Friday, February 28, 2014

The Truth About the Academy Awards

Many people look forward to the Academy Awards.  They will sit glued to the TV critiquing the choice of attire, the jokes, and the speeches.  Finally, after dragging on far into the night and beyond the allotted timeslot, the most prestigious awards are presented, and everyone goes to bed.  The same thing happens year after year.  It’s such a foolproof formula for drawing an audience that there are now 88 televised awards shows – that’s nearly two a week!

But that’s not the whole story.  For weeks before the awards, movie ads will promote the fact that they have been nominated.  The following day all primary news media outlets will broadcast or print the results, the best and worst in several categories, bloopers, behind-the-scenes looks, gossip, rumors, and “expert” opinions.  This will all be presented to us as “news.”

Not only is this not news, it isn’t even real.  It’s what Daniel Boorstin called in his 1961 book, The Image, a pseudo-event – a planned, staged, manufactured affair intended to draw and hold our attention with “a kind of counterfeit version of actual happenings” more exciting than our humdrum lives.

The truth about the Academy Awards is that, like the other 87 awards shows, it is just one big advertisement, a narcissistic orgy of people in a particular profession paying tribute to each other and to themselves as a group.  The resulting awards are used in further advertising.  In that sense it’s no different from political conventions, new product release ceremonies, press conferences, organized marches and demonstrations, even infomercials.  It is designed to sell you the stars, the movies as well as the products featured during the many commercial breaks.  The purpose of these events is to increase sales, in this case ticket and DVD sales, but in a similar case, it could be to gain votes.

Finally, they say that the movies are the best of the year as voted on by members of the Academy.  If that is the case, how do you explain comments like the following from CBS:  “Obviously, SAG and the Academy don't always agree…But the SAG Awards will give a window into support for Oscar favorites '12 Years a Slave' and 'American Hustle.'"  Should the results of one award show, rather than the merits of the movie itself, in any way influence the outcomes of another?

This is not meant to discourage anyone from watching.  Check out the gowns and the hairstyles.  Critique the presenters and recipients.  Root for your favorites.  But remember, this is not real life.  It’s not news.  It’s not anything but an elaborate sales pitch for the films nominated and for movie attendance in general.  If we remain aware of the strategy behind this show and the others like it, political as well as entertainment, we will be better equipped to resist the imbedded hype messages and be better able to make informed, objective decisions about our authentic wants, needs and preferences.

Monday, February 24, 2014

Black History Month

As Black History Month draws to a close, an important question comes to mind:  Will America ever be open-minded and accepting enough that there is no longer a need for such reminders?

To answer that question it’s necessary to look at behaviors and the incentives for those behaviors.  Black History Month has sponsors, as do many of the other commemorations, celebrations and recognition of accomplishments by minorities or those who otherwise see themselves as victims of society.  The sponsors include the NAACP and other local advocates.  According to a 2011 filing, the NAACP has 157 jobs with a payroll of $11,610,417 (average about $74,000).  The CEO salary is nearly $300,000.  They have a vested interest in maintaining a certain level of tension for their own job security and intrinsic rewards associated with fighting for a worthy cause.

Look at the March of Dimes as an example, founded in 1938, in response to the polio epidemic.  “With its original goal of eliminating polio accomplished, the March of Dimes faced a choice: to either disband or dedicate its resources to a new mission.” “In 1958 [it launched] its ‘Expanded Program’ against birth defects, arthritis, and virus diseases, seeking to become a ‘flexible force’ in the field of public health. In the mid-1960s, the organization focused its efforts on the prevention of birth defects and infant mortality”  “In 2005, reducing the toll of premature birth was added as a mission objective.”  These are all excellent causes, but see how the original purpose of the organization was flexed to fit the need to maintain the viability of the organization and jobs.  With one problem solved they redefined themselves, switching their efforts (along with the fund raising expertise and momentum) to related causes.

Advocates for women’s rights and gay rights find themselves in a similar position. Just as some environmental groups would never admit that the air or water is clean enough, advocacy groups have little incentive to see a final end to the cause they fight for.  If they do, they must modify their mission to stay in business.

It’s always easy to point to the ignorant or misguided among our fellow citizens who continue to judge others by the color of their skin, their speech patterns, sex or sexual preferences.  No matter how few, they provide examples of the need to continue working.  Bogus statistics, like the one about women earning 71 cents for every dollar a man earns will continue to be cited to keep such causes alive.  Black History Month, Pride parades, women's events and the rest will continue as long as people can credibly maintain their victim status and point accusing fingers.  Newscasters become willing accomplices with their litany of firsts that dwell on, rather than downplay differences – it gets almost to the point of parody:  the first gay native-Hawaiian Catholic woman to walk in space.  They also promote rather than dispel the notion that my heroes and role models must look like me – a concept that in itself is racist/sexist, but is put forth by people with a sincere interest in ending discrimination.

Powerful incentives are at play, but my hope is that such celebrations, announcements and staged events will some day become obsolete, stale remnants of the past, unable to survive thanks to changes in the attitude and behavior of all parties.

Friday, February 21, 2014

Medicine Is Not So Simple

Headline News:  A new study suggests that men who stand on their heads at least once a week have fewer heart attacks.  This fictional headline is not unlike many breaking stories we see daily on line, in print or on TV.  Someone does a study and the news releases the results no matter how wacky or unreliable.  Doctors and hospitals must be more careful in reaching conclusions and making recommendations.  The human body is complex and variable, and correlation does not prove causation.

Here is a real example.  The FDA advisory committee “voted 16-9 that the available data don't support a conclusion that naproxen has a lower risk of cardiac problems compared with the other NSAIDs.”  There may be some evidence and some excellent studies, but they are not yet definitive enough to convince the expert panel.  This is, in fact, contrary to a headline that came out about a week before this clarification was published. 

Another recent example comes from a Johns Hopkins bulletin.  After describing studies showing an association between daily coffee consumption and a reduction in some risks related to prostate cancer, they go on to warn:  “there is still not enough information to recommend that anyone start drinking coffee solely for its potential anti-cancer benefits...[because] all the studies…are observational, and these research efforts do not prove any clear cause-and-effect relationship between coffee consumption and prostate cancer protection.”  Again, they need clear evidence of cause and effect, from several well-designed studies.

Likewise studies of meditation find that it can be effective in reducing stress and anxiety, but the question of positive emotional benefits is still unanswered.  “Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.”  Clinicians must know this to counsel clients appropriately. 

In my fictional news story of the head standing, those who do may also practice yoga.  Yoga may lead to better circulation, which may reduce heart attacks.  Yoga may lead to practicing meditation to reduce stress, which may reduce heart attacks.  It may just be that overweight men are less inclined to stand on their heads, so the head-standers are in better physical condition, which reduces heart attacks.  Researchers may have studied, measured and compared the wrong things – as could also be the case in the coffee example.

These types of studies are happening all the time and the news media do not necessarily handle the information responsibly, preferring a big splash on the front page to the more careful approach taken by medical experts.  As a result we are faced with conflicting opinions about the relative effectiveness of mammograms, PSA tests and many other items of health news.  It’s important to keep in mind that medical science is more precise and careful than what a neighbor or relative reports, what the TV doctor recommends or what the latest breaking headline study suggests.  This understanding helps separate the real from the hoped-for, the effective remedy from the placebo, and the tested medicine from the prescription by popular opinion.

Monday, February 17, 2014

New Shoes

Walking through the mall last Saturday it was easy to spot the lines beginning to form at the various stores that specialized in athletic shoes.  Already at half an hour before opening, there were over a dozen eager customers waiting outside one grated entrance and maybe five or six at another.  The atmosphere was calm and even a little festive, with mostly guys standing around smiling and chatting to one another.  The one exception was the first in line, who must have arrived particularly early, equipped with a folding canvas camping chair where he sat slumped down with his smart phone busily engaged in some game or text exchange.  From his posture and demeanor, he did not strike me as a particularly athletic type, but maybe he was just saving his energy for the big game.

This observed behavior was all the evidence of a new sneaker release.  As it turned out Saturday was the very day when “the Jordan Brand would be bringing back the White/Infrared Air Jordan 6's once again, much to the delight of those sneakerheads who may have missed out in previous years.”  Ah-ha, that explains part of the mystery – these were not ordinary shoppers; they were heretofore frustrated sneakerheads ready to spend $170 for a pair of basketball shoes.  They were eagerly anticipating a new-found ability to “jump their highest and run their fastest”, as an old sneaker ad back in the Sixties used to put it.  (By the way, Nike, infrared is not even in the visible spectrum, but it really sounds impressive!)

Actually these so-called sneakerheads more resembled a row of large fish behind a deep sea fishing boat with the hooks firmly secured in their mouths ready to be reeled in.  Unlike the fish, however, they were not fighting for their lives with an eye on the future, but dociley submitting to the will of the fisherman, in this case, Captain Nike.  New shoes today versus college or retirement in the future? That’s an easy one.

Sadly, this display of behavior typifies the American consumer.  A lack of perspective makes him a sucker for the latest fad, the big hype, or the concocted sale – mark it up, then mark it back down again with lots of big percent-off signs.  When will we stop letting ourselves be so manipulated by the lure of advertisers and the promises of smooth politicians?

Friday, February 14, 2014

Economic Understanding

Economic Understanding is one of the key dimensions, but what is so important about it?  I have given several examples over the years showing how people make poor decisions when they fail to connect outside spending with their own financial welfare:  insurance claims raising the cost of insurance for everyone, legal settlements driving up the prices we pay, shoplifting affecting honest shoppers, businesses passing along the cost of government regulations, etc.

Another side of economic understanding is being able to predict unintended consequences of artificial interference in the normal course of business.  I have written several times about more insurance not being the answer to high medical costs, whether it be the current plan or some alternative.  (See April 16, 2012, September 10, 2012, February 22, 2013, October 28, 2013)  This prediction continues to come true.

A recent Huffington Post article tells of the impending doctor shortage.  How do you add millions of people to patient roles (by providing them with subsidized insurance) without adding more primary care physicians?  Doctors’ time doesn’t magically expand; new doctors don’t magically appear.  They must be trained and hired.  “According to the Association of American Medical Colleges (AAMC), unless something changes rapidly, there will be a shortage of 45,000 primary care doctors in the United States (as well as a shortfall of 46,000 specialists) by 2020.”

Using our economic understanding we can predict that hospitals will be bidding for those few doctors which will drive their costs up.  Patients will be forced to “pay” through extended waiting times or searching among the dwindling number of doctors who are accepting new patients.  “Many primary care doctors and dentists do not accept Medicaid patients because of low reimbursement rates, and many of the newly insured will be covered through Medicaid. Many psychiatrists refuse to accept insurance at all.”

On the surface the proposals look so enticing:  Insurance for everyone must be a good thing, caring and compassionate.  In the richest country in the world, why doesn’t everyone have access to quality health care?  The argument is compelling, but economic reality provides a brutal wake-up call.  Notice what happened about ten years after the government decided to make home ownership, “the American Dream,” available to more families.  Notice that college prices continued to climb even after the introduction of grants and “subsidized” loans – leaving graduates today with $29,000 debts.  It was not until colleges saw a reduction of state support and viable competition from tech schools and especially on-line courses, in other words real economic pressures, that they felt a need to drive down tuition costs.  The well-meaning proposals and programs often have the opposite effect.

If politicians and the voters they appeal to had a better economic understanding, some of these decisions, innocent and caring as they may appear, might have been questioned based on predictable negative consequences.