Saturday Bullets

• Hey, didja know that penises and vaginas are a social construct?
  

  Fine is a sure guide to the science, building up complexity without sacrificing clarity. By the time she’s finished, any lingering confidence that hormones exert a simple dose-response influence on our behaviour is thoroughly done for. Instead, testosterone works in intimate concert with relationship structures – a blow to its dignified reputation as the singular, commanding “male hormone”. Even something as incontrovertibly binary as our male and female genitals is shown to be part of a complex cultural system. As Fine says, “it’s the genitalia – and the gender socialisation this kicks off – that provides the most obvious indirect developmental system route by which biological sex affects human brains”.

• Now that Trump is president, even journalists can apply critical thinking skills again.
• Editors, please.
• Econ 101 still works, no matter how much "living wage" advocates wish otherwise.
  

  The real impact of the minimum wage, however, is much less clear than these talking points might indicate. Looking at historical experience, there is no obvious relationship between the minimum wage and unemployment: adjusted for inflation, the federal minimum was highest from 1967 through 1969, when the unemployment rate was below 4 percent—a historically low level.

  If you use general unemployment as a basis for your comparison (the real problem is specific unemployment among the low-skilled), you've already failed to address the argument.

Jerry Coyne's War On Blank Slate-ism

Evolutionary biologist Jerry Coyne, author of the terrific blog Why Evolution Is True (which I haven't previously linked to, but need to add to my sidebar posthaste) has gotten into a row about human sexual behavioral dimorphism with a post, "The Ideological Opposition To Biological Truth". Men and women have coevolved but differing responses to environmental pressures, and this has led to lasting effects on behavior. The left rejects these categorically, because "ideological blinkering leads to the conclusion that when we see a difference in performance between groups and genders, the obvious explanation is culture and oppression, and the remedy is [enforced] equal outcomes rather than equal opportunities."

To claim that there are no evolutionary differences in behavior and psychology between men and women is fatuous.  The data show otherwise, though of course for most traits we don’t know if it’s genetic. But the default hypothesis, based on observation of other species (especially primates) is that at least some psychological and behavioral differences will be based on genes that evolved via selection in our ancestors. Why is the brain immune to evolved, sex-specific differences but the body is not?

Holly Dunsworth at U. Rhode Island posted a series of claims on Twitter about human sexual dimorphism, and was picked up in a New York article, wrapping up with these tweets:

Knowledgeable people aren't objecting to facts. They're objecting to biased story-telling and its annoying and harmful consequences.

— Holly Dunsworth (@HollyDunsworth) December 16, 2016

Not only is [female procreation during childhood growth] absent, but selection on women's bodies be the driving force (if such a thing could be identified) ...

— Holly Dunsworth (@HollyDunsworth) December 16, 2016

...and it's as if women don't exist at all in these tales except as objects for males to fight over or to fuck but it's nice to have choice!

— Holly Dunsworth (@HollyDunsworth) December 16, 2016

As long as evolution, especially human evolution, is publicly championed like that, it's not going to catch on among thoughtful kind people.

— Holly Dunsworth (@HollyDunsworth) December 16, 2016

There's a lot of things one could say about this, but what's most preposterous about it is the idea that science is somehow responsible for being thoughtful or kind — i.e., adhering to "safety", the prevailing groupthink, a problem the atheists ran into a while back. Coyne answered these silly remarks resoundingly well here, and at even greater length, here. He makes four points, three of which are strongly supported by data:

• Among species of primates, there’s a good correlation between the polygyny of a species and sexual dimorphism: those species in which males have a higher variance in offspring number, and in which males thus compete more intensely for females, also show a greater ratio of male/female body size, even when corrected for phylogeny. (Too, in primate species in which males fight each other over females, the relative size of the canine teeth, used in battle, is larger than in species showing less direct male-male competition.)

• In humans, as in many other species in which males compete for females, the sex ratio at birth favors males. They then die off at a higher rate due to higher risk-taking and exploratory behavior, and also senesce faster, which is why among older humans there are so many more females than males. (Check out any Gray Line tourbus.) This is predicted by sexual selction theory.

• In line with the above, in humans and other primates, males show from the outset great exploratory and risk-taking behaviors, and as adults show many other behaviors that differ from those of females, such as greater dispersal. Is this due to the Primate Patriarchy? Probably not, given that these differences in behavior are shown in many species besides ours and make evolutionary sense.

Moreover, regarding Dunsworth's remarks, female growth emphatically does not stop after menarche (females continue to grow even into their late teens). "Dunsworth’s hypothesis is not only unsupported by data, but fails to explain the growth data that do exist." He concludes:

I can’t believe that simply my writing a post on human sexual dimorphism and its implications would drive anybody away from studying human evolution. After all, the give-and-take of hypotheses, critical thinking, and data are the very meat of science, and if you disagree with somebody, you don’t simply walk away from a field. I sure as hell am not leaving evolutionary biology because Dunsworth and New York Magazine took out after me!

This is a great response, and I'm glad to see someone pick up this flag.

We're Doomed Dep't: Now Docs In Their 60's Outnumber Those In Their 30's (Updated With Some Good News)

I cannot make this stuff up (PDF, see the 2014 population statistics on p. 4). I have written about this before; the insane problems of new physician minting will not go away, and apparently are not being attended to, titular but comically small efforts notwithstanding. In two years, about thirty thousand doctors entered their sixties, i.e. near retirement age, while physicians in their 30's actually diminished, both in absolute population and as a percentage of the overall population. The problems of healthcare costs can not be properly addressed until we get the physician shortage addressed.

Update 2017-01-14: Last night, in a Facebook conversation Jerry Thornton made the point that the headline good news was a 4% increase in the overall physician population from 2012 to 2014. It's useful to do some quick checks to make sure this is of significant import relative to the larger problem, i.e. that of overall physician-to-population ratio. From my earlier work, the OECD average is 30.6 physicians per 10,000 population, or 3.06x10^-3, expressed in scientific notation. How long will it take to get the US from where it is to there?

• 2012 estimated US population: 314 million. (Population is only known precisely in census years, but is estimated between them. Source page here.)
• 2014 estimated US population: 319 million. (From the same source above.)
• OECD most recent year physician-to-population ratio: 3.29x10^-3 physicians/population. (It's actually gone up.)
• US most recent year physician-to-population ratio: 2.56x10^-3 (from the prior link)
• US physician population, 2012: 878,194
• US physician population, 2014: 916,264

 Let's find the annual physician growth rate first.

916 264 = 878 194(1+x)²

Solving for x, the annual physician population growth rate, gets us

x = sqrt(916 264/878 194)-1 = 2.14x10^-2

Now, the general population is growing at the same time. How much? Let's do the same math:

p = sqrt(319/314)-1 = 7.93x10^-3

So when will these converge at the OECD average of 3.29x10^-3 physicians/population? (I ignore the growth in the OECD average physician-to-population ratio.) Note that the Journal of Medical Regulation census physician population divided by the US Census general population figure gives us 2.87x10^-3, which is higher than the OECD physician-to-population figure; we'll use that as a basis anyway, as both numbers are presumably more up-to-date, and won't make much of a difference relatively.

916 264 physicians * (1+2.14x10^-2)ⁿ/3.19x10⁸ population * (1+7.93x10^-3)ⁿ = 3.29x10^-3 physicians/population

Solving for n, the number of years until the US meets the OECD average physician-to-population ratio, we get 10.5 years, which is pretty fast as these timelines go. However, given OECD physician-to-population ratios are rising (almost certainly in response to population aging), it's probably somewhat misleading.

Update 2017-01-15: Even more interesting: feet-on-the-ground physicians vs. state populations for the 50 states ratio is 385 physicians per 100,000 population, which puts the US in the upper half, at least, and maybe the upper third. This makes me wonder about the OECD methodology; do they count expats in the denominator?

Lindy West Resigns From Twitter

In my pantheon of online annoybots, Lindy West is fairly far down the list. Unlike, say, Anita Sarkeesian, she hadn't proposed a centralized censorship regime for the Internet. However, she has endorsed the unprovable standard of "affirmative consent" in rape cases, has a history as a victimhood miner, and I suspect a bunch of other fairly middle-of-the-road (for modern feminists) policy nostrums. For a number of reasons, West has largely flown beneath my radar. So when I found a Vox piece on her voluntary exit from Twitter, I was not terribly surprised, given what I had read of hers. What interested me about that Vox piece was this passage (emboldening mine):

Rather, her breaking point — what made her feel she could no longer participate in the platform’s “profoundly broken culture” — was that Twitter has failed to acknowledge and deal with the alt-right’s use of the social network to spread its racist ideology, leading to severe, real-world repercussions:

The white supremacist, anti-feminist, isolationist, transphobic “alt-right” movement has been beta-testing its propaganda and intimidation machine on marginalised Twitter communities for years now — how much hate speech will bystanders ignore? When will Twitter intervene and start protecting its users? — and discovered, to its leering delight, that the limit did not exist. No one cared. Twitter abuse was a grand-scale normalisation project, disseminating libel and disinformation, muddying long-held cultural givens such as “racism is bad” and “sexual assault is bad” and “lying is bad” and “authoritarianism is bad,” and ultimately greasing the wheels for Donald Trump’s ascendance to the US presidency. Twitter executives did nothing.

Which is to say, she very expressly wished Twitter would have shut up those mean people over there with the temerity to disagree with her, in public, even.  This is not a surprise, and in fact there was at least one significant "tell" previous that she very much wanted her own echo chamber: her response to the Washington Post investigations showing the Rolling Stone story about a gang rape at U. Virginia was a hoax:

Turns out that the real #UVA rape "truthers" are @AmandaMarcotte, @JessicaValenti, @thelindywest and their hivemind pic.twitter.com/fPykKBZbVJ

— Yeyo (@YeyoZa) December 6, 2014

Or, you could just take her word for it:

Whenever I advocate for the safety of marginalized groups on the Internet, some genius always pipes up to say, “Oh, so you just want to live in your echo chamber?” And YES. OF COURSE I JUST WANT MY ECHO CHAMBER, DINGUS. If by “echo chamber” you mean “a space online where I can communicate in good faith with informed people who don’t derail every conversation with false equivalencies and rape threats,” then yes, I’m dying for a fucking echo chamber.

In fact, maybe that’s what we’ll call it: Echo Chamber, the first feminist social network.

Given that presumptive bestie (or at least sister-in-arms) Marcotte is on Twitter's Orwellian "Trust & Safety Council", her kvetching here takes an interesting color. The subtext is a bitter complaint that, if they can make Milo Yiannopoulos go away, why can't they get rid of all these other people she doesn't like, too? In that, it amounts to a positive sign for the beleaguered Twitter, which continues to struggle to find profitability. Chasing those eyeballs out en masse makes no sense. Bon voyage, Lindy, and don't let the door hit you on the way out.

Obamacare As Bad Slasher Pic

The cliché being that the thing has so many false endings, you never really know when it's over, but Obamacare's demise looks closer than it did before Trump got into office. The Democratic defenders of the law continue to delude themselves about the realities on the ground there, but decreasing numbers of providers (many counties have only one now) and dramatically increasing premiums (around 22-25%, depending on who you listen to) have set in motion real problems that cannot be wished away. Well, they can be wished away, as witness Kevin Drum, one of the bill's big proponents at the time, now a peddler of bizarre counterfactuals that would have been politically impossible at the time. Megan McArdle takes him to task (emboldening all mine):

So “lying” was simply not an option. Neither was “doubling the cost and whacking up the mandate.” Democrats were already having trouble getting their $1 trillion bill passed. This was a bill so unpopular that the state of Massachusetts (!) sent a Republican senator to Congress to stop it.

Let’s stop for a moment and ponder that. It’s common to hear Democratic pundits lament that centrist senators like Ben Nelson and Joe Lieberman held the bill hostage, forcing it to be underpowered to the task and leading to the failures of today. But if Massachusetts balked at signing up for this, then the problem wasn’t just with a few squishy moderates. Had Democrats pushed for a $2 trillion bill with a much larger mandate, as Drum wishes, the issue wouldn’t have been a handful of DINO senators -- it would have been the folks from deep-blue states fleeing for cover ahead of a mob of angry constituents.

Democrats have been running from that mob for three straight Congressional election cycles now, and appear to have learned nothing from it. The most common defense of the bill, one I hear most often from the bill's promoters, essentially amounts to, "I got mine". That is, because the speaker has subsidized insurance (or at times, insurance at all), Obamacare has no perceptible flaws and thus needs no "fixing". I have some sympathy for this position; my autistic brother was ineligible for medical insurance prior to ACA passage, on the bizarre grounds that he had a preexisting condition of some sort that precluded it. (Insofar as I know, autism comes with no other health problems that would make him a bad risk in that way, but the insurers wanted none of him.) So he is one of the "winners" in this game. Ditto Mat Gleason, the retired Angels blogger (and still publisher of Coagula Curatorial), who needed very expensive life-saving heart surgery he could have never afforded otherwise.

But these anecdotal wins are not statistical or electoral wins. By clinging to "I got mine", ACA defenders ignore the real problems the law inflicts on others. This has gone on for a while now; I posted back in August about Sarah Kliff's delusional attempts to woo her way out of that deep well. Well before the late election, Democrats had started to distance themselves from the law:

In October, Minnesota's Democratic governor, Mark Dayton, complained publicly that although the health law had "many good features," it was "no longer affordable to increasing numbers of people." Around the same time, Democratic House Minority Leader Nancy Pelosi, whose determination to pass health care legislation helped push the bill over the congressional finish line in 2010, was asked on Meet the Press about the high price of health insurance premiums under the law. "Let's see how it works, and let's improve it," was her response. She also noted, as she has before, that what she would really "love" is a single-payer system. Just three years before, as the law's coverage expansion kicked in, she had touted it as a path to "more affordability, more accessibility, better-quality care, prevention, wellness, a healthier nation honoring the vows of our founders of life, a healthier life."

Also in October came complaints from former President Bill Clinton about a provision of the law that provides financial assistance to individuals at between 100 and 400 percent of the poverty line. "The people that are getting killed in this deal are small business people and individuals who make just a little too much to get any of these subsidies," he said at a rally in Michigan. He called the subsidy scheme "crazy" and declared that "it doesn't make sense. The insurance model doesn't work here."

 So, will the Republicans repeal the law? It's not clear; as Peter Suderman writes,

Several GOP legislators said that a provision allowing dependents up to age 26 to stay on their parents' plans would almost certainly be kept. In anonymous interviews, GOP aides suggested that the Medicaid expansion, responsible for much of the law's coverage gains, might also stay in place. And any major rollback that did occur would almost certainly be delayed for a year or two while Republicans tried to put a replacement plan together.

"Sen. Lamar Alexander (R–Tenn.), the chair of the Senate Health, Education, Labor, and Pensions Committee, which would be critical to the development of any real plan, suggested that crafting a detailed alternative would take around six years", which tells you that the political struggles are real within the GOP. The political will to change the law is there, but wholesale repeal is another matter, and unlikely. Sadly, it's the popular features of subsidies and mandated issue that cause the most damage in terms of higher premiums, yet those are the least likely to go away. Stay tuned.