Don’t Make Drug Companies Police Usage

Is this a ridiculous amount of opiates for a single small town to prescribe. Sure thing. But I find the idea that drug companies being held to task for this, and thus implicitly the idea that they should have done something to supply fewer pills to these pharmacies deeply troubling.

I mean how would that work out? The drug companies are (rightly) legally barred from seeing patient records and deciding who does and doesn’t deserve prescriptions so all they could do is cut off the receiving pharmacies. Ok, so they could put pressure on the pharmacies to fill less prescriptions but the pharmacies also don’t have patient records so what that means is the pharmacies scrutinize you to see if you ‘look’ like someone who is abusing the prescription or a ‘real’ patient. So basically being a minority or otherwise not looking like what the pharmacist expects a real pain patient to look like means you can’t get your medicine. Worse, the people scamming pills will be willing to use whatever tricks are necessary (faking pain, shaving their head whatever) to elicit scripts so it’s the legitimate users who are most likely to end up out in the cold.

While I also have reservations about the DEA intimidating doctors into not prescribing needed medicine it is the government (who, I understand, is informed about the number of opiates being sold by various pharmacies) who should be investigating cases like this not the drug maker. Personally I think the solution isn’t and never has been controlling the supply but always about providing sufficient resources like methadone and bupenorphine maintenance so people who find themselves hooked can live normal lives.

Drug companies submerged WV in opioids: One town of 3,000 got 21 million pills

Drug companies hosed tiny towns in West Virginia with a deluge of addictive and deadly opioid pills over the last decade, according to an ongoing investigation by the House Energy and Commerce Committee. For instance, drug companies collectively poured 20.8 million hydrocodone and oxycodone pills into the small city of Williamson, West Virginia, between 2006 and 2016, according to a set of letters the committee released Tuesday.

There Is No Conflict Theory

Or Some People Are Just Wrong

So usually I find Scott Alexander’s posts pretty illuminating but, while his recent post on Conflict vs. Mistake Theories raises lots of interesting questions I think it fundamentally makes a mistake in trying to fit the type of extreme Marxist thinking he is describing into a framework of beliefs about the world and actions taken to advance those beliefs. While I think Scott appreciates this difficulty and attempts to wrestle with it, e.g., where he suggests the conflict theory take on is best exemplified by the “Baffler’s article saying that public choice theory is racist” ultimately his devotion to applying norms of charity to the other side leads him astray.

It’s not that there aren’t people like the conflict theorist Scott posits. I know there are a number of radical university professors who think to themselves, “Given the oppressive political structure and the power held by the elite the most effective way to bring about change isn’t to engage in rational argument but bring political or even physical force to bear.” However, for the most part the people Scott is trying to describe aren’t just like mistake theorists except they believe its intentional action by elites which makes the world bad rather than the difficulty of governing. No, such a theory would predict conflict theorists would retire back to their coffeehouses and perform cost-benefit calculations about the benefits of holding a particular protest or adopting a particular style of advocacy.

In other words conflict theorists aren’t mistake theorists who hide their true colors so as not to give the elites free ammunition but engage in the same kind of considerations as mistake theorists behind the scenes. No, fundamentally, most of the behavior Scott is seeking to describe is about emotional responses not a considered judgement that such emotional displays will best accomplish their ends.

Is The Foreign Corrupt Practices Act Appropriate?

Do We Really Respect A Nation's Soverignty When We Decide How Their Laws Should Be Understood And Enforced?

I’m rarely one to agree with Trump and disagree with Tyler Cowen but I’m inclined to think we should eliminate the Foreign Corrupt Practices Act rather than merely implement the minor changes he suggests. At a gut level I find the idea that we are imposing our norms about how law, public office etc.. should work on other countries unpalatable and at a more cerebral level feel that we shouldn’t put people in prison or even fine companies without a compelling reason to think it serves some important social good. My mind could be changed by substantial evidence this law improves the welfare in other countries but there is no apriori reason to think it will reduce, rather than increase, corruption overseas (e.g. the game theoretic aspects to providing insurance to the bribe taker that the bribe giver can’t turn them in).

If the question was whether we should help overwhelmed countries who find their anti-corruption efforts foiled by American companies wealth and global nature that would be a different matter and I support assigning DOJ resources to assist worthy local corruption prosecutions. I’d even favor a law which allowed the foreign government to request prosecution by a US court for bribery actions taken by US companies when they felt their own courts weren’t capable of doing the job. However, this law doesn’t leave the question of prosecution and appropriate sanctions to the jurisdiction where the crime took place but substitutes our American sensibilities about the badness of bribery and even the role of laws regarding bribery for local understanding.

One might object that this law is only triggered when the practice at hand is illegal under local law. That’s true, but all laws don’t mean the same thing. Imagine the UK had a law which imposed massive fines or a 10 year penalty for any UK citizen living in the states who intentionally ‘evaded’ local tax laws. Now it’s true that in the States we too regard many types of tax fraud as a bid deal….but there is a societal acceptance (perhaps a bad one) that evading state sales tax by ordering products from out of state isn’t a big deal the way cheating on income tax might be and any US enforcement of such laws will reflect that understanding but UK enforcement of a hypothetical foreign tax evasion law would not. Similar points could be made about laws with harsh penalties for consuming illegal drugs in a foreign country….often, as with decriminalization, what the laws on a country’s books say and how the society there understands the system to work don’t always agree.

In short, respecting the sovereignty1 of other states requires letting them decide on the relation between their explicitly codified law and actual enforcement/social understanding and the framework for this law seems to coopt that understanding.

Also, it’s not even clear if the net effect of this law will be to reduce bribery and corruption abroad. If, as might be expected, in corrupt countries foreign companies tend to be less corrupt than the locals the net effect of such a law might be to favor local companies that face no deterrence from the US government. As the structure of the law punishes bribes paid by US companies or the corporations they control or hire but not bribes paid by customers or local companies engaged in arms length transactions it creates an incentive for the most corrupt locals to start businesses they wouldn’t have otherwise2. Indeed, the very fact that a socially accepted system of bribery imposes a barrier that keeps US firms out of the market may even make public corruption reforms unpopular for protectionist reasons.

Finally, one needs to ask what the game theoretic effect is of a law. A really effective way to clamp down on bribery is to turn people who have given bribes into witnesses against the official (e.g. by offering them immunity in this or another case or even a reward) and often the bribe taker will be in far more jeopardy than the bribe giver potentially putting them at jeopardy of blackmail. However, add the potential for charges by the US government which the local prosecutor can’t bargain away but are unlikely to be brought at all as long as no one local rats and you have a very nice game theoretic mechanism of ensuring that your bribe giver doesn’t rat you out (threaten to report any company that bribed you to the US DOJ if you get convicted…might even be a good way of ensuring someone pays for your defense).

Whether or not any of these actually work out in the real world is anyone’s guess but that fact alone should be enough justification not to be (even potentially) handing out 20 year prison sentences. That is in addition to all the other problems of the law that Cowen notes.

How to Root Out Corruption Without Introducing More

Are you worried there may be corruption in the American executive branch today, yet also fearful that the tools for rooting out such malfeasance may be abused? If so, welcome to the dilemmas surrounding the Foreign Corrupt Practices Act.

  1. Now ultimately, of course, I only believe in respect for the sovereignty of countries (or the right of self-determination) because it’s a good heuristic for positive results but it’s a pretty damn good one. Not only do attempts to intervene in foreign cultures rarely work they tend to create a good deal or resentment against whoever does the intervention. This is true whether the intervention is a direct political one or merely a cultural one such as refusing to do business in the customary way in that place and the FCPA certainly raises that possibility. Even disregarding resentment when it comes to legal regimes there is a much stronger reason to respect sovereignty: penalties imposed by a foreign potentate rarely provoke compliance or respect so drag along all the harms of law enforcement plus without the social benefits that make those costs worth paying. 
  2. For instance, maybe a certain degree of bribery is expected to win contracts to supply the government with services and all local companies bidding simply pay the expected bribes. If US suppliers simply entered the market and complied with these necessary rules for doing business locally there would be little effect on corruption. On the other hand if they refuse but offer superior products at better prices there is a strong incentive for those locals who are best at greasing palms to set up a company which simply subcontracts the work to the Americans after bribing the government (without telling the Americans about the bribe) and since such a company is literally in the business of bribing and faces competitors in that buisness it is more likely to increase local corruption than if the US company had simply played along. 

Keep Executing The Innocent

4% Innocent Executions Is A Price Worth Paying For A Spotlight On Injustice

Since 4% of death row inmates are innocent we should keep the theoretical death penalty. I don’t want to execute anyone and ideally everyone on death row dies of old age before being executed but it’s only because of the death penalty that we have so much information about and public interest in the failings of our criminal justice system. I think that it’s only as a result of safeguards introduced because of worries about incorrect executions (DNA retesting) or fixes to forensic or legal failings that we don’t have more innocent people spending huge fractions of their lives in prison.

I don’t think being executed is much worse than life in a US prison. Given a choice between a coin flip between going free and being executed and the certainty of life in prison I’d take the coin flip. Hell, I’d take 9:1 odds. Other people’s preferences differ but I find it hard to believe that the death penalty is more than 10 times as bad as life in prison (and this is clouded by our irrationally strong drive to survive rather than a pure utility judgement) and a very small percentage of all convicts get the death penalty.

Without the death penalty there won’t be any ‘oh shit, was that guy innocent’ moment or double checks before execution. At any point the justice system will just delay or avoid reconsidering any issues and without the spotlight presented by arguments of innocence made by death penalty convicts people will just assume what’s easy to believe: our criminal justice system gets it right and the innocent are rarely convicted. If the price to pay for this is just 4% incorrect executions I think it’s worth paying.

Of course, it should be noted that the rate of innocent people being convicted will be much higher outside of death penalty cases. Inmates on death row had cases that not only went to trial but received far more scrutiny than even those non-death penalty cases that do go to trial. Personally, I wouldn’t be surprised if the true rate of people in prison for crimes they didn’t commit was as high as 10-20%

Study suggests that 4% of the people we put on death row are innocent

How well does the US justice system work? Given that many states still carry out the death penalty, it’s a rather significant question. Some biostatisticians have teamed up with lawyers in an attempt to provide a scientific answer to the question. Based on their figures, at least 4.1 percent of the individuals sentenced to death will eventually be exonerated.

  Category: Law
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AI Bias and Subtle Discrimination

Don't Incentivize Discrimination To Feel Better

This is an important point not just about AI software but discussions about race and gender more generally. Accurately reporting (or predicting) facts that, all too often, are the unfortunate result of a long history of oppression or simple random variation isn’t bias.

Personally, I feel that the social norm which regards accurate observation of facts such as (as mentioned in the article) racial differences in loan repayment rate conditional on wealth to be a reflection of bias is just a way of pretending society’s social warts don’t exist. Only by accurately reporting such effects can we hope to identify and rectify the causes, e.g., perhaps differences in treatment make employment less stable for certain racial groups or whether or not the bank officer looks like you affects likelihood of repayment. Our unwillingness to confront these issues places our personal interest in avoiding the risk of seeming racist/sexist over the social good of working out and addressing the causes of these differences.

Ultimately, the society I want isn’t the wink and a nod cultural in which people all mouth platitudes but we implicitly reward people for denying underrepresented groups loans or spots in colleges or whatever. I think we end up with a better society (not the best, see below) when the bank’s loan evaluation software spits out a number which bakes in all available correlations (even the racial ones) and rewards the loan officer for making good judgements of character independent of race rather than the system where the software can’t consider that factor and we reward the loan officers who evaluate the character of applications of color more negatively to compensate or the bank executives who choose not to place branches in communities of color and so on. Not only does this encourage a kind of wink and nod racism but when banks optimize profits via subtle discrimination rather than explicit consideration of the numbers one ends up creating a far higher barrier to minorities getting loans than a slight tick up in predicted default rate. If we don’t want to use features like the applicant race in decisions like loan offers, college acceptance etc.. we need to affirmatively acknowledge these correlations exist and ensure we don’t implement incentives to be subtly racist, e.g., evaluate loan officer’s performance relative to the (all factors included) default rate so we don’t implicitly reward loan officers and bank managers with biases against people of color (which itself imposes a barrier to minority loan officers).

In short, don’t let the shareholders and executives get away with passing the moral buck by saying ‘Ohh no, we don’t want to consider factors like race when offering loans’ but then turning around and using total profits as the incentive to ensure their employees do the discrimination for them. It may feel uncomfortable openly acknowledging such correlates but not only is it necessary to trace out the social causes of these ills but the other option is continued incentives for covert racism especially the use of subtle social cues of being the ‘right sort’ to identify likely success and that is what perpetuates the cycle.


A.I. ‘Bias’ Doesn’t Mean What Journalists Say it Means

In Florida, a criminal sentencing algorithm called COMPAS looks at many pieces of data about a criminal and computes the probability that they will commit new crimes. Judges use these risk scores in criminal sentencing and parole hearings to determine whether the offender should be kept in jail or released.