Nudgefail: The Case of Organ Donation

Behavioral economics is cool science with numerous applications. The concept of nudges, for example requiring newly hired workers to sign a form to stop automatic retirement contributions rather than having to sign a form to start them, is certainly useful in many contexts. But as I write in Washington Post’s Wonkblog, it can’t solve some problems, including the shortage of organ donations, which leaves over 120,000 Americans on the waiting list:

One commonly proposed solution to the organ shortage derives from behavioral economic “nudge” principles. Rather than requiring Americans to complete paperwork in order to opt-in to donation at death, the country could shift to the European model of presuming that donation at death was acceptable. But Tom Mone, chief executive of OneLegacy, the nation’s largest organ and tissue recovery organization, points out that “The recovery rate for deceased donors in the United States is actually better than that of European nations with presumed consent laws. The United States rigorously follows individual donor registrations whereas presumed consent countries actually defer to family objections.”

What this means on the ground, as Tom explained to me and our audience at a recent Stanford Health Policy Forum, is that when European health professionals show up to harvest organs from a newly dead individual, that person’s family often says “no way”, nudges be damned. The state could legally take the person’s organs by force of course, but unsurprisingly it does not. In contrast, in the US opt-in model, both families and the state respect the deceased donor’s wishes because they know they were the result of a proactive decision rather than a bureaucratically-designed nudge. More simply, an active choice has legitimacy that a nudged choice does not

Turning the clock back

No, I’m not referring to daylight savings time. The Supreme Court apparently thinks that making it hard for Texans to vote is a good thing. Catapult me back to 1964.
I guess we have to join Texas in that era. Bring back the Freedom Rides. I would hope that if we baby boomers got the ball (and buses) rolling, some of the Facebook generation might join us. Perhaps my youthful colleague Steve Davenport (who commented eloquently on Keith’s recent essay about Facebook narcissism) could be our liaison to the under-thirties. At my age, the prospect of a long bus ride does not thrill me, (please let there be adequate restroom breaks) but if a couple of my boomer pals from the RBC are in, I’ll ride to Texas to assist with voter registration. It’s just so confusing! Didn’t we do this already?

Consider Staying in the Closet

Three phrases I am tired of hearing in the media: “Breaks his/her silence”, “the last taboo” and “comes out of the closet”. The first appears regularly on the magazines at the supermarket checkout. Magazine covers trumpet for example that — at last! — a 3rd rate television star is “breaking his silence” over the failure of his marriage to a 4th rate country and western singer. The implication is that the breaking of the blessed silence is a gift to the world and we should be grateful, but I wish these people would just shut up. Why should strewing intimate details of one’s life be laudable? And why should anyone care about these incontinent bores in the first place?

“The last taboo” and “coming out of the closet” have a parallel existence in journalism. When gay people came out of the closet it was courageous and remarkable. Today, these phrases adorn stories about people — elderporn enthusiasts, those who admit to being beautiful, people who pay to increase traffic to their website, people who hang glide in their underwear — whose coming out is neither dangerous nor it has to be said particularly interesting. Calling them taboo-breakers is at one level media hype and at another, cultural self-congratulation, as if as a society we are only getting more mature as we let underwear-clad hang gliders tell their heretofore hidden story to the world, even though it will no doubt rattle the foundations of the establishment (or at least annoy our parents).

Most of human existence is simply not that interesting and certainly not newsworthy. And in an era where everyone is tweeting what they had for breakfast, being filmed by covert keyhole cameras, putting photos of their latest drinking binge on Facebook and having their naked selfies released from the iCloud, even the most modestly engaging stuff in our lives is being over-shared. We’ve wiped out even more “last taboos” than we have #2 men in Al Qaeda.

This makes me think that the true radicals today, the ones who are actually taking a risk, are those who refuse to dish out their personal details to the world. To those of you who keep something in your life — anything — out of public view, let me express my respect and thanks. May others follow your brave example of staying in the closet.

Now that I am done ranting, I am going to go do a bunch of things that I refuse to reveal here.

Weekend Film Recommendation: Murder by the Clock

vlcsnap-2575882Halloween month on RBC is devoted to movies about ghoulies, ghosties, long-legged beasties and things that go bump in the night. This week, I offer an admittedly off-beat film recommendation from the early days of talkies: 1931′s Murder by the Clock.

The plot centers on the Endicotts, a wealthy family in decline. The parsimonious matriarch of the clan, Julia Endicott (Blanche Friderici), lives in fear of a Poe-style premature burial and laments the fact that her direct heir is a musclebound half-wit (Irving Pichel, in a quasi-Frankenstein Monster sort of role). Julia reluctantly decides to leave the family fortune to her drunken, ne’er do well nephew (Walter McGrail). But his scheming, sexually voracious wife (Lilyan Tashman) isn’t in a mood to wait for Julia to die of natural causes, and begins using her considerable feminine wiles to get multiple men to work her evil will. Murders and mystery ensue.

Fair warning: Movie sound technology was not well-developed when this film was made. Microphones on the set were few in number, often in fixed positions and of low quality. As a result, actors had to talk more slowly and clearly and not move around too much as they did so. This understandably comes across as stilted to modern audiences. But as with the famous Lugosi/Browning Dracula which came out the same year, if you can let those limits of early talkies go and just enjoy a scary story well told, Murder by the Clock will greatly entertain you.

62-lilyan-tashman-554x417In style and plot, this film is an agreeable cross between the haunted house pictures of prior years and the monster movies that were just becoming popular (like Dracula, Frankenstein also came out in 1931). The other enormous appeal of the movie is the campy, vampy work of Tashman, in a part that screams “pre-Hays Code”. Dressed in a series of outfits that leave little to the imagination she sexually disables virtually every male character in the story (Tashman was apparently a sexual dynamo in real life as well, though her energies were usually directed at women rather than men, allegedly including Greta Garbo). Tashman has a lot of fun going way over the top and it’s intentionally funny for the audience too, as were many of the classic monster movies of the 1930s.

The atmospheric photography is another asset of Murder by the Clock, and amplifies the mood effectively. That’s a credit to Karl Struss, one of the first famous cinematographers, who worked with many of the early giants: Murnau, Griffith, DeMille and Chaplin. Struss gives fans of scary movies what they want: eerie shots of dusty secret corridors, foggy graveyards, and killers skulking through abundant shadows

If you just can’t stand the technically-imposed limitations of early talkies, this movie is not for you. But otherwise Murder by the Clock offers creepy, campy fun for the Halloween season as well as being of historical interest for its look and pre-Hays code salaciousness.

p.s. Pachel went on to direct an ever better pre-Hays code film that I recommended here two years ago, The Most Dangerous Game. Note also that Murder by the Clock is in the public domain, and you ought to be able to find it for free online.

Rick Scott and fangate: the limits of ignorance

[See update below]

Apparently the rules of the Florida gubernatorial debate forbade the contestants from using electronic equipment.  Rick Scott refused to participate (until his handlers told him how silly he looked) because Charlie Crist brought a fan on to the stage.

Yes, I know that there’s no legal minimum IQ required to become the governor of a state. But really, is it too much to expect the the former CEO of a big health- care company to know the difference between “electronic” and “electrical”?

Update Well … not perzackly. A reader points out that the debate rules banned “electronic devices (including fans).” Now, I still insist that passage is nonsensical, since a fan is an electrical device, as opposed to an electronic device such as a cell phone. I suppose there might be some sort of fan with semiconductor controls that was, to that extent, electronic – in which case the rules would bar such electronic fans, as opposed to normal fans,  but an ordinary air-moving machine with an electric motor is not, by any normal definition, an “electronic device.” So to me, the phrase is about equivalent to “birds (including bats)” or, in Lincoln’s example, “legs (including tails).”  To make sense, the phrase would have had to read “electronic devices or fans.”

Apparently Crist’s penchant for cooling himself was well-known.  And apparently his handlers didn’t agree to the conditions as suggested by the organizers, but added to the signature page *with understanding that the debate hosts will address any temperature issues with a fan if necessary.”

My understanding of the law is that when one party modifies a contract before signing it, the other party has the choice of accepting the contract as amended or refusing it. So it can’t, I think, properly be said that Crist broke the rules he had agreed to. Clearly, the organizers were remiss in not bringing the amendment to the attention of Rick Scott, which left Scott’s handlers believing that Crist was breaking a rule.

It was, still, I submit, unbelievably foolish to try to use that as an excuse to duck the debate, and it’s remarkable that it took the Scott corner six long minutes to figure out they couldn’t get away with it. But the original post wasn’t right to suggest that Scott doesn’t know that a fan isn’t a cell phone. After all, what are the odds that someone who cheated the federal taxpayers out of most of a billion dollars and never went to jail for it is actually that stupid?

Cheap power is progressive

According to a statistic I just made up, 97.3% of all technical “breakthroughs” trumpeted in press releases turn out to be either wrong or minor. Moreover, it’s well known that fusion is the energy source of the future, and always will be. When I was ten years old, economically relevant fusion power was thirty years away, and that number hasn’t changed in the half-century since.

Still, the folks at the Lockheed Martin Skunk Works aren’t very likely to be either fools or hoaxers, so when they say they’ve figured out how to make magnetic-confinement fusion practical and that they think they can have a prototype in five years and a production model in a decade, that’s worth paying attention to.

The gimmick, if it works, would have all the features that have made fusion such a dream: no greenhouse-gas emissions, no meltdown risk, no waste-disposal problem, no weapons-proliferation issue, and effectively unlimited fuel supply. Even better, they’re talking about 100-megawatt reactor that fits on a flatbed truck, not a 1000-megawatt behemoth like the current generation of fission reactors. That would make producing the devices a manufacturing problem rather than a construction project. (Even more so if you could retrofit a power plant now running on coal by simply substituting half a dozen of the new gadgets.)  With luck, this could put a big hole in fossil-fuel production and the environmental and political disasters it creates.

Of course the Lockheed Martin folks could turn out to be wrong about the physics (though that doesn’t seem especially likely), or (much more plausibly) one of the ancillary problems such as materials development could turn out to be insoluble or too expensive to be economically practical.

But the only reasonable reaction to this from someone not invested in Exxon or Koch Energy or Putinism is a (somewhat hesitant, because the idea is still more likely to fizzle than to work) “Yippeeeeee!!!!”

Therefore, I find it frustrating (and only wish I found it surprising) that ThinkProgress, run by people who consider themselves “progressives,” is rushing to pour cold water on the idea because the timeline can’t meet the arbitrary deadline someone in the global-warming PR business has dreamed up. (Really, of course, because cheap non-polluting energy would help reduce the relevance of a bunch of Green ideas about regulating this and subsidizing that, and because at some point after 1973 gloom and fear got to be the official emotions of the progressive movement, when by rights they belongs to conservatives.)

Since there’s no hope in Hell our current set of technical options, working under our current set of political and economic arrangements, are going to stop the rise of GHG levels by 2040, let alone 2020, bellyaching that a game-changing technology might come in a decade or so behind the current unattainable target is plain silly. If all we needed to deal with is a gap of a decade, or even two, there are geoengineering options that could be used to limit the damage in the meantime.

Every argument for subsidizing conservation and renewables applies with at least as much force to pouring money into this new version of magnetic-confinement fusion until it hits a brick wall, as it probably will. Since there’s no way a patent-holder could possibly internalize the social gain from making this work, the case for public funding is overwhelming. The social value of the discovery, if it can be perfected, couldn’t possibly be less than $10 trillion,  so spending $10B or so on even a 1% chance of success is an obviously positive-expected-value gamble.

Of course, if we have to triple energy prices in order to prevent a global-warming disaster – which might well prove to be the case – we should accept that, and the economic disruptions that would result, rather than accepting a 3-degree-Celsius rise in average surface temperature and the catastrophes that would result from that. But I’d rather not, thanks.

If cheap energy gets to be real again, that will be a tremendous boon to the planet, and especially to its poorest inhabitants. And if as a result we have to stop saying that 40,000-square-foot mansions are environmentally unsustainable, and have to go back to saying that they’re grotesque and vulgar, is that really such a steep price to pay?

A progressive movement that, in its heart, prefers scarcity is not one I really want to be part of, and it’s not one likely to command majority support.

 

More tinpot dictators in the schools

Some educators think the point of school is to get students to do their own thinking.   Others, not so much: the little Caesars in Bucks County seem to think their school is about sports and (for example) the school newspaper is there to gin up pep rallies so the high school players can do their job, which is to amuse ignorant white grownups.

Seriously, how messed up is this: students learn journalism by having their copy dictated by racist administrators?  Who obviously haven’t read a newspaper in twenty years?

More generally, there seem to be no limits to the degree that sports, especially football, can corrupt a community and degrade its culture (can you say Steubenville?) if the grownups go infantile; the good people of Sayreville seem to be more upset about missing a season of football than an epidemic of sexual assault (though in that case the school leadership is on the ball).

School team nicknames have many strange conventions, especially the taste for war and predation. A game isn’t a war, or a fight!  I always liked MIT’s choice of a beaver (your cougars or whatever may occasionally have a beaver for lunch, but they will end up working for them after graduation).  More mysterious to me is all the Trojans; why would you name your teams after history’s most famous losers?

Florida State (and Tallahassee) have plenty to work on about football and bad behavior by players. But the school took care to get the Seminole Nation to OK their team name.  I think that’s OK, especially as the Seminole are local to the institution, and Seminole is not a derogatory word.  As to Neshaminny, while the logo itself doesn’t have the particularly vile quality of the Cleveland pro baseball team’s, the idea that it has some aroma of local pride only demonstrates that the district’s curriculum doesn’t have much of a unit on Native Americans. He’s wearing the headdress of people who live a thousand miles away, a ludicrous inconvenience for eastern forest people trying to get around in trees and brush.

Oh well, seen one Indian, seen ‘em all, and there’s a game Friday night.

How UKIP Differs from the Tea Party

Americans who have heard of the UK Independence Party (UKIP) often assume that its members are roughly analogous to those of the U.S. Tea Party, i.e., disaffected conservatives who want the right-most party to move even further right. Some excellent political journalism has shown this is not correct, and a remarkable election result this past week underscores the point.

The setting was Heywood and Middleton, a Mancunian constituency in which Labour politicians have literally never lost a parliamentary election. I was acquainted with the late Jim Dobbin, who used to represent this pocket district, and he was with respect neither a scintillating orator nor entirely in step with many of his constituents on some social issues. But still, he was Labour, so like his predecessors he too always won, and by large margins.

Given this context, it is remarkable indeed that Jim’s Labour Party replacement almost lost the by-election to a UKIP candidate. In the 4 years since the last parliamentary election, UKIP increased its vote-share by a stunning 15-fold. If UKIP were truly just a party of disaffected Tories, this simply could not have happened in a Labour stronghold.

Ian Warren of Election Data blog did some revealing shoeleather reporting and data crunching regarding how UKIP did so well. He posted this photo of a UKIP voting neighborhood (that’s an “estate”, i.e., public housing) and pointed out that its not exactly the dwelling place of the horse and hound set.

hey3

Now take a moment to consider whether you think UKIP are just a problem for the Conservatives. Because this doesn’t look like a Conservative area to me. And consider that in May of this year UKIP took 42.3% of the vote here…..on these streets. Because at some stage somebody in Labour high command is going to need to explain to me how on earth they find themselves in a position where their bedrock supporters, the believers in ‘good old religion’ as I heard John McTernan call them last week, have simply stopped believing.

His whole analysis is worth reading. It reinforces my sense that the 2015 UK election is “everyone’s to lose”, by which I mean that, given the fracturing of old alliances and perspectives in the UK, there is an excellent chance that regardless of who wins, the majority of people who went to the polls are going to feel alienated from the new government from day one.

Athletics at Berkeley update

In late spring, big-time sports at Berkeley hit bottom on several dimensions, but things may be turning around. In the last few anni horribili,  the Intercollegiate Athletics program saddled the campus with about $400m in debt to rebuild the stadium and construct an accessory building that is about a third conditioning space for athletes, a third party venue for boosters and possibly players, and a third coaching offices.  A scheme to play the spread between tax-exempt bond interest rates and market returns on endowment, plus selling premium seats on long contracts (the ESP program), to retire this debt is in some trouble (ESP sales are steadily declining year by year).  At the same time, we were humiliated by the worst graduation rates in the country (football) and in the conference (men’s basketball) along with on-field performance in those money sports (1-11 in FB, 7th in the conference in MBB) that, let us say, does not sell tickets or open donor wallets.

We sent our athletic director packing (she wound up at Penn State…the world is a strange place in many ways) and the football team is no longer an embarrassment, 4-1 so far even though we did not beat the point spread in last week’s squeaker. More interesting, a task force stood up by the chancellor last winter has come out with a report, focused on “the academic performance of student athletes and the overall quality of their campus experience”,  that he has pretty much accepted.  It has a lot of good stuff in it and deserves a careful read.

Continue Reading…

Weekend Film Recommendation: Grip of the Strangler

haunted_strangler_poster_02Following Johann’s recommendation of Manhunter last week, I keep our RBC Halloween month tradition alive by focusing in the coming weeks on horror films. When Jean Kent died late last year, I decided to watch one of her films that I had never seen, and came away happy that I did. In one of her many roles as a naughty British lass, Kent is a chanteuse/madam threatened by a serial killer apparently risen from the grave in this week’s film recommendation: Grip of the Strangler (aka The Haunted Strangler).

This 1958 film has a wonderful backstory involving Boris Karloff. Alex and Richard Gordon grew up loving Karloff in the classic Universal horror films made before the war. When the Gordons were young adults, Karloff’s cinema stardom had faded but he was still working on the London stage. The two fanboys approached their idol, and ever the gentlemen, Karloff treated them kindly. When the great man was 70, the Gordons had the chance they had always dreamed of to produce a movie for him.

kentThe plot is spooky and engaging, mixing elements of Dr. Jekyll and Mr. Hyde, Jack the Ripper and even Frankenstein. You can also see the beginnings of a return to sexual explicitness in British cinema here, particularly in the scenes in Kent’s bawdyhouse (the champagne spill scene with pinup model Vera Day has to be seen to be disbelieved). But those elements work well in the story, which concerns a moralistic late-Victorian Era social reformer (Karloff) who believes a strangler of attractive women is still at large in the streets of London. He’s a hothouse flower of a man who faints when he sees abuse of prisoners, is terrified of rats and is extremely ill at ease interacting with a woman of Kent’s sensually confident ilk. Yet he is also unaccountably obsessed with the strangler’s brutal sex crimes.

It’s not a big budget film, but you largely wouldn’t know it. Director Robert Day started his career as a cinematographer and clearly learned how to use shadows, fog and lighting to keep the audience from noticing any economies in set design and art direction. The professionalism of the cast helps a good deal too. There are some actors who can’t seem to do a B-movie without somehow conveying to their fans “wink wink, I’m phoning in my part just so you know I’m above all this”. But such self-indulgence was unheard of in this era of British film and the result is a much better movie.

Kent is clearly at home in her showy part, even though it is unfortunately smaller than it could have been. Karloff is nothing less than brilliant, conveying the admixture of desire and repression, rage and sadness present in his character.

This is not a widely-known film outside of the horror film buff community. But it has captured some important supporters, most notably The Criterion Collection, who have made a pristine print available for you to enjoy.

p.s. Interested in a different sort of film? Check out this list of prior RBC recommendations.

p.p.s. SPOILER ALERT: Karloff’s physical transformation is even more impressive when you learn that he did it without makeup!