The economics of health

The economics of health has been complex. Diverse stakeholders - patients, providers, manufacturers and payors - who all seem to have a partial picture of the whole problem, have made it more difficult to solve. To top it all off, policy makers, with little understanding of this complex picture, seem to trade in photo ops and healthcare acts.

The value accruing to society is an important and possibly the only consideration of policy. The evaluation of policy choices will require an understanding of the value of the foundational units - the individuals, themselves. Unfortunately (or fortunately), the value of an individual is not the discounted stream of utility to society and thus healthcare systems around the world, making decisions on a fixed value of a human, are misguided. Since the individual is perfectly capable of changing the future stream of utility, she can only be considered to be a basket of interacting options. Thus, any policy that forces the individual to prematurely exercise such options is unambiguously suboptimal.  Additionally, policies that reduce the flexibility afforded to the individual to pursue new ideas will devalue the options held by the individual. This automatically reduces the value of the individual, both to herself and to society.

For example, any policy that can be shown to reduce the incentive of an individual to move from one job to a more attractive one, will have a deleterious effect on aggregate utility. Any policy that does not allow an individual to climb out of a low value position, either due to a capital constraint or due to failing health, will reduce aggregate utility. Any policy that does not provide incentives to prevent health problems for individuals will automatically increase the expected future costs in the system. Any policy that does not allow market forces to move the complex system to an optimal position by sharing the economics among the various participants will have a negative value to society.

Politicians are likely the worst people to create and implement healthcare policies. It has been known for ever that "healthcare is this complex." It will take a bit more than theatrics and politics.

Natural Intelligence

Recent news that researchers could now encode 215 petabytes of data in a single gram of human DNA (1) and possibly all the information created from human inception in a container of DNA that weighs couple of pickup trucks, is a constant reminder that Nature works in a dimension, possibly incomprehensible to humans. Recently, humans have been worrying about the growth of noise at an accelerating clip with over a zettabyte a year. Although some call this data and even information, an apt description of it is noise, as much of it is useless to advance knowledge.

More importantly, the capacity of data storage revealed by the DNA structure tells us that the status-quo technologies that some believe will propel us to the proverbial singularity are mere toys of insignificance. The only possible answer to the Fermi paradox is that extra-terrestrials find our level of development too premature to make contact. Evolution has been slow and biological systems seem to have taken almost 4 billion years to cobble together something that could start to think about knowledge replication and perpetuation. But the technology afforded to humans is too crude and likely in the wrong direction to make a significant leap toward harnessing high dimensional energy and tunneling through spacetime.

Those who are actively seeking "artificial intelligence" in Silicon may be well advised to return to studying natural storage and processing that appear to be fully integrated and freely exhibiting quantum states.

(1) http://www.sciencemag.org/news/2017/03/dna-could-store-all-worlds-data-one-room

Pipe-climbing bacteria

Recent news (1) that bacteria can climb up a pipe at an astonishing speed of 2.5 cm/day is a constant reminder that the first inhabitants of the Earth is highly capable of eradicating those who appeared late. As they happily climb out of every hospital sink across the world, infecting their distant cousins, it appears inevitable that advanced biological entities will eventually succumb to potent simplicity. The information slope in the first cell has been so astronomically high that it seems obvious that incremental additions since then, have been trivial. Meanwhile, humans have been chasing extra-terrestrials and artificial intelligence as if they have conquered everything else.

Ignorance has been a constant companion for humans from inception. Their observations of the heavens always resulted in wrong hypotheses. First they saw the Sun going around the Earth and now they see dark energy and dark matter. In medicine, first they saw inexplicable spirits affecting the human body to create diseases and now they see pathogens and the body attacking itself. Alchemists have given way to modern chemists, manufacturing concoctions they don't understand to solve both biological and engineering puzzles. And in economics, they have created theories that seem to work only in regimes and those diving head first into the financial abyss have turned into TV personalities. But complexity does not advance knowledge - it just adds to ignorance.

As the ignorance in chief leads the world to the brink of disaster, it may be worthwhile to keep an eye out for the little things, that creep up the pipes.

(1) http://www.sciencemag.org/news/2017/03/pipe-climbing-bacteria-might-spread-infection-hospital-sinks

Forecasting society's prospects

The future prospects of human societies could be dependent on two important metrics - per capita knowledge and per capita compassion. It is difficult to define either precisely but proxies could be on offer to measure the slope of both. If outcomes of system behavior point to a decline in either of these metrics, human societies could be in trouble from a long term viability perspective. Even moderate increase in these metrics may not be sufficient to propel societies to the next level.

There have been troubling signs for many decades. Scientific pursuits impacted by high uncertainty often produce results that are less compelling to move aggregate knowledge, let alone per capita knowledge, on a positive slope. To make matters worse, there has not been a jump in knowledge progression for over a century, dominated by applications of existing knowledge. On the compassion axis, society seems to have bifurcated - some exhibiting high sensitivity and others falling victims to materialism. This is a potent combination and a perfect storm that may move humans back, perhaps for the first time in their history.

Education systems seem to have failed to improve per capita knowledge and segmented societies seem to have arrested compassion. And this poison cocktail has paved the way for ignorance to rise to power and that can initiate a spiral down in both directions - knowledge and compassion. They are correlated and that indicates that there are no obvious solutions in the horizon. To feel compassion, one has to deeply understand others, even those who appear foreign. And, to gain knowledge, one has to understand how the universe works, even the corners that appear exotic.

A break in the dam is sudden, an earthquake unanticipated and death arrives unannounced. Are there sufficient numbers among the 7.5 billion who could right the wrong? It will be a shame to throw it all away after hundred thousand years of progress.

Autonomous microbial growth distribution systems*

As scientists worry about how to protect Europa (1), Jupiter's famous moon that harbors vast subsurface oceans with the possibility of life, it is scary to think about past contaminations on the Moon and lately on Mars. Microbes, the original inhabitants of the blue planet, have been able to fool their macroscopic cousins in almost every dimension. They can enter them whenever they wish, leave tell tale signs that confuse their immune system and almost wipe them out. They dominate the human infrastructure, providing ten times as many cells as human cells to the complex union. And, they could hitch a ride to anywhere humans go and almost certainly they have in the past. The only question is whether they fell prey to the harsh conditions they encountered at the neighboring moons and planets.

As humans shower robots across the solar system, it is highly likely that they are seeding the neighborhoods with robust microbes. Disappointed ET enthusiasts have been lamenting the lack of encounters with the non-terrestrial variety for ever. With the space agency drawing a hard line in the sand and proclaiming discovery by 2020, one way to accomplish it is by contamination. Although it is illegal to do so, history strongly points to reverse panspermia. Humans have shown high level of incompetence in sterilization and hospitals still are the most dangerous places for people.

Before the over excited space enthusiasts expand their physical search across the solar system, they may want to update the current protocols of space equipment sterilization. Otherwise, they may find abundant life across all their targets - Europa, Enceladus and others.


* - Attributed to Norine Noonan, University of South Florida
(1) http://www.sciencemag.org/news/2017/02/how-protect-europa-earthlings

A memory lapse

Modern science has been struggling to understand human memory for ever. It appears volatile and highly manipulatable but indestructible compared to the memory of the toys humans have been able to assemble. Attempting to bridge the gap in memory between humans and computers have led many researchers astray. Understanding human memory is a necessary condition toward a robust theory of consciousness. Without that, the over excited millennials trying to reach "Artificial Intelligence," are going to come out empty.

To understand a complex phenomenon, it is better to start in the basics. It appears that the hardware afforded to a human at inception is significantly more sophisticated than what humans have assembled thus far. The subtle differences in design in which the CPU is integrated closely with memory may provide guidance to those toiling to manufacture "deep mind." The human processing unit (HPU) is not a construct separate from its memory and thus functions differently from conventional computers. Consideration of memory as separate from processing power, has led conventional computer designs away from what is optimal for intelligent computing. Recent attempts by Hewlett Packard in hardware and MIT academics in software, could be in the right direction to elevate memory to be central to intelligent computing.

Intelligent computing, however, has never been in the scope of tactically optimizing humans. As they advance autonomous vehicles, deep learning game boy, music and breast cancer deciphering big steel, they seem to be unaware of a basic idea - computer scientists and engineers have never been able to understand the human mind, not even close. As they scorn the religious fanatics across the world, following unintelligible and unprovable hypotheses, they seem to be missing that they are are not too far. It is just that their ego is a bit higher than anybody else and that make them opaque to reality.

To advance computer science incrementally forward, it will require massive infusion from philosophy, psychology and creativity and a moratorium on engineers getting anywhere close to "Artificial Intelligence," technologies.

Expansion of the mind

When Lucy stood up in the African savannah for the first time, she demonstrated that humans could be fundamentally different from those who perished before them. Her mind was expanding and her thoughts, accelerating. With danger all around her, she was willing to explore information and that eventually propelled humans out of Africa and into the unknown. The expansion of the mind was the only attribute that fueled them out of mediocrity. However, recent history tells us that they are prone to the recurrence of ignorance.

Humans seem to have been successful in rewinding the progression of knowledge back - something that seldom happened for hundred thousand years. Knowledge was always expected to have a positive slope, and for most of the human history that was true. However, in the recent past it has substantially deviated from the expected norm. The reasons for this is unclear but one possibility is the availability of a large number of information channels. The advent of printing formalized and accelerated information flow that was largely constrained to word of mouth before that. Now that a large number of diverse channels allow the creation and dissemination of content, without the need for verification, information itself is losing meaning. In such a regime, aggregate knowledge can decline and this could create chaos in a system that relies on informed and rational decision-making at all levels.

The negative effects on policy due to loss of information are clear. Elections have produced sub-optimal outcomes and autocratic regimes have been able to sustain themselves without significant effort. As the seven billion cling together hoping for a better tomorrow, their leaders appear to lack information to move them forward. The only viable solution to this stalemate is education that provides the skills to distill noise into usable information.

A catastrophic divergence

For most of human history, knowledge was evenly spread across the populace. As they hugged each other to survive the extreme cold that reduced them to a few thousand, they shared information and knowledge freely. Human societies, thus far, thrived on the democratization of knowledge. Now, it appears that we are entering a regime in which there is a catastrophic divergence in knowledge among the seven billion, spread across the world. Most believe in religion and some in scientific theories, but neither is able to claim an understanding of the mystery that surrounds them.

Modern humans seem to have woven themselves into a web of confusion and complexity. The acceleration in aggregate knowledge provides a false impression of positive societal development. However, knowledge is increasingly concentrated in a small percentage of the population and the purveyors of this wealth are generally incompetent in their attempts to spread it. They seem inarticulate and stubborn, unable to bridge the gap between know-how and ignorance. Their language sounds foreign and their explanations of phenomena, downright incredible. This has left most of the population back in time, unable to lift their psyche from the depths of unprovable assumptions and pure speculation.

This divergence in knowledge is a dangerous trend for humanity. The situation is made worse by the incompetence of those who possess it and the inability of those who do not, to seek it. Education systems, catering to accumulating knowledge in a few, seem to have lost the plot. Educators have to understand that spreading knowledge is as important as advancing it. If they make the knowledge edifice ever taller without an expanding foundation, the long term results are likely negative.

Unless knowledge is spread more evenly across the population, a democratic society could arrest progress by elevating ignorance to power. This is arguably the biggest danger facing societies now.