Posts Tagged ‘Affordable Care Act’

Socrates and the Dunning-Kruger Effect

November 21, 2017

Socrates asked, “How is not this the most reprehensible ignorance, to think that one knows what one does not know?”

There are two parts to the Dunning-Kruger effect.  The first refers to the cognitive bias in which relatively unskilled persons suffer illusory superiority.  The second part refers to a cognitive bias for highly skilled individuals to underestimate the relative competence of unskilled individuals and assume that tasks which are easy for them are also easy for others.

So people who truly know a topic are aware of what they don’t know. But people who think they know a topic can be woefully ignorant of what they don’t know. So knowledgeable people typically qualify there answers. This was the problem President Truman had with economists. They would tell him on one hand there was x, but on the other hand there was y. Truman asked for one-handed economists. It is hoped that he never found one.

There is reason to think that the Dunning-Kruger effect has been magnified in this current era of technology. Life has become an open-book test. All one has to do is to look something up. But true knowledge requires thinking, and thinking takes time and effort. It is not analogous to downloading a file from the computer.

One of the best examples was the response a woman, who was wearing her technology and was well-plugged in to the question of what she thought about Obamacare. She responded that it was terrible and should be repealed. However, when she was asked about the Affordable Care Act, she thought it was wonderful. She did not caveat either response.

First of all, we need to be aware of faux news. So we need to evaluate the source and soundness of everything we see or hear. We should also consider other information that either supports or refutes the new information.

But even for topics we think we know, we need to explore the other side and follow not only the reasoning, but also data. In the case of governments offering health care to all its citizens, every other advanced country does so, and they do so with single payer government systems. Moreover, their medical systems are not only more effective, they are also significantly cheaper. This seems to be a glaring source of ignorance in the United States.

Readers might also consider reading or rereading the healthy memory blog post “Ignorance.”

© Douglas Griffith and healthymemory.wordpress.com, 2017. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

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Thinking About Politics

July 11, 2017

This is the ninth post in the series The Knowledge Illusion: Why We Never Think Alone (Unabridged), written by Steven Sloman and Phillip Fernbach. Thinking About Politics is a chapter in this book.

HM remembers when the Affordable Care Act was being debated, a woman was asked what she thought about it. She remarked that she was strongly in favor of it. However, when she was asked about Obamacare, she said that she was strongly against it. Such is the state of politics in the United States. A survey by the Kaiser Family Foundation in April 2013, found that more than 40% of Americans were not even aware that the Affordable Care Act was Law (12% thought it had been repealed by Congress—it hadn’t.)

Drs. Sloman and Fernbach write that public opinion is more extreme than people’s understanding justifies. Americans who most strongly justified military intervention in the Ukraine in 2014 were the ones least able to identify Ukraine’s location on a map. A survey out of Oklahoma State University’s Department of Agricultural Economics asked consumers whether the labeling of foods produced with genetic engineering should be mandatory. 80% of the respondents thought that it should. But 80% also approved of a law stating that there should be mandatory labels on foods containing DNA. They believe that people have the right to know if their food has DNA. So these respondents thought that all meats, vegetables, and grains should be labeled “BEWARE HAS DNA.” But we would all die if we avoided foods that contain DNA.

We all need to appreciate how little we understand. The authors write, “Taken to its extreme, the failure to appreciate how little we understand combined with community support, can ignite really dangerous mechanisms. You don’t have to know much history to know how societies can become caldrons in an attempt to create a uniform ideology, boiling away independent thinking and political opposition through propaganda and terror. Socrates died because of a desire for ancient Athenians to rid themselves of contaminated thinking. So did Jesus at the hands of the Romans. This is why the first crusades were launched to free Jerusalem of the infidel, and why the Spanish Inquisition drove Jews and Muslims to convert to Christianity or leave Spain between 1492 and 1501. The twentieth century was shaped by the demons of ideological purity, from Stalin’s purges, executions, and mass killings to Mao’s Great Leap Forward: the herding of millions of people into agricultural communes and industrial working groups, with the result than many starved. And we haven’t even mentioned the incarcerations and death camps of Nazi Germany.”

The authors write, “Proponents of political positions often cast policies that most people see as consequentialist in values-based terms in order to hide their ignorance, prevent moderation of opinion, and block compromise. They note the health care debate as a perfect example of this. Most people just want the best health care for the most people at the most affordable price. This is what the national conversation should be about how to achieve this. But this might be technical and boring. So politicians and interest groups make it about sacred values. One side asks whether the government should be making decisions about our health care, focusing the audience on the importance of limited government. The other side asks whether everybody in the country deserves decent health care, focusing on the value of generosity and preventing harm to others. The authors say that both sides are missing the point. All of us should have similar values: we want to be healthy, we want others to be healthy, and we want doctors and other medical professionals to be compensated, but we don’t want to pay too much. The health care debate should not be about basic values, because in most people’s minds basic values are not the issue. The issue is the best way to achieve the best outcomes.

Ideologies and ideologues are the bane of effective government. They constrain alternatives and blind us to obvious solutions. As mentioned in the second post in this series, other advanced countries have effectively addressed the problem of healthy care with a single payer system in which that single payer is the government. There are already proven examples from which to choose. But in the United States, ideology has deemphasized the role of government, and the single payer system is regarded as a radical solution.

© Douglas Griffith and healthymemory.wordpress.com, 2017. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

 

The Knowledge Illusion: Why We Never Think Alone (Unabridged) 2

July 2, 2017

If you have not read the immediately preceding post, please scroll down and read it. The immediate post presents HM’s thoughts about how the need to use knowledge from fellow humans fails. A good example of this can be found in the current debates about the Affordable Care Act and its replacement. Although the Affordable Care Act is flawed, information from fellow humans who have successfully dealt with this problem is being ignored.

The United States has the most expensive healthcare costs in the world, but results characteristic of a third world country. And it is the only advanced country that does not have a single payer system in which the single payer is the government. This progression did not happen all at once. It began in England after WW II and variants of it were gradually adopted over time by advanced countries with the notable exception of the United States.

How can this be explained? It can be explained most simply in one word, “beliefs.” In this case, the belief in free markets. Free markets are good, but what is frequently forgotten is that free markets do not remain free, they are manipulated and require government intervention to disrupt the development of monopolies. Moreover, free markets are not universally applicable. Economists have effectively argued that free markets are not appropriate for medical care.

However, even if one believed in the viability of free markets for medical care, how can they ignore the success of single payer systems in the developed world? The problem is that beliefs stymy new and creative thinking and using knowledge from knowledgeable people. New beliefs require thinking and thinking requires mental effort, which many people find uncomfortable.

Then there is the faux “Fair and Balanced” news. When the Affordable Care Act was being proposed, “Fair and Balanced” news featured an English Woman who had a complaint about a surgical procedure she had undergone. This woman was livid about this presentation on “Fair and Balanced” news. Although she had complaints about this one procedure, she was highly enthusiastic about the national health system in Britain. Moreover, none of the countries who have adopted a single payer system in which the single payer is the government have abandoned these programs. It should be noted that in the United States Medicare is a single payer system that works quite well. However, Medicare covers only a certain percentage of costs, so supplemental insurance is prudent.

So beliefs can thwart change and innovation. But not all beliefs are necessarily bad. Consider religion, particularly religions for which the medical suffering of fellow human beings is important. One would think that in the United States where such religious beliefs are widespread, medical care would be among the best, not the worst. What apparently happens here is compartmentalization. These religious beliefs are thwarted by beliefs about government and the supremacy of market forces. The result of this compartmentalization is that the health and finances of fellow citizens suffer.

© Douglas Griffith and healthymemory.wordpress.com, 2017. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Inside Knowledge: What Separates Fact from Belief

April 3, 2017

The title of this post is identical to an article by Richard Webb in the Features Section of the 1 Apr 2017 New Scientist.  HM answers this question by saying that it is the degree of belief.  Research has indicated that absent any indications to the contrary when we hear or see a fact, the default is to believe it.  When supposed facts are heard or read that do not correspond to the individual’s belief system, a noticeable signal is recorded in the brain.  This indicates that System 2 thinking has been invoked and this fact will either be rejected or postponed until further information and thinking can be performed.  Kahneman terms System 1 intuition and System 2 reasoning.  System 1 is fast, that’s why it’s the default processing system.  System 2 is slow and requires further thinking.  System 2 is supposed to protect us from false beliefs.  At the turn of he 20th century there were many physical scientists who believed that practically everything that needed to be known about the physical sciences was known.  All that was needed was to add some more decimal places of precisions.  Just five years later Albert Einstein published his Special Theory of Relativity.  Beliefs should always be subject to change and should never reach certainty.

Technology has developed at such an alarming rate that there are an enormous number of facts to evaluate.  All of science, both physical and social, is producing facts that lay people do not have the knowledge to evaluate. Moreover, there is a business of deliberately publishing false facts (See the healthy memory blog post, “Lies, Incorporated.”)

The remainder of this post is motivated by the box titled “Where Knowledge Comes From”  at the bottom of the article.  One way of classifying knowledge is by how we acquire it.

Perceptual knowledge comes from our senses but involves significant processing by our brains.  Basically the brain builds models of the world using this information, but it must be appreciated that we do not have direct knowledge of the world.  The truth is that we infer it, and this knowledge changes as information grows.  Everyone should be familiar with perceptual illusions, in which the psychological interpretation does not agree with the physical representation.

Testimonial knowledge comes from other people and media.  Here belief should largely hinge on the source of the information.  Different sources have different biases, as these biases must be taken into consideration.  The credentials of the sources are of primary importance.  Whether there is scientific evidence for the facts is especially important.  Sources that contradict scientific data must be evaluated with skepticism.

Our inner sense, the awareness of our own feelings and states, such as pain and hunger would appear to be highly credible, but some times we are out of touch with our senses.  Beliefs can actually greatly deaden pain in many cases.  Enter “placebos”  into the search block of the healthy memory blog.  (Enter “placebos” into the search block of the healthy memory blog to learn more about their effectiveness)

Inferential knowledge goes beyond actual facts in assessing the credibility of facts, and in making inferences about facts.  Critical thinking is key here.

Beliefs can blind us to facts.  A good example of this is the problem of health care in the United States.  Health care in the United States is the most expensive in the world, yet health statistics in the United States approach those in the third world.  Every advanced country in the world has a national system of health care except the United States.  The reason for this is that the Republican party sees government as the problem and not the solution to health care.  But all other advanced countries have successful health care systems in which the governments play a central part.  The affordable health care act, frequently referred to as Obamacare, used the government to increase access to health care.  It was a small effort that fell far short of Obama’s goals.  Trump promised that Trumpcare would be much better than Obamacare.  Had he formulated an improvement over the affordable care act, it would have been welcome.  However, the plan that was formulated was woefully short of the Affordable Care Act, and was defeated.

Republicans trumpet the value of market forces in health care.  But back in 1963 Nobel Prize winning economist Kenneth Arrow offered an explanation as to why markets do not work well in health care.  There is a huge mismatch of power information between the buyer and seller.  For example, if a salesman tells us to buy a particular television, we can easily choose another or just walk away.  However, if a doctor insists we need a medication or procedure, we are far less likely to reject the advice.  Arrow also noted that people don’t think they don’t need health care until they get sick, and then they need lots of it.

Beliefs are frequently compartmentalized and this has adverse effects on inferential knowledge.  Here again the Republican Party and healthcare provide a good example.  It should be understood that both parties have religious beliefs, but Republicans are especially strong in their beliefs which center on loving our neighbors, and caring for the needy and sick.  Yet compartmentalization of the Republican beliefs about the role of government blocked addressing religious beliefs about caring for the sick  with the result of increased unnecessary suffering among their fellow human beings

Beliefs are necessary, but they should never be absolute.  They are dangerous in that they can foreclose meaningful solutions to critical problems.  And they can hinder effective inferential knowledge.  A useful exercise is occasionally to try to ignore one’s beliefs and explore the ramifications of ignoring those beliefs.

© Douglas Griffith and healthymemory.wordpress.com, 2017. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Lies, Incorporated

January 18, 2017

Lies, Incorporated is the title of a book by Ari-Havt and Media Matters for America.  This book is so thoroughly researched that it could not have been done by one individual, consequently the research of Media Matters for America is key.  The sub-title of this book is “The World of Post-Truth Politics.”  An earlier healthymemory blog post titled “Did Corporate PR Initiate the Post-Fact Era” discussed the beginning of the post-fact era by discussing the false scientific effort to document that smoking was safe.  That post also including the false scientific effort to argue against global warming.  “Lies Incorporated” elaborates on these topics and then has chapters titled “Lie Panel:  Health Care,”  “Growth in a Time of Lies:  Debt,” “On the Border of Truth:  Immigration Reform,” “Two Dangerous Weapons:  Guns and Lies,”  “One Lie, One Vote:  Voter I.D. Laws,” “Shut That Whole Lie Down:  Abortion,”  “A Lie’s Last Gasp:  Gay Marriage.”

The book begins with the statement, “Richard Berman is a Liar.”  He relished the title of “Dr. Evil” and develops the nastiest PR campaigns to undermine and discredit truth.  Berman’s motivation appears to be one of money.  He’ll sell himself to the highest bidder.  For others, the motivation is one of convenience.  If you are in the petroleum business, global warming is indeed an “inconvenient truth.”  HM admittedly chooses to ignore the true dietary guidance his wife offers because it is an “inconvenient truth.”  But many are simply ideologues.  They know what they believe and force facts into those ideologies by ignoring genuine facts and generate their version of facts.   This is termed “motivated reasoning.”  The criteria of truth is ignored.

Perhaps the most blatant example is provided by the “Death Panel Lie” generated to defeat the Affordable Care Act.  In June 2014 “The Washington Post” reported the story of a woman and her husband who were employed but receiving no benefits and would rather pay a penalty for being uninsured than participate in Obamacare.  They were afraid of the discredited notion of “Death Panels” and were paying serious out-of-pocket medical costs stemming from chronic conditions.  These people were not alone.  A November 2014 Gallup Poll found that 35% of uninsured Americans would rather pay the fine prescribed by law than receive health insurance.  There were people who said that they did not want government involvement, but that hands should be kept off their Medicare.  This, in part, explains why the United States has the most expensive medical costs with the results of a third world country.  It leads one to think that if there were a Stupidity Olympics, the United States might well dominate the competition.

One of the most disturbing realizations was that there are people with degrees who are dominated by their ideologies and should know better.  Perhaps this is not surprising as there were scientists who were fascists and supported totalitarian regimes with vigor.

The following two paragraphs are taken directly from the text.  “The purveyors of misinformation have a built-in advantage.  Lies are socially sticky, and even after one has been thoroughly debunked, it will still have advocates among those whose worldview it justifies.  These zombie lies continue to rise from the dead again and again, impacting political debate and swaying public opinion on a variety of issues.
Misinformation is damaging to those who read and absorb it.  Once a lie—no matter how outrageous—is part of the consciousness of a particular group, it is nearly impossible to eliminate, and like a virus it spreads uncontrollably within the affected communities.”  Richard Berman explained to energy executives that once you “solidify [a] position,” in a person’s mind, regardless of the truth, you have “achieved something the other side cannot overcome because it’s very tough to break common knowledge.  That “common knowledge” is repeated on radio, television, in print, and at the water cooler.  With each new citation, the lie becomes more entrenched.”

It is commonly known that certain politicians use “code words” to disguise racist statements.  HM found it interesting that in this book the author of these words was Lee Atwater, who was a former chairman of the Republican National Committee who helped elect Ronald Reagan and George H.W. Bush.  Here’s Atwater’s explanation of the delicate balance the Republican Party must play when using racially tinged issues to win election without appearing outwardly racist—by “getting abstract” when talking about race:
“You start out in 1954 by saying, “n——-, , n——-, n——-.”  By 1968 you can’t say
n——-, that hurts you, backfires.  So you stay stuff like forced busing, states’ rights, and all that stuff.  And you’re getting so abstract now that you’re talking about cutting taxes, and all these things you’re talking  are totally economic things and a byproduct of them is, blacks get hurt worst than whites.  And subconsciously maybe that is part of it.  It is getting that abstract, and that coded, then we’re doing away with the racial problem one way or the other.”

So what can be done about this political cesspool?  Be aware and do not allow yourself to be pulled in.  Finding the truth has been made more difficult, but we must all persevere.  Availing ourselves of such sites as factcheck.org, politifact.com,
https://thinkprogress.org, and http://mediamatters.org.