Discourse Failure and Why Both Sides Do It

Murali

Murali did his undergraduate degree in molecular biology with a minor in biophysics from the National University of Singapore (NUS). He then changed direction and did his Masters in Philosophy also at NUS. Now, he is currently pursuing a PhD in Philosophy at the University of Warwick.

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37 Responses

  1. Pinky says:

    I don’t think you get to be the next David Brooks, because this article was worth reading.

    Now, I don’t know if this is a jerk comment to make, and if it is, I’m sorry. But wouldn’t public choice theory also testify that the same incentives exist within academia? I’d bet that there’s a higher cost in changing one’s mind in one’s profession than in one’s non-work life. The cost of “converting” too early or too late to, say, 10-dimensional string theory must be enormous if you’re a physicist. That conversion can be based on evidence, publishing pressures, tenure, or the mathematical style of the grad school you attended.

    I think it’s fair to say that people make, or stick with, bad assumptions for the reasons you stated. But a lot of the skepticism toward particular fields is grounded in the assessment that experts also make, or stick with, bad assumptions. It’s tough to argue atainst that assessment.Report

    • Patrick Cahalan in reply to Pinky says:

      I’ve come to conclusion that the difference between honest skepticism and anti-ism is the lack of inquiry.

      “I have questions about this counter-intuitive thing” is the beginning of both. “I don’t know who the experts are and I’m not sure what it takes, really, to be an expert” is the first sign of a split between the honest skeptic and the anti-ismist.

      The honest skeptic doesn’t regard “I have questions” as a position worthy of ending inquiry. The anti-ismist ends inquiry at that point. They find a collection of arguments that match their confirmation bias and call it a day.

      I don’t think this can be trained.Report

      • Pinky in reply to Patrick Cahalan says:

        Patrick – Don’t you think that it’s a matter of degree? We all suss out the things that are counter-intuitive to us, relying on the sources or experts we trust, but at some point we decide we’ve fulfilled the obligations of due diligence. The difference is in the amount of effort we put into the investigation.

        Actually, when I say it like that, I think I see a point in the original article that could be clarified. It may cost the individual very little to change his assessment of, say, fair-trade coffee, but the deeper cost is in the reassessment of the source of expertise that led to the original position. It’s more than a loss of affinity; it’s a weakening of all the positions which share the same reference.

        To give an over-the-top example, I used to listen a lot to Coast-t0-Coast AM, a crazy late-night UFO conspiracy radio show. Every guest and every caller share nearly the same positions on aliens, monetary policy, the Mayan calendar, men in black, and every other thing. Any guest who strayed outside the norm – like saying that the black helicopters were working for the UN, but not the aliens – would get attacked viciously by the callers. To question one of the principles was to raise doubt about all the theories with the same “op cit”.

        This may be a small point, but it’s one that’s more tangible than the article’s more vague idea of identity.Report

        • Patrick Cahalan in reply to Pinky says:

          There’s a point where a difference of degree becomes a difference in kind.

          Even that aside, it’s only really a difference of degree if you’re taking a very bondage-and-discipline structured approach towards your philosophy, where everything needs to be reduced all the way to the point of meaninglessness.

          That’s actually a good example; though. I’m not really talking about aggregate belief systems (which is a different animal altogether) – it’s a really important point, but it’s an aside. Yes, people have a tendency to adopt entire belief systems and reject challenges to individual bits of those belief systems based upon the challenge to the overall system, but that’s a different problem from being disconnected in your own head between what skepticism actually is.

          Skepticism is not default-deny. It’s just not default-accept. Anti-ism is default-deny. There’s a subtle difference there. Curse bivalent logic and the excluded middle.Report

  2. CK MacLeod says:

    Seems like a technocratic or scientistic way of re-phrasing common observations on the relationship between philosophy or science and politics or opinion going back to the ancients.Report

    • Patrick Cahalan in reply to CK MacLeod says:

      Yeah, this, too.Report

      • Murali in reply to Patrick Cahalan says:

        scientistic? The mere observation that the gold standard for successful academic enquiry seemingly lies with the hard sciences somehow lumps me with the likes of Richard Dawkins?Report

        • CK MacLeod in reply to Murali says:

          Dawkins wouldn’t have come to mind for me, though I guess there might be a parallelism.

          The point is that an awareness of the inability of the demos to ascertain its true interest goes back to the origins of political philosophy, and has been rather exhaustively considered and re-considered literally over the course of 1000s of years, and not just in the West or within the Western tradition. I wouldn’t have expected “public choice theory” to add much to this discussion, and I see no reason yet to revise those expectations.

          The same can be said for bureaucratic-administrative solutions or pseudo-solutions to social problems. Such problems remain merely technical problems until they are felt to impair the interests of the powerful in some intolerable way. At that point, the “technical” problem becomes the basis of a potential power struggle at whatever level, and we’re back where we started: Someone decides when “public deliberation” must be concluded, so that whatever action can be undertaken without further consultation. If the society doesn’t know who that someone is already, or how that decision is to be made, it will have to find out, and it may be surprised by or unhappy with the answer, since whatever laws or compacts or traditions, including the ones empowering whatever bureaucracy, are inherently subject to revision by whoever turns out to have the power of revision.

          The comment below from Rod about “what are you doing” put me in mind of a line of Leo Strauss’s from his discussion of Rousseau (esp. the Second Discourse) in the Natural Right and History: “The problem posed by political philosophy must be forgotten if the solution to which political philosophy leads is to work.” The people must be made to believe that it has freely chosen a decision that must be imposed on it or that it has been “tricked” into approving. The democratic spirit rebels, and demands the punishment (or banishment, or crucifixion…) of the philosopher who exposes its infirmity, an infirmity demonstrated by the demand, etc. Whatever the fate of the particular philosopher, the paradox remains, and retains the same structure however it is re-stated: We must freely choose our unfreedom, which also means unfreely choose our freedom.Report

  3. scott says:

    Just curious whether there’s moral luck involved in discourse failure when business and financial leaders fund tame think tanks which tell the public that we need to unleash the banks and that global warming is a fable. I think not. When I see one side motivated by their financial interests actively working to promote discourse failure, I don’t think that’s happenstance, that’s a choice it can be judged by. Lack of public deliberation is a real problem, but it’s a little too easy to blame the deficiencies of the yokels for our problems and to recommend limiting public power as a result. Glaring elite failure strikes me as a larger problem. (Also, can we leave economics out? Physicists and climate change experts have a right to call what they do science and to have some pride in their predictive record, but economists as a class have proven themselves to be a self-deluded and self-interested class of witch doctors. If the public doesn’t want to treat their word like gospel, that would seem to be nothing more than robust common sense.)Report

    • MikeSchilling in reply to scott says:

      fund tame think tanks which tell the public that we need to unleash the banks and that global warming is a fable.

      They need to be branded with a scarlet “T” (for “Tobacco Institute”).Report

    • Murali in reply to scott says:

      of public deliberation is a real problem, but it’s a little too easy to blame the deficiencies of the yokels for our problems and to recommend limiting public power as a result

      Sorry, but public deliberation is the problem. It is the very nature of the beast. The more we have of it, the worse things get.Report

  4. BlaiseP says:

    There really is very little failure of discourse. Strip away all the fallacious appeals and it always comes down to a matter of axioms.

    Equal pay for equal work.
    Morality must not be legislated.
    Church and State must be separated.
    Women and minorities deserve equal rights.

    All Liberal axioms. Nowadays, they’ve passed into the realm of non-discussion. The Liberals won these arguments. Nobody would dare oppose them directly but there’s still plenty of dog whistling about these concepts.

    Truth doesn’t enter into the debate without a grounding in axiom. It’s just a matter of whose axioms we accept and under which circumstances. Euclid’s Sixth doesn’t work in Riemann Geometry. The shortest distance between two points is not always a straight line. Our current conclusions about Bell’s Inequality can’t observe all the photons. But the great truth of Bell’s Inequality is this: any deterministic description of the quantum world is wrong. Either we can question the world or it’s all a colossal, fatalistic joke.

    I sometimes wonder if that is what Krishna meant-
    Among other things – or one way of putting the same thing:
    That the future is a faded song, a Royal Rose or a lavender spray
    Of wistful regret for those who are not yet here to regret,
    Pressed between yellow leaves of a book that has never been opened.
    And the way up is the way down, the way forward is the way back.
    You cannot face it steadily, but this thing is sure,
    That time is no healer: the patient is no longer here.

    Attempting to evict passion from argument, as if truth could be distilled out of discourse, is as surely a resort to fatalism as the fallaciously deterministic explanations of the quantum world. Things are the way they are and if we arrive at different conclusions about them, surely they are all wrong seen from a single perspective, all wrong except our own conclusion. It is the act of questioning which matters most. Others may take up the questions we ask and find bizarre and seemingly self-contradictory answers which in turn lead to more questions.Report

  5. Roger says:

    Nice post Murali,

    I believe there is another dynamic at play that corrupts the public discussion. Economics of supply and demand attracts experts that will present a rational excuse for even the most outlandish views. If half of America believes in Creationism there is a HUGE incentive for someone to fill the role as the scientist believing in Intelligent Design. Similarly, I suspect extremist rationalizers are being attracted to the extreme positions on Climate.Report

  6. Rod says:

    I was intrigued by this: …On the other hand, the expected cost of trying to comprehend and accept a counter-intuitive proposition is by comparison, much larger. This is because we will have to work against our tendency to prefer familiar and personal causes with designated villains to impersonal systemic explanations. and later, this: Also contributing to the problem is the psychological cost of giving up beliefs which are tied to one’s own moral, social and political identity. It is an unfortunate fact that people prefer to associate with people who tend to think and believe like themselves.

    During the interminable health-care debate of 2009 I remember hearing President Obama say something to the effect that health-care costs had been rising at 2 1/2 times the rate of inflation for the last 40 years. Consider the mathematical implications of that statement: If general inflation over that period was just 2% annually then health-care inflation would have to be about 5%, leaving a differential of about 3%. Three percent compounded over forty years is (1.03)^40~=3.3. If, for convenience, you round that result to an even three, it would imply that our current health care expenditures are now about four times as high as they should otherwise be if not for the influence of whatever villain is at the root of this problem. Wow. That’s a lot of money. If health care is currently running us about $2.5 T annually as a country, that implies that almost two trillion (1.8) of that is attributable to waste, fraud, abuse, or whatever.

    Simple question: Where the fish is all that money going? Some of it you can undoubtedly ascribe to benign causes; a graying population, advances in medical tech that are also incidentally sort of expensive, the AIDS epidemic, etc. But if you make the international comparisons and assume that other countries are experiencing those same cost pressures–and a lot of other OECD countries have it worse in that regard, particular aging populations–then you are still left with at least 50% of our health care costs unexplained.

    Now as a card-carrying liberal in good-standing, my go-to villain has naturally been the health insurers and BigPharma. But is it possible that they’re really wolfing down that much of the health-care pie? Both industries enjoy reasonable profits, and god knows their executives rake in a pile of cash, but over a trillion dollars annually? The math just doesn’t work. So I’m forced, simply by the numbers and the logic of the thing, to seriously question the narrative of “my” side.

    But having thrown my preferred explanation in question, that doesn’t necessarily support the opposing narrative either. It’s all well and fine to claim that government interference–subsidies, regulations, tax-exempted employer health plans, occupational licensing requirements, etc.–are to blame. But to support that argument it would help if you could point to exactly where that money is going. Are doctors, due to the AMA or licensing restrictions, actually making… not four times as much, but necessarily much, much more than they should, since their salaries are only a component of health care? And has that distortion got so much worse since 1970?

    Here’s the thing… all of the proffered villains, whether from the right or left, can explain why and how health care may be more expensive than it “should” otherwise be. What none of them can do, either individually or in combination, is explain why the problem has gotten progressively worse over the last four decades. And in a remarkably consistent fashion, I hasten to add. The inflation differential for health care has been stuck at an amazingly constant 2.5 over that entire 40 year history. It doesn’t wiggle-waggle up and down; it’s just a straight line. Despite all manner of changes in tax policies, whether Dems or Reps are in power, the rise of HMO’s and PPO’s, all kinds of technological changes, demographic shifts, etc., the differential remains a rock-steady 2.5.

    So for a while now this has been nibbling at the back of my brain. What could explain this? Then I read a short article by economist Dean Baker–who I generally respect, seeing as he’s one of “our” guys–about the “Haircut” effect. The idea being that domestic industries, generally services, will have a different rate of inflation than goods and services that can be imported like trinkets from China. Inexplicably to my mind, in the article he dismisses the theory as an explanation for the HC differential by… get this, comparing health care costs to the cost of actual haircuts. My god, he’s so smart, but that’s just really dumb. The market dynamics of health care and hair care differ along a number of different dimensions, so directly comparing the two invites a boat-load of question-begging. It just seems like a really shallow analysis.

    Finally (and I promise there’s a point here eventually), I just decided to look up some numbers and satisfy my own curiosity. And what did I discover? That the HC differential is almost precisely matched by a similar differential for legal services and financial services over that same time frame. And the relative cost of veterinary services has actually been rising faster than all three for the last ten years (the extent of the data available), as well as both higher education and K-12.

    This ought to change the entire debate. This shouldn’t really be about health care inflation, per se, at all. This is really about price inflation in professional consumer services generally. It only become a debate about health care because we care enough, as a society, about the provision of health care to our citizens to focus on it.

    I’m not disputing the opinions of the learned economists in explaining this data. There simply is no proffered explanation for the data to dispute. It’s incomprehensible that I’m the only one to discover this, that no professional economist has wondered about this and checked the same trail of bread crumbs. Perhaps it’s just a matter of compartmentalization; we’re talking about healthcare so I’m going to look at the healthcare market, full stop. Or maybe Pinky’s comment above from July 31, 2012 at 1:19 pm is on-target:

    But wouldn’t public choice theory also testify that the same incentives exist within academia? I’d bet that there’s a higher cost in changing one’s mind in one’s profession than in one’s non-work life. The cost of “converting” too early or too late to, say, 10-dimensional string theory must be enormous if you’re a physicist. That conversion can be based on evidence, publishing pressures, tenure, or the mathematical style of the grad school you attended.

    Maybe the reason I can look at this data and make these suppositions is precisely because I have so little on the line. I don’t have tenure or a professional career as an economist to worry about. I can just call it like I see it.Report

    • Don Zeko in reply to Rod says:

      My understanding of this is that most of the money is going to providers. And as far as the top-line figure goes, that sounds about right. We do, in fact, spend somewhere in the neighborhood of twice as much money per capita as the assorted other OECD states do, and it looks like a big part of that is simply that monopsony buyers like the NHS can bargain down the cost of basically everything.Report

      • Roger in reply to Don Zeko says:

        The data reveals that 0ne fourth of health care dollars goes to unnecessary care, tests, visits and prescriptions. That makes up half your waste.

        The other parts come from efficiency. There is no incentive to be more efficient when the person getting the service isn’t paying. Indeed the incentive is to become inefficient. Even more importantly there is no upper limit to what you can pay to keep someone alive an additional year, month or minute. It is possible to spend billions to keep someone alive a little longer.

        The same problems occur in government services and schools. My experience is that financial services costs have plummeted in past decade. My fees on investments and trades are a tiny fraction compared to the past.Report

        • Morat20 in reply to Roger says:

          What data? And I question this: There is no incentive to be more efficient when the person getting the service isn’t paying

          If that is true, why is every other system so much cheaper than ours? With better outcomes across the board?

          The rest of the First World seems to be the giant elephant in the room of Health Care. They ALL spend less than we do — (the next most expensive is half as much per person), cover EVERYONE, and have better longevity and better infant mortality (which are crude, but effective, metrics of care).

          And the only thing they have in common is not one of them is as ‘free market’ as our own. Some are nationalized, some are single-payer, some are like ours by regulated out the wazoo — so why the belief that if we just made our system LESS like theirs, it’d suddenly fart rainbows and puppies?

          Call me crazy, but when I have a systems failure and see 30 other examples of systems that DO THE SAME JOB, I don’t double down on whatever I came up with that didn’t work. I go look at what did.Report

          • James K in reply to Morat20 says:

            Every other government limits what healthcare it will pay for, the expensive stuff for the very old simply isn’t provided in other countries. They’ll either say nothing can be done, or they’ll put you far enough down the waiting list that you’ll die waiting.

            That’s certainly a valid approach (and really it’s the only valid approach when the government is picking up the tab), but try convincing the old people who actually run your country of that.Report

            • Morat20 in reply to James K says:

              Every other government limits what healthcare it will pay for, the expensive stuff for the very old simply isn’t provided in other countries. They’ll either say nothing can be done, or they’ll put you far enough down the waiting list that you’ll die waiting.

              Assumes facts not in evidence. I’ve heard this canard a LOT of times, yet no one seems to support it.

              It’s especially interesting insofar as the one area American HAS a first world system is for the elderly — Medicare. Whose costs are, strangely, NOT out of line with the rest of the world’s care on elderly — and much better contained than the supposedly younger, healthier, set thrown to the employee system.

              Doubly so that these granny-killing countries all seem to have better life expectancy to boot. They apparently only kill off granny to save money after she’s outlived her American counterparts.

              But I’ll wait. Get me that hard data on how England, France, Sweden, Germany and the rest kill Granny.Report

              • Will Truman in reply to Morat20 says:

                Whose costs are, strangely, NOT out of line with the rest of the world’s care on elderly

                Not so sure about that.

                On a more anecdotal note, foreign doctors with which I am familiar are astounded on the resources we expend on end-of-life care.Report

              • Jaybird in reply to Will Truman says:

                I think it’s because we don’t believe in pain management (to the point where the pain is alleviated).

                So we’re stuck trying to make people better.Report

              • Don Zeko in reply to Jaybird says:

                Speaking as the son of a working psychologist, I agree. Down with the Docs and Lawyers, and up with behavioral intervention and coping mechanisms!Report

              • James K in reply to Morat20 says:

                Doubly so that these granny-killing countries all seem to have better life expectancy to boot. They apparently only kill off granny to save money after she’s outlived her American counterparts.

                Someone dying at 85 instead of 86 does bugger all to a country’s life expectancy. The US’s high suicide, accident and homicide rates on the other hand…Report

          • Don Zeko in reply to Morat20 says:

            I’m with Morat. I’ll believe the arguments about competition creating efficiency in health care when I see anyone pull it off in the real world at anything approaching the scale at which single-payer systems have succeeded in controlling costs everywhere else.Report

            • Will Truman in reply to Don Zeko says:

              For single-payer to work here, you have to have a population willing to accept its downsides. I have my doubts. I came really close to getting on board with single-payer, until I determined that the system would collapse under the weight of our expectations (among other things) and/or evolve into a system not unlike what we have now (except, most likely, with more Medicaid and less access to care per Medicaid recipient).Report

            • Roger in reply to Don Zeko says:

              Morat and Don,

              Socialized medicine or single payer or whatever it is that it is cool and hip to call it nowadays won’t have any trouble at all controlling costs. You just set a master plan and arrest anyone charging more or trying to cut the lines. Easy breezy.

              What it is terrible at is innovation and progress. It can steal ideas created via other systems and do mock ups of it. It is easy to socialize a drug. Not so eay to create new drugs via socialism. Google “Trabant”. If we socialize medicine worldwide, my fear is we will bequeath future generations the medical equivalent of a Trabant.*

              American health care is actually the worst of both worlds. But we have already been over this a half dozen times, havent we?

              * Well, not all of us of course. The well off of the world (such as us) will just resort to medical tourism. Airfaire costs are irrelevant when it comes to most major medical. The little people will all have their little medical Trabant, while you and I will be basking along the pool in Costa Rica. Pura Vida!Report

    • Pinky in reply to Rod says:

      Rod – There’s very little meaning in comparing health care costs over time. How much would a 1972 cornea transplant cost? Lithotripsy? Anti-depressents that don’t leave you an emotional cripple? AMD treatments? Anti-virals for shingles? Knee reconstruction surgery? I’m not thinking of exotic treatments here – I’m just running down a list of things that friends or family have gone through in recent years.

      With regard to knee reconstruction, I’ve seen the difference in quality over the last ten years. I’m no surgeon, so I don’t know the specifics, but everyone I know who had one done in the 90’s ended up with a limp and only a slight reduction in pain. It looks like they’re doing life-long mends these days.

      One of the real problems in the health care debate is talking about “health care” like it’s eggs or gasoline. (Although even eggs and gasoline have changed over time, too.) It’s nearly impossible to talk about a minimum standard of care without it sounding like rationing. but I don’t think anyone’s calling for universal premium care. Anyway, my point is, our comparisons of health care have not been sufficiently serious, given the importance of the debate.Report