Thursday, 13 February 2020

Public health and vaccination

There could well be a case for having a public agency focused comprehensively on vaccination and communicable disease. 

But the proposal that the folks over at Public Health Expert isn't that. In a post framed around the recent measles outbreak and noting the risks around antimicrobial resistance and pandemics, we get this conclusion:
Business as usual is not a rational or viable option for NZ. There are almost daily reminders about the large current and impending public health challenges faced by this country. These challenges include the health consequence of persistent inequalities, the increasing burden from rising obesity and non-communicable diseases such as diabetes, and persisting problems of poor mental health and suicide. Possibly even more alarming are the rising environmental consequences of climate change and ecological collapse that take us beyond ‘planetary boundaries’, and emerging infectious diseases including rising levels of antimicrobial resistance and the emerging coronavirus pandemic. The current national measles epidemic is just another reminder that our national public health capacity and systems are no longer fit for purpose.

The good news is that the present Health and Disability System Review could map out the design for a new kind of public health agency to lead the transformative change that NZ needs to achieve its goals of improved public health and equity, and support its shift to a sustainable future.  Public Health Aotearoa could well provide the high quality sustained public health leadership needed to eliminate measles, improve our health security, and manage other long-term public health challenges.
It would be ...surprising... if this kind of agency maintained any kind of focus on pandemic prevention and vaccination promotion. It would quickly instead become an agency pushing for greater controls around lifestyle issues related to noncommunicable disease and, from the description above, social justice issues. And when that shift resulted in another great forgetting of the importance of vaccination and core public health, it would complain come the next measles outbreak that it simply hadn't had enough funding.

I could rather strongly favour there being an agency solely responsible for reducing the risk of communicable disease. That's core public health work. It would encourage research into vaccination uptake - finding ways to get folks vaccinated who are averse to vaccination. It would have targets around vaccination rates. It would make sure that public health nurses get into the schools to make vaccination routine. If it ever came to it, it could help coordinate quarantine regimes.

I really like the kinds of things that Nick Wilson writes about pandemics and preparedness. But I have no confidence that a new public health agency would pay any attention to pandemics or vaccination rates outside of a crisis.

Like, why would it be any different than the general focus of the current regime, in which it is dead simple to find millions of dollars in grants to Otago Uni to run focus groups about smoking (while Marewa does the real work out on her own) but hard to find much evidence of support for research into encouraging vaccination?

I'd put in an OIA request last year asking the Ministry of Health to list any research it's commissioned around vaccination. This is what I got back. It isn't much, despite waning vaccination rates.

Vaccination just seems to be low priority until there's a crisis. I wonder whether one tobacco researcher, by herself, has gotten more funding than the whole vaccination research agenda noted below.


Wednesday, 12 February 2020

Conversations with Atwood

Not everyone seems to have enjoyed Margaret Atwood's book forum in Auckland with Chloe Swarbrick.

I wasn't there.

But I did catch Tyler Cowen's superb talk with her. The podcast and transcript are all up here. A few highlights below. Cowen's breadth always amazes. You look across the range of folks he's interviewed, and the depth he'll cover...
COWEN: I’m a big fan of your novel, Hag-Seed, which I believe is your latest. A few questions about that and Shakespeare: How sympathetic is Shakespeare to Caliban in The Tempest?
ATWOOD: Shakespeare himself, when he was doing The Tempest, I think, saw Caliban as one of his comic figures. But as always with Shakespeare, nothing is two-dimensional. So The Tempest underwent a number of different metamorphoses in performance since Shakespeare. We have The Tempest. Then we have Oliver Cromwell. The theater gets shut down. The tradition is broken.
When the theaters come back, they can’t actually remember how these things were done. So in the 18th century, The Tempest was an opera, and they added some people. They added a person called Dorinda, who is Miranda’s sister, so that they could have an ensemble group of singers, obviously. Then they added another guy so that Dorinda would have somebody to marry. Then they learned how to fly Ariel, and Ariel flew around.
Then when they tried to bring back the original Tempest, nobody liked it because they wanted the opera. They wanted Dorinda and the flying Ariel. In the 19th century, when Ariel was always played by a woman who flew around, Caliban became a romantic sort of Byronic hero, oddly enough. Because by that time, people had caught up with slavery in the United States, and noble savages and other things like that that were of the 19th century.
COWEN: And he has real charisma.
ATWOOD: Well, it depends how he’s played. It really depends, and I’ve seen, by this time, a lot of performances of The Tempest, including film ones. One by Julie Taymor, in which Prospero is Prospera — she’s the duchess of Milan — has a pretty good Caliban.
But he has a lot of resonance. He’s given the most poetic lines in the play, actually. There’s a big question about him, which is, what happens to him at the end? We’re not told. It’s another of these open questions. We just don’t know.
COWEN: How sympathetic are you to Prospero? There’s a line in Hag-Seed: “He would seem to be the top jailer in this play.”
ATWOOD: Well, he is.
COWEN: Do you like him?
ATWOOD: Like or dislike, it kind of doesn’t matter. Whether I like or dislike him, I’m sympathetic to him in some ways. But he says himself that he got himself into this. He was the duke. He didn’t do his dukely duties. He didn’t behave in a duke-like way. He went off to study magic instead, and he let his brother usurp the kingdom. By doing so, of course, he threw his young child into danger and ended them up on this island.
If you want to know why he wants to get off of it, look at the menus, which I did. I did a little foodie piece for a food magazine on what they were actually eating. It’s not fun.
COWEN: As Leggs suggests in Hag-Seed, is there any chance that Prospero is Caliban’s dad?
ATWOOD: Think about it.
COWEN: Someone has to be, right?
ATWOOD: Think about it. Somebody has to be his dad. So, if we’re not accepting the devil as being the progenitor of Caliban, who is? I ask you. They’re both in the magic business. Why would they have not met up at a convention? Sort of a one-night stand producing Caliban.

COWEN: Handmaid’s Tale — is it an accident that you started it in West Berlin in, I think, 1984?
ATWOOD: Wasn’t that corny? It was very corny, but I couldn’t avoid it. If I had been able to do it in some other year, I would have because, inevitably, this question comes up. But I just happened to be in West Berlin. I didn’t go there on purpose to do that. But there I was, and how handy it was because it was the wall all around. And being Canadian, I could go into places like East Germany and Czechoslovakia and Poland easier than German nationals could. So I did.
COWEN: You had had a prior trip to Afghanistan. Did that influence the book at all?
ATWOOD: A bit, yeah. I was lucky enough to see Afghanistan six weeks before the present unpleasantness started. Six weeks before they assassinated Daoud. It was clear, and it always has been a crossroads, and it’s always been desirable. It’s always been desired by China, by Russia, and by anybody else in the vicinity because things went through it.
At the time we were there, there was a great big Chinese embassy. There was a great big USSR embassy. And there was a great big American embassy. Daoud was doing quite well by playing them off against each other and getting stuff out of them. They should have stuck with him. But it’s been chaos ever since. I saw it at the last minute before a lot of things just got blown up.
COWEN: Did reading the Book of Genesis serve as an actual influence on Handmaid’s Tale? Or it’s just a connection you noticed later?
ATWOOD: Oh, no, it’s right there in the epigraph. So the question to you is, if you’re going to take the Bible literally, how literally would you like to take it?
COWEN: Is it the Jacob version of this story or the Abraham-Sarah-Hagar version of the story that grabbed you? Usually you mention the Jacob version of the story.
ATWOOD: Yeah.
COWEN: There’s the second one. Why?
ATWOOD: Because it’s got more people in it.
COWEN: But the first version has a happy ending, right? You get Isaac, you get Ishmael. They each found tribes.
ATWOOD: Why would I write a book with a happy ending?
[laughter]
ATWOOD: Yeah, it’s not such a happy ending. It’s a very ambivalent ending, I would say. Abraham is a very dicey character in the Bible. But there’s a wonderful book called God: A Biography, which is by Jack —
COWEN: The Miles book, yeah.
ATWOOD: Yeah, it’s a wonderful book. I love it. It’s got the best exploration of the Book of Job that I’ve ever read. I think it’s brilliant.
But remember where my roots are. I’m Canadian. We took the Bible in school. There wasn’t any separation of church and state. Then I went to college and studied with Northrop Frye. Then I went to Harvard and studied with Perry Miller. And for all those people, you had to know the Bible.
Go read or listen to the whole thing. I had no clue about her entrepreneurial ventures and patents.

Tuesday, 11 February 2020

Jacinda says I'm wrong


I'd had a chat with Breakfast TV on Monday morning on the back of Matt Nippert's absolutely excellent continued sleuthing into those subsidies.  
Currently, Mr Crampton says there is around $170 million spent in subsidies to international films. He says other industries are also affected by not getting a slice of that money, because they aren’t getting the people they need in the right jobs.

“The video game industry at the end of last year was complaining that they can’t get workers because they’re all being sucked in to video animation in the subsidised film industry,” he says.

“Where does it end? We shouldn’t be on this kind of rollercoaster. Every country in the world competes on these kinds of subsidies and it’s a mistake to be in that game.”

Jacinda Ardern disagrees. She says she believes the flow on affect of the film sector is worth it for New Zealand.

"You ask anyone who works in the industry whether or not it makes a difference... the flow on affect is huge," the Prime Minister said today.

"The film industry is completely unique."
The big problem that I had with the government's "wellbeing" budget is that it made absolutely no attempt to gauge whether anything in it was particularly useful in improving wellbeing. Funding went into areas where there were demonstrated problems, but with no particular way of telling whether those were also the areas where more spending could do the most good.

I guess I was hopelessly optimistic in expecting that a government that professed to care about wellbeing actually were serious about it.

If the Prime Minister's method for evaluating whether giant film subsidies are the best possible use of tax money is to go and ask the recipients of the subsidies whether they make a difference, well, I suppose we should all ratchet down our expectations for Budget 2020.

You might have thought that putting a couple hundred million dollars a year into Pharmac might do more good than film subsidies - it would be a 20% boost to that budget. Or any of a pile of different areas, including an education system that has trouble teaching graduates the difference between effect and affect. But no. Film subsidies.

It makes for fun syllogisms though. If tax is love and Avatar sequels are tax, are we required to love the Avatar sequels? I hope not.

Previously: Film subsidies are stupid

Monday, 10 February 2020

Congestion charging

The same kind of technology that lets commercial trucks handle road user charges painlessly could be installed on petrol vehicles. Petrol excise would go away, with road user charges taking their place to collect the same amount of money for the land transport fund.

Carbon charges on petrol would, of course, remain.

The purpose of a congestion charge would not be to fund new roads, or road expansions, or public transport, or anything else. The purpose of a congestion charge would be to get rid of the hassle and time and frustration cost that each of us bears when stuck in traffic, and to replace it with a monetary charge instead that would allow traffic to flow freely.

If you'd like an analogy, think about the old Soviet Union. Prices were officially very low in the government's stores, but everyone had to sit in queues for hours if they wanted to be able to buy toilet paper. That's how we run our roads: the government's set price for getting onto the road is zero, but you have to queue.

Ideally, congestion charging would be revenue-neutral. Road user charges would fund the roads, but congestion charges' only job is to alleviate congestion. The government could take every dollar collected in congestion charges, net of the cost of running the system, and give every person in the country an equal payment out of the collected funds.

Letting prices work can solve a lot of problems. It can also then make additional investments in roads rather less necessary. Traffic engineers like building roads to handle times of peak use. Charges that spread that traffic load more evenly over the day mean that you don't need to invest as much in increasing capacity in the first place.

Even better, the collected congestion charges can start to tell you when it does make sense to increase capacity – to twin Wellington's Mt Vic tunnel, for example, or to turn some of the chokepoint traffic circles on Johns Road in Christchurch into offramps and flyovers. If collected congestion charges around the chokepoint signal that people really put a lot of value on getting across town, that starts making the case for increasing capacity.

If instead we see that the congestion charge needed to for traffic to flow freely around the chokepoint at peak hours is rather low, then the economics of fixes like a second tunnel are likely rather poor.

It's hard to tell which is true until we start pricing congestion.
Like carbon prices, congestion prices are one of those things where the economic merits are obvious, but the politics in getting there are hard. Heck, Mark Blaug explained the case for them in a public lecture at Canterbury more than a decade ago.

Making the charge revenue neutral will be important in making the thing feasible. If people expect this to be a tax grab to fund all manner of new initiatives, they'll rightly balk. Using a congestion charge that way makes a hash of it. If you use the thing with revenue as an objective rather than a byproduct, you'll set the prices incorrectly. I like the idea of just giving everyone a cheque for their equal share of the collected net revenues.

At the same time, we do need better ways of funding roading infrastructure. And that's where Road User Charges could come in. If we have the transponders in place for congestion charging, we can use them to set different base prices for different roads. If it turns out that a second Mount Vic tunnel makes sense, which we'd quickly see if the congestion charge necessary to ease traffic around the tunnel were high, then you could fund the second tunnel with a dedicated charge on that route - that dedicated road-specific RUC could pay off the bond that funds the tunnel. And if it looks like there's no way that driver demand, as demonstrated by willingness to pay to use that route, would cover the cost - well, then digging would be a waste of money and shouldn't be done.

Friday, 7 February 2020

Tie-breaker

In this week's column in our Insights newsletter, I wonder a bit about whether T20 matches really need tie-breakers. 
I’m not convinced there’s anything wrong with a tie. Why are we always trying to break them?

We left Friday’s T20 match between the Black Caps and India after the 16th over. New Zealand needed only 26 runs from 24 balls with plenty of wickets in hand. The WASP had New Zealand almost certain to win. It was well past 11 pm, and our 9-year-old was dozing off.

I read CricInfo’s commentary aloud to my rather more awake son and his friend as we walked to the car. Back at the stadium, the roars we heard from a crowd heavy with India’s supporters during the final over probably meant wickets rather than boundaries, as CricInfo eventually confirmed.

So they were off to another Super Over that would take the game to a too-familiar outcome, well past midnight. And we were off to get the kids to bed.

The drive home had me wondering about tiebreakers.

If both teams end a match with an identical score, is there any fair way of determining which side deserved to win?

Deciding a match on the number of boundaries tends to reward the flashier team over a patient one grinding forward on ones and twos. Is the former really better than the latter?

Equally, handing a win to the team with more wickets in hand says that it’s worse to run out of wickets than to run out of overs in a limited-overs game. Both are surely valuable, so why set the one above the other?

But going to a Super Over is plainly a mistake – not simply because of any recent and repeated unpleasantness. You might think that, because an extra over in a twenty-over game gives us 5% more information about which team is really the better one, it is a fair way of resolving a tie. But this format privileges the team with top-heavy talent over the side with talent spread across its order.

Ties are more likely to happen when both teams have comparable skill, so it is no surprise that picking a winner between them involves some arbitrariness. Worse, every method of choosing can skew the pitch.

Yet nothing in cricket demands every match have a winner or loser. We could just accept that both teams were equally decent on the night.

At least that's better than being forced to consider New Zealand’s performance in the Super Overs. 
I tend to run cricket stuff past Scott Brooker to make sure I'm not beclowning myself too badly as a relatively recent convert to the game. 

Scott had an excellent suggestion for a way of avoiding ties, should one wish to avoid ties. 

At the start of the second innings, flip a coin. The coin flip determines whether the chasing team needs to meet the defending team's score to win, or exceed that score. Both teams then have the full inning to chase or defend a known target. No chance of a tie. And nothing that skews play. I rather like it. If you don't want to allow ties.

And this idea also has merit:

Wednesday, 5 February 2020

Purity Spirals

Lately we’ve been witnessing more and more small worlds fall apart under the weight of their vast moral centre of gravity. In the past year, the middle-class, middle-aged, overwhelmingly female knitters of Instagram have descended into internecine conflict over racism allegations. Young adult fiction has exploded into an ethical gazumping war over who is allowed to write about what colour of character. In Canada, the music business has become so consumed by ethical etiquette that a juror who submitted the band Viet Cong for the nation’s top music prize was compelled to write a lengthy apology over how culturally insensitive his action was.

I’ve become fascinated by the link between what we see in examples like these, and a dynamic we’ve seen play out through history.

In 1967, Mao’s Red Guards took to the streets determined to root out the ‘four olds’ of traditional Chinese culture, killing hundreds of thousands in the process. By 1968, they had fallen apart as factions fought each other to represent the truest version of Maoism. In 1794, Robespierre found himself on the same tumbrel he had prescribed for so many other problematic persons. In both cases, a bidding war for morality turned into a proxy war for power.

In my new BBC Radio 4 documentary I wanted to join the psychological dots between history’s pinnacle nightmares and what happens at the end of your road. I decided to call both the phenomenon and the documentary, “The Purity Spiral”. A purity spiral occurs when a community becomes fixated on implementing a single value that has no upper limit, and no single agreed interpretation. The result is a moral feeding frenzy.

But while a purity spiral often concerns morality, it is not about morality. It’s about purity — a very different concept. Morality doesn’t need to exist with reference to anything other than itself. Purity, on the other hand, is an inherently relative value — the game is always one of purer-than-thou.
Read the whole thing. And catch the BBC podcast as well.

The entire dynamic may also have consequences for dating markets.

Tuesday, 4 February 2020

Ports and Portability

Alas, Bernard didn't keep the headline I'd picked for this week's Newsroom column

It's about whether it makes sense to move Auckland's Port. I don't know whether it makes sense to move it or not, but I do think that the first step is figuring out just how much value could be unlocked by turning 55 hectares of waterfront real estate over to other uses, whether residential, commercial, or anything else other than a stadium.

So: Ports and Portability.

Bernard went with "Hard numbers needed before 'blue sky' Port talk".

Ah well. I still like Ports and Portability. He's the expert though.

A snippet:
Moving Auckland’s port might make sense – someday.

But I do wonder about some of the talk of moving Auckland’s port to put in a waterfront stadium, or museum, or other large, iconic, and expensive facility.

Stadium maths are almost invariably bad. Rather than revitalising cities, stadiums more typically become white elephants needing ongoing financial support. Putting one on some of the city’s most valuable property would not only ensure it could never cover its own real costs, but would also forgo far better uses for prime commercial and residential land.

If you owned a quarter-acre section in Epsom, with a sprawling ramshackle workshop and shed in the back yard, rising property prices might eventually convince you to make some changes. Clearing the workshop out could be a bit expensive – and especially if you needed to find some other facilities for your projects. But subdividing could let you clear the mortgage and pay off a few other bills.

Unless you had money to burn, deciding to take on all the expense of clearing out the shed and finding another place to work might be a bit silly if you decided instead to put in a swimming pool. It could be nice on a warm evening, but it certainly would not help with the problem of covering the mortgage. And the bank might have something to say about it.

As downtown property values rise, eventually the Council-owned Port’s fifty-five hectares of land and wharves will be valuable enough in other uses to cover the cost of clearing the land and building new facilities elsewhere. Those costs will not be small, with consultancy reports battling over just how close to $10 billion the bill might wind up being. But the value of the underlying property will not be small either.
I worry that where the government wants to decide on whether to move the port before deciding on what to do with the waterfront land, we could too easily wind up with a waterfront stadium.
In the Hitchhiker’s Guide to the Galaxy, Douglas Adams wrote of how numbers written on restaurant bills within the confines of restaurants do not follow normal the laws of normal mathematics but instead follow Bistromathics. He imagined spaceships powered by this new math. Numbers used in economic impact assessments of stadiums are even stranger than bistromaths. To put the academic economic consensus simply, public investments in stadiums do not deliver the promised benefits.

A waterfront stadium the size of Eden Park would sit on about $600 million dollars’ worth of property, if that waterfront land winds up being worth about $10,000 per square metre; construction and running costs of a stadium would be additional. If the stadium had zero running cost and zero construction cost, it would still need to generate revenues of almost $50 million per year to cover the capital cost of the land alone.

And Eden Park’s total operating income last year was just short of $16 million. A stadium might not be the best possible use of waterfront land. It is just too easy to imagine combined governments spending billions of dollars to move the port based on business cases involving selling the port’s land, only to then spend easily over a billion dollars on a new stadium for the site instead.