Wednesday, December 30, 2009


Some follow up to a previous post and readings from David Brooks Sidney Awards, Part 1 and Part 2.

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We had a white day-after Christmas. The family partook in Nathan's present and went to see Avatar in 3D. My take on the technology is first, it has definitely improved. The glasses now look more like normal sunglasses. I could imagine wanting to see other movies done this way, though my wife did complain of a headache afterward. Second, the technology has its biggest impact up front. The mind hasn't adjusted to it yet so it is most noticeable. Some way into the movie, the story takes over and the technology doesn't seem to matter nearly as much thereafter. Third, there was one part of the movie where the technology really helped in telling the story. This is when the protagonist, Jake Sully, first tries on his avatar of the Na'vi. He is awkward and uncoordinated and the 3D helps to convey that sense. There are flying scenes later in the film where it is more spectacular because of the 3D. But it didn't seem consistently important throughout.

My take on my previous post about pantheism, etc., is that Douthat gave us something of a misdirection. The film is overtly anti-imperialist, particularly of the American kind (send in the Marines) which are depicted as instrumental about their own needs and unthinking about everything else, particularly the well being of the natives. So the military solution becomes the first best option rather than the last resort. Patience as a virtue apparently isn't. Given the historical moment in which this film appears and America's extended presence in Middle Asia, one might not be too happy with this not very subtle bashing. So rather than take that one on straight away, with most of the the Times readers (me included) still feeling that WMD and Saddam shows the idiocy of this approach, a more conservative view needs to undermine the message of the film but in a more subtle way, one that might make the audience reflect. I did and wrote my earlier post as a consequence, but I hadn't seen Avatar when I wrote it. Douthat's piece probably wouldn't have resonated with me as much, had I seen the movie earlier.

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I liked How American Health Care Killed My Father. It's a thoughtful analysis. I especially liked Goldhill's desire to separate out health insurance for catastropohic incidents from the rest of health care. I've long thought that should be the case and that there are huge distortions in the system from bundling the two of these. Thereafter, he argues for the rest of health care to be financed by the individual, so that "ordinary" health care is procured as a consumable. This, his argument goes, would be the best first step toward containing health care costs and making the system responsive to the patients. It is an interesting argument.

I like to take arguments like these and attack them on their merits. Goldhill, himself a businessman and obviously quite literate financially, may not see the weakness in his own position. In this case the main weakness is that most consumers are not so literate about their finances (one big explanation for the Housing Bubble we experienced). In Goldhill's terms, health care would then have a substantial asset management component and one would wonder whether on their own consumers would get it right. Comparatively healthy people might then under consume health care in the form of precaution/prevention. Comparatively sickly people might over consume treatment. As an investment decision, who will help the consumer with these choices? Would that be the family doctor? If so, does his solution look so different from what is being proposed?

As a result of reading this piece I did some quick Google searches to find out about physician income. Most doctors whom a patient sees only when they have a condition that warrants the visit, face a certain sort of moral hazard that Goldhill describes in the piece. But physicians who have a long term relationship with the patient may still have a moral hazard, akin to the one that financial advisers have with their clients. Goldhill's analysis needs to work that consideration through. It isn't there in this piece.

More generally I got to think who among the entire industry of health care provision might lose if recommendations like Goldhill's were to be taken seriously. It would be good to see the analysis from the point of view of the drug companies. Based on some work by Larry Kotlikoff from a while back, my sense is that if you do a cost-benefit analysis on most new treatments, the conclusion would be that the treatments were inefficient. You get the reverse only by making the an ethical argument about extending life or improving quality of life via the treatment. Goldhill is silent on this issue too, though I believe if his solution were implemented it would move things closer to the efficient outcome without the ethical argument. Hmmm.

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I did not like The Rubber Room, a designation for a place where tenured New York City teachers who have been deemed unfit to teach must go in order to receive the remuneration to which they are contractually entitled. Steven Brill, the author, does not appear to be a neutral observer in the piece, but rather a witness for the prosecution. A piece like this can get written because now so much thinking about schools rests on the research finding that good teachers matter, a lot. So it must be that bad teachers matter too, in a way that is not good for the children. The view from management, then, is to attract and retain the good teachers and weed out the bad ones. I'm afraid this is the state of the art with current management thinking in K-12 education. It makes little or no allowance for a feedback effect where "the system" influences the goodness or badness of the teaching. And it makes the relationship between principals and teachers seem necessarily adversarial.

This is a simple categorization of how a tenured teacher might be found to be bad:
(1) The teacher was bad all along, even before tenure was granted, but the system made an error and judged otherwise when tenure was granted.
(2) The teacher was never bad, but was judged bad after tenure was granted via some sort of Type 1 error.
(3) The teacher was good at the time tenure was given but deteriorated thereafter for reasons due to the system.
(4) The teacher was good at the time tenure was given but subsequently had some problem essentially unrelated to work that made the teacher bad.

Let me dispense with these in inverse order. We can all agree that (4) is possible. Getting rid of tenure is not necessary to address (4). The efficient solution would be some form of buyout where the teacher then seeks other work or chooses to retire. This, in essence, is the same issue with faculty tenure at universities without mandatory retirement. Tenure gives bargaining power to faculty. It doesn't ensure attachment in perpetuity. It means the terms of separation have to be mutually agreeable.

Brill's piece is essentially unconcerned with (3), but I think it is the heart of the matter. Does the system wear teachers down? What can be done to refresh teachers in the form of professional development, new assignments, and reorganization of the schools? Will the young teachers of today, the ones the system is trying to attract, be the burnouts of tomorrow?

Brill does discuss (2) in the piece - a teacher at Brooklyn Tech was (falsely?) accused of making sexual advances with a student. What Brill doesn't discuss, but what does require elaboration, is if students in general recognize they have power via this route the tone it can set in the classroom.

As for (1) Brill suggests that there was a regime change when the Bloomberg-Klein leadership took over - acceptable teacher performance under Giuliani, Dinkins, or Koch, might no longer be acceptable. Fine. But the feeling one has reading the piece is that Brill embraces a hostile takeover mentality and decisions teachers made to become teachers in the prior regimes hold sway now as to the current allocation. So we begrudge the current payment or the possibility of buyout, though the analysis should be like (4).

In the current labor market, being a teacher may be an attractive option - any job may be an attractive option. Long term, however, getting good people to want to be teachers as a career, not just as an interlude before the real career starts, is a serious problem. Designing a system that does this and also does a reasonable job with the bad apples is what is needed. Brill's piece, by ignoring the long term incentive issues, can go for the jugular and place the blame squarely on the teachers. Does that really make sense?

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