A trip to the dentist

I went to see a dentist, since it has been over six months since I saw my dentist in Hong Kong. The experience with the dentist has left me mulling over the differences in medical systems.

We had a great dentist in Hong Kong. My wife’s insurance paid for dental care, and it was not that expensive; the cost was about US$120 per visit. I never understood how Dr. Leung stayed in business (and sent his sons to private international school, and to private universities in the US), since he had an office in Central, and a receptionist plus two assistants, yet he did all the dental cleaning and consultations himself. 

About 10 years ago, he got headphones so you could listen to music while he cleaned your teeth. Then about 5 years ago he got video goggles, and then a video screen, so you could watch videos. I think young people got more hip music, but I got the likes of Yanni. I loved that Dr. Leung explained everything thoroughly, and that he was very conservative. He did not do anything unless it was really necessary, and did not suggest additional treatments or cosmetic upgrades.

In Saint Louis, I had to pick a doctor from a list of doctors provided by our insurer. It took over two hours to find an appropriate dentist, because the list had minimal information and I had to google each one. I eliminated all those that said they had over 35 years of experience—yes, I admit to being ageist, but I recently read an article that recommended doctors with some experience but not too much time away from their training. I also wanted a dentist reasonably nearby. One practice I called only served children—that was not clear on my list or on their website. Finally I found a doctor I will call Dr. Smith. She had about 10 years of experience, and I was able to make an appointment for the following week.

 

The electronic reader I signed

First thing I noticed was that even to make the appointment, I had to give them all my insurance information. Then, when I arrived and spoke to the receptionist, I was asked to sign an electronic reader three times, even though I was not shown the text to which I was agreeing. I thought this was a bit odd. I always grumbled at the Hang Seng Bank that they made me sign a blank form before they entered my information, and I did not expect to have to sign with no statement in the US. Ironically, one of my signatures was supposed to indicate that I accepted HIPAA, the national privacy rule. I commented to the receptionist on how weird it was that I was signing a privacy release form without seeing the text, and she said they would print a form out for me later. They did. Of course it is four pages long, in small type, so I guess they don’t want people like me to actually stand there and read it.

As an aside, the form says in 13 languages that you can call for assistance in other languages. The line in Chinese is in traditional characters, and seems to be written by some non-thinking bureaucrat. It literally says, “Note: If you use traditional Chinese characters, you can receive language assistance service. Please dial 1-800-XXX-XXXX.” (注意: 如果您使用繁體中文,您可以獲得語言援助服務. 請致電 1-800-XXX-XXXX.) What does "traditional characters" have to do with it?! Why did it not just say “If you speak Chinese…”?! Plus, all mainland immigrants must feel left out, since it is in traditional and not simplified characters! And it does not specify whether the service is in Mandarin, Cantonese, or any other "dialect."

I was then brought into a room for X-rays. They took a panorama of my mouth, and then an image of each pair of teeth, so lots of X-rays. The assistant assured me because the machine is digital and does not use film like they did in the old days, the amount of radiation is less than what I would get from a sunny day. It was a more elaborate process than at Dr. Leung’s.

Then I was moved to a consultation room. When I sat down, someone else’s records were on the computer screen in front of me. Ha! I wonder if that is allowed under HIPAA. The assistant quickly changed the records to mine, and I waited a few minutes until Dr. Smith came in. She told me that my teeth were fine, and that one sensitive tooth is actually fine. Then she said the manager would come to see me. I wondered, why?

The manager came, and then I understood. She used the computer screen to show me what each of my cleaning processes would cost, and was covered and not covered by my insurance. Most bizarrely, the first column was the “list price” and the next column showed the discounted price negotiated by my insurance company. The third column showed what the insurance company would pay, and the fourth and last column showed the portion I would have to pay. She said there were three levels of cleaning, including a top level “laser cleaning” which is not required but highly recommended. The screen showed that for the top level, I would have to pay for it entirely—the insurance did not cover it. Bizarrely, the prices are for one quarter of your mouth, so each procedure is listed four times. Turns out, my insurance only pays for the basic cleaning. How am I supposed to decide whether I really need the laser cleaning? I decided to try it once. But I had to schedule a separate appointment for the cleaning. It had taken an hour for the initial consultation, and it would be another hour for the cleaning. Dr. Leung does the cleaning in 30 minutes. He works and moves very fast. The technician is more deliberate. Not sure which is better. I’m happy with a technician doing the routine cleaning, but I know some people prefer to have the “real” dentist work on their teeth.

Another interesting difference is that both my dentist here and the technician wore a special kind of magnifying glasses with an LED light in the middle of the forehead. They are called dental loops and my technician told me they cost over US$2000. At the same time, and probably because of the LED light, they had me wear yellow safety goggles while they worked on me.

One advantage of being in the US is that it is much easier for me to chat with service personnel, and I enjoy that very much. Hierarchy and language differences made chit chatting more difficult for me in Hong Kong. On the other hand, some of the conversations here are kind of strange. My dental hygienist was shocked that I had lived in Hong Kong, and that I could survive 15 hours in an airplane. She admitted that did not like leaving home, and said that when she goes to Florida for a vacation, she worries something might happen and so as soon as she arrives she begins planning how she would escape. This is not Hong Kong, where people dream of vacations in Thailand. (In fairness, people in Missouri also dream of tropical vacations, but in the Caribbean).

I realized once I had the cleaning done that Dr. Leung charged about $130 for the same process, but just my portion of the bill here was almost $400! The insurance paid another $600. It is not like Hong Kong is a poor country with a lower cost of living. It is hard to understand why the cost in the US is so much higher for medical care.

Elisabeth Rosenthal, who was the NY Times Beijing correspondent for 6 years in the 1990s, has written a book on the medical system. I heard her speak on NPR’s Fresh Air where she talked about the problems of the US’s medical system. She was a physician before becoming a reporter, initially as a medical reporter before becoming an international correspondent. She is very clear about the ways that medicine is not a market like automobiles. She notes that a for-profit health care industry will seek to treat a medical condition, not to cure it. A cure for diabetes would wipe out a billion dollar industry. She also explains how prices will rise to whatever the market will bear, and they never go down (“sticky prices”). The Republican faith that market competition will solve all of the US’s health care problems is simplistic at best. I found the process of finding a dentist and choosing service to be quite time consuming—and I can’t really say I chose intelligently.

Now my dentist has recommended I see a surgeon about a cyst above a tooth. Dr. Leung knew about that tooth and said we’d just watch it. I suspect the surgeon will want to operate. My cousin, who is a surgeon, has told me that surgeons believe they can solve any problem with their scalpel. That’s why they’re surgeons. So if the oral surgeon recommends an operation, is it just a way for him to drum up business? Do I really need this surgery? I may have to ask Dr. Leung.

Hate and the Vice President

Yesterday, I joined several hundred volunteers at a Jewish cemetery, the Chesed Shel Emeth Cemetery, in University City, for a clean-up. Over the previous weekend, 154 tombstones were knocked over in an act of vandalism that may have been anti-Semitic (see video of the damage here). 

I now live in University City, and with all the hate going around, I decided to go to help and to make a political statement against prejudice and hate. Police do not know who did the vandalism. While usually anti-Semitic violence is accompanied by painted swastikas and other obvious messages, there was no such symbolic message other than the overturned tombstones. It could be just the work of mischievous youths, but the large number of vandalized tombstones suggests it might be a hate crime. Police are still investigating.

The cleanup was organized for Wednesday afternoon, and the new state governor, Eric Greitens, was scheduled to speak at 3:00 pm. Greitens himself is Jewish, and it is important for leaders to speak out against such vandalism and hatred.

Anticipating a crowd, I arrived early, at 2:30, and was surprised by the heavy police presence. Then I was surprised that we had to go through security screening. While in line, some started to speculate that Vice-President Mike Pence might be attending, since he was already in St Louis for another event. When I saw that we were being screened by a Secret Service agent, I suspected that might be correct. And when we saw over a dozen police cars arriving, we knew that was likely the case. The Secret Service agent made us remove all our metal from our pockets, and then checked us with a metal detector. Once passed security, we were given a colored sticker: I was in the yellow group, assigned to clean up a drive and clip a hedge at the south end of the cemetery.

Pence and Greitens came from a side entrance; they came to the center of the cemetery and stood on the back of a pickup truck and made some brief comments. (See local newspaper story here) Greitens said that the vandals do not represent Missouri, but that we, the volunteers, did. He also said that he had spoken to President Trump that morning and that he had been told by Trump to thank us for fighting anti-Semitism. Pence also said that the volunteers represent what is good about America. Both were brief and made appropriate and good comments.

The NPR radio report said that Greitens and Pence joined the cleanup and the interfaith ceremony afterwards, but they did not (the longer online article was accurate, so this was no doubt an editing error)[Correction: they did use a rake for a few minutes for a photo op]. They left after about 15 minutes. But I do not begrudge them that; they have more important things to do, and it was already good that they came to emphasize opposition to anti-Semitism and hate.

But I can’t help but feel like Pence was largely whitewashing the Trump administration’s responsibility for the rise in hate. Just last Thursday, Trump refused to answer a question about anti-Semitism from a Jewish reporter, telling him rudely to sit down (see NY Times story here). Two days ago, an article in Slate.com referred to Trump's "disturbing dalliance with anti-Semitic rhetoric". Trump is largely responsible for the rising climate of intolerance and bigotry that is returning to the country.

The St Louis Post Dispatch article said Pence and Greitens received “resounding applause” at many points, but that was not my impression. I thought it was clear the response was muted, and only a few people were very loud in cheering when Pence introduced himself saying, “I’m Mike Pence, and I’m the Vice President of the United States.” Of course, we were in a cemetery, and it was a somber occasion, so it was not the kind of place where you would cheer loudly. Still, I don’t think most in the crowd were strong Trump fans. And while most people were no doubt happy that leaders were taking this attack seriously, many must have also thought, as I did, that it was a bit late to condemn such violence. After all, Trump stoked white resentment and never spoke up against the KKK and other hate groups. So it is a bit disingenuous now to be surprised and saddened by what he has sown.

As he left, Pence shook hands with many in attendance. He walked right by me, and shook the hand of one of the friends I was with. But I stepped back, as did another friend. I could not bring myself to try to shake his hand. Power attracts, but I felt I would be a hypocrite if I shook hands with this politician who was responsible for anti-LGBTQ laws in Indiana, as well as reactionary economic policies. I’m told Pence is a good person, but I profoundly disagree with him on many issues. While I was glad he finally spoke out against hate, and relieved that this was finally something all could agree on, I still found his administration partly responsible for the environment that makes such hate and vandalism more likely. Maybe I’m just adding to the polarization of the country. But just maybe, sometimes, we have to make moral statements.

Safety and Security in America, and our new house

Photo by Boyd Polkinghorn

We moved into our new house in early December. It is an old house, built in 1909, but well maintained. It is in a neighborhood known as Parkview, which was developed between 1907 and about 1920. There are 255 homes in the neighborhood, and each house had its own architect so is quite different from there others--quite a contrast from new neighborhoods today, where typically homes look similar with minor variations.

In the month before we moved in, two crimes occurred in the neighborhood. In one case, a woman returning home from work at 6:30 pm (in the dark) got out of her car to move a recycling bin and a man with a gun forced her to hand over her car keys. He drove off, picking up two accomplices down the street. In another case, two men in hoodies cut the electricity to a house and attempted to break in, but ran away when the residents raised the alarm. These two incidents worried many residents, because though no one was hurt, they were violent and potentially life-threatening.

In mid December, the neighborhood held a security meeting. Eighty-one residents and ten of the twelve association representatives attended. Police officers said they did not want to downplay the crimes, but reminded residents that the neighborhood is actually among the safest in the county. They also informed us that suspects had been arrested in both crimes.

Security panel, under thermostat

Our house is large, and old, so it makes sounds. The heat is provided by radiators, and the pipes sometimes make a bang as they expand and contract. My wife's company provides, as an employment benefit, a burglar alarm system, which was installed the very first work day after we closed on (i.e. owned) the house. Every window and door has a sensor, so if someone were to force open the door or window, an alarm would go off, and the police would be called. There are also motion detectors (for when we are away), and breaking glass detectors (in case burglars break a window to get in, but do not actually "open" it). We've been using the alarm, especially at night when we are asleep upstairs, and I have to admit that though I'm not very worried about crime, it does feel reassuring to have the alarm on.

On the 4th night we were in the house, the alarm went off at 1:53 am. In addition to a blaring siren, a voice announced "Second floor first bedroom left window open". I groggily went to check the window, but there was no sign of any forced entry. At the same time, we received a phone call from the alarm company. I answered the phone and sleepily told the voice that it was a false alarm. He responded, "Uhh...." Then I remembered, I had to tell him the secret password, to confirm that it really was all OK, and that they did not need to send the police.  The alarm company came a few days later to change the sensor on that window, because they suspected it was defective.

Security company sign, as deterrent

Since then, we've  had no problems, and use it every evening and when we are away. I sometimes even turn it on when I'm in my office up on the 3rd floor, since I cannot hear sounds downstairs very well. When we had family members visiting over Christmas, we did not always turn it on, especially because they had dogs, and I did not want them to accidentally trip the alarm in the morning when they let the dogs out to do their business. I had no trouble sleeping, even though the alarm was off. But the first night all our guests were away, and we used the alarm again, I heard the sounds of the old house, and had to remind myself the alarm was on. It seems that having other people around calmed me, and made me less worried. As the title of the book by Zborowsky and Herzog (about the Jewish shtetl) has it, "Life is with people."

Apparently, there is a long running debate in the neighborhood about whether to seal it off to "outsiders." Some residents want to limit access to the neighborhood, to make it like a gated community, so as to make it safer. Others believe it is safer if there are more people around.

Gate on neighboring street, blocks cars but not pedestrians

St Louis has a system of street gates that I have never seen anywhere else (though I have not really studied this, so perhaps it is not that rare). Many neighborhoods put gates across streets to prevent people from driving through them. The gates are always locked. Parkview, my neighborhood, can only be entered by car from one of four sides, the east. Google maps is actually still not correct on this, showing a Westgate entrance as still open. Parkview is a bit different because the streets are actually not city streets, but belong to the neighborhood association (we have to pay to pave and clean them, too). That is why there are no google street views of our neighborhood. We are actually more like a gated community, in that we control our streets and there is one gated car exit on the west side for which only residents have the gate opener. But even city streets are sometimes gated (and always shut). The gates prevent people from using the residential streets as shortcuts, so the streets are safer for children. But the assumption is also that robbers will be less likely to come because it is harder for them to get in and out--at least by car! As you can see in the picture above, the sidewalk is not gated for pedestrians.

Neighborhood access: black means open, red requires code

My neighborhood, however, has gates with locks (operated by number codes) to keep outsiders from entering the neighborhood. This is because the neighborhood is next to the Delmar Loop, a street with many restaurants and funky shops. (Among our new favorites are Indian and Middle Eastern restaurants, and a pub called "The Three Kings", a reference to Henry VIII, King Kong, and Elvis). The neighborhood is great because it is so close to these businesses, but "we" don't want drunken students to wander through our streets, hence the locked pedestrian gates. I'm told that not everyone agrees to these gates being locked, and in fact, there are three other paths into the neighborhood that are not locked. Two of them are are not well marked (see blue arrow on map). That is the compromise: open, but not off of Delmar Avenue where the bars are.

Blocked gates and the open "secret" path

At the security meeting, there was disagreement about whether to install more street lights. Some believe it will make the neighborhood safer; others point out that they are expensive ($10K each!), and that the big trees in the neighborhood block much of the light anyway. One person said she liked the neighborhood as it was and did not want it to be lit up like a used car lot. Everyone was very polite, but it is clear that with so many opinions (and professors, lawyers and doctors used to expressing their opinions and used to being heard), it is going to be hard to agree on many changes.

As we get used to the neighborhood, and our house, we are feeling more secure and safe. We hang up our paintings, decorate with our things, and gradually make the house our own. The ghosts of previous owners gradually recede to the shadows, where they belong. We are only the fifth owners of our house, but we are very aware of the previous owners when we wonder why that light switch is located there, and why there is that crack in the stained glass window (what happened to crack it?). There is a common tradition in the US (I think) of hanging up old license plates, so I've hung up my old Hong Kong license plate in my garage: a small reminder of my old home in my new (old) home, and a small talisman to shoo away the ghosts of owners past, and make our new house our home, and make it safe.

Icons made by Scott de Jonge from www.flaticon.com is licensed by CC 3.0 BY
Icons made by Freepik from www.flaticon.com is licensed by CC 3.0 BY

The Trump Election

A number of friends in Asia have asked me about the 2016 US presidential election, so let me make some comments.

First, on the polls that were wrong. There has been some gloating by people who do not understand math, claiming that polling does not work. That would put into question well over half of social science research! I think the more intelligent position is to try to understand why the polls were wrong, and that will take time. But I do want to point out that Nate Silver and the FiveThirtyEight.com team did a very good job of emphasizing the uncertainty of the presidential race (see article here). They do not run polls themselves, but they noted that because the polls were so close, and because there were so many “undecided,” they had Clinton only at about 65% chance of winning in the days before the election, and at 71% at midnight Monday night, when their model issued its final answer. The New York Times and many others had Clinton at over 90% in the week before the election (and Huffington Post was at 98.2% on election day), but Silver had warned that though Clinton had many paths to victory (i.e. states she could win, and was likely to win, to get to 270 electoral college votes), because the polls were so close and because states would vary together, she was far from sure to win. In other words, if she did poorly in Florida, it was also likely she would do poorly in North Carolina and other states. And so it was.

Second, on why Clinton lost. There will be many explanations, but I think the issue of branding and symbolic thinking is one that has an anthropological angle. On election day (so before we knew the results), the Washington University in St Louis PR newsletter published a story in which Raphael Thomadsen, associate professor of marketing, noted that

“Clinton’s camp failed to rise to the branding challenge: Instead of giving her a clear, consistent message, it provided messages that were muddled and scattered. Thomadsen contrasted that with Trump’s “Make America Great Again” slogan, noting his campaign material constantly backs up that slogan.”

Clinton raised a number of criticisms against Trump, from his treatment of women to his bankruptcies, to his not releasing his taxes, to his temperament. While these all added up to showing Trump as unfit for the presidency for those who decide things “rationally” and for those Democratic partisans who already favored Clinton’s proposals, they did not provide a convincing case for the swing voters.

“Ultimately, Hillary Clinton didn’t effectively brand herself, so Trump did it for her,” Thomadsen continued. “Trump’s ‘Crooked Hillary’ terminology is ubiquitous. In the absence of any coordinated message against this, that brand has stuck.”

This rang true when the day after the election, I heard a voter on NPR say he did not really like Trump but voted for him because Hillary Clinton is the most corrupt politician the US has ever had in Washington. This is an absurd statement, at least in its literal sense. Trump had four business bankruptcies, used questionable methods to avoid paying income taxes, stiffed contractors, changed his positions on issues, had no fixed views andcontradicted himself, was judged by Politifact.com to be lying 68% of the time (19% mostly false, 34% false, and 17% pants on fire) compared to 26% for Hillary Clinton (14% mostly false, 10% false, and 2% pants on fire), and made statements like “Obama founded ISIS” (http://www.cnn.com/2016/08/11/politics/donald-trump-hugh-hewitt-obama-founder-isis/ ). Clinton’s “scandals” pale in comparison to the adultery (his open affair with Marla Maples), sexual assault, and failure to release his tax returns. The “crooked” person was, from one point of view, Donald Trump, but he somehow managed to get that label attached Hillary Clinton. That is branding at its best (or worst).

This weakness in branding was noted during the campaign; “Bill Clinton complained throughout that [campaign manager Robby] Mook was too focused on the ground game and not enough on driving a message-based campaign,” a Politico article notes, adding that there was no chief strategist like David Axelrod. 

I am among the majority of Americans who did not vote for Trump, and I am among those who like David Remnick, are horrified and worried about what damage he will do to the world, the country, and to general civility. But I’m also upset that I did not see his appeal. I do not know any Trump supporters, because in America, most people avoid talking about religion and politics in polite society. Obviously, many people I have had dinner with or met in casual encounters were Trump supporters (though they are fewer in the city). Still, I have heard them speaking on the radio, and I understand that most of them are actually decent and good people (the few hotheads and disgraceful types seem to be overrepresented on TV, because they make for a good show).

Clinton appealed to me because she understood that problems are complicated and require careful thinking and balancing different interests. If some people are hurt by free trade, but the nation as a whole benefits, assistance programs need to be made available. Most problems do not have simple answers, or they would have been solved by now. She "won" all three debates, by most measures, and yet that was not enough.

Trump appealed to magical thinking. He claimed to be the only person who can solve the nation’s problems. He portrayed himself as the savior. (Hm, that was true of Obama 8 years ago too.) He blamed economic problems on illegal immigrants, and demonized Muslims. As American Anthropological Association President Alisse Waterston put it in an email to members, “Strong, divisive language gained the most public attention, sometimes escaping the orbit of facts and launching into some parallel universe.”

Part of that “parallel universe” was created by Facebook and Twitter, and there are already questions about what can be done to prevent the segregation and formation of echo chambers that social media create, and also questions about how to deal with false news (see Bloomberg article here). Trump supporters widely forwarded stories that the Pope endorsed Trump and that Huma Abedin could be a terrorist agent, though they are both false.

Some people feel that the media, especially social media, did not do a good enough job of exposing Trump’s flaws (here is one example). But the information was there; Trump supporters chose not to act on it. We need to ask why facts that seem so important to Democrats and people on the two coasts were not important to Trump supporters. It turns out that Trump was a good communicator; he knew how to use symbolic speech. Part of it was the reprehensible scapegoating of illegal aliens (economists do not agree that they “steal jobs” because they do work that native Americans will not do). But what seemed to me to be simply repeating the lie was “staying on message” and building a brand.

That “parallel universe” Trump supporters created is the symbolic thinking we see in every culture. It is clearest in what we label religion, but it shows up in any area where identity and core values are at state. An excellent article on Politico notes that in a change year, it was impossible for Hillary to claim to be a change agent. The Clinton camp thought her age would be the main problem of her campaign, as well as the fatigue that sets in against the incumbent party. Age was not an issue, since Sanders and Trump were both older than her, but they both opponents tapped anger at the “rigged economy and government” which seemed to be used in a literal sense by Trump, but was more symbolically understood by supporters as a system tipped in favor of those with money and power. The problems with the Clinton Foundation (even though no explicit quid pro quo was found) and Podesta’s emails (which mostly just showed the wheeling and dealing of governing, and nothing illegal), fit into the narrative that Hillary was an insider. It was in this sense that she was “corrupt.” She tried to use the argument that Trump was temperamentally unfit to be president, and that her experience was valuable, but she obviously did not convince enough voters. Even mobilizing voters on the ground turned out not to be enough.

To educated people and intellectuals, the truth matters. I respect Obama’s and Clinton’s calm, cerebral approach. They believe in science, and do not deny climate change. Unfortunately, many saw Obama’s cautious and deliberative approach as weakness. I doubt foreign leaders saw it that way. But in Trumpworld, Clinton and Obama were traitors (see here and here, though it is upsetting to read). 

Anthropologists often study people who make fantastical claims. (When it is a foreign culture, we can do so with respect; when it is our own culture, it is often offensive.) Some people we study claim to speak to deities, some say they are able to see ghosts, others claim to have been abducted by aliens. Anthropologists know that often such statements are not literally true, but are understood metaphorically, or express larger truths. Evans Pritchard said the Azande understood witchcraft as a language for speaking of tensions in social relations. And most of Trump’s supporters do not expect him to actually build a wall, let alone to have Mexico pay for it. They understand that as symbolizing his hostility to globalization. Today, NPR’s All Things Considered interviewed people who voted for him in Ohio, and one said that even if he does just 10% of what he promised it will be enough, because at least it will be progress. That shows they did not take his words literally. Voters select based on symbols and images, ideals, hopes and fears. They are not rational philosophers carefully weighing the issues, as intellectuals often imagine and want to believe.

This is not the first time that American voters turn their back on the smarter and more cerebral candidate in favor of a popular personality: Adlai Stevenson II ran for president in 1952 and 1956 against Dwight Eisenhower, losing badly in both elections. He was known as a gifted speaker, and the historian Arthur M. Schlesinger Jr. said that “to the United States and the world he was the voice of a reasonable, civilized, and elevated America.” Yet, he was dismissed as an egghead. Eisenhower, a war hero with no political experience, won the elections.

Even if Trump had lost, we would need to explain how a vulgar, bombastic, lying, isolationist, racist, misogynistic and thin-skinned candidate could get close to half the votes. It is hard to understand how the leader of the "birther" movement, who then shamelessly blamed it on Clinton, could be taken seriously but millions of Americans. In addition to the power of symbols, there is also the power of celebrity. Just as he can force himself on women and get away with it, he is assumed by many to have power and mana. We do not rationally know whether he actually has billions of dollars, but through celebrity and fame, he has power. 

Now that he has won, there are going to be major changes to US policy that contradict bipartisan consensus. As an Atlantic article from the day before the election shows, Trump has been consistent over almost 30 years in his 1) opposition to U.S. alliances; 2) opposition to free trade; and 3) support for authoritarianism. And I’d really like to understand why Republican voters supported him even though he wants to create a huge $500 billion infrastructure investment program, something Obama tried to do but was blocked by the Republican Congress.

In the end, I agree with Obama that government as incremental. Fortunately, no one person can cause that much damage. Already, it is clear that to rule, Trump has to pick from the Republican talent pool, and hopefully they will moderate some of his dangerous ideas. Plus, he will need to rule through Congress, which even though Republican controlled, has very different ideas about the role of government. (Hopefully they will simplify the tax code.)

I am more worried about the country’s institutions being destroyed by his authoritarian tendencies, not by the country going in the “wrong” decision (deciding the “right” direction is what democracy is all about, after all). I’m worried his isolationism, and his need to show that he is “strong,” will cause unintended disasters. My fear is that Trump’s ignorance and short attention span will weaken or destroy American institutions, but hopefully, the institutions are strong enough to withstand any mischief he might commit. We will soon find out.

Voting and Economists

It took me an hour and a half to vote this morning. Though I got up at 5:45 am to arrive at the polls as soon as possible after they opened at 6:00, by the time we got there at 6:10 there was a long line already. But everyone patiently waited in line, mostly quietly, a few people exchanging greetings with neighbors and friends who passed us to get to the back of the line. We finally finished voting at 7:20, and did not get to our apartment (just across a park) until almost 7:30.

This reminded me of the argument by economists that it is irrational to vote. Steven Levitt, of Freakonomics fame (and whose work I generally admire), has said on his podcasts with Stephen Dubner that he considers voting irrational because his vote does not make a difference, and plus, he is not really interested in politics.

LEVITT: Well, one good indicator of a person who’s not so smart is if they vote in a presidential election because they think their vote might actually decide which candidate wins.

Like most mainstream economists, he thinks people are motivated to vote by individual pleasure:

LEVITT: I think the reason most people vote, and the reason I occasionally vote is that it’s fun. It’s fun to vote, it’s expressive, and it’s a way to say the kind of person you are, and it’s a way to be able to say when something goes wrong when the opponent wins, “well I voted against that fool.” Or when something goes right when you voted for a guy to tell your grandchildren, “well I voted for that president.” So there’s nothing wrong with voting. I think you can tell whether someone’s smart of not so smart by their reasons for voting.

Standing in line at 6:00 am was not fun. I didn’t see others “having fun” either.

Levitt displays a common occupational disease of economics: blind individualism. Levitt is not exceptional; the same Feakonomics episode quotes another economist, Bryan Caplan, at even greater length claiming voting is irrational.  (See also here.) 

Economists build their models assuming a rational Homo economicus and then see how much that model can tell us about the real world. But often, economists forget that their model is a simplification, and they begin to believe that if everyone were rational, like Vulcans, that the world would be a better place. They often assume that smart people are “rational” and that any other “emotional” (i.e. cultural or “irrational”) decision-making is a deviation from some ideal. But that “ideal” was their own model, not a model that any major civilization or religion has proposed.

Thus, for economists, since my vote (at the margin) does not affect the outcome, I should not bother to vote. I don’t understand why it does not occur to them, or bother them, that if everyone thought like that, then no one would vote and democracy would be impossible.

Economists’ thinking on voting seems to suffer from excessive individualism. Too many economists (and many Americans influenced by this thinking) get upset that their vote does not count. I say the opposite: it is a good thing their, and my, vote does not count much except in the aggregate. Most times, when individuals have had a lot of influence, things have not turned out well (see Stalin, Mussolini, Hitler, Mao, Pol Pot).

Freakonomics also had a program about whether presidents really can do that much.   They argued, correctly, I believe, that there are strong limits to what the president can do, and though candidates like to take credit for “creating jobs” and for the state of the economy, there are really few things they can do, and they can only influence the economy. This is generally true, although some presidents have made horrible decisions that caused a lot of misery (e.g. Bush’s decision to invade Afghanistan and Iraq), and it is also true that Trump’s economic plan could seriously derail the world economy if he started a trade war.

Economists have an overly individualistic view of society. They assume human nature is selfish and individualistic, but human nature is also political, social, and moral (see Wilk and Cliggett). People may vote because it gives them some satisfaction, but they also vote because it is socially expected, and because they want to help make a better world (i.e. moral and altruistic reasons), and because they were taught by their parents and school that it is the right thing to do. Economists seem not to get this. They see society as just a collection of individual preferences, a view that let to Margaret Thatcher’s infamous comment that there is no such thing as society, just individuals.  

The same individualistic assumptions have led many Americans to believe that it will take one person to change the system. Trump has said, “OnlyI can fix it” at the Republican National Convention. Aside from the hubris and braggadocio, the notion that one person can change a whole system is laughable. And this is leaving aside the fact that Trump has no political experience (so would not be able to get legislation he wants passed), and that he has not specified what the new system will be like. His appeal is the classic one of a demagogue.

It is actually a sign of a mature democracy that one individual has limited power. Authoritarian leaders in recent history that have had a lot of power have caused catastrophes. Trump could do a lot of damage to American institutions, and to the world economy, but he would have many brakes on his power. He would be frustrated, but that is a good thing. Obama disappointed many by not revolutionizing America, but he was very clear that his power was limited and all he could do is move the country gently in what he considered a positive direction. The benefit to limiting autocratic power is something many Chinese, Russian, and Philippino advocates for authoritarian government may come to learn.

In the meantime, it is important to vote, even when the system is not entirely fair. No human system is totally fair. Taiwan’s biased elections (biased in favor of the KMT until the 1990s) created a foundation for real democracy. No one person’s vote will make a difference in any election, but collectively, each vote does make a difference. Only economists don’t see that.

A native anthropologist at home in what has become a foreign country

After 24 years of teaching and research in Hong Kong, I have moved back to the Midwest, to St Louis, Missouri. Things are still new, and there are new discoveries every day. Missouri, or at least St Louis, is generally considered part of the Midwest, and since my wife and I grew up in the Midwest (Indiana, to be exact), there is some cultural affinity. People are generally very nice to one another; little road rage (people alternate when merging on the highway, and don't cut in line or fight for every space like in Hong Kong), and service personnel are "friendly" (I realize that is partially a culturally defined term). There is a lot going on in St Louis, and it is much nicer than many people had let me to believe. Among initial (superficial) observations:

Everything is big.  The egg tarts (蛋塔) are labeled "European Bakery Creme Filled Tart" and the size of a fist.

The choices in the supermarket are overwhelming. It takes us over an hour to go shopping each time as we have to a) find things in these enormous stores, organized in ways that I still don't understand (except that the milk is in the back; see Planet Money story on this) and b) the choices are so great.

 This is the bacon section! We hunted for 5 minutes to try to get a small package (to use in cooking, not to actually eat as meat) and ended up having to buy 12 oz., the smallest size (after much searching).

 On September 18, Halloween-themed products were already in the stores. They now have "Pumpkin beer" and "Oktoberfest pretzels." I suppose that is "American ingenuity".

 My lunch yesterday; note the size of the sandwich in comparison to the fork. It was very good, but too much. Only once have my wife and I remembered to order one meal and share it, and that was a very enjoyable dinner as a result.

 This is a car (a Hummer) that is parked in our building's garage. It should not be legal to drive such a large car on the streets because it is a menace to other drivers. I cannot help but wonder what the owner of this car is trying to compensate for.

SUVs are now the normal car in the US; the rise of "SUV culture" occurred while I was out of the US, so I have not caught up to the style. Keith Bradsher, now a NY Times correspondent in Shanghai, wrote a great book about the rise of the SUV. I insisted on getting a regular sedan, and my choices were constrained because SUVs are so common.  SUVs are also considered cool, and one pays a premium for it. The Subaru WRX is the SUV version of the Impreza, and one pays about $8000 more for turbo and the privilege of riding 5 inches higher off the ground.

Hong Kong service and communication

I just had one of the culturally confusing experiences one often has in Hong Kong, one that reminds me of Linda Young's Crosstalk and Culture in Sino-American Communication. In that book, Young analyzes a conversation between a HK police officer who tries to be polite but is misunderstood by an American businessman, who mistakes politeness for weakness and then blows up when he can't push the policeman around.

In my case, I called HP to try to buy a new power supply for my desktop computer, which surprisingly has a 220-240 volt power pack. I only told the woman on the phone (who I will call Izzy--I never did get her name clearly) I needed a 110 volt power supply for my computer, a computer that is out of warranty. Before I even told her what model of computer I had, she told me that HP does not sell that power supply any more, and told me to go buy the part from another vendor (I understood her to mean the small vendors like at Golden Arcade in Sham Shui Po). I asked her how she could know that it was not available, since I had not told her the model number. We went around in circles, but basically, she was telling me that because it was out of warranty, and since I wanted to buy the power supply myself, it was not made any more. I told her I did not believe this, and asked to speak to her manager. She did not say no, but did not call the manager, and instead went through a repetition of all these nonsensical details (just like in the Linda Young case). I told her I did not believe her because she did not know my model number, so she looked it up and found out my model of computer was last sold in 2012. She kept going back to the fact that since it was out of warranty, there were no parts from the factory. I asked if her reply would be different if I asked HP to change the power supply for me. Gradually, it turned out that in fact, if I asked HP to change the power supply, they would do it, but the labor would be HK$650, and the cost of the part would be over HK$2000, so the total was over US$300, which is basically more than a 4-year old computer is worth.

So basically, I was too stupid to understand her meaning from the start, which is that if I wanted to change the power supply, then I should go with a small vendor who will do it cheaply, not with HP which is not interested or equipped, really, to do such "repairs" or modifications. I imagined a company with parts on hand for repairs, which would allow me to get a quality part that would fit in the computer case, but apparently that is not the way computers work. Even after years in Hong Kong, I can still have these confusing conversations--in part because I don't speak Cantonese and Izzy's English was poor, but also because we did not understand each other's speech strategies and assumptions.

Frustrating, but fun, too.