Sunday, June 23, 2013

Sunday Reading

We Spy — George Packer in The New Yorker on the open culture we’ve created through Silicon Valley.

Is it really surprising that the brotherhood of hackers turns out to be more like central intelligence? It doesn’t take much of an imaginative leap to go from gathering every last move you make online, and sharing it with marketers and advertisers, to divulging it to spies. Google, Apple, and Facebook have long since stopped being mere instruments of individual empowerment through collecting and processing information. Benignly democratic terms like “open source” and “transparency”—still in ubiquitous use around Silicon Valley—have become outmoded distractions from the source of the tech giants’ phenomenal growth, which is data-mining and its monetization.

Yes, it’s voluntary—no one forces you to enter credit-card information on Home Depot’s Web site, or to let Facebook track every purchase you make on Amazon—whereas Prism, the N.S.A.’s top-secret program for mining e-mails, videos, chats, and other online communications, is not. Markets involve choice; laws do not. Being a consumer is discretionary; being a citizen isn’t. But Prism, for all its breathtaking reach and intrusiveness, is less creepy to me than all the trillions of bits of information that commercial companies have stored up on all of us, gathered through a sophisticated mix of temptations, deceptions, default settings, carelessness, and sheer market power. It’s sinister when Big Brother is watching you, but it’s even more sinister when Big Brother is you, sharing. Prism is designed to prevent terror attacks on Americans. Advertising algorithms are designed to increase Google’s and Facebook’s profits. Which involves more of a public benefit? Between career officials at the N.S.A. and marketing managers at social-media companies, I trust the former more than the latter to maintain my privacy and use the information they have on me with maximum restraint. (Private contractors like Booz Allen Hamilton are a different story—the outsourcing of national security is one of the worst post-9/11 trends.)

I’m sympathetic to the dilemma of technology companies that are faced with government requests for access to information. There is an interest in protecting their users’ privacy (or whatever is left of it), and there is an interest in protecting Americans from attack. The government hasn’t proved that the full breadth of the N.S.A.’s program is necessary to uncover, track, and stop terror plots. Its critics haven’t proved that the program has been abused, that the collection of so much abstract data has led to unwarranted specific intrusions. What the whole debate obviously needs is much more clarity—for the government to allow more daylight into the nature of its surveillance programs (its fanatical level of secrecy is at least partly self-serving and designed to thwart critics as much as terrorists), and for the companies to be allowed to stop lying about their involvement. If we are going to have an N.S.A. with such broad powers of surveillance, and a technology industry with such extensive involvement in that surveillance, both have to be monitored and regulated (a hated word in the Valley) much more heavily than they are. Members of the congressional intelligence committees need to be able to discuss what they know without resorting to elaborate circumlocutions, and White House officials need to try persuasion instead of mere assertion. Courts need to be able to reach decisions that are accountable to parties other than just the government itself. Reporters need to be able to dig up important stories—as long as they don’t put lives at risk—without fear of the Justice Department. Technology executives need to be able to describe their industry’s participation in language that’s at least translucent, if not transparent. And the public needs to be able to understand, and then judge, this latest manifestation of the ancient trade-off between liberty and security.

Good Money — Peter Orszag and John Bridgeland, budget officials in two different administrations, look agape at how we throw money around.

Allow us to share some behind-the-scenes illustrations of what our crazy system of budgeting looks like—and to propose how the lessons of moneyball could make our government better.

When one of us (Peter) began his tenure as the director of the Congressional Budget Office in 2007, he took a Willie Sutton approach to the nation’s huge and growing fiscal mess: he went after health care, which makes up roughly a quarter of the federal government’s spending, because that’s where the money is.

The moneyball formula in baseball—replacing scouts’ traditional beliefs and biases about players with data-intensive studies of what skills actually contribute most to winning—is just as applicable to the battle against out-of-control health-care costs. According to the Institute of Medicine, more than half of treatments provided to patients lack clear evidence that they’re effective. If we could stop ineffective treatments, and swap out expensive treatments for ones that are less expensive but just as effective, we would achieve better outcomes for patients and save money.

Both parties should find much to like in such an approach. It would offer Republicans a way to constrain the growth of government spending and take pressure off private businesses weighed down with health expenses. And it would offer Democrats a means of preserving the integrity of Medicare and Medicaid and thereby restoring faith in a core government function.

And yet getting funding for the research needed to assess and compare medical treatments has been like pulling teeth. As a rule, legislators seem to lack a natural affinity for economists and budget analysts (alas, they are hardly alone). But Peter made himself exceptionally unpopular with some Democrats and many Republicans by insisting on such funding in the 2009 stimulus bill, and then working to expand it in the 2010 “Obamacare” legislation. Despite these modest successes, less than $1 out of every $1,000 that the government spends on health care this year will go toward evaluating whether the other $999-plus actually works.

Getting the right information is less than half the battle. Acting on it, once it’s in hand, is harder still. As one small example, some evidence suggests that moving toward “bundled” payments for all services needed by a patient during a course of medical treatment could produce better value than paying piecemeal for each service and procedure, because the piecemeal approach creates an incentive for more care rather than better care. During one meeting with members of Congress in 2008 to discuss how to expand bundling and include a performance incentive in kidney dialysis, Shelley Berkley, a Democratic congresswoman from Nevada, accused Peter, as he remembers it, of trying to destroy the dialysis industry. “You and your staff may have your Ph.D.s, but you have no clue,” he recalls her saying. “We don’t need any of your fancy analysis.” (Berkley says she does not remember the meeting, or those comments.) Berkley had received campaign contributions from several dialysis companies and organizations, and her husband owned a dialysis business. Whether these factors may have influenced her thinking is a question we will leave for the reader.

Clearing the Heir — Britain deals with the perpetual question: who gets the title?

Viewers of “Downton Abbey” spotted the family-destroying potential of primogeniture in the first episode, when the Titanic sank and Lord Grantham, father of three daughters, was left with no obvious heir.

Luckily, the distant cousin who emerged as the next in line proved willing to ditch his dreary day job, marry one of the daughters and cleverly produce a son before his own abrupt demise last season.

But what of those poor, no-prospects daughters, forced to look alluring and wait around for suitable husbands?

The practice of primogeniture — in which titles and estates pass only to male heirs, even negligibly related ones excavated from other continents — may seem as outrageous and antediluvian as denying women the vote, but it is still the law of the land for the aristocracy in Britain.

“My father always said, ‘Remember to wear a safety belt, because your face is your fortune,’ ” said Liza Campbell, a daughter of the 25th Thane of Cawdor (yes, there is one in real life, not just in “Macbeth”), and now, after her father’s death, sister of the 26th.

Also known as the Earl of Cawdor, the current thane, Colin, is the middle child among five children. But he is the oldest boy, and was always considered the most important, for title-continuity purposes. “I love my brother, but it’s a peculiar situation,” said Ms. Campbell, 53, an artist and writer who grew up on the family’s Scottish estate — 50,000 acres, plus castle — but now lives in London. “There’s one chosen one in the family, and everyone else is superfluous to requirements.”

Until recently there has been little appetite to change the law, a reflection in part of Britain’s inability to decide, finally, whether its aristocracy is an essential part of its identity, a quaint vestige of the past or a bit of both.

“The posh aspect of it blinds people to what is essentially sexism in a privileged minority, where girls are born less than boys,” Ms. Campbell said.

But the issue has been percolating through Parliament since the recent passage of a law allowing the monarchy to be passed on to the monarch’s firstborn child, regardless of sex (this means that William and Kate’s impending baby will become the third in line to the throne, whether it is a boy or a girl). New legislative proposals would allow peerages — basically, inherited titles and the estates that can come with them — to be passed on this way, too, to the oldest child rather than the oldest son.

“We seem to have not got rid of titles, but I think since we have them, I would like to see them gender-blind,” said the bill’s sponsor in the House of Lords, Lord Lucas of Crudwell and Dingwall, who because of a historical quirk is one of the few hereditary peers whose titles can pass to girls as well as boys.

Doonesbury — The Women’s Room.