Secrecy is Unsafe

The latest issue of Foreign Policy includes a commendable piece by Jacob Shapiro, “Strictly Confidential” (summarized; full article behind paywall).

Shapiro makes an intelligent case that opening government improves security. “When government officials curb access to information,” he writes, “they cut themselves off from the brain power and analytical skills of a huge community of scientists, engineers, and security experts who are often far better at identifying threats, weaknesses, and solutions than any government agency.” Shapiro provides a couple of examples where openness has improved security systems.

“Putting information behind lock and key does not make targets safe from attack. It leaves security analysts unable to find solutions to other weaknesses in the future. It also leaves government and industry less motivated to find safeguards of their own.”

Good stuff.

Here’s One Embargo SiCKO Won’t Violate

USA Today initially reported that Michael Moore will be screening his new film SiCKO at a Tehran film festival in October.  Alas, one of Moore’s producers responded with an even-tempered denial (which was dutifully reported by USA Today).

That’s a shame. 

With the help of a beautiful and intelligent attorney, I uncovered a Treasury Department guide to U.S. sanctions against Iran.  Officially speaking:

The receipt or transmission of postal, telegraphic, telephonic or other personal communications, which does not involve the transfer of anything of value, between the United States and Iran is authorized.

I’d say that gives SiCKO the green light.

You Are Entitled to Your Own Opinions…

..but not your own facts, as the saying goes. Michael Rubin of the American Enterprise Institute argued earlier this week in USA Today that the United States should pump more money into Iran in an effort to bring about the overthrow of the Iranian regime. According to Rubin, “those denouncing U.S. funding are not the imprisoned student and labor activists, but reformists loyal to theocracy, and gullible pundits.” Presumably that’s me in the role of gullible pundit, but let’s have a look at these “reformists loyal to theocracy” who constitute the only Iranian opponents to U.S. attempts to bring about regime change in Iran.

This from an article by Negar Azimi in the New York Times Magazine:

It is particularly telling, perhaps, that some of the most outspoken critics of the Iranian government have been among the most outspoken critics of the democracy fund. Activists from the journalist Emadeddin Baghi to the Nobel laureate Shirin Ebadi to the former political prisoner Akbar Ganji have all said thanks but no thanks. Ganji has refused three personal invitations to meet with Bush. A member of a U.S.-based institution that has received State Department financing and who works with Iranians told me that the Iranians had expressly asked not to have their cause mentioned in presidential speeches. ”The propaganda campaign surrounding the launch of this campaign has meant that many of our partners are simply too afraid to work with us anymore,” she told me on condition of anonymity. ”It’s had a chilling effect.”

This from an article in Time by Scott Macleod:

Several mainstream Iranian reformers tell TIME that from the start they transmitted their opposition to the democracy program indirectly but clearly to American officials via the back-channel talks. Besides warning that it could trigger a crackdown, they argued that Iran’s reform movement had strong popular support and did not want or require foreign help. Outside backing has been an unusually sensitive issue in Iranian politics ever since a CIA-backed coup d’etat in 1953 installed the former Shah. Instead, many of them argue, Iran’s democracy movement would be better served if the U.S. lifted sanctions and improved relations with Tehran, which would enable trade and cultural links to be expanded. “There is no serious individual inside or outside Iran who is going to take this money,” an Iranian reformer told TIME. “Anyone having the slightest knowledge of the domestic political situation in Iran would never have created this program.”

Note how Rubin has moved the goalpost such that genuinely Iranian voices of political reform with constituencies inside Iran have now been written out of the acceptable-to-the-US opposition to the Iranian government. Shirin Ebadi, the Nobel laureate who has most recently been working to spring imprisoned Wilson Center scholar Haleh Esfandiari from Evin prison, has become “loyal to theocracy.” And the only folks left are Michael Rubin-approved dissidents who want the U.S. government to become more deeply enmeshed with the opposition to the regime, with only one plausible outcome: poisoning the domestic political legitimacy of the opposition and getting the U.S. government more invested in regime change.

Maybe we need an Iranian Ahmed Chalabi.

Toward Open Wireless Networks

One of the hottest issues in tech policy this year is the regulation of wireless networks. The transition to digital television is almost complete, and the FCC is planning to conduct an auction next year to determine who will get to use the old analog television spectrum once the television stations are done using it. Some scholars have argued that the FCC should impose a variety of regulations on the winner of that auction to promote competition in the market for wireless services.

I’m skeptical of this argument, but I do think the critics are right about one thing: in the long run, open networks (like the Internet) do tend to be more innovative than closed ones (like AOL). This is true for much the same reason that free markets are superior to central planning; open networks facilitate decentralized decision-making and low barriers to entry for entrepreneurs. The people who founded Netscape, Google, eBay, Yahoo, and dozens of other successful Internet businesses didn’t have to ask anyone’s permission to do so.

Right now, the wireless networks are not as open as many people in the technology industry would like. Someone wanting to create a new cell phone or a new wireless application or service has to go through a long and cumbersome negotiation process with each wireless carrier. There are good reasons to think this is slowing down the pace of innovation in the wireless market. However, the big debate is over what to do about this. Some people think the FCC should step in and mandate open access to wireless networks. For reasons I laid out in TechKnowledge last month, I think that’s a bad idea. My view is that the wireless industry is still in its infancy, and that market forces will drive carriers to gradually open their networks over time.

Last week, we saw two examples of how this might happen. First, Ed Felten, a computer science professor at Princeton, had a great post pointing out one way the iPhone could shake up the wireless marketplace:

An open system would provide more benefit overall, but most of that benefit would accrue to consumers. The carriers would rather get a big share of a small pie, than a small share of a big pie. In most markets, competition keeps this kind of thing from happening, by forcing producers to account for consumer preferences. You would expect competition to have forced the mobile networks open by now, whether the carriers liked it or not. But this hasn’t happened yet. The carriers have managed to keep control by locking customers in to long contracts and erecting barriers to the entry of new devices and applications. The system seemed to be stuck in an unstable equilibrium. All we needed was some kind of shock, to get the ball rolling downhill.

Only a company with marketing muscle, design mojo, and a world-historic Reality Distortion Field could provide the needed bump. Apple decided to try, in the hope of selling zillions of the new, more capable devices. The real significance of the iPhone, whether it succeeds or fails in the market, is that it will trigger the transition to more open networks. Once people see that a pretty good phone can be a pretty good mobile computer, they won’t settle for less anymore; and mobile networks will be pried open.

One of the issues that critics of the wireless carriers often cite is the fact that American carriers have refused to support cell phones with built-in WiFi connections, which could save consumers money by allowing them to save money on their calling plans by making free calls over the Internet. Critics charge that carriers refuse to allow that because they want to force you to make every call over their network, allowing them to soak you with per-minute usage fees. Today David Pogue has an article in the New York Times describing a new offering from T-Mobile that allows consumers to do just that: when the phone detects an Internet connection nearby, it will automatically route calls via the WiFi network, and the customer isn’t charged for the call. As Pogue points out, this is a direct result of T-Mobile’s desire to get a leg up on the competition:

Have T-Mobile’s accountants gone quietly mad? Why would they give away the farm like this?

Because T-Mobile benefits, too. Let’s face it: T-Mobile’s cellular network is not on par with, say, Verizon’s. But improving its network means spending millions of dollars on new cell towers. It’s far less expensive just to hand out free home routers.

Furthermore, every call you make via Wi-Fi is one less call clogging T-Mobile’s cellular network, further reducing the company’s need to spend on network upgrades.

T-Mobile has the smallest market share of the four national wireless carriers, so they have the least to lose and the most to gain from a shake-up of the market. As a result, they’ve proven most willing to take risks in order to gain market share. If this service proves to be a hit, as I suspect it will, it will force the larger carriers to follow suit or risk losing market share.

That’s how competition works–it steadily forces companies to offer more consumer-friendly products and services whether they like to or not. It’s frustratingly slow for people who are used to the rough-and-tumble of the promiscuously open Internet. But it’s moving in the right direction, and given the FCC’s poor track record when it comes to protecting consumers, I think it would be a mistake for Congress or federal regulators to try to “fix” it.

Does Cost-Sharing for Rx Reduce Health?

Unknown, say Dana Goldman, Geoffrey Joyce, and Yuhui Zheng of the RAND Corporation. 

In this week’s Journal of the American Medical Association, the team presents a meta-analysis of “132 articles examining the associations between prescription drug plan cost-containment measures, including co-payments, tiering, or coinsurance[;] pharmacy benefit caps or monthly prescription limits[;] formulary restrictions[;] and reference pricing[;] and salient outcomes, including pharmacy utilization and spending, medical care utilization and spending, and health outcomes.”

Here are their principal findings and conclusions, from the abstract:

Increased cost sharing is associated with lower rates of drug treatment, worse adherence among existing users, and more frequent discontinuation of therapy. For each 10% increase in cost sharing, prescription drug spending decreases by 2% to 6%, depending on class of drug and condition of the patient. The reduction in use associated with a benefit cap, which limits either the coverage amount or the number of covered prescriptions, is consistent with other cost-sharing features. For some chronic conditions, higher cost sharing is associated with increased use of medical services, at least for patients with congestive heart failure, lipid disorders, diabetes, and schizophrenia. While low-income groups may be more sensitive to increased cost sharing, there is little evidence to support this contention.

That last sentence was certainly interesting. But here comes the kicker.

While increased cost sharing is highly correlated with reductions in pharmacy use, the long-term consequences of benefit changes on health are still uncertain.

That echoes points I’ve made previously in this blog:

  • The mere fact that cost-sharing causes people to reduce their consumption of prescription drugs (or other medical care) does not mean that their health suffers. 
  • Even if cost-sharing does cause some people’s health to suffer, that does not mean that the overall health effects of cost-sharing are harmful. 

Indeed, as Goldman et al. conclude that these studies leave open the question of long-term health effects, the best evidence on this point remains the RAND Health Insurance Experiment, which showed that the overall health effects of cost-sharing are nil.

But as Tom Firey has argued in this blog, even if it could be shown that cost-sharing does reduce overall health outcomes, that is not a public policy problem.  It means that people prefer to spend their money on things other than medical care.  That is their right.  We might try to persuade them to spend their money differently.  But we are not justified in taking their money away from them to spend it according to our preferences – or more likely, those of the health care industry – rather than their preferences.  Whose life is it, anyway?

Unequal Justice?

There it was, emblazoned across the front page of the Washington Post, a headline made especially disturbing by its publication on July 4:

Justice Is Unequal for Parents Who Host Teen Drinking Parties

What did it mean, I wondered. Poor parents go to jail, rich parents walk? The law is enforced in black neighborhoods, winked at in white suburbs?

Not exactly. In fact, the Post reported,

In Virginia and the District, parents who host such parties can be charged with contributing to the delinquency of a minor, a misdemeanor that can carry jail time. In Maryland, hosting an underage drinking party is punished with a civil penalty, payable with a fine, even for multiple offenses.

So it’s not a story about unequal justice, just about different jurisdictions with different laws. But the Post sees it differently:

The stark contrast in punishments is just one inconsistency in a patchwork of conflicting legal practices and public attitudes about underage drinking parties.

“Inconsistency.” “Patchwork.” “Conflicting legal practices.” This is ridiculous. Move along, folks, nothing to see here. On the Fourth of July, let’s pause to remember: The United States is a federal republic, not a unitary centralized state. Different states and even different cities and counties have different laws.

One of the benefits of a decentralized republic is that laws can reflect people’s different values and attitudes. Decentralism also allows states and counties to be “laboratories of democracy.” If voters in Maryland and the District of Columbia read about how Virginia sentences parents to 27 months in jail for serving alcohol to teenagers after taking away their car keys — and they think that sounds like a good idea — then they can change their own laws. Or if Virginia voters notice that Maryland has a slightly lower highway fatality rate, then they might decide to change their laws.

States in our federal republic have different laws about lots of things, certainly including alcohol since the repeal of national Prohibition. I grew up in a dry county in Kentucky — no legal sales of alcohol of any kind — but neighboring counties were wet. The old joke was that Bourbon County was dry while Christian County was wet, but that seems not to be true any more. First cousins can marry in some states but not in others. The rules used to vary on interracial marriage until the Supreme Court stepped in and banned laws against it. In the past couple of years we have begun to experience different state laws on same-sex marriage.

Some people seem to want all laws to be uniform across this vast nation, from California to the New York Island, from the redwood forest to the Gulf stream waters, from sea to shining sea. They use their power in Congress to impose national speed limits, national environmental rules, national school testing laws, national marijuana bans, and so on. But the beauty of America is that we have resisted many of those pressures, and there are still real differences in the laws of San Francisco and San Antonio; Manhattan, New York, and Manhattan, Kansas; Wyoming and Wyomissing, Pennsylvania.

The laws are even different in Virginia and nearby Maryland. That does not mean that justice is unequal.