Rational Philosophy

Or “will the real statistic please stand up.”

Last week I found myself both defending Giuliani against critics that he’d lied to make his case against socialized medicine and criticizing him for using selective statistics. Now I feel compelled to criticize N. Gregory Mankiw for criticizing the use of healthcare statistics, not because his criticisms are wrong, but because he couches his arguments in cool economic terms rather than political terms and doesn’t follow them through to a logical conclusion.

In his ‘economic view‘ N. Gregory Mankiw goes beyond economics in the subtext of his comments about healthcare statistics to tease up matters of broader political sway.  The gist of Mankiw’s argument is that Canadian health stats are better than American health stats not because the Canadian health system is better, but because Americans are more violent, fatter, and more promiscuous as teens. (Ra! Ra! America!) He also says that many of the 47 million uninsured aren’t citizens and that a nationalized healthcare system wouldn’t change this. And finally that healthcare costs should be rising on a per capita basis — this is progress.

Mankiw reasons that a new healthcare system won’t make Americans less violent, thinner, nor less promiscuous (nor, one presumes, less likely to immigrate illegally). Ipso facto — no need to nationalize the healthcare system.

(Note to self: contact Mankiw to see whether he would be willing to fill out my tax return.)

What Mankiw doesn’t conclude is that America, being relatively more violent, fat, and promiscuous than its northern neighbor may have a few things to learn from Canada about how to become safer and healthier. And who knows, in the process we may even decide that we like the idea of socialized medicine.

This is a bit of a tangent, but whenever I think about socialized medicine I think about the private road that leads to my mother’s house. The road (really more of a short dirt track) serves several houses. The houses jointly share responsibility for the upkeep and maintenance of the road. Inevitably, the road is a pitted, potholed liability, unpassably muddy on foot when it rains (which, where my mother lives, is often).

All of the good things about a good system of socialized medicine can be encapsulated by thinking about what a wonderful thing it would be if the local council were to take over responsibility for the maintenance and upkeep of that little stretch of road. And all of the pitfalls of privatized medicine can be encapsulated in an exaggerated way by thinking about what would happen if every road needed to be maintained by the people living or working along its route…

N. Gregory Mankiw’s intelligence and sophistry brought to mind another piece today, one that also traffics in sobering statistics. I imagine that Mr. Mankiw (a professor of economics at Harvard, former adviser to President Bush and adviser to Mitt Romney) received a bang-up education, or at least a comprehensive education. (Although in Mr. Mankiw’s case it seems that a good education can’t teach one everything.) But the country today faces, and has for some time, an educational crisis. America’s system of public education, something that only the most die-hard of conservatives seem to itch to want to dispense with, needs care and attention. Education can’t solve every social and economic problem, but one can be certain that without a good educational system our chances of solving the social and economic problems of the future will be much hindered.

Well, after reading Paul Krugman’s encouragingly negative piece on Giuliani’s statements about cancer survival rates, I trotted off to research my own damning indictment of Giuliani’s propaganda against Democratic calls for healthcare reform. I should have known better. What I found wasn’t so encouraging.

Of all people, I should have known better. I’m English; my father died of cancer, in England. I know first hand that the American health care system, in some ways — like shorter waiting periods and accessibility of newer treatments — tends to be better than the English healthcare system. (I also know first hand that in other ways — like community outreach — the English system seems better than the American system.) Giuliani’s propaganda should be condemned, perhaps, but not because he lied; as far as I can tell he didn’t lie he simply chose to use the most conveniently damning statistics.

It’s unfortunate that people abuse statistics as they do. The world would be a much better place if one needed a license to wield statistics. We need a license to drive a bus or to inspect an elevator, why not a license to fire off numbers?

Benjamin Disraeli wasn’t the first to coin the phrase about there being three kinds of lies, but he popularized it across the Atlantic, as Mark Twain did here.

Statistics should be carefully handled, thoroughly understood. Very few statistics tell their stories in straightforward, unequivocal terms. How were they gathered? what’s been included, what’s been excluded? what was the sample size? were other influencing factors eliminated, if so, how? And even if we understand the statistics, how can we use them in such a way that we disclose everything we know about the statistics so as not to mislead people?

Here’s an example: If someone were to release statistics about the time I get on the subway to head into the city on weekday mornings, they could cite my average alighting time as 8:06am. But the standard deviation around this mean departure time is over 49 minutes!  Pretty eractic, what a flake.

Now, only those who had access to and took the time to study the underlying data would see that on three days each week I leave at 7:30am (so that I can go to the pool for an early dip). And on the other two days I get on the train at 9am after dropping my son at pre-school.  I keep a pretty regular schedule around those times, with a standard deviation on any particular day of the week of no more than a few minutes.

We like statistics because they feel definite and concrete. They feel as if they will support the weight of some action that we can take to alter them in some way. If my departure time appears erractic, I must strive to be more regular in my schedule! But unless the statistics really do tell the story we think they tell, then they will only support incorrect conclusions and unhelpful actions.

Giuliani clearly liked the statistics that seemed to show that the English healthcare system was vastly inferior to the American healthcare system. He didn’t go looking broadly for statistics that would bear out this conclusion in all facets of the healthcare system. He didn’t drill down to show how the Democratic health reform bill would specifically lead to problems of reduced quality care in the American system. He simply plucked appropriately scary numbers off the statistic vine and tossed them out to support his aversion to increased government healthcare spending. Giuliani selected statistics that on their face lead us to want to reject the Democratic healthcare plan, whereas they don’t necessarily support this rejection at all. We would need to understand a great deal more about the proposed plan and about the potential impact on the quality of healthcare before arriving at such a conclusion.

It could be that the healthcare plan will improve the overall quality of care in America. I would imagine that this is what its proponents intend. But instead of finding out the facts we’re stuck talking about whether Giuliani lied or not. So often, politics gets stuck in meta-discussion, and we all lose out.

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For some reason that I couldn’t quite put my finger on right away, I found Cafferty’s comment today (Judge makes a disgraceful decision) on a judge’s efforts to slow or halt a program that would require employers to fire workers with faulty social security status (illegal immigrants) distasteful. I think it was his sentiment rather than his logic that offended me, his presumption that enforcement of national law supercedes human decency and compassion, whatever the circumstance.

In another story — “Bush vetoes expansion of kids’ health insurance program” — Rep. Todd Akin, R-Missouri, supporting Bush’s veto, complains: “we’re going to provide health care to the children of illegal immigrants.”

In one section of LIFE! Why We Exist… And What We Must Do to Survive I examine the origin of the impulses that lead us toward a conservative or liberal way of thinking. It’s a spectrum of course, but the impulse toward conservative thinking seems to derive from a focus on the importance of the self (one’s right to govern one’s self, the live and let live mentality) versus the liberal impulse to value people generally and to not consider one’s own needs over and above the needs of others. I’m dramatically over-simplifying, but I hope you’ll see the point.

If we feel that national law should be put ahead of human decency, our perspective will tend toward a hard line on immigration. If we feel that the rights of human beings are more important than national concerns, then we’ll be concerned about the effects of a hard line approach on illegal immigrants. A conservative will tend to feel that we shouldn’t make exceptions when deportation of just some members of a family will break up that family. A liberal will wonder why the law must be so unfeeling.

Again, as I discuss in the book, once we have sought out the origin for these perspectives, we can consider whether either perspective is more right or better than the other. To cut to the chase, I conclude and show logically that the more liberal perspective is more enlightened and bodes better for the survival of the human species. I’m sure that a conservative would disagree, but I am also sure that he or she would be hard-pressed to defend such a position rationally and logically. Are we not all part of the human race, wherever we happen to be born?

 

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