crime leader who distributed the precise same substance to street dealers, with similar consequences. What sentence do you think he would receive? Is there anything wrong with this picture?

Wednesday, January 22, 2020

Oh no! Are we all going to die?

Yes. However, very probably not because of the novel coronavirus that has appeared in China. This seems to be front page headlines in every media outlet on the planet, and  the World Health Organization has convened a meeting to decide whether to declare an official Global Health Emergency.

This sort of flapdoodle happens every time a novel pathogen appears. Back when I lived in the Hub of the Universe a mosquito-borne disease called West Nile virus appeared (having formerly been large confined to, yes, west of the Nile). For weeks, every time a new case was identified it would be on the front page of the Boston Globe. The Commissioner of Public Health sprayed Boston's residential neighborhoods with insecticide, killing of course every arthropod in the air column but probably not very many mosquitoes.

Now here's the thing about West Nile virus. The large majority of people who are infected have no symptoms at all, but derive life-long immunity. The vast majority of the rest have mild symptoms and probably think they just had a cold. They also derive life-long immunity. In rare cases, people develop meningitis, which even more rarely may go on to become serious causing permanent neural damage or death. Well, West Nile virus has no been in the U.S. for more than a decade and we've pretty much forgotten all about it because as public health problems go, it is utterly trivial. Far more people are seriously sickened or die from all sorts of other pathogens which we don't worry about at all, because it isn't worth worrying about, unless you happen to be one of the very unlucky ones.

So a reasonably sober assessment of the situation is here. According to the Chinese authorities, so far 17 deaths have been attributed to this virus, apparently all among people who were already sick and frail from other causes. (This happens to be true of most deaths attributed to influenza, BTW.) The Chinese have attributed 444 illnesses to the virus but that means the actual number must be far higher because most people just get a cold, don't show up for medical care, and don't get counted. That's what always happens with these outbreaks, of course. If, as some have estimated, there have actually been as many as 4,000 cases, then the case fatality rate is about 4.25 out of a thousand, which is pretty much in line with the case fatality rate for influenza. However, this virus appears to be much less transmissible and there is no reason to think it will become very widespread. (Previous coronavirus outbreaks known SARS and MERS fizzled out without much consequence.)

So why the mass hysteria? Well, public health authorities are always paranoid about novel pathogens because some pretty bad things have happened in the recent past -- HIV, Zika -- and in the more distant past, the Black Death, which killed something like half the population of Europe; and the smallpox and other epidemics that largely wiped out the indigenous people of North America. Nowadays we know a lot about viruses and we can identify and classify them and combat them effectively enough that it seems unlikely anything like the Black Death will happen, but nobody wants to find out the hard way so they tend to be hypervigilant. Which I suppose is a good thing. But let the assigned paranoiacs worry about this one. We'll let you know if and when you need to start worrying.

Tuesday, January 21, 2020

Stepping back and looking at the big picture

I'm going to step away from current events for a bit -- okay, I might intersperse a post on something exigent -- and contemplate the nature of the historic epoch in which we find ourselves. I'll begin with the most basic history of Homo sapiens. Paleontologists use the abbreviation Kya for "thousand years ago." So, our species emerged in southern Africa maybe 200 Kya or slightly more. We can't be sure because we might not have found fossils of the oldest of our kind and we also can't be sure if the earliest anatomically modern humans were also behaviorally modern, the most important question obviously being language. Actually around 200Kya there were multiple populations in Africa that appeared very similar to modern humans. Were they really like us in capacity for language and cultural development? We just don't know.

In any case, the early human population remained confined to southern Africa until about 100 Kya, when it expanded into central and then northern Africa and then, around 50 Kya, crossed the Red Sea. Homo sapiens arrived in Europe about 45 Kya, and made it to  southeast Asia and Australia at about the same time. They made it to central and east Asia - al the way to the Pacific coast -- just 5,000 years later, and crossed into North America during the glacial age 15Kya, when the Bering Strait was a land bridge, and made it to the tip of South America in just a couple of thousand years.

It's very important to understand, however, that these migrations were undertaken by very small bands of people. Genetic diversity in Africa is far greater than it is throughout the rest of the world. Something like 1,000 to 2,500 individuals initially moved from Africa into the Near East. Dispersion thereafter occurred in a similar way. The band would settle in a new place and once it grew too populous for the local resources to sustain, a small group would move on and found a new colony. The way of life might change gradually in response to available resources and climate in new places, but people continued to subsist by hunting and gathering, using tools of stone, bone and wood until around 10,000 years ago. They lived in small groups, knowing nothing of different lands. Although some goods traveled surprising distances through trading networks, the people on the ultimate receiving end would have known nothing of their origin.

Recently extant hunter-gatherer bands averaged 28 individuals, organized into larger groups we usually call tribes, of about 500. Population density is on the order of fewer than 1 person per square kilometer. At these densities communicable disease is limited, but presumably as density increased in a new environment it became more of a problem. So we can reconstruct a pattern of peopling of a new environment, a period of relative health and prosperity, followed by a period of scant resources and increasing disease, followed by out-migration and repetition of the pattern. So the total global population increased as its geographic extent expanded, but its density did not, for some 100,000 years.

See Henn, BM, Cavalli-Sforza LL, Feldman MW. The Great Human Expansion. Proceedings of the National Academy of Sciences, 2012.

Sunday, January 19, 2020

Checking up on the economy

I am continually amused by the claims of Trumpistas that the U.S. is experiencing an economic resurgence and utopia, for which of course the vulgarian in chief deserves all the credit. Joseph Stiglitz, who unlike them and me has won a Nobel Memorial Prize in economics (it's not a real Nobel prize, economists added it later because they wanted one too) knows otherwise.

This is a fairly dense essay which it's difficult to summarize without quoting, but I'll try. Meanwhile one pull quote:

Two years ago, a few rare corporate leaders were concerned about climate change, or upset at Trump’s misogyny and bigotry. Most, however, were celebrating the president’s tax cuts for billionaires and corporations and looking forward to his efforts to deregulate the economy. That would allow businesses to pollute the air more, get more Americans hooked on opioids, entice more children to eat their diabetes-inducing foods, and engage in the sort of financial shenanigans that brought on the 2008 crisis.Today, many corporate bosses are still talking about the continued GDP growth and record stock prices. But neither GDP nor the Dow is a good measure of economic performance.
I actually think even less of GDP as an indicator of anything we should necessarily feel happy about than does Stiglitz, whose critique includes the observation that it is actually growing slowly. That doesn't necessarily bother me, but these facts do:

U.S. life expectancy is actually falling. We haven't seen that in an economically developed nation since, well, the collapse of the Soviet Union.

This is because a) millions of people have lost their health insurance as the Administration has worked assiduously to sabotage the Affordable Care Act and b) people are dying at unprecedented rates from suicide, alcoholism, and drug addiction.

The 2017 tax act cut taxes for the very wealthiest people but it will actually raise taxes on middle income people. Since Orange Julius took office, the median household income has been stagnant. It rose a bit in the first year, continuing the momentum of the Obama years, then stopped. And earnings for Black men continue to be 3/4 of white men's earnings. And the tax cuts didn't spur investment at all -- instead they spurred $800 million in stock buy-backs, which benefits shareholders obviously, but not workers. Oh yeah -- the trade deficit is higher than when OJ took office, including the deficit with China, which has increased by 25%. The pace of job creation is lower than during the Obama years, and the percentage of the working age population which is employed has also grown more slowly. Then of course there is the gutting of environmental regulations which will mean more people are poisoned by air and water pollution, among other unpleasant consequences.

So no, economic conditions do not favor the incumbent.

Update: And you don't have to take my word for it. "A 70% majority of Americans view the economy as unfairly favoring those with power, and large majorities also say politicians, giant corporations, and wealthy individuals wield too much power over the economy, according to Pew Research Center. Also, real wages were completely stagnant in 2019.

Sunday Sermonette: Exiting Exodus

We've finally come to the end of the incredibly long, detailed, multiply repetitious tale of the tabernacle. This obviously seemed very important to the people who wrote it down (and wrote it down, and wrote it down . . . .) but it is not at all obvious why. In the final chapter it gets switched on, as it were. While this is said to happen on the first day of the first month, we don't know immediately when that actually is. The Jewish calendar has multiple "first months" for different purposes. Nisan is the first month of the ecclesiastical calendar, from which the dates of festivals are counted. Passover is on 15 Nisan. Tishrei, the seventh month of the ecclesiastical year, is the civil new year, Rosh Hashana. Later in the chapter, however, we are told that this is the first month of the second year, i.e. it has presumably been a year since the exodus from Egypt (although it doesn't seem to add up to a full year) so this must be Nisan. In that case, however, Passover should be on the first of the month, not the 15th. In any event, this ceremonial opening of the temple is not, as far as I know, a continuing tradition.

At the very end of the chapter, they get on their way again. However, the story is put on hold for the entirety of the following book, Leviticus, in which nothing happens except dictation.

40 The Lord spoke to Moses: On the first day of the first month you shall set up the tabernacle of the tent of meeting. You shall put in it the ark of the covenant,[a] and you shall screen the ark with the curtain. You shall bring in the table, and arrange its setting; and you shall bring in the lampstand, and set up its lamps. You shall put the golden altar for incense before the ark of the covenant,[b] and set up the screen for the entrance of the tabernacle. You shall set the altar of burnt offering before the entrance of the tabernacle of the tent of meeting, and place the basin between the tent of meeting and the altar, and put water in it. You shall set up the court all around, and hang up the screen for the gate of the court. Then you shall take the anointing oil, and anoint the tabernacle and all that is in it, and consecrate it and all its furniture, so that it shall become holy. 10 You shall also anoint the altar of burnt offering and all its utensils, and consecrate the altar, so that the altar shall be most holy. 11 You shall also anoint the basin with its stand, and consecrate it. 12 Then you shall bring Aaron and his sons to the entrance of the tent of meeting, and shall wash them with water, 13 and put on Aaron the sacred vestments, and you shall anoint him and consecrate him, so that he may serve me as priest. 14 You shall bring his sons also and put tunics on them, 15 and anoint them, as you anointed their father, that they may serve me as priests: and their anointing shall admit them to a perpetual priesthood throughout all generations to come.
Note that like many of God's promises, this was not fulfilled. The priesthood is no longer hereditary.
16 Moses did everything just as the Lord had commanded him. 17 In the first month in the second year, on the first day of the month, the tabernacle was set up. 18 Moses set up the tabernacle; he laid its bases, and set up its frames, and put in its poles, and raised up its pillars; 19 and he spread the tent over the tabernacle, and put the covering of the tent over it; as the Lord had commanded Moses. 20 He took the covenant[c] and put it into the ark, and put the poles on the ark, and set the mercy seat[d] above the ark; 21 and he brought the ark into the tabernacle, and set up the curtain for screening, and screened the ark of the covenant;[e] as the Lord had commanded Moses. 22 He put the table in the tent of meeting, on the north side of the tabernacle, outside the curtain, 23 and set the bread in order on it before the Lord; as the Lord had commanded Moses. 24 He put the lampstand in the tent of meeting, opposite the table on the south side of the tabernacle, 25 and set up the lamps before the Lord; as the Lord had commanded Moses. 26 He put the golden altar in the tent of meeting before the curtain, 27 and offered fragrant incense on it; as the Lord had commanded Moses. 28 He also put in place the screen for the entrance of the tabernacle. 29 He set the altar of burnt offering at the entrance of the tabernacle of the tent of meeting, and offered on it the burnt offering and the grain offering as the Lord had commanded Moses. 30 He set the basin between the tent of meeting and the altar, and put water in it for washing, 31 with which Moses and Aaron and his sons washed their hands and their feet. 32 When they went into the tent of meeting, and when they approached the altar, they washed; as the Lord had commanded Moses. 33 He set up the court around the tabernacle and the altar, and put up the screen at the gate of the court. So Moses finished the work.

The Cloud and the Glory

34 Then the cloud covered the tent of meeting, and the glory of the Lord filled the tabernacle. 35 Moses was not able to enter the tent of meeting because the cloud settled upon it, and the glory of the Lord filled the tabernacle. 36 Whenever the cloud was taken up from the tabernacle, the Israelites would set out on each stage of their journey; 37 but if the cloud was not taken up, then they did not set out until the day that it was taken up. 38 For the cloud of the Lord was on the tabernacle by day, and fire was in the cloud[f] by night, before the eyes of all the house of Israel at each stage of their journey.

Footnotes:

  1. Exodus 40:3 Or treaty, or testimony; Heb eduth
  2. Exodus 40:5 Or treaty, or testimony; Heb eduth
  3. Exodus 40:20 Or treaty, or testimony; Heb eduth
  4. Exodus 40:20 Or the cover
  5. Exodus 40:21 Or treaty, or testimony; Heb eduth
  6. Exodus 40:38 Heb it

Wednesday, January 15, 2020

Denial is not only a river in Egypt . . .

it's a river in the U.S. as well. I've mentioned this before but it seems like a good time to pay it a visit, since the world in general has its collective head up its ass in many ways. (Viz. Australia.)

Over geological time, the Mississippi River has continually changed its course. This has been known for a long time. Here's a map made in 1944 that shows some of the geological history that was already known back then. This happens because it flows across the flat midsection of the country and it meanders. On the outside of a meander the water moves faster and cuts into the bank. On the inside, it flows slowly and deposits sediment. So eventually it cuts a new channel. For example in 1876 the city of Vicksburg, which was formerly on the river, suddenly wasn't any more.

Too bad for Vicksburg (which was subsequently reconnected to the river by a canal), but that was only a local disaster. But if not for a massive engineering project called the Old River Control Structure, as of today the Mississippi would not flow through New Orleans. Rather, it would jump course and the main flow of the river would go down the Atchafalaya. If that doesn't sound like it would be such a bad thing:

a) Yes it would be very, very bad and
b) It will happen.

The Old River Control Structure is destined to fail, because sediment builds up downstream of it and continually increases the pressure. With the increasingly frequent and severe flooding caused by the Chinese Hoax, the likelihood of failure increases even faster. No-one can predict exactly when it will happen but when it does:

Barge traffic to and from New Orleans will become impossible. That means the U.S. will be unable to export agricultural products from the midwest, including 60% of the nation's grain exports, creating a global food shortage. Morgan City, Louisiana will be destroyed along with several small towns. Pipelines and electrical transmission lines that currently cross the Atchafalaya will also be destroyed. Vast areas will lose electricity and natural gas. One and a half million people will lose fresh water. [Update: This means that New Orleans will have to be abandoned.] Notice I use the future tense, not the conditional. All of this will happen.

There is a solution, which is to let it happen gradually. That will mean eventual abandonment of existing Mississippi River ports, and creation of new ones. Morgan City will replace New Orleans as the principle city at the mouth of the Mississippi. (It will have to be moved as well as greatly expanded.) The refineries and other infrastructure currently at the mouth of the Mississippi will have to be abandoned and rebuilt at the mouth of the Atchafalaya, but all that's going to happen anyway.

However, people are not sufficiently wise.

BTW I gave you the link to Part Three of the three-part Weather Underground series on this. You might want to start here.


Tuesday, January 14, 2020

It can be done

Dylan Scott tells the tale of Taiwan's successful implementation of single payer national health care. If you read the whole article you'll find a strange ambivalence. He seems to feel compelled to practice both-sideism and find a downside, but he fails to put it in context.

The purported downside is that health care costs keep rising so they have to choose between raising more revenues and restricting services. But that has nothing to do with the single payer system. That's true everywhere, no matter what kind of payment system, including in the U.S. In the UK, the Conservative governments have failed to provide enough revenue for the National Health Service for many years now, which has resulted in some problems with quality and waits for elective procedures, as well as physician burnout. But that's no an indictment of the concept, it's an indictment of the execution. Both the UK and Taiwanese systems are much more efficient than the U.S. system, by not squandering 20% or more on administration, marketing and profit; and they cover everybody.

Another problem in Taiwan is a shortage of doctors. Basically, the production of new physicians didn't keep up with the increased demand  once everybody got coverage. But this is also a solvable problem. It is expensive and does take a long time to make new M.D.s, but a lot of routine health care can be provided by professionals who are a lot cheaper and faster to produce -- physician assistants and nurse practitioners. If the Taiwanese would make that investment, they could solve that problem in a few years I would think.

Those issues aside, the program is extremely popular. Everybody's covered, out of pocket expenses are largely trivial, and the taxes that pay for it are less than the insurance premiums Americans have to pay -- whether they know it or not because they may be hidden in payroll deductions.

But, the bad news is that the system was created before Taiwan became a democracy. The unelected leadership implemented it based on recommendations from American policy specialist Uwe Reinhardt, and they didn't have to worry that it was unpopular at the time. But once it actually happened, it became extremely popular and has continued full strength under subsequent elected governments. And that's the problem we face. Medicare for All loses support when people realize that it will mean a big change from the status quo, which may be okay for many of them; and of course it is opposed by the insurance industry and many providers and suppliers who expect their own incomes will be squeezed, and probably rightly so.

So it's a daunting problem politically. But it's the right thing to do.

Sunday, January 12, 2020

Sunday Sermonette: Bez does it all

Yep, he's not just a carpenter and a goldsmith and a perfumer, he's a tailor and a jeweler . . .

Thank God [sic] Exodus is almost over. There's one more chapter after this, then we get into Leviticus, which is maybe slightly more interesting than all of these specifications. However, the narrative doesn't start up again until Numbers. We're going to spend the next few months mired in the intricacies of various categories of rules, including believe it or not a Diagnostic and Statistical Manual of Skin Diseases. The interesting thing about these last few chapters of Exodus is that nobody pays any attention to them any more. The priestly garments described here in 39 are long forgotten. The whole thing seems pointless to us now but obviously it seemed very important to the people who took the trouble to write all of this down, and possibly to actually make this stuff although we can't know that it was ever real. Leviticus is different however. Both Jews and Christians basically pick and choose from it, although they choose differently. But which parts are still observed today and which are not seems largely arbitrary. Anyway, here is the description of the priestly garments. What it all means I cannot say. Well, one thing. Back in Exodus 28 we learned that the bell and pomegranate are to warn God that the priest is entering the holy place so that God doesn't kill him. God just isn't very aware, it seems.

39 Of the blue, purple, and crimson yarns they made finely worked vestments, for ministering in the holy place; they made the sacred vestments for Aaron; as the Lord had commanded Moses.
He made the ephod of gold, of blue, purple, and crimson yarns, and of fine twisted linen. Gold leaf was hammered out and cut into threads to work into the blue, purple, and crimson yarns and into the fine twisted linen, in skilled design. They made for the ephod shoulder-pieces, joined to it at its two edges. The decorated band on it was of the same materials and workmanship, of gold, of blue, purple, and crimson yarns, and of fine twisted linen; as the Lord had commanded Moses.
The onyx stones were prepared, enclosed in settings of gold filigree and engraved like the engravings of a signet, according to the names of the sons of Israel. He set them on the shoulder-pieces of the ephod, to be stones of remembrance for the sons of Israel; as the Lord had commanded Moses.
He made the breastpiece, in skilled work, like the work of the ephod, of gold, of blue, purple, and crimson yarns, and of fine twisted linen. It was square; the breastpiece was made double, a span in length and a span in width when doubled. 10 They set in it four rows of stones. A row of carnelian,[a] chrysolite, and emerald was the first row; 11 and the second row, a turquoise, a sapphire,[b] and a moonstone; 12 and the third row, a jacinth, an agate, and an amethyst; 13 and the fourth row, a beryl, an onyx, and a jasper; they were enclosed in settings of gold filigree. 14 There were twelve stones with names corresponding to the names of the sons of Israel; they were like signets, each engraved with its name, for the twelve tribes. 15 They made on the breastpiece chains of pure gold, twisted like cords; 16 and they made two settings of gold filigree and two gold rings, and put the two rings on the two edges of the breastpiece; 17 and they put the two cords of gold in the two rings at the edges of the breastpiece. 18 Two ends of the two cords they had attached to the two settings of filigree; in this way they attached it in front to the shoulder-pieces of the ephod. 19 Then they made two rings of gold, and put them at the two ends of the breastpiece, on its inside edge next to the ephod. 20 They made two rings of gold, and attached them in front to the lower part of the two shoulder-pieces of the ephod, at its joining above the decorated band of the ephod. 21 They bound the breastpiece by its rings to the rings of the ephod with a blue cord, so that it should lie on the decorated band of the ephod, and that the breastpiece should not come loose from the ephod; as the Lord had commanded Moses.
22 He also made the robe of the ephod woven all of blue yarn; 23 and the opening of the robe in the middle of it was like the opening in a coat of mail,[c] with a binding around the opening, so that it might not be torn. 24 On the lower hem of the robe they made pomegranates of blue, purple, and crimson yarns, and of fine twisted linen. 25 They also made bells of pure gold, and put the bells between the pomegranates on the lower hem of the robe all around, between the pomegranates; 26 a bell and a pomegranate, a bell and a pomegranate all around on the lower hem of the robe for ministering; as the Lord had commanded Moses.
27 They also made the tunics, woven of fine linen, for Aaron and his sons, 28 and the turban of fine linen, and the headdresses of fine linen, and the linen undergarments of fine twisted linen, 29 and the sash of fine twisted linen, and of blue, purple, and crimson yarns, embroidered with needlework; as the Lord had commanded Moses.
30 They made the rosette of the holy diadem of pure gold, and wrote on it an inscription, like the engraving of a signet, “Holy to the Lord.” 31 They tied to it a blue cord, to fasten it on the turban above; as the Lord had commanded Moses.

The Work Completed

32 In this way all the work of the tabernacle of the tent of meeting was finished; the Israelites had done everything just as the Lord had commanded Moses. 33 Then they brought the tabernacle to Moses, the tent and all its utensils, its hooks, its frames, its bars, its pillars, and its bases; 34 the covering of tanned rams’ skins and the covering of fine leather,[d] and the curtain for the screen; 35 the ark of the covenant[e] with its poles and the mercy seat;[f] 36 the table with all its utensils, and the bread of the Presence; 37 the pure lampstand with its lamps set on it and all its utensils, and the oil for the light; 38 the golden altar, the anointing oil and the fragrant incense, and the screen for the entrance of the tent; 39 the bronze altar, and its grating of bronze, its poles, and all its utensils; the basin with its stand; 40 the hangings of the court, its pillars, and its bases, and the screen for the gate of the court, its cords, and its pegs; and all the utensils for the service of the tabernacle, for the tent of meeting; 41 the finely worked vestments for ministering in the holy place, the sacred vestments for the priest Aaron, and the vestments of his sons to serve as priests. 42 The Israelites had done all of the work just as the Lord had commanded Moses. 43 When Moses saw that they had done all the work just as the Lord had commanded, he blessed them.

Footnotes:

  1. Exodus 39:10 The identification of several of these stones is uncertain
  2. Exodus 39:11 Or lapis lazuli
  3. Exodus 39:23 Meaning of Heb uncertain
  4. Exodus 39:34 Meaning of Heb uncertain
  5. Exodus 39:35 Or treaty, or testimony; Heb eduth
  6. Exodus 39:35 Or the cover

Thursday, January 09, 2020

The Growing Importance of Medical Intervention

For most of the years while I was coming up in the world of public health and social policy, it was accepted truth that medical intervention made only a small contribution to population health. Quantifying "population health" as a single entity is obviously highly problematic. There are many components that people will value differently. There is mean life expectancy at birth, which is a common measure that is not terribly difficult to calculate; although as I have explained here before and won't bother to do again right now it's a fictitious construct that does not predict how long you actually have to live. Rather it's a snapshot of the ages at which people are dying today.

Regardless, there's a lot it doesn't tell you. Even with regard to lifespan, a few people living to a ridiculously old age will pull it up but maybe we care more about how many people get to live whatever we might consider to be a "full lifespan," which conventionally has been three-score years and ten, i.e. 70. Maybe we care more about relatively early deaths rather than extremely long lives, in other words. It also doesn't say anything about inequity. And of course it doesn't say how healthy people are or how rewarding or happy their lives are. There are measures called Quality Adjusted Life Years and Disability Adjusted Life Years that try to provide aggregated measures of longevity and well-being combined, but they are highly value laden and controversial. (Again, I've discussed these before, you can look them up.)

Nevertheless, people would try to quantify the contribution of medical intervention and you'd typically see estimates ranging from 20% to 50%. The remainder is a consequence of the social and physical environment (given that genetic heritage isn't really controllable and is taken as given). Since the social environment strongly determines our physical environment -- including diet, exposure to pollution, occupational risk, psycho-social stress and so on -- these are often summarized as Social Determinants of Health, or SDH. One respected thinker, Ivan Illich, even made an argument that many found convincing, that medical intervention was a net negative for humanity (mostly in a book titled Medical Nemesis).

It is still true that SDH are probably more important than doctors, and even more strongly if you compare rich and poor countries and counties within the U.S. Nevertheless the relative contribution of medicine has increased somewhat, in many people's opinion which I largely share. It's been a slow process with plenty of two steps forward and one step back; and plenty of bad mistakes along the way including treatments which indeed do more harm than good. Nevertheless the general direction has turned out to be positive in the long term. Bad news: It's gotten more expensive, which means that medical services eat up more and more of the economy and there's a cost to that. We might get more bang by spending some of the bucks elsewhere, which is no contradiction to the claim that medicine is now contributing more to health and well-being.

An important case in point is the cancer death rate. You can read all about it here. The overall age adjusted cancer death rate has fallen steadily since 1991 through 2017, resulting in 2.9 million fewer deaths from cancer than had the peak rate persisted. (This is the age adjusted rate, which they don't bother to mention most of the time. Actually the raw number of cancer deaths has increased because there are more people and they tend to be older, but you have to wipe those facts out when you think about this.) The rather novel message is that most of this is due to improved treatment. Yes, the biggest contributor is lung cancer deaths and yes, lower smoking rates are part of that, but better treatment is just as important. Better treatment for myeloproliferative disorders (leukemia), melanoma, breast cancer and prostate cancer also contribute. Lots of cancer is now definitively curable, and lots more has greatly increased survival time, though not necessarily with great quality of life. All of this means a cancer diagnosis doesn't have to be as terrifying and final as it used to be.

On the other hand a lot of this treatment is very expensive. On the one hand that means that universal access to affordable health care is more important than ever, on the other hand it means it's harder to pay for. But that's the way it is. We'll keep this context in mind in future discussions of public health and health care policy.


Sunday, January 05, 2020

Regrettable News

Sadly, I events have motivated me to re-launch the blog formerly known as Today in Iraq, Iraq today, Today in Iraq and Afghanistan, and Today in Afghanistan. I have also retitled it, Today in the Endless War. I will make appropriate changes to the sidebars in due course. I am profoundly sorry, and angry, that this occasion has arisen.

Sunday Sermonette: A whole lotta loot

Exodus 38 continues the repetitive, mind numbing description of the tabernacle. The interesting part is at the end, however. According to Skeptics Annotated Bible, the amount of metal used for the tabernacle works out to a metric ton of gold (i.e. 1,000 kg), 3.5 metric tons of silver, and 2.45 metric tons of bronze. According to my calculations, the gold alone would be worth more than 54 million dollars today. This is particularly strange because, as you may recall, all of their gold has already been melted down to make the golden calf and then destroyed.

Also rather strange is that there are 603,555 men in the group, and therefore a couple of million women and children. There were 70 Hebrews about 400 years ago in Exodus 1. That's being fruitful and multiplying for sure. Also, too, they're eating one hell of a lot of manna.

38 He made the altar of burnt offering also of acacia wood; it was five cubits long, and five cubits wide; it was square, and three cubits high. He made horns for it on its four corners; its horns were of one piece with it, and he overlaid it with bronze. He made all the utensils of the altar, the pots, the shovels, the basins, the forks, and the firepans: all its utensils he made of bronze. He made for the altar a grating, a network of bronze, under its ledge, extending halfway down. He cast four rings on the four corners of the bronze grating to hold the poles; he made the poles of acacia wood, and overlaid them with bronze. And he put the poles through the rings on the sides of the altar, to carry it with them; he made it hollow, with boards.
He made the basin of bronze with its stand of bronze, from the mirrors of the women who served at the entrance to the tent of meeting.

He made the court; for the south side the hangings of the court were of fine twisted linen, one hundred cubits long; 10 its twenty pillars and their twenty bases were of bronze, but the hooks of the pillars and their bands were of silver. 11 For the north side there were hangings one hundred cubits long; its twenty pillars and their twenty bases were of bronze, but the hooks of the pillars and their bands were of silver. 12 For the west side there were hangings fifty cubits long, with ten pillars and ten bases; the hooks of the pillars and their bands were of silver. 13 And for the front to the east, fifty cubits. 14 The hangings for one side of the gate were fifteen cubits, with three pillars and three bases. 15 And so for the other side; on each side of the gate of the court were hangings of fifteen cubits, with three pillars and three bases. 16 All the hangings around the court were of fine twisted linen. 17 The bases for the pillars were of bronze, but the hooks of the pillars and their bands were of silver; the overlaying of their capitals was also of silver, and all the pillars of the court were banded with silver. 18 The screen for the entrance to the court was embroidered with needlework in blue, purple, and crimson yarns and fine twisted linen. It was twenty cubits long and, along the width of it, five cubits high, corresponding to the hangings of the court. 19 There were four pillars; their four bases were of bronze, their hooks of silver, and the overlaying of their capitals and their bands of silver. 20 All the pegs for the tabernacle and for the court all around were of bronze.

21 These are the records of the tabernacle, the tabernacle of the covenant,[a] which were drawn up at the commandment of Moses, the work of the Levites being under the direction of Ithamar son of the priest Aaron. 22 Bezalel son of Uri son of Hur, of the tribe of Judah, made all that the Lord commanded Moses; 23 and with him was Oholiab son of Ahisamach, of the tribe of Dan, engraver, designer, and embroiderer in blue, purple, and crimson yarns, and in fine linen.
24 All the gold that was used for the work, in all the construction of the sanctuary, the gold from the offering, was twenty-nine talents and seven hundred thirty shekels, measured by the sanctuary shekel. 25 The silver from those of the congregation who were counted was one hundred talents and one thousand seven hundred seventy-five shekels, measured by the sanctuary shekel; 26 a beka a head (that is, half a shekel, measured by the sanctuary shekel), for everyone who was counted in the census, from twenty years old and upward, for six hundred three thousand, five hundred fifty men. 27 The hundred talents of silver were for casting the bases of the sanctuary, and the bases of the curtain; one hundred bases for the hundred talents, a talent for a base. 28 Of the thousand seven hundred seventy-five shekels he made hooks for the pillars, and overlaid their capitals and made bands for them. 29 The bronze that was contributed was seventy talents, and two thousand four hundred shekels; 30 with it he made the bases for the entrance of the tent of meeting, the bronze altar and the bronze grating for it and all the utensils of the altar, 31 the bases all around the court, and the bases of the gate of the court, all the pegs of the tabernacle, and all the pegs around the court.

Footnotes:

  1. Exodus 38:21 Or treaty, or testimony; Heb eduth



Friday, January 03, 2020

Bullet List

Too much going on for one post today.

1. Sock puppet?

We have a reader who is obsessed with his false conclusion that the commenter Don Quixote is actually my sock puppet. I ask you please to stop wasting your time and mine with this delusion. We do know each other, but we have seen each other once in the past 15 years or so. I live in Connecticut and he lives in the midwest, more than 1,000 miles away. Whatever I have to say, I am more than happy to say in my own name, and I do. BTW I am not known as Michael.

2. Mad King

Your Intertubes are all aflutter with speculation and discussion about the neurodegenerative disease many believe is affecting the Resident. Lapsed economist Duncan Black has perceived dementia for a long time, while wisely declining to offer a specific diagnosis. I take the same stance. I am not a neurologist, and even if I were and had the opportunity to examine the subject, it is actually not possible to definitively classify most forms of dementia except by autopsy. And autopsy is normally counterindicated in a living patient. So arguments about whether we are seeing Progressive Supranuclear Palsy or Primary Progressive Aphasia or whatever are feckless and a meaningless distraction.

However, diagnostic labeling aside, a few things are apparent. The observable symptoms began with disordered speech, and speech disorder continues to be the most prominent and apparent manifestation. This includes increasingly impoverished vocabulary, strange word substitutions (oranges for origins), repetitiveness, abrupt and clanging digressions, episodes of dissolving syntax and at the worst, word salad.

In addition to the obviously progressive aphasia, many people perceive declining motor skills. His gait seems lumbering and his gestures are increasingly awkward. He no longer gestures with his hands as he once did; rather his arms move in a characteristic accordion playing motion while his hands are rigid. He appears to be wearing some sort of a back brace which is visible under his jacket. His behavior is increasingly weird, as the sharpie incident attests. This all appears to be some form of frontotemporal dementia. The rate of progress is unpredictable but many actual experts have commented on the likelihood of dementia including psychiatrist Seth Norrholm, psychologist Jon Gartner, as well as journalists who have observed numerous disturbing incidents including Paul Waldman, and various others. I don't like to give any credit to the coward Anonymous but he's pretty clear that the Resident is losing his marbles. If this progresses much further he will no longer be presentable in public. We'll see if he's capable or reading the SOTU speech from the teleprompter soon enough.

3. War

I fear I may have to revive the Today in Iraq and Afghanistan blog, and add Iran to the title. I'll make my own comments brief right now; it's not clear how this will unfold. But let me refer you to some knowledgeable resources.

The Center for Middle East Policy at the Brookings Institution gets a lot of its funding from pro-Israeli sources and seldom offers criticism of Israel. Nevertheless I find that senior fellow Daniel Byman provides an informative perspective. It is true that that Quds force, headed by Maj. Gen. Qassem Suleimani who the U.S. assassinated this morning, has been responsible for many attacks on U.S. troops in Iraq, and that the Quds brigade provides assistance to various actors in the Middle East who the U.S. does not like. (Regarding the former, remember that the U.S. invaded Iraq in an illegal war of aggression and that the militias the Quds force assisted considered themselves to be acting in defense of their country. This is the point of view of many people in Iraq, including the Iranian-aligned militias and political leaders who continue to campaign for U.S. forces to leave.) Byman recognizes all this but makes the pragmatic argument that the U.S. action is likely to have severe adverse consequences and there does not seem to be any overarching strategy behind it. Juan Cole is equally, if not more worried. He sees this as a desperate attempt to change the subject from Trump's corruption and the ongoing impeachment action in Congress. He provides a lot of context and some international perspective.

Maybe I'll write about Australia tomorrow.

Thursday, January 02, 2020

Personal Responsibility

A fundamental assumption of libertarianism, and of ordinary conservatism, is that people's lot in life is generally deserved. Poor people, substance abusers, offenders -- they didn't work hard enough, they are moral failures, they don't love Jesus, whatever, it's their own fault. People who are economically and socially successful earned what they have. Social problems are individual problems -- if we try to help the unfortunate, we just enable their failings.

Back in the 1990s (while Bill Clinton was president) the CDC cosponsored a study with Kaiser-Permanente on what are called Adverse Childhood Experiences (ACE). Sure, we all have adverse experiences in childhood and right on through life. But it's a matter of degree. An official ACE doesn't mean you fell and broke your arm, or even that a bully stole your lunch money or your crush didn't like you back. ACEs are really traumatic experiences, such as witnessing or experiencing serious violence -- including being a victim of abuse -- having a family member attempt or complete suicide, and living in a family with mental illness or addiction. CDC offers a brief fact sheet here.

You might be surprised how common these are. More than 60% of people report having experienced at least one, and some 16% reported four or more. Here's the big point: these are strongly associated with problems in adulthood. To quote the CDC fact sheet:

ACEs can have lasting, negative effects on health, well-being, and opportunity. These experiences can increase the risks of injury, sexually transmitted infections, maternal and child health problems, teen pregnancy, involvement in sex trafficking, and a wide range of chronic diseases and leading causes of death such as cancer, diabetes, heart disease, and suicide.
ACEs and associated conditions, such as living in under-resourced or racially segregated neighborhoods, frequently moving, and experiencing food insecurity, can cause toxic stress (extended or prolonged stress). Toxic stress from ACEs can change brain development and affect such things as attention, decision-making, learning, and response to stress.
Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. These effects can also be passed on to their own children. Some children may face further exposure to toxic stress from historical and ongoing traumas due to systemic racism or the impacts of poverty resulting from limited educational and economic opportunities.
The associations are complex and multifarious -- they can't be neatly summarized. If you're interested you can find a bibliography here. But the point is, we don't make ourselves. Sure, some people overcome adversity, but they generally do it with a lot of help. The world is not naturally just. Our lot in life has a whole lot to do with the good or bad fortune of our childhood. And children are not at fault for what happens to them. We have to make justice, and that means taking affirmative action.