Moving Up to the Big Leagues! https://mikemiesen.com

I finally bit the bullet and purchased my own domain, so all posts will be there from now on…  http://mikemiesen.com. Go there!


Saturday Links

  • Indispensable post from Ezra Klein on guns and mass shootings in the United States. There’s a lot to say about gun control and violence in the United States, but I don’t know that I’m qualified enough to say it.
  • If you pay much attention to American health care costs and policy, it’s not difficult to conclude that one route to reducing costs is to pay physicians less – they’re paid twice the OECD median, after all. As the author notes, this is far easier said than done, thanks (in part) to the lobbying muscle of the American Medical Association. One solution – which the author touches on but doesn’t dive into – is to allow Nurse Practitioners and Physician’s Assistants to practice independent of MDs (kind of a pet cause of mine). As you can imagine, the AMA fights this, too, but over time it’ll happen – the set of issues a MD can do that an NP or PA can’t is getting smaller each year
  • A great Foreign Affairs primer on inequality of opportunity in the United States, with a discussion of causes and potential solutions. You’ll notice that a lot of his solutions require significant funding – which is, of course, why they’re not currently in practice. Most are relatively uncontroversial, though – they only need advocacy and political will
  • Inequality of opportunity, writ small – fantastic piece on one girl trying to find her way out of poverty and make a better life than what she started with
  • Continuing today’s American labor policy focus, a great piece on technological change and “creative destructive” often leave many worse off; this issue doesn’t lend itself to simple solutions, but understanding it is the first step towards figuring out the right questions to ask
  • As you decide what organizations to donate to this holiday season, this is the best place to start – it’ll help you think through who you’re giving to and why. It highlights GiveWell, Charity Navigator, and other organizations designed to evaluate “effectiveness,” (one of GiveWell’s favorites this year is GiveDirectly – an unconditional cash transfer program for poor Kenyans via M-PESA… it’ll be interesting to see if this type of giving catches on in America)

Sunday Links

  • Reengineering a patient’s T-cells to fight off cancer- using HIV. If it works for leukemia, it could potentially work for many other types of cancer (including some breast cancers)
  • I’ve seen most of Bill Gates’s top TED Talks playlist – highly recommend the talks by Hans Rosling, Melinda Gates, Atul Gawande, Salman Khan, and Susan Cain
  • No Christmas season is complete without sitting around a fire and listening to A Krampus Carol. All I want for Christmas is a niceKrampuskarten

Book-Blogging: The White Man’s Burden – Chapter Eleven

This is part of my effort to write my way through a number of development-focused books, starting with The White Man’s Burden. Previous chapters: onetwothreefourfivesixseveneightnine, ten

This is it, folks – the final chapter, where Easterly will rain down catch-all solutions to the myriad problems of aid and development. Right?

Of course not! As he notes, “If you think I will now offer a utopian blueprint to fix aid’s complex problems, then I have done a really bad job in the previous chapters at explaining the problems with utopian blueprints.” So… end of chapter, end of book, right? Not quite.

Right away, Easterly recommends ditching the utopian goals and instead contends,

“The aim should be to make individuals better off, not to transform governments or societies… Put the focus back where it belongs: get the poorest people in the world such obvious goods as the vaccines, the antibiotics, the food supplements, the improved seeds, the fertilizer, the roads, the boreholes, the water pipes, the textbooks, and the nurses.”

This sounds great to me! In addition to project-based aid, Easterly also argues that aid agencies could work on higher-level concerns such as,

“…distilling practical knowledge on operating banking systems or stock markets… simplifying business regulations, or making piecemeal reforms that promote a merit-based civil service”

Here’s what I intuit Easterly as arguing: there’s a sizable amount of aid that works – focus on that. This is essentially  the opposite of what I expected coming into the book, but I’m glad that this is the argument he lands on; it’s pragmatic, partially technocratic, and narrowly-focused – which is where my intuition generally tells me to go.

What else? First, have the aid agencies put a focus on research — ex ante and ex post intervention, so that knowledge can be shared and “best-for-now practices” (my phrase, not his) can be discovered. Share results – especially failures – and always keep the focus on what can help the poor. As Easterly notes about education interventions in Kenya, “The lesson of all this research is that some equally plausible interventions work and others don’t.” It’s the on-the-ground research that distinguishes interventions that sound good with interventions that do good.

Next up: specialization. This would be a huge shift for most multilateral agencies, and the politicking to get it done would be ridiculous. Which is not to say that it can’t be done – I have all kinds of models scribbled in my notes – just that a degree of caution may be warranted. If the multilateral agencies can’t be revamped, perhaps the way they implement change can be, with a focus on competitive bidding, transparency, and incremental gains. I suspect I’ll have more to say on this in the future, as I continue learning.

Easterly points out two researchers – Dennis Whittle and Mari Kuraishi – who have proposed something similar to what I had in mind: a “marketplace instead of central planning, a kind of eBay meets foreign aid.” Their website – www.globalgiving.com – is well worth a look; I think it needs some revamping but the backbone is in place to do some pretty cool things.

There are a number of other innovative ideas that Easterly touches on: vouchers, conditional cash transfers, and prizes all stuck out to me as plausible interventions that could be pretty neat to see in practice. Conditional cash transfers are big in Mexico (the Progresa program) and have shown success; in Poor Economics, Esther Duflo and Arhibit Banerjee discuss this in some detail. Prizes have more to do with research (finding a successful vaccine for malaria, say) than on-the-ground implementation, but definitely appear to play a role.

All in all, an interesting chapter to capstone an interesting book. A summary post will be up next with some of my final, overarching thoughts.


Book-Blogging: The White Man’s Burden – Chapter Ten

This is part of my effort to write my way through a number of development-focused books, starting with The White Man’s Burden. Previous chapters: onetwothreefourfivesixseveneight, nine

We’re on home stretch of the book, with Easterly focusing on the success stories of Japan and China (countries never colonized by the West), and the atypical success stories of previously-colonized Singapore and Hong Kong. The thesis of the chapter may best be described in Easterly’s contention that “It is easier to search for solutions to your own problems than to those of others.” While this statement doesn’t scale (I’d actually contend that in a lot of cases, he basically has it backwards – sometimes an outside pair of eyes can provide the solution that insiders are blind to), let’s go with it for now.

Japan’s success can partially be ascribed to their attitude towards the West in the 1860s:

“’Japanese spirit, Western learning.’ The young revolutionaries combined patriotism with pragmatism – they realized the West was ahead, and they wanted to borrow Western methods to catch up, while preserving Japanese institutions, culture, and independence… They invited Westerners to Tokyo, and themselves went on long tours of the West. But this was to create no dependence on the West; the watchword was ‘self-help’”

With strong government institutions, private property rights, and a sufficient tax base, Japan was poised to capture the gains from the private sector’s innovation (known to those us in the West as giant conglomerates like Mitsubishi), and success begat success. Then came World War II and the annihilation of Japan, followed by America’s rebuilding of the decimated country (physically and institutionally). I think it’s fair to say that much of what America did was similar to its Marshall Plan in Europe – the physical and institutional infrastructure existed previously, so Japan simply needed the funding and the time to rebuild.

But what, if anything, should Japan’s experience tell us about foreign aid specifically? Monetarily, Western foreign aid was sparse – but that’s because it wasn’t needed. Indeed, it’s difficult for me to ascribe any significant lesson from Japan to the developing world today with respect to monetary aid. What was needed included Western expertise from a technological and business management standpoint, which can be seen throughout Japan’s history: the “Western methods” the revolutionaries picked up in the 1860s and Deming’s post-war injection of operations expertise led to the creation of some of the world’s most vibrant and prosperous companies (Sony, Mitsubishi, and Toyota among myriad others). I think this lesson is largely transferable; where possible, Western methods, expertise, and general know-how can serve as innovation catalysts for entrepreneurs and innovators in the developing world – if done in a culturally-sensitive and humble way.

Next up: what’s the deal with Singapore and Hong Kong? They’re both former colonies, yet they’re killing it in the global marketplace. Easterly holds that their success can partially be explained by the fact that,

“they were unoccupied territories that the British colonized with the permission (or coercion) of the nearby local rulers….The British also left the Chinese communities free to pursue their incomprehensible customs and more of less govern themselves…”

To simplify things a bit: the former colonies are successful today because the British didn’t upend everything – mainly because there wasn’t much to upend in the first place. Here too, I think it’s tough to make the argument that significant lessons for today’s environment can be learned from Singapore and Hong Kong, other than a very general “try not to change everything as you try to help – only do what’s absolutely necessary.” Even this is problematic: “absolutely necessary” is an awfully flexible phrase, open to wide interpretation with the benefits of hindsight.

Next up: China. Let’s be honest: China is a weird success story; as Easterly notes,

“It is an unconventional homegrown success, failing to follow any Western blueprint for how to be modern. It combines lack of property rights with free markets, Communist Party dictatorship with feedback on local public services, and municipal state enterprises with private ones.

I am decidedly not an authority on recent Chinese history, so I have a hard time taking a critical eye towards this section; it’s impossible to ascribe China’s success to any one causal explanation, and it’s hard to say if China’s “weirdness” will continue to be a boon for its unheard of growth.

In any event, Easterly’s claim about China – and subsequently India – is that Western intervention was not the proximate cause of their growth; homegrown Searchers were. He holds that the World Bank and IMF are trying to take credit for a success that isn’t theirs. This may or may not be true, but it’s kind of a specious argument; successful development can’t be ascribed to Western help, but all cases of unsuccessful development are at least partially caused by Western ineptitude, Easterly seems to argue.

In short order, Turkey, Botswana, and Chile are heralded as exemplars of homegrown development. I’d rather not touch on Chile (much has been written about Milton Friedman’s “Chicago Boys” and their influence on the country – well worth reading up on), but Botswana warrants some attention. Easterly holds that Botswana is an example of an African country that shows that “if Africans can get good government from their rulers, the abundance of natural resources can be turned into a blessing.” At the same time, Botswana doesn’t typify African countries, so it’s hard to draw a 1:1 conclusion:

“…favorable factors were benign neglect by Britain during the colonial period, the absence of ethnic conflict because of the relative homogeneity of the Tswana people, and clear indigenous property rights based on cattle holdings.”

We can decry colonialism all we want, but we’re stuck with its deleterious effects. Most African countries don’t have the mix of favorable conditions that Botswana does, so the question isn’t “How can we scale Botswana’s success to other African countries,” it’s more like “How can we assist in developing the institutions necessary to allow other African countries to positively draw from Botswana’s experience?” As we’ve seen throughout the book, Easterly would hold that we shouldn’t play a part in that – democracy and free markets are great, but implementing both in a country ready for neither is a recipe for disaster. My intuition says that there should be a third way that is more moderate, but I’m also very new to this, so I’ll hold off on thinking through these possibilities on paper for now.


Friday Links

  • Live in the future, then build what’s missing” is a fantastic way to think about innovation/entrepreneurship, as Paul Graham notes. It’s also a pretty cool way to think about the life one wants to lead (like in the Avvett Brothers song, “Decide what to be, and go be it.”) If you click on just one of these links, make it this one
  • Do you want to learn about zombie-making organisms? Of course you do! If you aren’t kept awake at night by the knowledge that a wasp can cause a spider to build a “radically-different [nest], a home not for the spider but for a parasitic wasp that has been living inside it,” you don’t have an expansive-enough imagination (as an aside, Carl Zimmer – the author of this article – is a fantastic raconteur: listen to a heart-wrenching story of his – from Radiolab, naturally – here)
  • A sort-of silly article on computer-aided diagnosis (partially through the lens of Watson, the program that famously kicked Ken Jennings’s ass in Jeopardy) and a real-life Doctor House from UCSF Medical Center (Dr. Gurpreet Dhaliwal). Look: Watson is neat, and however society can use technology to aid diagnosis and allow physicians to focus on other items (like patient care) is wonderful… but physician diagnosis isn’t likely to completely disappear. There will always be a Dr. Dhaliwal – he or she will probably just consult Watson the same way he/she uses Epocrates (an app encyclopedia of pharmaceuticals) or Shots (similar to Epocrates but for injections) today: as an assistant
  • Connecting back to my post on Chapter Seven of The White Man’s Burden, the new PEPFAR plan explicitly disallows funding for family planning.   This is… unfortunate – family planning has been shown to be integral to reducing the fertility rate of a country (see: Bangladesh), which leads to higher economic growth, which is a good thing (something which – ostensibly – is part of the purpose of aid). Frustrating
  • Interesting emerging theory on dopamine’s role in the brain: it has more to do with motivation than pleasure. Whenever I hear about dopamine I think back to a great Radiolab segment on “Seeking Pleasure” and the micro-level workings of dopamine as an “expectations engine.” Fascinating stuff

Book-Blogging: The White Man’s Burden – Chapter Nine

This is part of my effort to write my way through a number of development-focused books, starting with The White Man’s Burden. Previous chapters: onetwothreefourfivesixseven, eight

Taking the age of colonialism to the age of invasion, Easterly looks to the recent past to understand if Western military intervention has led to boom or bust by analyzing countries caught up in the Cold War.

Here’s the thing: analyzing America’s Cold War interventions in terms of the countries invaded isn’t a particularly difficult thing to do – it’s easy to see that almost everything about them is negative. To back up perception with data:

“Statistically, the cold war countries in table 8 have far worse institutional outcomes than other developing countries on all six dimensions that World Bank researchers measured in 2004: democracy, political stability, government effectiveness, regulatory quality, rule of law, and corruption”

(The countries, if you’re interested, are present-day Vietnam, Cambodia, Afghanistan, Guatemala, Korea, Iran, Liberia, Ethiopia, El Salvador, Nicaragua, Democratic Republic of Congo, and Angola).

Again, we’re stuck with corrupted data – these countries aren’t random (whether the reason was defensible or not, there was a reason the United States became involved with them), but the conclusion can still be broadly drawn: none of the listed countries turned out great (with the possible exception of South Korea, though that needs to be weighed against the famines and general craziness of its northern cousin).

As an aside: in his sardonic way, Easterly also grades the interventions in terms of a silver lining for America (to use Ethiopia as an example: “Live Aid concert to help Ethiopia in 1985 gave valuable experience to Live 8 musicians to help Africa twenty years later”). I thought this was cutting and sad-funny.

The next section of the book focuses on the case studies of Nicaragua and Angola. In Nicaragua, the United States backed the right-wing Contras (whom President Reagan called “the moral equal of our Founding Fathers” as word leaked of significant human rights abuses) over the Communist Sandinistas by providing arms and training. The stated goal of this was to protect America, ostensibly from the possibility of one or more Communist countries in Central America serving as a satellite or weapons cache of the Soviet Union; in the overheated rhetoric of the Cold War this seemed to convince enough Americans. History hasn’t judged the American intervention a success, though; economic growth has been stagnant and the political system is a mess in Nicaragua. To be fair, this may have been the case without American intervention – it could even be worse, really – but the balance of the evidence seems to show that intervening was a mistake paid for in local lives.

Angola is a fascinating case of colonization leading to long-term instability and chaos. In short: Portugal colonized the area, putting Portuguese in positions of government and economic power; native Angolans started a guerilla war for independence in 1961, and were granted it in 1975 in a very haphazard faction as the Portuguese fled. Without authority and worried about the future, the white business leaders fled, leaving both the civil service and the economy in tatters. After independence, the multiple Angolan rebel groups could not get along – partly because the Soviet Union, United States, and Portugal each backed a different group – and Angola was stuck in civil war for the next twenty-seven years.

Each of these case studies typifies the (possibly inevitable) errors that Western and Soviet incursion into local military affairs led to: an increase in arms and bloodshed; prolonging the conflict; propping up a less-than-satisfactory leadership group post-conflict. I want to make a comparison to America’s past conflicts, but it’s difficult to do: without French involvement in the Revolutionary War (spurned by its self-interest), the colonists could very well have lost; with British involvement in the Civil War (for selfish, cotton-importing reasons) the North could very easily have let the South secede. Comparisons are messy. What’s less messy is that a decisive victory is better than a muddy, brokered peace, all things considered:

 “…peace usually succeeds war because of a decisive victory by one side, not because of negotiated settlements by outsiders. The intuition is simple: military victors are likely to form a more stable government, whereas a coalition of recent antagonists imposed by outside planners is like to be unstable…There can be awful military victors as well as good ones, but local actors are statistically more likely to find peace on their own.”

If we’re comparing instances where America did get militarily involved, does it makes sense to also look to examples of instances where America didn’t get militarily involved? Were the outcomes better? Counterfactuals are especially difficult (we don’t know what today would be like with intervention, of course), but my intuition is that Western intervention in Rwanda and Sudan could have stanched the atrocious genocides (a tautology, to be sure) that occurred. More recently, it’s possible that American intervention in Syria could shorten the conflict and oust Bashir Al-Assad there. All of these examples are too recent to judge – and genocides are probably different than “typical” conflicts from a moral and tactical standpoint – but it seems to me that it’s a discussion worth having. Again: it’s messy, and there’s almost certainly no one answer.

So where does that leave us? Foreign incursion into local conflicts – especially for selfish reasons – appears to be a net negative, though an argument can be made that in certain instances intervention could be justified. Not exactly clear-cut, but then again nuanced situations rarely are.