Tuesday, January 1, 2019

Brain Drain From Emigration of Medical Professionals May Be Imaginary

The UK at one time (and for all I know, maybe still) had a policy not to recruit aspiring physicians from the developing world to the UK's medical schools. Policy-makers thought that to do so would be to take the best and brightest from abroad and (selfishly) build human capital in the UK, immorally exacerbating the brain drain from already struggling countries - the assumption being that the newly-minted physicians would not return home to contribute to building their economy with their new skills. Sometimes true, yes, but it's worth pointing out that Dennis Mukwege, 2018's Nobel Peace Prize recipient (who is Congolese) got his obstetrics training in France, and was recognized for his surgeries to repair or save women raped by the military. It's a good thing France does not have such a policy, or those women would have been disabled or killed by their traumas.

It should also be mentioned that if YOU are an aspiring physician in a developing world country who wanted to pursue your career, and you have your sights set on a British medical school but you're rejected because you're from a developing country - this might not seem to be the most moral choice.

So a recent study of emigration of skilled medical professionals (nurses) from the Philippines is a useful contribution to this discussion. To be clear, these are nurses trained in the Philippines who then leave the country to work in the USA - an even "worse" brain drain than what the UK policy aimed to prevent - so if there is no problem here, there wouldn't be a problem with developing-world physicians getting trained in the UK. What did they find?

"...we show that enrollment and graduation in nursing programs increased in response to demand from abroad for nurses. For each new nurse that moved abroad, approximately two more individuals with nursing degrees graduated. The supply of nursing programs increased to accommodate this. New nurses appear to have switched from other degree types. Nurse migration had no impact on either infant or maternal mortality."

This is damning for the UK's policy, because it strongly suggests that all they were doing was discriminating against the developing world's applicants, without helping the developing world's economy. Whether this new information affects the policy is another question - if appearing to your countrymen as if you care is more important than actually helping the people you say you care about, then nothing will change.

Original paper here - Abarcar P and Theoharides C., "The International Migration of Healthcare Professionals and the Supply of Educated Individuals Left Behind." H/T Marginal Revolution.

Thursday, September 20, 2018

Happiness by State in the US, 2018

A study done by Wallethub (their image below) using their own 31-factor happiness index shows the Bad Stripe, along with a few other interesting patterns.

1) The Bad Stripe (West Virgina, Kentucky and Tennessee, Missouri, Arkansas, and Oklahoma) is evident as a negative outlier as usual. These make up 6 of the bottom 11. For fans of Albion's Seed, this is where the Reavers are, i.e. Greater Appalachia. This also shows the limitation of a state-level analysis. There is significant structure within the states. Pennsylvania's southwest if taken separately would very likely look like West Virginia. The southeast if taken separately would be much more like New York and New Jersey. Same thing for Missouri - the northern part of the state is likely more like the Upper Midwest, and the southern part is the Ozarks, part of the Bad Stripe and more like Arkansas.

2) The Upper Midwest and Utah stand out as positive outliers, as usual. Moynihan's Law - is it the result of Yankee settlers (again Albion's Seed), non-British Isles North European immigrants, or some combination? (Map below from Wiki on German Ancestry in the USA and Canada.)

3) Very interesting that two demographically similar states like the Carolinas could be so different in this rating. North Carolina has done better economically than South Carolina, and culturally does tend to move in sync with Virgina (perhaps most famously in the 2008 presidential election predicted by Nate Silver) - which makes sense because South Carolina was largely settled from Georgia initially, and North Carolina from Virginia. Still, they're not THAT different, and they have a very different happiness outcome.

4) I can't argue for similar historical links to the Reavers for Mississippi, Alabama and Louisiana, who as always fare very poorly. You'll have to develop your own theory for that!

Saturday, September 1, 2018

Patterns that Emerge In Both Social Conservatives and Social Leftists

The American left is beginning to curiously resemble the right - not in its positions, but in dynamics and behavior. I can't quite say "mirror" unless we're talking about a tinted fun-house mirror, because it's not the specific concrete positions of the left that resemble those of social conservatives, but rather the social dynamics and patterns of the discussions about these concrete positions that are becoming so bizarrely similar. I use "social leftist" rather than liberal or social liberal because a clear division has emerged. What I mean by this term is a group of American progressives more focused on race and gender issues than the average liberal, active and strident on social media, and demanding removal of platforms and free speech protections for political opponents. Conservatives have traditionally been divided among social, nationalist and economic conservatives ("God, country and market") and the cracks inside the GOP show these tectonic segments. The Democratic party of the late twentieth century was more divided among identity politics lines (which we're now paying for; more on this in a second) but the Dems are not immune to the realignments in American politics either, and what's emerging is something I think very like the traditional divisions within the GOP. And what's more, these divisions mirror the old GOP fault lines, for reasons of basic psychology, and similar dynamics emerge.

For the past one or two decades there has been a growing awareness that each person's political positions are strongly influenced - maybe even dominated - by our temperament. This is in turn determined by genetics (yes, really) and our early life experiences and cultural programming, none of which is within our conscious control. This is actually quite a depressing reality since in a democracy, we hope that we can change our minds about politics based on reasoning about new information, as opposed to psychotherapy or genetic engineering. The psychologist Jonathan Haidt founded the field of moral foundations theory, showing that all humans base their moral sense on five dimensions - care/harm, sanctity/purity, authority/respect, loyalty, and fairness. Only a truly disordered or feral mind ignores any of them completely. Where we differ is in the importance we assign to each. Not only do humans differ significantly, we tend to fall into clusters. Given the nature of those moral dimensions, you can already imagine how this might sort us politically, and indeed there are clear differences in which of those dimensions liberals and conservatives value.[1] This is why you can travel to other countries with open political systems and instinctively figure out who the conservatives and liberals are by talking to or seeing the kinds of people in each party, although the concrete coalitions on-the-ground that make political engines run in the real world can mask this from time to time.[2]

And this is what's so interesting about the social left, because it's diverging from "traditional" American liberals in its emphasis on certain values that historically have been conspicuously unimportant to American liberals. What follows is an analysis of the social left's behavior and what this tells us about those emerging value differences, an explanation of the concrete moving parts in the psychology of social leftists, and a demonstration of the parallels to social conservatives.

1) Social conservatives and the social left tend to take positions that resemble tribal affiliations or identity, and any effort to reason coolly about them meets with outrage. Social conservatives and the social left seem to think that if (people stopped having casual sex and abortions, or the white power structure was destroyed) that suddenly all the world's problems would be solved, and are quite offended when asked to objectively, quantitatively measure the harms that these claimed evils are causing. People in the social arm of both ends of the spectrum tend to be much more insular and extreme. Interestingly, libertarians have a much easier time getting along with more economic leftists and rightists alike. This may be what it necessarily looks like when people on right and left confuse politics with uncompromise-able cultural and/or moral values, and I suspect that it's the tribal identity and in-group thinking this engenders that explains why the social arms of political affiliations demonstrate these patterns. That this would emerge in the social left is not surprising given the ongoing focus on the left on identity politics, so that now these political affiliations are associated with ethnicity and unfortunately even more set in stone, but now that here is unfortunately a white identity politics on the social right, the parallels are striking.[3]

2) While both conservatives and liberals value the care/harm value foundation, it's much more important to liberals and much more abstract, and this is exaggerated on the social left. That is, conservatives focus on active harm done to one's concrete in-group, especially family; for liberals, it can be mere absence of caring for other humans that you've never met. In fact not actively caring for certain people is constantly conflated with actively harming them. Witness the meme virtue signaling, "If you can't understand why you should care about other people, you're beyond help", usually with a conservative response having to do with neglecting one's concrete in-group peers "maybe you should take care of your kids first", etc. Many conservatives and libertarians are at best puzzled by the liberal fixation with others having a right to be cared about, and sometimes outraged at the presumptuous demand to care about strangers this places on them. The social left in particular demonizes not caring enough, and the care should be self-sacrificial of any claim to morality or authority if the obligated carer is far enough below the care-ee in the victim hierarchy.

3) The social left's extreme focus on the harm/care foundation is reinforced by the use of outrage as moral currency, and in this closely imitates social conservatives. That is, the public profession of negative affect as a sign that one has the right values, has them so much a part of their identity that threatening them causes such a strong reaction, and that this reaction will motivate the person to work in service to the tribe. Negative affect also includes sadness but sadness is a weakening emotion, and if you're using this for a status display to appear high-status to others in the tribe, negative affect mostly has to be anger.

4) A result of outrage as moral currency and well-spring of status is that any attempt by an outgroup to decrease the outrage, even by apologizing and reversing exactly the act/position/statement that incurred the outrage to begin with, will meet with even greater outrage. An outsider trying to decrease anger is profoundly threatening, because they're essentially shutting off the status-ATM that the outraged person is getting rich from. This is why apologies to either the social right or especially social left are inadvisable, because they don't ever work - in fact they cannot.

5) Among social conservatives, the outrage factory's fuel is threat to authority and sanctity, which are not as important to traditional liberals, but are important to social leftists. "Normal" liberals can get angry when conservatives don't care enough, but they don't typically appeal to personal authority or the sanctity of an abstract entity, whether it's a group of people or a symbol.[4] Point out an inconsistency in the Bible to an American social conservative, and you know what will happen. But the same will happen if you do the same with Marx or Linda Sarsour to a social leftist. (Try to quote them in support of your position and the reaction may be even worse - see #9 below.) The "victimhood hierarcy" and the groups of people in it (the groups - not the individuals, but the abstract groups) are all-important to the social left as sacred. To the social left, none of the very real historical tragedies can ever be truly corrected and to suggest concrete policies that might actually do that produce explosions of outrage. This seems strange because you might think you're addressing this person's concerns, but really what you're doing is trying to dissolve the central sacred object. Imagine you invent a time machine and go to the Pope, offering to go back and stop the crucifiction of his beloved savior from taking place. His reaction won't be an immediate "yes", will it? So another way of putting this: smart-ass atheists that point out to Christians that they should be thankful to Pontius Pilate for facilitating Christ's sacrifice get the same reaction as traditional liberals who suggest to the social left that Policy X may actually really-and-truly correct the impact of slavery and racism on African-Americans. I suspect that there is a feedback loop once any group (political or otherwise) begins to see itself as a tribe, as a group per se, and separate itself from outsiders, that induces a focus on and strengthening of authorities and sacred objects. (As opposed to a bête noire, we might call those authorities and sacred entities "white beasts". The negative connotation of the term and the parallelism with objects of scorn makes it better than "sacred cow.") One interesting difference between the two tribes is that often, social conservatives are open to pointing out that things are off-limits, that they're flat out not interested in seeing if reason supports their positions, etc. The social left has to do a lot more rhetorical fluorishes to support their own authoritarianism, because it's important to tribal identity that they are not authoritarian, and don't you dare question that or there will be consequences!

6) Just pointing out the inviolability of authority or sanctity of the white beasts of social rightists or leftists raises blood pressure, because it draws attention to their unquestionability and implies that it's possible for these things NOT to have authority or be sacred. ("I'm not disagreeing, just trying to understand. So this cracker actually IS the body of your god?" "Wait, why do black trans women have it worse than white gay men?") Many on the social left argue that some people are just so far outside the victim hierarchy that they can never really be considered to be oppressed, and if you suggest otherwise or keep asking questions, it's because you're morally bad. E.g., point out that maybe a broke single mother of four in Appalachia with a tenth-grade education is oppressed in some ways, and you'll be called a racist, and told of course you believe that because you're white (or male, or straight, whatever.) Here you are, a heathen, telling a Christian "Come on guys, actually getting crucified doesn't hurt THAT bad, and anyway the gospels aren't really that well-written." Again, this is the social left's reaction. Traditional liberals might disagree with you on something, but are likely to try to explain it instead of telling you that you're a dirty sinner and to shut up.

7) The social left's demand for censorship of dissenting voices over the past few years (both defectors and traditional opponents) is another sign of the appeal to authority previously unusual among traditional liberals. And consistent with the theory, the argument is that free speech on the right harms the most valuable people in the sacred victim hierarchy. So far the main authority where they'e been able to exert influence is universities. This is probably the behavior that contrasts the most with traditional liberal temperament and not surprisingly troubles traditional liberals the most. (And outraged social leftists - if you've gotten this far in the post, it's worth pointing out that when free speech does get restricted, it's never an intellectual or artist who's enforcing it based on just principles - see: Trotsky vs Stalin - it's the local J. Edgar Hoover or Donald Trump, deciding what offends his personal authority and taste. By demanding a roll-back of speech freedoms you're giving Trump what he wants - if not tomorrow, then next week.)

8) Outrage-as-status-currency makes it very hard for social leftists or rightists to "come in from the cold". They're only as good as their last expression of angry moral contempt. If they stop doing this, they become turncoats to the movement, inauthentic people willing to actually engage with the other side and get moral cooties. Think of a rebel leader who might not really want the civil war in his country to end, because his skillset is limited to organizing violence, and does not include drafting constitutions or getting elected to public office. (Think of the absurdity - someone who started out fighting to get rid of the old guard, but because of their entrenched interests, doesn't really want the fight to end.) Turncoats are often met with more anger and derision than those who've been in the outgroup the whole time.

9) Among tribal thinkers including social conservatives and leftists, beliefs usually serve more importantly as markers of tribal loyalty than as tools to make decisions (and "decision" in politics means policy.) Even though a social leftist or conservative might say with desperate passion that they wish the government would do X - goodness forbid that a political opponent actually does X! Although a rational person would say "Good, I'm glad we got through to somebody - even though I disagree with the other side on everything else, at least they did something right and we're moving forward on this one thing." But that's not what happens is it? No, the appropriation of a sacred value is also profoundly threatening to the moral authority of tribalist thinking. At first the outrage is that the enemy says they will do X, but (so the outraged parties claim) the enemy won't really do it - or is doing it for the wrong reasons (so what?) And then, when X actually does come to pass, strangely the tribalists aren't so interested in talking about it anymore. Witness the inexplicable anger from the left at Obama's switch to supporting marriage equality, or the irrational grumbling from the right at Bill Clinton's embrace of certain business-friendly practices. And I understand the tendency. (A self-disclosure gives a current example - Trump is the worst president we've ever had and the sooner he's gone, the better. But his administration just proposed decreasing business tax reporting from quarterly to semi-annually. I have to admit this isn't a bad idea. And yet I still feel the urge to say that he's probably just saying it and won't really put it through, that the idea probably didn't come from him, or if it did he probably has some personal tax angle on it, etc. - but it's still a good idea.)

10) It's useful to notice the specific kinds of people who've served as canaries in the political coal mine who have first noticed the curious behavior of social leftists, relative to traditional liberals - especially when the canaries are actually social leftists themselves! These people are a) little-l libertarians (who argue with their traditional liberal friends about economics but are usually on board with social issues), b) atheists (the majority of whom are at least socially liberal) and c) traditional centrist liberals. Centrist liberals are low on the authority and sanctity dimensions, as are atheists; the censorship and inability to question social leftists in good faith troubles them (even centrist-liberal Obama addressed this while he was in office.) Little-l libertarians are in addition low on the care dimension, and they resent being told who they have to help (which costs money); unlike many conservatives, libertarians have no problem with marriage equality for example, but being told they have to use certain pronouns and can't ask why certainly rubs them the wrong way. And these groups of people are increasingly pointing out the uncomfortable disconnects in social leftists' viewpoints, which of course social leftists will not explore or tolerate having questioned or pointed out. Chiefly among them is the double-standard where Christians (you would think, according to the leftists are the only oppressors of women and LGBTQ people) which puts social leftists in the bizarre position of defending the most oppressive backward and medieval religion in the world (amazingly, atheists who criticize Islam become oppressor imperialists in this narrative.) Another example which is gaining traction is the discrimination by elite colleges against Asian applicants, uncomfortable to social leftists for several reasons. First, the university is the leftists' natural home and the one place where they actually do exert any authority. Second, that there ARE elite universities which perpetuate class divisions in fact more effectively than the business world or even the racially well-integrated armed forces is not a welcome topic of inquiry. And third, that there exists an ethnic minority with its own history of institutionalized oppression (Asian-Americans) who have nonetheless succeeded superlatively in the U.S. - in fact, moreso economically than whites! - cannot be acknowledged without threatening the whole edifice, along with the fact that universities are now unique among American institutions in stating openly that they discriminate against non-whites in admissions.

Unfortunately for the authoritarians of the right or left, their white beasts are in fact quite open to discussion, no matter how offended they might get.[5] People on the left, in terms of organization their people around strong central authority, often sigh and make comments about herding cats. That lack of unity is core to the psychology of people drawn to the left and has always been the left's main obstacle to power, and I suspect that this newfound authoritarianism on the social left is too unstable to last very long.


[1] There are also temperament differences between liberals and conservatives, related to the moral foundations; for example, conservatives tend to be more anxious, which could be argued is related to the conservative feature of considering authority more important. Autonomy is nice but if you're constantly under threat, you give some away to a strong protector.

[2] There may be an argument that bizarre coalitions make for less bitter politics. From the Civil War until Nixon's Southern strategy turned the blue South red, the U.S. actually had quite an odd coalition in each of its parties. The Democrats had Northern ethnic-minority labor unions and conservative Southerners (still amazingly enough voting with the unions out of spite at Abraham Lincoln.) The Republican party had Northern business and Southern minorities. This could only have lasted as long as it did in a two-party system, but Nixon recognized the fundamental mismatch that this accident of history had produced, especially obvious after the Johnson-Goldwater inversion of the electoral map in 1964. Since the Southern strategy our map in the East has looked much more like a Civil War map and the rest is an urban-rural divide and the tone of our politics has changed for the worse since then, because the parties identify more closely with immutable sociodemographic categories.

[3] You might ask, if identity politics was an earlier central influence on the left than the right, why the social left didn't emerge first. I think it has to do with access to public platforms. Before the internet era, right-wing white Christians, aligned as they were the business establishment, had more cash and therefore easier access to platforms than the left, which was relegated to a few magazines circulating in particular communities. That is to say, blame the internet. Today the right has both FOX and a lot of people on Twitter, while the left is still mostly online (MSNBC is not remotely the FOX of the left and is in any event a recent arrival.)

[4] Authority is about valuing without question, bargaining, or deliberate interpretation the word of a human. Sanctity is about doing the same for an abstract entity, which could be a symbolic physical object (e.g. the flag) or a people (e.g. the LGBTQ community.) As a result of this observation, I would bet that these two are the most closely related pair out of all possible pairs in his system.

[5] The rhetorical hostility of outrage-driven movements is easily hacked. In the same way that being the first to question a social conservative's conservative credentials will initially outrage then cow them (you can explain that you brought it up first because you're the real conservative, and now the other person is trying to explain, just like a mealy-mouthed liberal would!), when talking to a social leftist, always call them a racist immediately in the debate. They'll try to argue they're not, just like a racist would! Try it, it actually works - and in so doing, you'll be eroding the tactic's usefulness.

Thursday, August 2, 2018

Dry Counties - Roughly Track the Bad Stripe

Above, map of dry counties in the US (Wiki.) Compare to one of many Bad Stripe maps, a map of Well-Being, below. This stripe pops out on various maps as a coherent region of the US ("Greater Appalachia") with various unique cultural characteristics and poor human development characteristics, here.

How America Uses Its Land

Full map with all use-types here.

Sunday, July 22, 2018

Our Future: Trading Reliability for Power

I've often heard people 40+ grumble in the following way about modern communication technology: "Yeah email and text and voicemail and all that are great. But in 1982, you called a number, and either the person answered, or they didn't. There was no 'Oh your text got buried,' 'It must've gone into my spam folder,' et cetera." (All the more annoying because they're all plausible excuses.) Having all these technologies makes our reach much greater, but ironically, much less reliable.

If you're not sure this is such a great trade, it's worth thinking about, because something similar is increasingly happening with public services. Startups are replacing a lot of the services that local government typically provides in the U.S. - e.g., information reporting for state governments (traffic light is out at Third and Grant), DMV appointments, metro bus routes, trash collection, etc. Yes, sometimes those services are already spotty. The concern is that with, say, trash collection, barring gross dereliction of duty, I know the majority of days they'll get my trash, I know who to call if they miss it, and I know next week and next month and next year it'll be my city that's doing it. In a truly efficient market, there's no guarantee that if Startup A is doing it this week that they'll be doing it next year - yes, Startup B might replace them because it's doing a better job, but with that marginal improvement comes a whole lot of friction - a new schedule, new rules to learn, etc. This is a cost which, in making this trade, I don't think is adequately appreciated. It's already enough of a pain that you have certain friends eat up your bandwidth remembering which media platform is the one the check regularly. Expand this to other domains in life, and pretty soon all you're doing is keeping lists, which change constantly.

The analogy: you have to choose between being Clark Kent who can bench a respectable 400 lbs any day of the week, vs Superman. The catch is that 20% of the time Superman is sick in bed with kryptonite flu and you never know when that will be, and the medicine for kryptonite flu is constantly sold at different pharmacies and his health insurance changes unpredictably.

Saturday, July 21, 2018

Low Rainfall Predicts Assassination of Roman Emperors

Paper here, from Christian and Elbourne in Economics Letters, H/T Marginal Revolution. Nice to see a rigorous quantitative paper show the association, although it's not surprising - a simple model of Roman political history is that since there was no formal succession rule, the Emperor had to keep the army satisfied through pay and morale (successful conquest.) Low rainfall leads to starving troops in the provinces leads to a desire for a new emperor and assassination.

Interestingly enough, in 2010 Haber and Menaldo showed that democracies cluster in areas of moderate rainfall, and autocracies cluster in deserts, semi-arid areas, and the tropics. If we assume stability produces a tendency toward democracy, this is consistent with ancient Rome's experience. After all, much of Rome's territory was semi-arid areas.