A threat to the Internet

The US Congress is considering the “Stop Online Piracy Act,” a bill which, if passed, would greatly increase the power of corporations to censor websites, either by insisting on government action or by directly intervening.  Here are a few links to reports about how bad the bill is and what can be done to stop it.

Huffington Post, “Internet Companies and Lawmakers Speak Out Against the Stop Online Piracy Act

Ars Technica, “Republicans, Democrats, Google, and the Church of Sweden Unite to Stop Hollywood

BoingBoing, “Stop SOPA, save the Internet

BoingBoing, “How SOPA will change the net

BoingBoing, “Joe Biden: SOPA is un-American- but not when America does it

Will visits to the doctor go the way of visits from the doctor?

In the last few days, television audiences in the USA have been hearing a great deal about IBM’s “Watson” computer system.  The occasion of this publicity is Watson’s appearance as a contestant on the popular quiz show Jeopardy.  IBM has emphasized Watson’s potential in the medical field:

Throughout this material, IBM’s spokespeople keep inviting us to imagine a near future in which Watson or systems like it will be found “in every doctor’s office.”  What this phrasing suggests to me is a situation in which there are about as many doctors as there are now, those doctors are distributed in offices as they are now, and in those offices they examine patients who come to them as they do now.  The state of affairs that this phrasing suggests is that these future offices will differ from their present-day counterparts in that Watson-like natural language processors will be installed to provide the patient with an “instant second opinion.”

A moment’s reflection will reveal that there is essentially no likelihood of such a scenario being realized, at least not in the USA.  As soon as a machine is invented that is capable of giving a medical opinion that is of any value whatsoever, flesh-and-blood doctors will vanish from the lives of low-income patients forever.  Once the machine is so improved that it can be trusted to give a sound diagnosis most of the time, with none but the trickiest cases requiring review by human doctors and none but a small percentage of those requiring active intervention to overrule the machine, the only patients who will ever meet their doctors will be the very wealthy and the scientifically interesting.

The parallel I would draw is with the institution of the “house call.”  As recently as 40 years ago, it was so common for doctors to call on their patients at home that when people occasionally had to go to the doctor’s office to receive care, it was considered grounds for a radical overhaul of the healthcare system.  Now, when a doctor does make house calls, it’s national news.  I predict that 40 years from now, it will be as rare for a patient to visit a doctor for examination as it is today for a doctor to visit a patient at home.

What will the consequences of this change be for public policy?  The central dilemma in technology policy is always the same, that there is little or no interval between the time when it is too soon to say what the effects of a development will be and the time when it is too late to do anything about that development.  One thing we can say is that demand for medical doctors will drop dramatically, probably to 1% or less of the current per capita demand by 2050.  Whether that means we will have only 1% as many doctors then as we do now, or that some larger number will share 1% of the income that doctors now collect, of course depends on a wide range of factors.  Whichever way it goes, certainly no prudent investor would be interested in funding a new medical school at this time.

The cost of health care is a focus of much discussion in the USA, where it represents at least 1/7 of GDP.  Eliminating doctors would change the way this spending breaks down, but would neither reduce demand for health care nor increase its supply.  Moreover, many have argued that the reason health care costs so much more in the USA than in similar countries is that Americans do not really have a market for health care.  Rather, employers pay for health insurance in order to avoid paying the corporate income tax.  Since employers pay insurance companies money that would otherwise go to the taxman, they have little incentive to negotiate lower premiums; since insurers raise premiums when providers charge them more, they have no incentive at all to negotiate for lower prices.  As long as the corporate income tax and its health-insurance deduction remain in place, US health care costs will continue to rise no matter how little money goes to doctors.  Perhaps if the USA were to abolish the corporate income tax and replace it with a consumer-driven revenue source like the Value Added Tax, a consumer-driven health care system might emerge, but until then, technology cannot solve our problems.

Of course, unemployment is also a public policy problem.  What happens to all the M.D.s whose degrees will become worthless in the years ahead?  And what happens to public opinion when the appearance of a horde of jobless doctors makes it clear that education is no guarantee of employment?  Marxism may be dead, but will it stay buried in a world where the owners of capital are the only economic group who lead lives secure enough to plan for their futures?

Some interesting things from the web

1. Al Wood, proprietor of the magnificent Ukulele Hunt, disclaims any interest in politics, but he has a post up about copyright law that everyone should read.  He calls for a scrapping of the 95-year term of protection that is now standard in the developed world, and a return to the once-standard renewable 14 year term.

2. Some CT scans subject a patient to the radiation equivalent of 900 chest X-rays.  Several years ago, I heard the physicist Joseph Rotblat explain why he’d become an activist against the testing of nuclear weapons:

People began getting worried about all these tests.  In order to pacify the people, the Atomic Energy Commission issued a statement- this was the beginning of 1955- saying you didn’t need to worry at all about the fallout because the dose which people in the United States received from the tests was not more than from a chest X-ray.

Most people didn’t know how much radiation you get from a chest X-ray.  I knew… [A]fter this statement, I thought this was terribly dangerous.

3. A new article about T S Eliot in Commentary asks “But might it be allowed that one can write or say anti-Semitic things without being an anti-Semite? Eliot is guilty of the former, but does not, I think, stand guilty of the latter.”  The major theme of the piece is the great difficulty his Calvinist heritage left the Tse-Tse in his attempts to enjoy life.  Certainly a man who made several well-publicized anti-Semitic remarks, then earnestly declared anti-Semitism to be a sin, would seem to be an example of someone not having fun.

4. Seats in the US Senate are not apportioned by population, with the result that a candidate can lose by a landslide in one state, while candidates in other states can receive fewer votes and win elections.

 

The future ain’t what it used to be

In the twentieth century, many people looked ahead and saw high-tech solutions to high tech problems.  In the twenty first century, we have the high tech solutions, but as Tom the Dancing Bug points out, many low tech problems still leave us stumped.

Time to speak out for sexual freedom

Earlier today I was catching up with the latest of the fascinating discussions that always go on in the comment threads at Alison Bechdel’s Dykes to Watch Out For blog.  In response to a topic that had come up, I began writing a comment that was far too long to appear in a comment queue.  So I cut most of it, and pasted it below. 

One commenter linked to this Newsweek story titled “The Anti-Lesbian Drug,” about a project that a scientist named Dr Maria New is currently conducting.  Another commenter, who is personally acquainted with Maria New, protested that Dr New is not at all the sort of person to try to invent an “anti-lesbian drug,” and gave reason to believe that her work has been caricatured.  Here is the comment I posted there: 

@Alex K #73: I’m perfectly willing to accept that Maria New’s research may have been distorted in the press. The standards for science coverage generally seem to be pretty low, even when no hot-button social issue is at stake. When right-wingers see a chance to twist the work of a female or minority researcher so that it sounds like something that supports their agendas, all restraint goes out the window.

Whether Dr New ever contemplated developing an “anti-lesbian drug,” the Newsweek article Calico links in #67 and the reactions it reports go to something I think about all the time. Lots of same-sexers and allies seem utterly certain that a scientific explanation of the biological basis of homosexuality will be a great blow to homophobia. Yet it seems obvious to me that nothing of the kind will happen. On the contrary. Homophobes will take that news as confirmation of their idea that homosexuality is a disease. That will be bad enough; what is vastly worse is the likelihood that they will be armed with drugs with which they can “treat” that “disease.”

Every time this comes up I have a very strong sense that I know just what’s going to happen, and it is horrible. So I’m writing a post on my own blog about it, because I don’t want choke up this thread with a long essay. Suffice it to say, I’m worried.

Here’s what I cut out:

Today, people who disapprove of homosexuality may make the same-sexers in their lives miserable by insisting that they should turn themselves into heterosexuals by some more or less magical process of willpower.  They may push them into various flagrantly bogus imitations of psychotherapy.  Or, they may resort to violence against them.  I doubt that any of these approaches has ever turned a homosexual into a heterosexual.  Each of them, however, has turned living people into corpses, whether directly from violence or indirectly in the suicides and addictions to which they sentence many of their targets.  To oppose these methods, same sexers and their allies need not discuss sexual morality.  We can simply appeal to the common decency that recoils from bullying and embraces life.   

Looking ahead, it seems to be just a matter of time before biologists and anthropologists identify some physiological processes that are associated with an increased rate of homosexuality and other processes that are associated with an increased rate of heterosexuality.  It’s hard to imagine that behaviors as widespread and persistent throughout human cultures as same-sex attraction and the construction of social identities built around that attraction could fail to have a biological basis that explains at least part of their prevalence.  When these processes are identified, the people who now support antigay bullying will see an opportunity to develop methods that will in fact achieve the goals their current strategies so consistently fail to meet.  They will demand that pharmacologists develop drugs that suppress processes associated with an increased rate of homosexuality and promote processes that are associated with an increased rate of heterosexuality.  And sooner or later, this demand will be supplied.

If society makes as much progress in coming to terms with the rights of same-sexers and the dignity of their relationships in the next 40 years as it has in the last 40 years, then perhaps by 2050 the world will be ready for an explanation of the physiological factors that contribute to sexual orientation, gender identity, and related social phenomena.  In that future, there wouldn’t be much demand for heterosexualizing drugs, and a definite stigma against anyone who promoted them. 

But that isn’t the way things are in 2010.  Public opinion surveys in the USA still consistently show that about one American in three believes that there should be criminal penalties for consenting adults who have same-sex sex in the privacy of their homes.  Billions of people around the world support violently heterosexist religious and political groups.  In the current climate, the first company to produce a viable drug to ensure prospective parents heterosexual offspring would make immense profits, probably well into the trillions of dollars.  For all that Dr Maria New and other self-respecting scientists might refuse to be part of the research that will produce that drug, they won’t be able to stop any number of others from joining in the contest, not when the prize is so fantastically lucrative. 

What happens once the heterosexualizing drugs are on the market?  If the world is like it is now, same-sex attraction will soon carry not only the stigmas already imposed on it, but also the stigma of low social class.  If the drugs are not paid for by public-sector insurance, as they likely would not be in countries where there are enough pro-gay forces to keep governments from endorsing them, then homosexuality will become a badge of poverty.  In those cases, parents who refuse on principle to use prenatal drugs to impose the standard sexuality on their prospective children can expect children who do turn out to be same-sexers to beg them for whatever treatments are available at their age.  Where the drugs are available to all, such parents can expect their own peers, and therefore their children’s peers as well, to regard them as neglectful and unfit.  Again, the children are likely to beg the parents for treatments rather than join in their disgrace. 

As heterosexualizing drugs become more effective, homosexuality will become less common.  That means that those same-sexers who remain will be less likely to find each other, less likely to come out, less likely to jolt the people who care about them into stopping for thought.  As unsatisfactory as the world of 2010 may be for millions of same-sexers, it may well seem a paradise compared with the world that is coming.  A world where homosexuality is not only seen as a disease, but as a disease of the past, is likely to look with incomprehension on the idea of sexual freedom. 

My view, therefore, is that those of us who do not want to see a world where a standardized sexuality is routinely imposed on children should move now to increase social acceptance of same-sexers and of others who do not comply with that standardized sexuality.  Time is running out.

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