Sunday, January 29, 2017

Strategy v/s tactics

For many hundreds of thousands of years, the human brain specialized exclusively in tactics. Managing a simple objective function with two dimensions - food and sex, clearly pointed to maximizing utility in short horizons. Very recently, human societies have been treading on strategy to maximize long term viability of their species, something that is not well understood by a great swath of them. Strategy is inherently inefficient, especially if viewed through a tactical lens, for strategy almost always show negative benefits in short horizons. Human societies, led by those less mentally equipped to understand strategic implications, could deteriorate fast as their leaders attempt to implement tactics to benefit themselves.

Humans may be entering the most dangerous phase of their short existence. Sporting a badly designed infrastructure, thanks to a highly inefficient CPU and a physical infrastructure designed to last less than half of their expected lifespan, they appear to be in real bad shape. Thoughts don't come natural to them, but actions do as the males of the species went out every day, hunting and pillaging to their own satisfaction. It was never profitable to think and it has always been beneficial to show power as their opponents were either from a different clan or animals, substantially better built than themselves. Dislike and hate come to them without effort as they see a specimen that does not exhibit the attributes they are familiar with. Ironically, little do they know that the surface features or the origin of their fellow human beings are noise of such irrelevance that they have an equal chance to be related to anybody in the world as their neighbor. These ideas are indeed abstract and strategic, something the politicians and policy-makers around the world are not able to analyze.

As the extra-terrestrial seeking engineers and scientists lament at the absence of the travelling kind, they have to ask why an entity of intelligence would even make contact with them. After all, humans do not seem to understand biological entities, less endowed than them. It seems hopeless as the potent and deadly combination of ego and ignorance appears to lead the inefficient species to their certain extinction. 

Monday, January 23, 2017

Depressing - but there is hope

It is depressing to think about the fact that nearly 100 in the US and ten times as many across the world succumb to suicide every day. That is almost a person lost every minute, somewhere in the world. With nearly 10% of the US population suffering from depressive disorders, we may not be paying sufficient attention to a disease that kills silently. Nearly 10% of this cohort - almost 3 Million, suffer from Bipolar Depression, a condition that shows 20- 30 times higher probability of attempting suicide than the general population (1). This horrible disease sometimes leads to Acute Suicidal Ideation/Behavior (ASIB) - a condition that integrates suicidal thoughts with planning. And, it is growing at a 24% per year clip (from 1999-2014), especially among young adults.

The human brain, an evolutionary quirk, is a complex and fragile organ, prone to malfunctioning in many different ways. Initially designed to monitor and manage routine systems of the body, its massive excess capacity predictably led to thoughts and emotions, not typically seen in other biological entities. That was the beginning of trouble for the humans, as they struggled to understand and cope with the energy hog they carry on their shoulders. Primitive humans equated diseases of the brain to maligned acts of spirits and set out to ferret out the miscreants through unthinkable interventions. Ironically, the contemporary treatment regimen for ASIB is not substantially different, as patients are mostly locked in psychiatric hospitals, and receive electroconvulsive therapy (ECT). With no available medication for this indication, patients require many sessions of ECT, resulting in memory loss and confusion (1).

Large pharmaceutical companies have enjoyed a profitable franchise of Central Nervous System (CNS) treatments including SSRI/SNRI based antidepressants that carry an increasing risk of suicide. These widely available therapies are not effective in ASIB, a costly condition to treat as patients often progress to inpatient settings and ECT to tactically reduce the risk of catastrophic loss. The challenges to develop new medicines in neuroscience and particularly in psychiatry are very large, such that many big Pharmaceutical companies have abandoned psychiatry after their antidepressants became generic. However, ASIB appears to be a druggable target (1) as Bipolar Depression and in particular suicidal thoughts, may be modulated by the brain's NMDA receptor.

Treating this horrible disease with high risk of death with a medicine is potentially a great prospect for patients, but it will require investments and concerted efforts. Recent publications indicate that ketamine - an anesthetic, and potent NMDA blocker, reduces the impulse for suicide and for depression- which though related - seem not to be the same (1). However, its effect seems to be short lived, 4-7 days, and, it is administered through an iv infusion, making it important to find options that can extend its effect and allow patients to be treated on an outpatient basis once they are not a danger to themselves anymore. 

Saturday, January 21, 2017

It's time for universal basic income

Finland's grand experiment, albeit in small scale, in providing a Universal Basic Income (UBI) without preconditions, ushers in a new dawn in modern societal design. The idea is already late for many countries as accelerating technology makes routine jobs irrelevant and any education less than college, nearly valueless. It is a regime change in such a short time that disallows gradual adjustments and it affects large swaths of populations across the world. Finely tuned welfare programs that create a disincentive for the poor to seek work and policies such as minimum wages that curb opportunities for the young to gain experience, has been creating stress in the social fabric for many decades. UBI will not only correct such disincentives but also remove the cost and inefficiencies associated with the bureaucracies that manage such programs.

The objective function for a modern society is clear - maximize aggregate happiness. Most research on happiness indicate an inverted U relationship with significant disutility in the absence of basic necessities or the fear of not having them in the future. UBI will remove such fear but avoid any disincentive effects. More importantly, UBI could provide optionality for each individual with private utility functions to select optimal pathways to maximize own happiness. If each individual has the flexibility to design such pathways, then society will unambiguously maximize aggregate happiness. What's missing from the status-quo of centrally administered myriad of welfare programs is flexibility for the individual to maximize own utility, unencumbered by the lack of basic necessities - food, shelter, health and information. UBI could provide that at a lower cost than current programs.

Universal Basic Income is conceptually and practically elegant. But to implement it, politicians have to acquire a desire to do something good during the course of their long and uninterrupted careers.

Monday, January 16, 2017

Change resistant society

As India copes with demonetization - a minor perturbation to a cash dominated society - it is clear that its long history and comparatively low diversity may be contributing to significant resistance to change - any change. A democratic system, largely driven by a few personalities since independence, has been trying to break out for ever but India remains to be a "country with unrealized but great potential." In spite of the legend, not many tortoises win races as they succumb to watching laggards zoom past them. To propel the country to the next level, it has to substantially change its attitude, and it is unlikely with the current generation, steeped in pride, history and an unwavering ability to cling to the status-quo.

Even though it is one of the largest economies on a purchasing power parity basis, it is highly insular thanks to "strategic policies," pursued by its non-capitalist leaders from inception. It does not figure in the top 100 countries on exports or imports as measured as a percent of GDP. It is also symptomatic of its lack of understanding as to how economies grow. Specializing in its own comparative advantages and freely trading with others who do other things better, is a simple economic principle, something the leaders in India never seem to have understood. No country is good at everything, India included, but this could be anathematic to the Indian diaspora, let alone its leaders.

Blindly following what seems to be successful elsewhere is an equally dangerous proposition, especially if they are pushed by policy makers enamoured by what they see on trips abroad. And, India's leaders appear to be very prone to this disease. The wisdom of a few has never been shown to be effective in understanding and implementing optimal policies. What India needs is globalization not transplantation - and the confidence to free trade and implement free markets. If so, there appears to be no stopping it but it is a tall order.