Evolution of a New Atheist

Evolution of a New Atheist

Recent events in global politics seem to have brought the spit-flecked anti-Islamic radicalism of the New Atheists out into the open. Dawkins has had a bit of a thing about Ahmed Mohamed that is perhaps a little strange, but his most recent tweet drawing some kind of weird parallel between Mohamed and some poor child in Syria who was forced/brainwashed into beheading a soldier is really kind of off. Meanwhile in a podcast Sam Harris announced that he would rather vote for Ben Carson than Noam Chomsky because Ben Carson understands more about the Middle East.

Vicious, slightly unhinged attacks on children, and voting for a religious madman because he would keep out religious madmen seem like prima facie evidence for some kind of fevered new level of anger, so is it the case that the New Atheists are finally letting the mask slip, and revealing their prejudices in their full, naked glory? Harris is apparently an atheist but he would vote for an avowed born again christian who is completely immune to facts and probably wants to force the end of separation of church and state: when you vote for someone who is anathema to all your fundamental beliefs because of one specific policy you are signalling your policy preferences very clearly. Meanwhile, Dawkins is just … whatever he was trying to say with that tweet, it wasn’t pretty. Have recent events finally caused them to lose it?

Just recently I wrote an angry post about the Church of England trying to invade my leisure time, so in the interests of balance I think it’s only fair that I have a go at the New Atheists, who I find just as annoying in their own special way, though ultimately I think they’ll be far less influential than the current Archbishop of Canterbury. By the New Atheists I mean that crew of sciency types who publish books about how terrible religion is and affect to be experts on all things religious: people like Richard Dawkins, Sam Harris, the late Christopher Hitchens, PZ Myers. Although I don’t doubt their atheism, I think they aren’t really acting first and foremost as atheists. Rather, I think they’re establishment scientists reacting in a particularly atavistic way to two kinds of insurrection that really make them feel threatened: the American vulgarist insurrection against science, which is primarily (but not only) driven by fundamentalist Christianity; and the Middle Eastern reaction against colonialism and imperialism, which has sadly shifted from a politically nationalist framework to an avowedly religious framework. The former threatens them intellectually and the latter threatens their identity, so they react viscerally. But in their visceral reaction I don’t think they’re acting against religion generally, and I think their visceral reaction is not a good thing for atheism. Even if they weren’t straight up reactionaries, I think they make poor spokespeople for atheism (to the extent that atheism is a movement of any kind). Here I would like to give a few reasons why.

The New Atheists will never change anything

In attacking Islam so vociferously, the New Atheists have chosen an easy target, but they aren’t going to change anything in Islam, and in any case they can’t even change Christianity. They don’t live in majority Islamic countries, so they’re in no position to make any changes to Islam; and by aligning themselves so closely with the Islamophobia of the religious/militarist right in the USA they instantly render any serious critique they have of Islam inaudible. In any case, Islam is not a monolithic entity like the Catholic church, it has no central leaders or doctrines, so there is no single force they can bend to their prodigious will. But even within their own Christian countries they’ll never effect any change because they’re going about it completely the wrong way. Religions can be institutionally monolithic, like the Catholic church or the Church of England, but they’re also diffuse and incredibly culturally resilient. You can’t change a religion by standing outside it yelling at it, because a strong religion is composed of both a powerful religious institution and a plurality of supporters, who are in a constant cultural tension with that leadership but identify strongly with what that leadership represents. Religions don’t change because people yell at them because changing a religion requires simultaneously changing its intellectual leadership and its adherents.  The best way to change a religion is to slowly move all of society forward, through technological, scientific and cultural advances, and then watch the religion catch up. It’s slow, hard, dirty work, the kind of work you don’t get accolades for and can’t distill into self-aggrandizing tweets, but that’s how religions change. Perhaps the best secular example of this is the relationship between labour unions and labour parties in the early part of the last century in countries like Australia and the UK. To change policy in those environments you had to be active in the union, working at the grassroots, but also active in the elite system of the unions and its associated mass politics. People like Bob Hawke and Gough Whitlam emerged from that environment and they were formidable intellectuals with a very practical understanding of both the levers and the limits of power. Of course, the New Atheists aren’t going to have much of a sense of class politics, so they probably don’t have a clue about the secular equivalents of what they’re dealing with, either.

Furthermore, it’s often the case that the leading agents of change are people within the religion – your Martin Luthers and Gandhis – not angry outsiders. One hundred years from now, when Islam has moved forward to wherever it’s going, people will look back and say “look at that Turkish dude who reformed education in the 21st century” and “how about that Sudanese chick who campaigned against genital mutilation”. No one will be thanking Richard Dawkins for tweeting a picture of an ISIS child soldier brutalizing and being brutalized[1]. These people will never change anything.

Scientists are not good Atheists

There’s a kind of intellectual arrogance in the “elite” branches of science – physics, biochemistry, some parts of evolutionary biology – in which they believe that they can enter any other field of human endeavour and just pwn it with their superb intellectual skills. This is visible at its most nakedly ugly in the behavior of those cosmologists who think they are going to disprove (or discover!) god, and those terrible nuclear bomb makers who turned the whole thing into a sick parody of childbirth. But in this case it means that scientists are entering a world that is very unscientific, that has a completely different language and culture, and trying to understand it in terms that make sense to scientists, and thinking they can. This is why they seem to think that religions are anti-science because their books are kooky, and they think they can effect change through logical debate built on attacking the principles of those books. In science you look at founding principles and build arguments on them; in religion you play fast and loose with founding principles in pursuit of a story (or something; I’m not really au fait with how this stuff works). Yelling at people and claiming to be able to understand the way their religion works because you’re used to logical thinking is not going to get you very far. Laughing at silly origin stories (7 days! ha!) doesn’t get you very far because – newflash – most people don’t give a fuck about how smart you are until they need you to fix their TV and then they’re all like “what do you mean you study geckos?” When you engage with people outside of your field of expertise you need to set aside your field of expertise, or find a way to bring it to the engagement that doesn’t appear arrogant and out of touch. Which brings us to …

The New Atheists are poor scholars

Every field of intellectual inquiry has its own rules, its own language and its own disciplines. You can’t just go into another field of inquiry and start talking about it with the language and discipline of your own field – you’ll misunderstand and get confused. If you talk statistics with a statistician, you need to understand what “consistency” means; if you discuss economics at some point you need to come to terms with their weird and stupid definition of “efficiency”. Believe it or not, religions have their own language and disciplines, and the study of religion is a long-standing and well-respected intellectual field, connected with cultural studies, social science and art theory/history. But the New Atheists don’t give a fuck about that, they just barge on in and start arguing. This is most obvious in Sam Harris’s embarrassing little spanking from Noam Chomsky, where he thought he could engage in debate with one of the preeminent scholars of American foreign policy on the basis of a single reading of just one of his books (“I thought I could read it as a self-contained whole,” what, do you think it’s a Little Golden Book?), without any of the disciplines or scholarly background of international relations. It’s also obvious in the response of scholars of theology to Dawkins’ The God Delusion, which panned it as, for example, work that would make a first year theology student wince[2]. This is what happens when otherwise intelligent, well-educated scientists decide that they can enter into other scholarly debates without the proper debate and, dare I say it, the proper respect. And this is the real problem here: they don’t understand or respect the religious impulse or its history, they don’t respect anyone who believes differently to them, and they base their scholarly approach to religion on this lack of respect for its intellectual origins. This is very, very stupid. For much of human history religion was the wellspring of science, and almost all of our modern intellectual tradition is built on Catholic, Muslim, Jewish[3] or Hindu science. When a scientist goes into their world that scientist is dealing not with weird, kooky idiots who think the world was made in 7 days, but people who understand science and theology, and are comfortable believing in one while working in the other. You can’t knock these people over with second rate arguments about whether god could make a stone so heavy even he couldn’t lift it, and when you try they’ll come back at you with sophisticated discussion of exactly where that question fits into a range of epistemological, ontological and cosmological debates.

These religions didn’t develop through 1000 or 5000 years of history because they had a complete disregard for scholarly endeavour. But the New Atheists approach the mysteries of religion as if they were a first year biology problem. That’s bad scholarship, derived from a lack of respect, which is why I can say that …

They give atheism a bad name

Being an atheist doesn’t mean you think everyone who believes in God is an idiot. Sure, there are some cute jokes about sky fairies and stuff, but they’re rhetorical fluff, not to be confused with the substance of how atheists should (and generally do) approach believers. To me, first and foremost, atheism is about inquiry. I’m fascinated by all this stuff that goes on in this amazing and beautiful world, and that doesn’t just mean I’m interested in what will happen to the polar bears when the ice melts; it also means I want to know what my Muslim colleague thinks about things he maybe didn’t have to think about before he moved to Japan, or what my lapsed Catholic friend thinks about Shinto. It doesn’t mean that I just dismiss all that stuff as dumb-arsed imaginary-friend psychological props. It also doesn’t mean that when I see a member of a certain religion (I’m looking at you Mr. Mohammedan) doing a terrible thing I should immediately decide that all people from that religion are insane arse-hats. But please forgive me if that’s how I interpret the recent behavior of the New Atheists, who seem to have got a real bee in their bonnets about Islam, and are really seriously concerned that it’s the end of civilization. By throwing away their critiques of other religions, siding with religious lunatics, and dropping all pretense at mild manners or rational debate, they make it pretty clear that they have a certain, specific animus against a certain, specific religion. They look, in fact, like racists. Some of them also look like unreconstructed sexists. But in the modern era, they are also the main voice of atheism that most people recognize. Which means that in the public mind they speak for me.

My Muslim colleague is very concerned about the image of Islam that ISIS project. He sometimes talks about it with me – raises the terrible things they have done, tries to talk about how they are perceived by people not like them – and I can see he is worried that I might get a bad idea of his religion from the antics of its worst children. He also makes jokes about his own religion, and is comfortable dealing with the social conflicts living in Japan presents. It’s as if he is just a normal guy trying to get by in this crazy world, who believes some different stuff to me. But to hear Sam Harris’s latest utterings, he’s a monster waiting to blow me up. Or he might be, or something. When people say shit like that about any other group you back away slowly, or you give them hell. But these guys think they’re cool with it, and as the tide of public opinion turns against Islam I guess, increasingly, they will be. But sometime in the future, once ISIS are a bad memory (and they will be!), people will remember that those dudes were atheists, and they will assume that atheism is about racism and hatred or, at best, that it is completely attuned with popular opinion about who the latest bad guys are. Which it isn’t. Atheism is much bigger than that. It is much bigger than this small group of arrogant rich white scientists, and the sooner they let it go and give it back to us the better.

Atheism is not a movement and never will be

At the heart of this is a simple fact that perhaps we didn’t have to think about back when our spokesperson was Bertrand Russell, a man who would never have supported the Iraq war: Atheism is not a movement. It is the antithesis of a movement. It’s a group of people who have quietly decided to go their own way on this spiritual shit. We just don’t do it, but there’s no movement we can form to make that fact public – how can we? We don’t agree on anything! Sure, the Satanists are doing a great job of trolling some Christians in a completely cute and fun way, but they don’t represent us and no one thinks they do. We aren’t A Thing. Sure, sometimes we’d like to be – those atheist bloggers in Bangladesh might not have been killed if they were part of a movement with its own stormtroopers – and being part of a movement has many benefits, but that’s not what Atheism is. In it’s own way it’s as intense and personal as religion, it’s a feeling you have that you can’t project onto anyone else although the best of us will put our case carefully and wait for those we love and care about to maybe feel it, or maybe not. But I think the New Atheists would like us to be a movement, and I think you know who they think should be in charge of that movement.

But I don’t to be part of any movement that turns my inner life into a caricature of itself so they can spit on Muslims and use child soldiers as a rhetorical tool in some kind of shitty twitter war over a fucking clock. I don’t want to be part of any movement whose leaders think they’re intellectually superior to a couple of billion people, and I don’t want to be part of any movement whose representatives would vote for a religious lunatic who’s probably a con artist just because he hates the same people they do.

Once this war on Islam is done – and it will be done, once ISIS are gone, and they will be gone – these New Atheists will discover how fickle their new bedfellows are. When their new anti-Muslim fundamentalist christian friends kick them out, don’t welcome them back. Tell them they sold themselves cheap, and they can be footsoldiers in someone else’s intellectual battle. Atheism doesn’t need them, and neither do the religious people they think they’re helping.

fn1: Seriously WTF were you thinking, dude? Have you been following the movement against child soldiers, are you aware of what a complex, cruel and brutal thing the recruiting and enslavement of child soldiers is? Do you understand that the media have conventions about showing child victims? When the BBC interviews child soldiers they pixelate their faces. What were you thinking, comparing an American kid to a child soldier in the act of beheading someone? Do you have any respect at all for human dignity?

fn2: Read that review. That is how reviews are done.

fn3: Noam Chomsky, for example, grew up in a Jewish tradition heavily steeped in Jewish intellectualism.

Very apt ...

Very apt …

On the plane back from Italy I watched Ant Man, which my friend told me was better than expected and because I saw Jurassic World on the way over to Italy. Ant Man was an okay movie – the action scenes were okay, the ant-dude got a few decent moments of humour, the ant-control stuff was alright, and by super-hero comic standards the bad guy’s evil scheme was relatively plausible (he developed a super weapon and sold it to some bastards). I absolutely hated the Falcon from the moment I saw him and just thought he was completely naff, and in this case the “good guy”‘s plan was just stupid and dumb and ridiculous and that made enjoying the movie a little difficult, but I was toughing it out okay until I discovered that the central emotional hook in the plot was going to revolve around Hope’s issues with her daddy. At this point I cringed and lost most of my interest in the movie.

Why do so many American action movies have daddy issues as their central human drama? Just off the top of my head I can think of Treasure Planet, the Lego Movie, that execrable Star Trek remake with the completely implausible time travel plot (if you could go back in time to attack the Federation why didn’t you use your time travel powers to stop the meteor you dipshit?) and now Ant Man. In many cases (Star Trek is an obvious exception, because it was unrescuable) these daddy issues just dragged the movie down. The Lego Movie even managed to combine the daddy issues with “it was just a dream” which is like combining the nadir of emotional manipulation with the nadir of story-telling. I was absolutely loving the Lego Movie until that horrible final 10 minutes, which even manages to creep up on you with this horrible, careful forewarning – you don’t just get the end spoiled for you, but you spend a couple of minutes having your perfect fantasy world slowly impinged on by this Sauron-esque level of daddy issues.

Daddy issues in action movies are always a bad emotional hook, for so many reasons. First of all, not all dads are dickheads but you would never get that impression if you turn on netflix. Secondly, the resolution of the daddy issues is always completely implausible: Hope is on the board of directors of a major international company, she’s a kick-arse fighter and a scientist and she’s hot, but her dad has treated her like shit for 30 years because – sorry to break it to you Hope – he’s a complete arsehole, and yet at the end of the movie something she does is going to convince him he should treat her better. Sure, 50 year old men change their opinions of their highly successful, beautiful and super functional daughters just like that … Thirdly, the movies usually reinforce the daddy’s arseholery through techniques the director seems to think are meant to presage this implausible turnaround, which is just dumb. There are several moments in Ant Man where we are led to believe Pops understand he’s being an arsehole – but he keeps it up anyway. We’re meant to take these moments as a sign he’s redeemable but they just really make him seem like an egregious arsehole. Fourthly, they turn one character into a useless waste of space. Hope could have saved the world but her dad won’t let her so she ends up being just a pretty waste of space who exists in the movie to give her dad a chance at redemption. Sorry, director dude, but I like my action movie chicks to be active. Finally, they reduce the density of explosions: every scene devoted to exploring the characters’ daddy issues is a period of time when shit is not being blown up, and I came to this movie to watch shit being blown up. Sure, it’s based on a marvel comic for teenagers but most of the audience are not teenagers – we’re adults, and we’ve come to terms with our own stupid family relationships, we don’t need to have our precious explosion time diluted with time-wasting emotional antics we aren’t engaged with. Sure, I understand that human drama is hard to do well and the best way to do it is to invest it with fighting and explosions: Star Wars, Terminator 1, The Last of the Mohicans and Titanic are examples of movies that improve otherwise ordinary human drama with explosions, fighting and spectacular damage. But it doesn’t work the other way, you can’t make shrinking a man to the size of an ant more interesting by giving his love interest daddy issues. So just drop it from the script, and either shorten your movie (I missed the end of the final battle because the plane landed, and I would have seen it if they hadn’t wasted time on Hope’s angst for a man who is obviously a worthless piece of shit who deserves to pay for all his past unethical behavior) or replace those minutes of worthless sentimental bloat with something worthwhile, like more explosions.

The way daddy issues are handled in modern action movies is also something of a sinister tale for impressionable viewers. To the extent that movies play a normative role – describing what is and how things should be done – these action movies with daddy issues present a universally terrible norm. Obviously we don’t take all our moral cues from movies but they do play a role in establishing and defining norms, just as all cultural products do, and the ubiquity of daddy issues in action movies, combined with the age and vulnerability of their audience (teenagers and young adults, more likely male than female) means we should pay some attention to the messages these movies are putting out. First of all they give viewers the impression that all relations between children and their parents are fraught – i.e that all dads are dickheads – which isn’t true, and furthermore by making these broken relationships central to the emotional tension of the movie they exaggerate the importance of these damaged relationships, or serve to reinforce the insecurities of young people about their relationships with their parents. But worse still, through all of these daddy issues movies there is an implication that the kid can do something to fix their dad’s dickheadness, as if the whole thing is their fault. They always come to a resolution where the kid manages to change the way their dad views them and treats them through either emotional appeal or action or both. Everyone with an actual parent (i.e., pretty much everyone) knows that this isn’t how parents work: most parents don’t accept that their kids have grown up, let alone change long-established patterns of behavior in which they are the boss and their kids are appellants. Unequal power relationships like this where the powerful person is a dickhead do not change through the action of the weaker person, because the powerful person’s behavior has nothing to do with the behavior of the weaker one and is not their responsibility. Dickhead dads are dickheads because they’re dickheads, not because the 8 year old child didn’t try hard enough. These daddy issues movies always send out the opposite message though: something you do can change how your dad treats you. i.e. how your dad treats you is somehow your fault. It’s not, but most people spend a large part of their life working towards this understanding. Perhaps if these movies made that clear it would be easier for young adults to get the hint and start being more realistic about their relationships with their parents.

I wonder why American action movies suffer so badly from this problem? Here I am going to suggest two possible reasons: a cohort effect, and an allegory for the relationship between the citizen and the state. You’ve come this far, gentle reader, so bear with me …

Cohort effects on crappy movies

As someone who grew up in the UK in the 70s and 80s, I can sympathize with the notion that dads are arseholes. All the dads I met when I was growing up were unreconstructed arseholes, the kind of men who hit their kids out of laziness or spite rather than any kind of theory of discipline[1]. Also, watching young adult movies of that time, like Stand By Me and The Breakfast Club, you get the impression that American dads were really cold and stand-offish (all the boys referred to their dad as “sir”!). My guess is that the majority of today’s script writers and storymakers are American men who grew up in that period, probably mostly middle class, and their experience of family life is a powerful, distant father who terrorized them and a weak mother who did nothing to protect them, and that is why they routinely give their female characters power then strip it away (e.g. Hope, Hermione, Captain Ahab in Treasure Planet) and make daddy issues central to the emotional content of the story. The world has changed since then, however, and modern fathers are given much more emotional leeway, and emotional involvement with their children is supported and respected in a way it never was when I grew up. Compared to an era when it was cool to say your kids were annoying and should be “seen not heard” it is now normal for a dad to say he loves his children, to want to spend time with them, and to be engaged in and proud of their personal lives. So while these script writers might be writing about their own experiences, they’re writing a story that is unfamiliar to the majority of both the men and the children watching their shows. So why do they keep doing it? They’re paid a lot of money to recycle this drek, and personally I really don’t care what happened between whatever dude “wrote” Ant Man and his dad. If this is the reason that they’re writing these cheap emotional stories, I think they should do better – try and look outside their own experience for five minutes of their lives, and write someone else’s story for once.

The father as allegory for the state

The problem with the cohort effect explanation, though, is that daddy issues seem to be uniquely a component of American action movies. The Kingsman, for example, involved the (dead) father as a story hook but it was by no means a central part of the story – like most British movies the relationship with the mother was just as important, and even though the mother was a feckless dickhead the kid was immune to her behavior, interested in rescuing her from her situation but not feeling himself to blame for it. Similarly Japanese teen movies don’t focus on broken father-son relationships, often backgrounding parental relationships entirely in favour of the angst of teenagers (Neon Genesis Evangelion is a classic example of this). So unless American dads are uniquely fucked – an unlikely prospect, given the universal fuckedness of parents – there must be some other uniquely American reason for this obsession. My suspicion is that it could be explained by growing uncertainty about the relationship between American citizens and their state (bear with me here). In its classical representation, the state plays a role very much like a distant but essentially loving father. It can be demanding and harsh but ultimately its love is unconditional – if you are a member of its family you will get its support, whether at home or abroad. But recently this relationship between citizen and state has started to unravel, with a whole rash of policies that undermine the unconditional nature of this relationship. The most obvious is the desire of certain states to strip citizenship from people who fight against them – the political equivalent of being disinherited. But there are others: three strikes laws and mandatory sentencing; the excesses of the war on drugs; permanent sex offender registries; targeted killings of citizens in foreign countries; recent revelations of unconstrained spying on the communications of citizens; attacks on social security; the horrible and US-specific practice of civil forfeiture; and some of the more dubious sting operations that American authorities have employed in recent years. To be clear, these extra-judicial extravagancies have always been deployed against black people and certain types of domestic dissident, but in the past the victims of such excesses have typically been those who the state has refused to accept as full citizens (black people and communists). The more recent civil rights violations have expanded their reach to include middle class whites, who have always believed themselves to be the core group that the state will love unconditionally. This slow degrading of the basic rights of ordinary Americans, and this subtle change in the relationship between individual and state, might not be something that these white middle-upper class American screenwriters are directly aware of, but the general change in climate might be affecting the way they feel, and not having directly identified their concerns, it’s possible that they’re being reflected in their cultural product through uncertainties in their depiction of core human relations. If this were the case though one would think that similar allegories could be seen in other types of relations (such as the treacherous lover in Total Recall) – I don’t get the impression that this is the case though. Nonetheless, in a climate of increasing economic, legal and cultural uncertainty, it’s not impossible to imagine that screenwriters would project these uncertainties onto one of the key relationships that defined their own development. It’s also noteworthy that in modern movies at the same time as these daddy issues are being played out we also see the hero or other major characters caught up in some other excess of state power – the Ant dude with his prison issues, for example, or the way that super heroes often find themselves facing off against a shadow government agency that is up to no good.

Of course it could just be that American screenwriters are often shit, and Ant Man was written by a terrible screenwriter, or that this daddy issues thing is just some shallow Hollywood fashion that will fade away. If so, I hope it fades away sooner rather than later. If there’s going to be an emotional involvement in my action movies I want it to be simple, plausible, and positive – like The Last of the Mohicans – not filled with faux depth and unbelievable angst, and I don’t want it to be loaded down with unpleasant moral messages about how your fucked up relationship with your parents is your own fault. Get that drek out of my explosions!

fn1: It’s hilarious now to hear law-makers from that era oppose laws against slapping children on the basis of disciplinary practice. I had a friend called Christian in the UK who threw a snowball at his dad, and his dad didn’t like it and was in a bad mood, so we stood there and watched as he carefully packed a snowball with a stone in the middle, taking his time to really pack that ice tight while he ordered Christian not to run away, preparing that snowball with an intense expression of deep hatred, and then finally when he had it nice and hard, he threw it right in his own son’s face as hard as he could, then slapped him when he started crying. This kind of shit was pretty normal when I grew up – now the men of that generation complain that their child abuse is being outlawed and try to pretend it was done out of a need to instill discipline. They were lying bullies then and they remain lying bullies now.

Date: 2nd November 2166

Weather: Sunny! I got laughed at for carrying an umbrella by all the old ladies in the square …

Outfit: Yoga pants and a jacket. I thought Venice was meant to be the centre of fashion so packed all my shortest skirts and my coolest tights, and I had such a selection of fake haut cauture blouses and one pieces, but then I discovered that not only is Venice entirely stairs and men looking up your miniskirt but every girl here is wearing just yoga pants and a jacket and I felt so out of place except for the old ladies going to church who are so stylish but who does that so I had to run out and buy a set of yoga pants and a jacket (because I couldn’t wear the jacket I took to Rome since it’s covered in blood and that was such a nice jacket but Dirty Rum says he’ll replace it, I get expenses for this mission!). So now I’m walking around Venice wearing these super thin yoga pants and I can see every other girls panties through the fading patches on her bum and I’m super paranoid everyone can see mine but if I wear anything better I feel like everyone’s looking at me which you don’t want just after you have killed a major religious figure and left him in the bath with his big old man’s stiff prong getting stiffer before the polizia find him. Better to be incognito but I don’t feel incognito running around this ancient, crumbling crowded city in what is basically underwear, but no one notices me now because that’s what everyone else is wearing. Maybe I should download a yoga chipset to match this dodgy culture chipset that keeps making me go into boring museums!

Mood: Betrayed! Not because of the job, which went perfectly although the old man begged at the end and I felt like I was killing my grandpa, but then I saw the videos on his phone and realized that his night of lechery wasn’t ever intended to end in a big fat payout which I probably should raise with Dirty Rum but I guess since I was only in the bathtub so I could kill the old man there’s no use getting overly anxious about the fact that he was only in the bathtub so he could kill me. How does a crusty old dude like that kill a young woman anyway? I guess I learnt the reason when I toured the art galleries which is also why I’m feeling so betrayed! Because Dirty Rum said to me “you’re going to Rome to kill a man, and after that you should take a couple of days’ holiday. Go to Venice, soak in some culture,” so I thought when he said “soak in some culture” he meant to download a chipset on the renaissance, which I did, but why would I go to Venice just to download a chipset? That’s what the husk is for, I could have walked all of Venice’s crowded, crumbling streets right here in my bedroom! But Dirty Rum and I really needed this job so I went, and I downloaded the chipset from a cheap roadside vendor by the Fondamente, and at first it was fine but then it kept making me want to go to museums I didn’t want to go to even after I’d been in one and realized how much I hate this “art” these Venetians are peddling but it kept pushing me to go to more which is when I realized someone had bugged my chipset to make me spend money on museums I don’t like, and squished it under my (not high!) heel. So now here I am sitting by the canal with a crodino, thinking it’s probably good that Italy fell apart, because this whole place is just living in the past, and feeling betrayed by that chip-seller at the Fondamente. I would go back and drown him, but it’s bad enough wearing dry yoga pants – wet yoga pants would be just the worst!!! There’s some old Italian prince-dude called Machiavelli who probably has something good to say on this now, but since I ripped out that chipset I can’t remember any of the details of this place. I don’t speak any Italian or English either, and the only New Mandarin speakers are leading tours by that god-awful church by the lake, so I guess I’ll be staying right here by the canal until I go home.

I went to Rome to kill a man. Some old dude who runs a cult, an old cult that’s been around since humans were riding around on horses and dying of smallpox and blaming it all on some old dude in the sky. Rome used to be in this place called Italy but the old dude lives in a kind of summer house to Rome that has these really big walls. Anyway after Italy got carved up by the corporations and broken up into different little bits, this old dude was raising hell about it and saying it should all be put back together, and his little cult have some kind of influence all around the world, kind of like Nestle but through preaching instead of baby powder, and nobody really cared but then this little sect of his cult, called Optical Day or something, decided to get all terrorist and start blowing corporate assets up (why would a contact lens company blow up another company? Contact lenses are like a contract to print money, you don’t need to start any corporate wars if you’re a contact lens company! But Italians seem to be a hot headed bunch, must be all the typhoons in the mediterranean that drive them crazy). So finally the corporations decided to kill this old dude but he drives around in like a bullet-proof, rocket-proof AV and has his own personal guard of bad-arsed swiss dudes, and he lives behind these big walls all the time, and they couldn’t afford to nuke him (cheap!) so they needed to find another way in. And it turns out – shock! – that this old dude has a thing for young girls, but he likes variety, and he’s never had an inuit, and so here is Dirty Rum trafficking me into those high walls to some special place in there with a big bath and a very fancy day room and wall-to-wall porn of like the scariest kind, and my job is simple: kill this old dude in the bath and then shoot my way out.

So I did that, and on my way out I happened to kick his phone where it was plugged into one of his porno screens – I slipped, there was a lot of blood – and it somehow flicked to a new channel and that’s when I spent half an hour watching videos of the previous girls he’d had in the bath, and it wasn’t pretty and I suddenly had this big urge to send Dirty Rum a message saying “this job’s on me” but then I remembered that I’m not stupid, so I used the old dude’s dead finger to bypass his security, and mailed the whole lot to a couple of TV stations. Then I left, and went to Venice.

I only went to Venice because Dirty Rum said I should soak up some culture. I’ve never really been on a holiday before unless you count an afternoon of girls talk in Mister Donut, and I don’t really get why people go all the way to another country to pry into its dirty past. I mean, every culture is built on a bunch of horrible things and bad old ideas, and it always seemed to me like a lot of unnecessary effort to go halfway across the world to go prying into someone else’s bad secrets, like a kind of cultural voyeurism. Not that that’s the reason I never went to Disneyland – I just can’t afford it. Also Disneyland got nuked, so probably isn’t the best place to visit and who wants to go to America anyway? I’ll never meet an American I trust, I’m sure! But Dirty Rum said this one was on him, and have you ever seen Venice in the Autumn? So I took a train from Rome to Venice, and Dirty Rum arranged a nice hotel for me that rises above these narrow cobbled streets like an angel of steel and glass, and I can look over the whole thing, its pools of pale light and deep canyons of shadow, and think – I killed your stupid cult leader. You owe me.

Of course the bells are ringing a lot now he’s dead, and the TV stations are kind of frantic with all this talk about his paedophilia and his necrophilia, but me, I’m taking in the airs. Strolling the canals in my yoga pants, listening to my chipset tell me about how such-and-such a rich dude from the same cult built this building, and so-and-so rich dude from the same cult built that building, and oh by the way did you know that this piece of crumbling mosaic was dedicated to some poor sappy guy who was killed by enemies of the cult? This whole town is built on this stuff.

So I was kind of interested to find out a bit more about this cult, so I went to the big church in the square by the lake, where they have this tour that you can see the old church that is still running, and it’s meant to be impressive but really it’s only impressive because a bunch of people from 500 years ago could make a small house and put some badly shaped gold crust on the ceiling. You walk around and think it’s kind of pokey and what would these people have thought if they’d been taken to a Fay Ling Moon concert 500 years ago, they’d probably have died. It was kind of nice when I stood near the edge of this group of people who were praying, they sang a little song of devotion in pure and beautiful voices, the candle light wavering on their yoga pants and jackets and the voice of the crusty old dude ringing clear and faithful through the church. But then I turned away to walk out and there was this series of three little weird curtained booths with names over them that my chipset told me were confessional booths, where you can go in and hide your face while you tell the old man whose name is over the booth about bad things you did or even thought and he collects your stories so that he can go home later and imagine you without your yoga pants on doing those bad things that really aren’t bad at all, and I thought that old man leading the prayer was actually a kind of sleazy old man wasn’t he, just like his boss. And I looked at those booths and the curtain hanging limp there waiting for a person to sit inside it feeling bad for being natural and I thought it’s kind of like the biohazard suits we had to wear in the Indo zone, only to keep the hazard in, not out. And suddenly I felt kind of tired and sad looking around at the weary old gold-crusted ceiling, thinking about all the thousands of women who’ve trooped through here, entering those little booths of biohazard shame feeling like what happened in their yoga pants was okay, and leaving ashamed of themselves because some slimy old man told them so. And then I walked out kind of fast because I was getting angry and I didn’t want to do anything stupid to blow my cover.

… and then I got this desire to go to the old art gallery, which is called the Academy or something but the locals have got surprisingly bad English so they mis-spelled it and it took me ages to find it in my dictionary (why did I download a culture chipset instead of a language one?! I think I should upgrade my neuralware next time I’m in Russia, it’s cheap there and reliable). It cost a small fortune for an Inuit girl to get into the Academy, but I kept a receipt because Dirty Rum is paying for all this, and so in I wandered to look at all the art, and the chipset was full of all this knowledge about how great it all was, but as the rooms passed me by I started to get this really bad feeling about it all, like … these people really have built their entire artistic heritage on a pretty rough foundation, haven’t they? And I trust Dirty Rum but I’m starting to give him a good bit of side-eye now because I’m wondering why he thinks it’s culture to be painting a bunch of poorly-rendered pictures about some chick who had a baby without having sex which is like impossible, and a dude whose dad killed him just so he could be famous, and everywhere these really nasty, scary-looking babies that sometimes have wings and sometimes look really skeezy. And every time that virgin mother is in the picture there’s a bunch of super old dudes staring at her in this really dirty way and it’s like for 400 years the artists of this entire country couldn’t work out how to paint a finger or an arm or let alone a baby but they were like pre-eminent masters at getting that sleazy look so perfectly captured that it beamed on down through the ages to where a young girl looking at it today is like “that is the universal embodiment of sleaze!” What a lucky virgin mother this Mary chick was … It’s really weird too how the only reason she’s special is that she had a baby whose dad killed it just to get onto some ancient talent show, but then everyone thinks that she couldn’t be special at all if she had actually done some sweaty tussling with a man to get that baby going – that’s some real dirty double standards shining through right there and you can see that double standard in every roughly drawn picture of her carrying her stupid baby that’s gonna die, looking so stupid and innocent while a bunch of old men are leering at her thinking they want her but they’re dirty for thinking they want her.

Which I think is why that old dude I killed had to kill the girls after he’d diddle them, because he hated himself for doing what everyone knows is really just natural, though kind of gross, and his stupid religion tells him he’s bad for doing all the things that his body needs to do, and somehow on this peninsula that bad way of thinking got to be a thing, until the guy who represented that thing was so special that he could fly a bullet-proof AV and get to strangle any Inuit girl he wants, because he feels bad about wanting to be inside her.

Of course all these crazy ideas came up before people invented guns and contraception and cyberware, and now the world is different and any girl with a dentata and a pair of rippers can do away with some sleazy old strangler who wants what he doesn’t deserve. And now the whole cult is in tumult, I guess, because girls can run around in yoga pants killing their idols or other people’s idols, or having sex with them if they want though why you’d want to has always been a mystery to me, and doing the things that girls naturally want to do like chatting with their friends freely in public and shooting people for money. And those old pictures now they’re just relics of a time when nobody knew any better and girls like me couldn’t be free to do what we wanted, but there’s still people in the world who think the bad things that we were are important to the good things we’ve become instead of something we should be ashamed of, and I was sitting there on one of the benches while all the pretentious arty fashion types were walking past me talking about colour and light (probably – they weren’t talking Mandarin or Inuit so who knows if they were but they seemed to be!) and thinking, no, this is just dross, it’s old paper with bad scrawlings on it, let’s take some photos sure so that the people who like history can study it but maybe we should just burn this stuff down now? Because this building would make a great shooting range, if we cleared a few walls away. Or a dance club!

What we could be

What we could be

And then I left. But that chipset still had me thinking I needed to go to another weird old museum of skeezy dudes, and it led me across this bridge and then there was this museum of modern design that I managed to get into even though the chipset was really making me feel uncomfortable about it. And the museum had a special display about glass sculptures which was mostly terrible but I found this little side door that led into a dark room that had these two pieces of glass hanging in air like shreds of angels, and they were pieces of glass moulded in the shape of the lower torso and legs of people. They glowed there in the air, suspended in silence and darkness and carrying their own luminous flesh so powerfully that I could feel my own cyberskin moved and moving to the same colour. And I just assumed they were male torsos because all the art I had seen was about men but then I saw the little secret slits and the smooth beauty of their parts and I realized that these were some kind of floating embodiment of femininity, and I stood there entranced and my thoughts briefly washed away from me except the chipset was nagging me to go, go, go and watch some real art about men and their needs so I ripped it out right then and crushed it on the floor and just stood there thinking yes, we are in a better place, this world we’re in now where girls can hang luminous in the darkness, their skin flawless and glowing and their power complete, just like mine was when I strangled that nasty little man in the bath, one hand around his neck as his eyes bulged and my rippers sliding in and out of his sagging, filthy belly, the blood mingling with the bubbles in the bath and the spilled champagne, his gasps like a kind of choir singing hosannas to the perfection of modern womanhood in gurgling, ragged sighs.

And I didn’t go to any more museums. I’m going to enjoy the sun by the canals and watch the tourists wander by, until my flight lifts me out of this crumbling kingdom of old ruins and ruined old men, and takes me back east, where the future is.

Today Vox had an article about a new study of health insurance in America that annoyed me in a number of ways, and highlighted both Vox’s patronizing know-it-all style, and the simplistic economics-worship of some of its writers (in this case Ezra Klein). It’s one of those Economics-101 “Yes, you think A but really this [insert shallow confounder] means not A! Wow!” arguments that are beloved of pop economists, and it’s really frustrating to see it being trotted out now by Vox at a time when the USA is going through a major ideological battle over universal health coverage.

This post may turn out to be a bit long and kind of technical, depending on how frustrated I get reading further on the topic as I write …

The basic argument

Klein has taken a new working paper by Finkelstein et al and used a few of its apparently central findings to build up a story around a question. Finkelstein et al analyzed the Orgeon Health Insurance Experiment to find out how much money medicaid recipients were willing to give up in exchange for medicaid, and how much utility they get from their health insurance. As part of this they found that the uninsured actually don’t pay for much of their treatments: only 20% of their out-of-pocket expenses are paid by them, the rest being shouldered by someone else. This is a central part of Klein’s discussion and, in my opinion, a terribly uninformative finding. Klein has a whole section of the article about how the uninsured are actually “kinda-insured,” which is kinda-true but also kinda completely misses the point, in a very important way that, in my opinion, says a lot about the reasons Americans are having so much difficulty with this whole universal health coverage (UHC) thing. He then moves on to a discussion of the findings of the original Oregon Health Insurance Experiment paper in the New England Journal of Medicine, which found that medicaid wasn’t actually that good for a lot of its recipients; there is a lot wrong with this paper and a lot of reasons its findings need to not be over-stated, but Klein doesn’t really consider them, and gives the study findings more weight than (in my opinion) they deserve. He then goes on to one of those discussions that only economists have, which I guess they expect the rest of us to take seriously, that are deeply poisonous in their basic assumptions, and often wrong: “is health insurance worth it?” This is like the classic economics paper on why voting is a waste of time: superficially appealing but absolutely and completely wrong. He finishes with an important statement, that health insurance should be assessed in terms of the value it offers people, but then juxtaposes value with cost-control as if the two things are mutually contradictory. Pretty much everything in this Vox article is superficially right but deeply wrong, and I want to talk about why it’s wrong and what this means for the health insurance debate.

The Oregon Health Insurance Experiment

The Oregon Health Insurance Experiment (OHIE) is at the heart of the findings in this Vox article, but it’s probably not something we should put too much faith in. Basically, the Oregon state government expanded medicaid places a few years ago, but it could only expand to 30,000 so it ran a lottery for the 70,000 potentially eligible people. The 30,000 potentially eligible people then applied for medicaid, with many getting rejected, and Finkelstein cunningly convinced the government to let her study the results. This is a joyous opportunity for health insurance research because it offers a randomized controlled trial (RCT) of access to health insurance: the gold standard of medical research, enabling us to eliminate a whole bunch of confounders and explore only the effect of health insurance.

Unfortunately there are many problems with the Oregon Health Insurance Experiment and the original paper which launched it to fame. First and foremost, although 30,000 people won the lottery, winning the lottery only increased the probability of accessing medicaid by “25 percentage points” because many didn’t apply or were ineligible, and many non-winners somehow finnagled their way into medicaid. Thus the “Experiment” suffers from massive contamination of the kind that usually renders an RCT ineligible for publication, because most of the intervention group ended up as controls and some of the control group ended up as interventions. While the process of assignment to these two groups was random, the process of transition between groups and final allocation was not, and in fact is decided by a very clear set of factors with a high risk of confounding, such as age, unemployment, etc. The second big problem with the OHIE is that the follow-up period was only 2 years, but lottery winners went on a waiting list, so the actual follow-up time from starting medicaid to study end was less than 2 years, but many of the outcomes they studied (blood pressure awareness, treatment and control, for example) require long follow-up, and key outcomes such as financial catastrophe (see below) are dependent on much longer follow-up times and/or retrospective analysis. Note that the non-medicaiders received a full 2 years follow-up, another minor source of bias. The third problem is that many lifestyle and consumption variables that are crucial to understanding the home-financing impacts of health insurance were obtained from a mailed survey with 15,500 respondents (out of 70,000 in the original study!), one of the most infamous ways of introducing bias into studies (respondents to mail surveys are even less normal than you, dear reader(s)). In contrast, surveys of health financing issues in developing nations (which in my opinion are the gold standard of health financing surveys) routinely get 95-98% follow-up in detailed, complex door-to-door interviews. I have said before on this blog that I think American health finance researchers could learn a lot from what the developing world is doing, and this is another example. The fourth problem is the choice of outcomes: even in systems that are completely free (such as the NHS), health outcomes that can be analyzed over just two years of follow-up are heavily dependent on health-seeking behaviors and non-financial access barriers (e.g. work and time off), and the best measure of health success in a health insurance plan is in serious but often rare outcomes – all-cause mortality, hospitalization, that sort of thing. Also, the OHIE didn’t do much analysis of financial outcomes, which are the main point of health insurance programs. Finally, the study is only ethical if you squint and tilt your head: randomizing people to receive health care is not ethical, and the only reason this study gets grace on that count is that America’s system is insane, but the general ethical view of the medical establishment is that just because the state does something convenient, that doesn’t mean it’s ethical to participate in studies of that thing (see e.g. debate in the British Medical Journal for the Godwin-level examples). Regardless, most people accept the validity of the OHIE, so let’s run with it for now, bearing in mind its flaws: flawed papers often still have a lot to tell us.

The uninsured are “kinda-insured”

In my view the central flaw of the Vox opinion piece lies with its uncritical acceptance of the working paper’s finding that only 20% of expenses were paid for by people without insurance, and the implications of this. The Vox article states:

It’s perhaps easiest to explain this through example. Imagine John breaks his leg. If John is uninsured, his brother, Mike, pays for his medical care. But if John has Medicaid, then the government pays for his care. John got medical care either way. So in this case, Medicaid’s money actually didn’t go to John so much as it went to his brother, because it was his brother who actually would have ended up paying the tab.

This is the kind of superficial gotcha that economists like Ezra Klein love, and it’s annoying and … superficial. There is a large body of research on the health financing aspects of health insurance, and a key concept used in that literature is distress financing. In developing nations, distress financing is defined variously as using any of the following strategies to pay for medical care: selling assets from the home or family business, using savings, calling on family members for financial support, or withdrawing children from school to work [yes, you read that right: this is what lack of health insurance does]. What John did was distress financing, and one of the goals of universal health coverage is to reduce or eliminate the incidence of distress financing. Sure, Mike is better off if John gets medicaid, but in health financing we don’t care about Mike, Tom, Dick or Harry: we are designing a system that protects John from financial catastrophe and distress financing. This is because it is of no interest to us if Mike spends his money on a plasma-screen tv or his brother’s appendix or indeed his own, the purpose of health insurance is to pool risk, that is to ensure that no person – whether directly afflicted or not – has to spend unexpected amounts of money on health care. No doubt there are people out there whose monthly premiums are paid for by friends, sugar daddies or family. We don’t care. The important point is that we have established a universal risk pool into which everyone pays, and everyone draws. It’s no concern to us whether Mike pays for John or John pays for John or John’s sugar daddy pays for John, and typically health insurance research doesn’t ask about how premiums are paid, so why should we care how out-of-pocket expenses are paid? So Klein’s example completely misrepresents the moral purpose of health insurance, by assuming the wrong things about why we have health insurance, and misunderstanding the tools that are available to understand how health insurance works.

I also think Klein has misunderstood the working paper on this issue, because I don’t think the working paper makes as big an issue of this distribution of costs as he does. Finally, if John and Mike are sharing the cost of their health care, then really what’s happening there is that they are establishing a very inefficient, unregulated risk-pooling mechanism – a private version of medicaid. When John gets medicaid we aren’t seeing a situation where suddenly Mike is better off because John can pay for his own care, we’re seeing a situation where Mike is better off because John has been drawn into a larger, better-managed, better-regulated risk pool.

Estimating the utility of health insurance

The working paper is largely aimed at estimating the utility of health insurance, and it uses techniques from economics that I’m definitely not qualified to critique. I know nothing about utility functions or their optimization, so a lot of the language and techniques are a mystery to me. However, there seem to be a couple of aspects of their analysis that insert strong biases. For starters, their assumption 3 on page 8:

Individuals choose m and c optimally, subject to their budget constraint

which is explained as:

The assumption that the choices [of some functions] are individually optimal is a nontrivial assumption in the context of health care where decisions are often taken jointly with other agents (e.g., doctors) who may have ddifferent objectives and where the complex nature of the decision problem may generate individually sub optimal decisions
This assumption ignores the possibility that individuals choose not to consume health care, a common problem amongst the uninsured. It’s also a particularly dubious assumption about the poor, who are often not able (through resource constraints and e.g. work situations) to make optimal decisions. A good example of this is abortion: the welfare-maximizing decision might be to have a legal abortion, but there are many states in the USA where this is becoming increasingly difficult for poor people to do for non-financial reasons (travel requiring time off work, the risk of humiliation in small towns, etc.), while for the wealthy it remains a simple utility-optimization decision. A poor person might make the extremely risky decision to have an illegal abortion, which has stochastically-varying risks (mostly none, occasionally many). It’s not enough, in my opinion, to talk about this as a limitation: it needs to be carefully modeled.
The working paper also uses an unorthodox method for assessing income, basically dividing household income by family members[1], and doesn’t consider the issue of disposable income. Typically studies of this kind use the family’s disposable income (or some similar measure of available consumption) during analysis, because people have other fixed expenses (most especially, a house) that they can’t fiddle with.
As a result of these assumptions and estimation processes the working paper comes up with a finding that individuals would be indifferent to giving up medicaid or consumption of about $1000 – $1500. This seems to be actually an astounding finding, given that average income in the people receiving medicaid is $3800. Would you give up just under half of your income for health insurance? Is this an indication that the health insurance is of low utility, as Ezra Klein concludes? Note also that there is no assessment here of financial catastrophe, which is important because these people only need to spend about $700 a year on health care to be in the catastrophe zone (usually about 25% of disposable income, which seems to be about $2800 in the assumptions of this study, though I may have misunderstood it). In order to understand the benefits of health insurance properly in this community we need to understand what their risk of financial catastrophe and distress financing is and what proportion of that risk they are protected against by medicaid; but we are instead treated to a completely irrelevant estimate of what amount of money they are “indifferent to”, based on income and expenditure information from a very small sub-sample of the people originally eligible for the trial.
I’m not convinced that the OHIE is capable of answering the questions we need to know about health insurance coverage, or that this study adds anything except to tell us that poor people will use up to nearly half of their income to purchase health insurance.
Vox’s conclusions
Klein concludes that maybe health insurance isn’t that great, and we need to make it more appealing, or something:
That isn’t to say health insurance is useless, or that medical care doesn’t help. But we’re probably paying too much and getting too little, and now that we’re a lot closer to a world where every American who wants health insurance can afford it, we should be focusing on making sure that all that health insurance we’re buying is actually delivering the health we’re expecting.
Much of this paragraph is based on the published NEJM paper from the OHIE, which as I showed above is not very informative about the health benefits of health insurance. The subsequent working paper hasn’t told us much about its health insurance benefits either, because it was misdirected. So how can Klein conclude from this study that we’re probably paying too much and getting too little, and why would anyone conclude that from medicaid, which is a specific system for the very poor in America? The reasons why medicaid is ineffective are probably closely related to social determinants of health; the reason why standard health insurance plans (or the Obamacare bronze plans) are ineffective probably has a lot more to do with access issues, arbitrary payment systems, and high overheads. This seems like really weak sauce to conclude with, and as a remarkable economic finding it also seems kind of empty. If you went out to buy a plasma-screen TV, I’d tell you to find the best one you can for the lowest price you can, and definitely make sure it works. Klein’s conclusion in this article is that … the community should buy the best health insurance it can for the lowest price, and make sure it works.
So somehow Klein has gone from a gotcha based on a flawed study (oooh look! you thought health insurance works but this study showed it doesn’t!) to saying … we need to make sure we spend money on health insurance wisely. While the rest of the world continues with its process of spending less money than the USA on health insurance, and getting better results.
It’s not really a very helpful conclusion is it?
What is the relevance of this to America’s health debate?
Assuming Vox has any relevance America’s health debate, or to anyone anywhere, that is. This whole article seems to me to be a representation of the strange atmosphere of debate about health insurance and health care in America. First of all it is a discussion of a set of studies trying to find out whether health insurance works, something that the rest of the world takes for granted. Secondly, it buys into a strange economists’ logic of who benefits from health insurance that is almost completely ignorant of a large body of research on health insurance outcomes, and also seems to see health insurance as a consumer good rather than a risk-pooling strategy – i.e. it frames the entire health insurance debate in terms of something that people want to buy, rather than something society thinks everyone should have. It’s another example of how America’s intellectual elite seem to be really clueless when it comes to health care, and it’s a real worry that a site that is supposedly informative is publishing articles by a major economic pundit about one of America’s central social reform issues that are largely clueless about the central debates in that issue. How is the general American public meant to understand a fractious, long drawn-out healthcare debate if public intellectuals like Klein are missing the key issues and presenting the framework of that debate in a completely erroneous and misleading way? Healthcare policy is far from simple and there’s no reason to think ordinary people should understand it without help, but here we have a major public intellectual and economist completely misrepresenting the core elements of the debate, running his readers off down the wrong track into a loopy set of conditions on health care (and a really weird definition of who benefits and who we want to benefit) before ending with a completely uninformative and vapid conclusion (we need to buy more for less!) Is this really the standard of public debate on healthcare in the USA?
Let’s hope the Supreme Court don’t read Vox, and be glad it wasn’t around when Obamacare was first developed!
Fn1: The correct method is to scale the household size to consumption equivalents using a power law, the value of the power being estimated from a regression model: for the USA the consumption-equivalents scale as approximately the square root of household size. This is perhaps not a very important flaw in the paper but it points to a bigger flaw: none of the standard experts on health financing from the broader health financing field are referenced and Ke Xu, the world-recognized expert on this, is not included in the reference list. Once again: researchers in the USA could learn a lot about the best methods to study health financing from those who are doing very serious work on UHC in developing nations.




Getting out of that fridge is hard

Getting out of that fridge is hard

Mad Max: Fury Road is a masterpiece of Australian cinema, that makes the rare achievement of building on its predecessors in the series to bring post-apocalyptic film-making to what must, surely, be its apotheosis. Visually stunning, with a brilliant sound-track, incredible pace, and a simple joy in hedonistic old-school road wars violence that is deeply infectious, this movie immerses you in its insane world from the very beginning and doesn’t let you escape until the credits roll. It is thorough in its vision of a grim, wartorn post-apocalyptic wasteland, unrelenting in pursuit of heady, dizzying action and absolutely frantic. But beneath its simple patina of gorgeous landscapes, sweeping chases and exciting stunts, it is also a movie of many layers, combining an uproarious vision of a freakshow post-apocalyptic death cult with a powerful homage to Australia’s alternative and bush culture, and a subtle nod to an eco-feminist critique of the societies that are driving to their own destruction. This is one of those movies that you can appreciate for its visual splendour and action sequences, but also that you can enjoy for its crazed Aussie clowncar humour, and contemplate afterwards in the light of its ecological and feminist politics. This, in my opinion, is the perfect balance of themes for a post-apocalyptic movie. It doesn’t make the mistake of unrelenting hopelessness that characterizes some movies like The Road; it doesn’t dull you to sleep with the empty spaces and silences of an empty world, like The Last Man on Earth or Legend; and it offers something more uplifting than the empty survivalism or post-human cynicism of much of the zombie survival genre. Through the post-apocalyptic setting it offers both excitement, gore and social critique, all couched in such a spirit of over-the-top, raucous and invigorating fun that surely only a zombie couldn’t help but at least slide into the scene and get that rev-head spirit going.

The introductory scenes of the movie leave us with a bewildering array of visions of craziness and freakish people that are confusing and overwhelming, as the scenes of Max’s capture are played through the tunnels and byways of what looks like a massive underground punk/skinhead garage. It will be some time before we figure out what’s happening to him or why, but before we do we’re given a sumptuous feast of the sick, the freakish and the mad as we watch the elite of the citadel lording it over their filthy crazed masses. This 10 minutes is like Peter Greenaway on speed, without purpose or sense, but then we hit the open road and get a few minutes to start putting it all in place – oh, that‘s why the women are being milked, that‘s why the freaks are running the circus, those women are running away from him! Then the trouble starts again and we’re back into chaos, but with a few sentences of expository dialogue (finally!) and the dawning realization of the trouble Max is in, and all of it set against a backdrop of classic 1990s Aussie sub-cultural monuments: the punk styling, the rev-heads worshipping V8 with their elaborate steering wheels, the skinhead warboys who’re whiter than Aryan and go all chrome and shiny to die on the Fury Road … In a couple of minutes of frantic action we’re shown an ecosystem, the skeleton of an apocalyptic death cult, and an entire aesthetic to go with it. Then the chase starts and we’re still absorbing it as Mad Max is roaring (or, more accurately, being roared) onto the Fury Road, which in this world is basically anywhere wheels can turn. But the freakshow doesn’t subside – just when you think you’ve seen it all, come to terms finally with the internally consistent madness of it all, new craziness pops into the scene, and tears up the desert with more chaos, and then makes sense again. What you see on the trailer – some dude in a harness with a flame-throwing guitar, a gigantic dude with oxygen tanks, that scary dude with the mask – that seems so over the top and stupid, it all makes its own brand of crazy sense before you’re even twenty minutes in, and you haven’t even met the object of all this craziness, or even the worst of it all yet. Then when it’s all said and done and you’re reading the credits and seeing who these people were – the Doof Warrior, Rictus Erectus, the Organic Mechanic, Nuks the Warboy – you realize you still didn’t get all of it because nobody told you their full name but every detail of their names is a homage to Aussie subcultures, especially the doof scene but also punk, hardcore and all the tattered, dreadlocked, bullet-studded chaos of the 1980s and 1990s underground. Here it is, flying out of your cinema screen in one last glorious death rattle of insanity, road-rage and revhead joy.

Beneath this infectious ecstasy of the open road the main characters are laying out an ecofeminist thesis. The basis of the story is a group of women – called the Wives – who are apparently genetically perfect (and very beautiful!) fleeing from their tyrannical husband Imortan Joe, with the help  of his best road warrior, a one-armed woman called Imperator Furiosa (played by Charlize Theron). Joe hopes to have healthy babies by these women, and keeps them locked up for his use until he can get a male heir to rule after he is gone. But they don’t want to be things, so they leave, and his warboys have to chase them. This is a pretty basic feminist plot, made stronger by a couple of narrative devices. First of all, the alleged hero of the show gets fridged at the very beginning – as in literally, nearly – and only gets drawn into the story by accident. He manages to fight his way to Furiosa’s side but his role in the story is just luck, he was meant to be just another thing back at the citadel and it’s pretty clear first, at least, that Furiosa isn’t particularly comfortable with the idea of bringing him along. He’s the passenger for much of the first quarter of this movie, and the chicks are driving the car. Then, these women are not helpless – they are agents of their own destiny, and act with all the tools, strengths and wiles at their disposal to make their getaway. They don’t know how to fight and they aren’t strong (and one is about to give birth) but they don’t let any of that stop them doing all they can to take charge of their situation. These women are also the expositors of the film’s ecofeminist thesis, using their few moments of dialogue (no one in this movie wastes breath speaking!) to drop a few choice eco-feminist koans. The crux of it all comes when one of the Wives is trying to push Warboy Nuks out of the truck, and they are arguing about whether she is one of the citadel’s folk or not. Nuks says that he is not to blame, but she demurs, and yells “Then who killed the world!?” before tossing him overboard. At another point one of the women is credited with calling bullets “anti-seeds”: you plant one and watch something die. These are classic tropes of eco-feminist thought, being delivered by strong women whose presence on the screen is inextricably tied to their femininity and their fertility, and a war being fought to control their powers of birth, that are so precious on this planet that (the implication is) was blighted by men like Imortan Joe. They don’t stand up to expound on a manifesto or to make demands or philosophical claims but every time these girls speak they say something linked to an eco-feminist creed. Even the first time we meet them, one of them is cutting off a chastity belt with teeth built into it, freeing herself of patriarchal sexual shackles, and the perverse vagina dentata fears that the patriarchy brings with them.

I must confess I love it when a good movie works an ideology into its very bones, but does it so well that even though you know it’s there you just get sucked along with it anyway. I have no care for Mal’s simplistic libertarianism in Serenity but I did love watching him righteously defend it; I can’t stand the authoritarian violent message underlying 300, or the way it elided Spartan slave-holding and paedophilia, but I loved watching those men fighting for their worthless cause. When a movie saturates itself with an ideology but does it so well that you either don’t notice or don’t care, or – best of all – everything makes sense in the context of that ideology, that is when you know a movie is well crafted. And Mad Max: Fury Road has carried this off brilliantly, with the rollicking plot and the rollercoaster of stunts and enemies and explosions and madness carrying you all the way to the eco-feminist oasis – and back again.

With this movie I think George Miller has drawn together a few ideas he was playing with in the first three Mad Max movies, but wasn’t quite able to pull off. We see hints of a feminist agenda in Beyond Thunderdome, with the powerful Aunty Entity running the town and trying to use Max as a pawn in her schemes. We see here too the role of oases and lost places as signs of hope, but in Fury Road Miller has been able to better combine them with the narrative of judgment on those who brought the world down that he played with in Mad Max 2. The whole thing is also carried off with a remarkable creative continuity: the names, the punk styles, the language of speech have a certain similarity to them, as do the baroque car designs and the hard scrabble economics of theft and hyper-violent rent-seeking. Even the actors are in some cases the same: Imortan Joe is Toecutter from Mad Max 1. This is a full campaign world Miller has created over the past 30 years, leavening it over time with better production values and now a much stronger environmental message, and maturing some other themes (like the role of power-mongers), but that campaign world has been remarkably consistent across all that time.

For all of these reasons, Mad Max: Fury Road was a movie well worth waiting 30 years for. Later this year Star Wars 7 will come out, and we have to hope that there, too, we will finally see continuity with the original legend after 30 years of lost chances. I am not holding my breath on that, but I can assure you, dear reader(s), that Mad Max: Fury Road is something special, and will redeem this year of cinema – and possibly this decade – no matter what happens at christmas. Watch it, and ride eternal, shiny and chrome!


Full of terrors ...

Full of terrors …

This is a level 7 cleric spell that does 10d10 damage per round (no save) to a single target. It also instantly grants the caster a profound insight into the psychology of everyone who witnessed the death of the target. After receiving this insight, the caster must make a save vs. death to avoid losing all respect for those whose mind she now knows.

[Warning: this post contains spoilers for both the TV show Game of Thrones and its associated books. Don’t read on if you haven’t yet got to season 5 episode 9]

So last night Stannis Baratheon did what any sane viewer of this show should expect him to do, both on character grounds (he’s a murderous arsehole) and metaplot grounds (George RR Martin is a murderous arsehole). But reading around the traps this morning it appears that a lot of people are shocked that Stannis – the man who killed his little brother with an abomination born through adultery to a psychopathic witch, and cut off his advisor’s fingers, and burnt Mance Rayder alive for shits and giggles – is willing to sacrifice his own daughter to the lord of light’s [insatiable] blood lust just when his entire life’s goal is going pear-shaped. Others are shocked that a show that threw a kid from a window in episode 1 – and allowed the incestuous arsehole who did it to redeem himself later! – and burnt two farmboys to death because of reasons, should somehow murder a noble child that everyone loves.

The Guardian has an excellent episode-by-episode blog of the show, with generally excellent above-the-line posts and great below-the-line banter, including by some dude who writes only in the voice of Stannis Baratheon. The blog writer, Sarah Hughes, declares that burning a child to death may be a step too far for her, in the same episode that we are shown another character paying to fuck a child and making it pretty clear that the child is going to be severely damaged by the affair (“you’ll have another one for me tomorrow,” he warns the brothel madam). This is not the first child we’ve seen burnt to death, or thrown from a window; it’s not the first barely-adult teenage girl we’ve seen murdered (though usually they’re raped first) and her fate is hardly special against the general backdrop of violence and murder in this show. What about that horrible little tete-a-tete north of the wall, where a bunch of men in black find a community in which a single man rapes all his daughters, murders their male children and raises the girls as sex slaves; and what do the crows do? They rebel against their leader so they can take the guy’s place. But burning some girl you were starting to like is a step too far? Lots of people in comments are complaining that this is outrage for the sake of it, suggesting that it’s just done to lure public attention or something (because the most pirated TV show in history really needs more press!) Have these people been watching the same show as me or is there some kind of politically correct, heavily pixelated version that Guardian readers can download? Because I can’t comprehend how anyone would be surprised that a man as cold, driven and vicious as Stannis Baratheon would burn his own daughter at the stake, or that burning a child at the stake is somehow a step further in any direction for this show. In response I can only think of that great Raul Julia line from Streetfighter: “For you it was the most important day of your life, but for me it was just … Tuesday.” This is not a show where a single extra dead child is going to tilt the scales.  Especially when you consider that the week before everyone was singing the praises of a 20 minute long battle scene in which multitudes of children died and were reanimated, and one excellent character was attacked and murdered by undead children.

There’s an obvious class analysis to be had here: how is it that some rich, educated girl in a dress dies and we are all up in arms about it; but no one notices the way that Sansa was completely relieved and happy to learn that two boys burnt alive were not her brothers. They’re just two farmkids, irrelevant in the scheme of things, their deaths a hapless accident that brings her joy because it confirms her brothers (real people!) are still alive. And of course wildling children aren’t even human, right? By now we’ve all become so complicit in the vicious intrigues of the elite that we’re now thoroughly indoctrinated into their code of combat: only rich people matter, and though their lives are expendable they should only be expended for a purpose. To channel Drew’s dialectical ephemeralist for a moment, quoting the Falcon:

Little people they liquidate. And time and again they cream your liquidation, your displacement, your torture and brutal execution with the ultimate insult that it’s just business, it’s politics, it’s the way of the world, it’s a tough life, and that it’s nothing personal.

In my opinion one of the great joys of this show is that it gets us complicit in the brutality and bloody-mindedness of the ruling elite that we should be despising, so that we even feel horror and indifference when they do. Sure, you burnt a few farmboys but I’m much more well-disposed towards you now I know they weren’t important; and sure, you raped and murdered a girl but rich boys will be boys, eh?

Which brings us to the obverse of this, which is the shock that many people on the ASOIAF reddit are apparently feeling that the show would lead Stannis to this bitter and barren path. I can’t read the reddit, because it contains spoilers (I tried and I think I just found out Jon Snow’s fate which is really annoying) but the word on the Guardian blog (and expressed by a few people directly there too) is that the reddit is up in arms about how the show “broke” Stannis’s character and goes against his character in the books. The latter argument is easily dismissed since apparently the show’s makers have revealed they got this little bbq party straight from George RR Martin; but the former is interesting. There are actually people out there who believe that it’s out of character for this murderous, devious, sinful man to kill his own daughter if it suits him – and worse still they don’t like him anymore. They’ve been led so deep into the psychology of the books that, I guess, they actually think his previous horror shows – the mass burnings, the satanic rituals, the fratricide, the prisoner-killing and the ruthlessness of his war tactics – are all signs of a good man. Presumably if he had just ordered all the guards on the picket tortured and hanged (which he did) and then held off burning his daughter everything would be a-okay … The truth, of course, is that there is nothing about Stannis’s conduct that is morally acceptable, and he is a deeply evil man. His daughter even said this, that picking sides was the reason for all the trouble in the first place and if everyone just stayed home none of this shit would hit the fan in the first place. I guess we’ll never find out where this logic would take her, since her dad decided to burn her alive in order to ensure the side he picked won.

It’s interesting that the readers of these books seem to be prone to picking up the psychology of the psychopathic ruling class to the extent that they can accept Stannis despite his many evil deeds; but they haven’t picked up the cosmology of the show that they can accept that the sacrifice of Shireen is obviously essential to the success of his mission (because of magic reasons). Because once you accept his religious fanaticism and the undoubted efficacy of his red witch’s powers, it’s obvious that when you’re in a bind you should burn whoever proves handy to her. It’s only morally beyond the pale for a man of Stannis’s sterling qualities if it’s useless, and it’s clearly not useless. But many people on the Guardian blog were protesting that it was senseless savagery, and many on the ASOIAF reddit appear to have the same view, and they can get behind a man who commits deeds too foul for words if they’re useful but they can’t accept a man who murders his own daughter because they think it’s useless. Is this ability to engage readers in the psychology of the books, but fail to bring them into the cosmology, a failure of George RR Martin’s? Or is it a failure of his readers’? Having not read the book I don’t know but I’m inclined to the latter because the people protesting this “senseless” savagery on the Guardian blog hadn’t all read the books, and so presumably had also managed to accommodate the ruthless logic of the TV show but not its magical cosmology. Is it a problem of the low-fantasy genre that we don’t believe the power of magic? Or is it just a problem when lots of people not steeped in the fantasy genre watch a fantasy show?

I think it takes special skill to get people to accept a deeply flawed and immoral world view so completely that it takes the burning alive of a schoolgirl to get us to snap back to our normal frame of reference. This is great work by the TV show’s creators, and really shows how far they’ve sucked their viewers into the horrible world they’ve created. Let’s hope next week they reward us for our complicity with a river of noble blood.

I’ll finish by quoting someone from the Guardian blog:

Guess i’m rooting for the Night’s King now then….

I have never been able to argue with authorial authority

I have never been able to argue with authorial authority

In a recent discussion with my regular role-playing group one player was complaining about the plethora of super-hero movies being released recently, and her increasing exhaustion with this genre. Another defended it partially on the basis that he has always really enjoyed superhero comics so seeing good movies of them is fun, but yeah maybe there are a few too many. I chimed in to this essential conversation to observe that I’ve never been able to get into super hero comics by Marvel and DC (and I guess Vertigo too) because I find the text so incredibly frustrating to read. The way they put bold/italic emphasis on almost random words in the text – in almost every piece of text – really distracts me from what I’m actually reading and drives me crazy. The original complainer agreed that she, too has always found this off-putting.

As an example, consider this blog post at Lawyers, Guns and Money about what a superb comic artist some guy is. It gives a long, detailed dissertation about how the action within the frame is juxtaposed with the flow of the panels to inculcate in the reader the same sense of discomfort and challenge experienced by the character the panels are about. This seems like a fairly plausible interpretation of the effect of this particular set of panels but I just can’t care about how great this makes the artist because the entire scene is so devastatingly annoying. What is with all that emphasis in all the text? Why emphasize the word “lightning bolt” and the names? It’s distracting and annoying.

I’ve felt this way for years of course but never really investigated, so I tried a bit of googling to see if I could find anything on the topic, and a brief search revealed nothing – possibly because including the words “Marvel”, “DC” or anything similar in a search term drowns out the rest, but possibly also because no one writes about this stuff. So what is going on? Why do they have to put emphasis in comic book text at all, let alone randomly throughout every second speech bubble? Is it something about the reading age of the audience? Is it meant to add dramatic tension? Is there no one in either of these quite large companies who reads this stuff, finds it annoying, and occasionally considers maybe not doing it? Are there two types of people in the world? As far as I know the method isn’t used in manga, at least not in Japanese and I don’t remember it in English either. Why do these comics do it? And is there a legion of haters of this stuff out there? If you do hate it, is it possible to enjoy the comics at all or are is it always overwhelming?

Inquiring MINDS want to KNOW.

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