Understanding century 21 - IT, Globalization and urban-urban migration

In the 90s the world kind of made sense. Since then, not so much. I don’t know if teens truly are experiencing an anxiety epidemic, but any American growing up in the new millennium has reason to be anxious.

I think the root causes of our disruption are globalization (China and India) and information technology (AI, robots, advertising supported web, etc) leading to peak human/mass disability and the collapse of the GOP.

I’m now considering a third factor — namely urban-urban migration (though it may be a consequence of globalization and IT rather than a root cause). The population required to sustain a viable local economy keeps increasing; this is absolutely not what we expected when the net was young. Once a city of 10,000 was viable, then a city of 50,000, then a few hundred thousand. We seem too heading towards a million as baseline.

This is politically potent here because the structure of American government gives disproportionate power to low population density regions. The pain of these communities is politically consequential. This is usually described as a “rural” crisis, but these aren’t “rural” in the traditional sense. They are regions around large towns and small cities that are no longer economically viable.

I was a family medicine resident and a young physician in communities like these. Recent stories feel familiar — they remind me of my desolate drives along the Erie Canal and the IT driven end of the mill town. It’s a worldwide thing.

Humans have been migrating from rural areas to cities for centuries. It’s often been socially disruptive. It still is, particularly because of the way American government works. The dying regions have power, and as they lose their cognitive elite they are ever more desperate and easier to deceive.

See also

• Gordon’s Notes: Crisis-T: What’s special about rural? 2016. Similar ideas from a year ago.

After Trump: reflections on mass disability in a sleepless night

I’m having trouble sleeping. There are a few boring reasons for that, but the election is not helping. So it’s time to write while sleep-impaired. I’ll try to keep this short, but I’m also going to break it into sections.

Context

My son has a substantial cognitive disability and little prospect of self-sustaining employment. His temperament is different from mine. I am novelty-seeking and instinctively skeptical of authority, he loves routine and structure. I am Vulcan, he is Klingon.

I am elite. He is not. Obama is my ideal President, he declared for Trump (though, interestingly, he chose to abstain in the end). I used to be uneasy around police, he loves K9 cops.

My son’s growth and development has shaped my life and thought for 20 years. He has informed my thinking about mass disability, something I’ve been writing about for 8 years. Because of him I have sympathy even for the Deplorables, angry and lost in a world that doesn’t want them any more.

The Big Picture

I don’t think any period in human history has seen as much cultural change as America 1950-2016. Civil Rights. Feminism. Gay Rights. Atheist Rights. Gender Rights. I have a flexible mind, and I feel a bit awed by all I have had to unlearn and learn. It’s not just America that’s changed of course. I believe that, in addition to ecological collapse and economics, the 9/11 world is a reaction to the education and empowerment of women.

And then there’s the demographic transformation of America. There’s a fertility transition that continues to drop family size; without immigration America’s population would be shrinking.  There’s the rapid aging of the post-war boomers. There’s the transition of the euro-american to minority status.

Now add China. No period of human history has seen anything comparable to the rise of China — if only because it is nation of a billion people. The economic transformation is severe; there is a limit to how quickly economies can adapt.

And, of course, no period of human history has seen an intelligent machine. We live in the AI era. Not the sentient AI era, or at least not so far as I know. But we now have distributed, almost ubiquitous, machine intelligence. Pre-AI technologies have already eliminated much of the work that supported the non-college middle class. The service work that remains pays far less and demands strong emotional control. A control that many men, and some women, don’t have.

The AI era is the era of mass disability. An era when the work that is valued and compensated requires cognitive and emotional skills that perhaps 40% of the US population does not have. No, more college will not help.

Extreme cultural transformation. Demographics. China. The AI era and mass disability. I haven’t even mentioned that pre-AI technologies wiped out traditional media and enabled the growth of Facebook-fueled mass deception alt-media.

We should not be surprised that the wheels have come off the train.

The GOP in 2016

We will lose the consumer protections and financial regulation slowly built over the past 8 years. We will lose Obamacare. The Gender Rights movement will stall.

I’ve seen some talk of the Senate minority slowing this, but we are also going to lose the filibuster.  We are unlikely to win the House or Senate in 2018 — so this will happen.

This will be sad and it will hurt a lot of people, not least Trump supporters.

It may not be as bad as some fear though. ObamaCare was failing. It was a tough political compromise that ran into GOP hellfire; the GOP blocked the post-launch fixes any big legislation needs. It was from the start intensely corporate and bureaucratic, with a misguided focus on analytics and top-down controls. GOP Representatives and Senators are not going to risk the wrath of their constituents, especially the non-college whites who are at risk of losing coverage. There will be a replacement. It will cover fewer people but perhaps it can be built up.

CO2 control seems to be hopeless now, but I’m not so sure about that. Sure, Trump is an idiot, but not everyone in the GOP truly believes that global warming is a good idea. There’s a chance the GOP will make changes that Obama could never get past the GOP.

This was all going to happen with any large GOP victory. Indeed, with his political core of white non-college voters Trump is going to be more cautious that Cruz or Ryan.

Trump: the mass disability conversation

I once wrote a blog post titled "Donald Trump is a sign of a healthy democracy. Really.”. It was really prescient:

… I enjoy seeing the GOP suffer for its (many) sins, and it would be very good for the world if the GOP loses the 2016 presidential election, but Trump won’t cause any lasting political damage. Unless he runs as a third party candidate he’ll have no real impact on the elections.

Hah-hah. Laughs on me.

This part holds up better:

Trump appears to be channeling the most important cohort in the modern world — people who are not going to complete the advanced academic track we call college. Canada has the world’s highest “college” graduation rate at 55.8%, but that number is heavily biased by programs that can resemble the senior year of American High School …

… about 40-50% population of Canadians have an IQ under 100. Most of this group will struggle to complete an academic program even given the strongest work ethic, personal discipline, and external support…

… this cohort, about 40% of the human race, has experienced at least 40 years of declining income and shrinking employment opportunities. We no longer employ millions of clerks to file papers, or harvest crops, or dig ditches, or fill gas tanks or even assemble cars. That work has gone, some to other countries but most to automation. Those jobs aren’t coming back.

The future for about half of all Americans, and all humans, looks grim. When Trump talks to his white audience about immigrants taking jobs and betrayal by the elite he is starting a conversation we need to have.

It doesn’t matter that Trump is a buffoon, or that restricting immigration won’t make any difference. It matters that the conversation is starting. After all, how far do you think anyone would get telling 40% of America that there is no place for them in current order because they’re not “smart” enough?

Yeah, not very far at all.

This is how democracy deals with hard conversations. It begins with yelling and ranting and blowhards. Eventually the conversation mutates. Painful thoughts become less painful. Facts are slowly accepted. Solutions begin to emerge…

I guess we’re having the conversation now. Too bad we didn’t have it four years ago. Obama, my ideal president, missed that one. He wasn’t alone, as recently as 2015 I complained “Both DeLong and Krugman missed the college vs. no-college white middle-age cohort, and I think that’s the important story” (K had a false start in 2012.)

Late in the campaign Obama picked up the theme with work on labor market monopsony and “predistribution”. Some of the Bernie Sanders themes that Clinton adopted, like free community college, were a first step. Overall though my team missed this one. It was a huge miss. They should have been reading Gordon’s Notes …

Trump: white nationalism and patriarchy

Half of college educated white women voters voted for Trump. I can’t quite get my head around that one. That cohort would have given Clinton the election.

Half.

What do we understand that? We need to resurrect anthropology and fuse it with journalism. How? I’ve no idea, but we need a way to explain ourselves to ourselves. A NYT piece made a good start with an interview of some of these women. Rage about the Black Lives Matter movement and critiques of police (prime job for the blue collar) were a factor; as well as susceptibility to Facebook-fueled right wing agitprop. I suspect these women are also relatively comfortable with traditional male-female roles. They want a “strong leader”; maybe they favor “enlightened patriarchy”. (The article had one significant error, it claimed white college-educated women voted for HRC. They did not. If they had we wouldn’t be talking about this.)

The whites are acting like a tribe. It’s different from acting like we own the country. This is shades of old racism mixed with aggrievement, loss, and bitterness. Unfortunately, unlike other tribes, the white tribe votes.

Reagan pioneered the use of white racism to win power. Trump has kicked it up several notches. He has summoned  our demons at just the right wrong time. Now we live with the consequences. Trump isn’t going to beat these demons back, he is much more racist than Reagan was (more than most of us imagined).

On the other hand the GOP is going to get nervous about this. The party is not going to be comfortable with overt white racism. There will be some GOP help with stuffing the Nazis and Klansmen back in the bottle. We will need that help.

The Resistance

In my home town of St Paul Minnesota a mob has been blocking a freeway. That’s dumb team. Stop doing that. We need more leadership. There’s a guy I know who’s going to be out of a job in seven weeks…

Ok, so Obama is probably going to want to take a break. We are going to need someone though. This isn’t just one crazy election. Remember the “Big Picture”. There are huge forces at work, especially the lack of demand for non-elite labor (what I call “mass disability”). If you think we’re in trouble now, imagine what’s going to happen to China in the next few years. (Russia is toast.)

We need to oppose Trump. He’s a twisted wreck. I suspect, however, that he’s going to find a lot of long knives in DC. The GOP leadership are not nice people, and they prefer Pence to Trump (not that Pence is good news).

We need to oppose Trump, but we also need to remember why we have Trump. We need to focus on the big picture - there are solutions. We live in whitewater times; we need to hold onto each other while we try to steer the raft. Because there’s a waterfall ahead …

See also: 

I’ve been writing about this for a bit over 8 years …

KRISTOF: Watching the Jobs Go By - his weakest column in years 2/2004. Very early thoughts in this direction.

Why your daughters should be roofers — not architects 3/2004. Precursor ideas.

On redistribution 6/2004. From an article in The Atlantic: “It is doubtful that in any society with universal suffrage the majority is going to sit on the sidelines and watch, generation after generation, while a handful of investors and corporate managers reap almost all the benefits of technological and economic progress."

The limits of disaster predictions: complex adaptive systems 2/2007. We have survived doom before.

Mass disability and Great Depression 2.0 3/2008. 

"I believe that about 20% of adult Americans aged 25 to 65 are effectively disabled in our current globalized post-industrial economy. I believe this number will rise as our population ages. I believe this is the fundamental problem, along with network effects, driving modern wealth concentration.

Over time the economy will change to develop niches for unused capacity (servant economy?), but the transition need not be comfortable. In the meantime technological shocks, such as ubiquitous robotics, may induce new disruptions to a non-equilibrium economic structure — risking extensive economic breakdown."

Causes of the Great Recession: China, GPSII and RCIIIT. Now for Act III 4/2010

Civilization is stronger than we think: Structural deficits and complex adaptive systems 5/2010. Hope.

Post-industrial employment: adjusting to a new world 5/2010. College is not the answer.

Unemployment and the new American economy - with some fixes. 1/2011 “In a virtualized economy workers with average analytic and social IQ less than 125 are increasingly disabled. Since this average falls with age the rate of disability is rising as the we boomers accumulate entropy …Start applying the lessons learned from providing employment to cognitively impaired adults to the entire US population.” Looking back this is when my thinking about mass disability began to crystallize.

Mass disability goes mainstream: disequilibria and RCIIT 11/2011. I thought we’d have the conversation then, but it didn’t go forward. Unfortunately.

Life in the post-AI world. What’s next? 9/2011

The Post-AI era is also the era of mass disability One of my favorites. 12/2012

Addressing structural underemployment (aka mass disability) 5/2013 Some ideas on solutions. Good ideas by the way.

Donald Trump is a sign of a healthy democracy. Really. 8/2015

Trump explained: Non-college white Americans now have higher middle-aged death rates than black Americans 11/2015 “Both DeLong and Krugman missed the college vs. no-college white middle-age cohort, and I think that’s the important story” 

Trumpism: a transition function to the world of mass disability 8/2016

How does the world look to Trump’s core supporters? 9/2016.

After Trump: information wants to be free, but knowledge is expensive 11/2016. This feels fixable, but it’s a fundamental problem.

Trump explained: Non-college white Americans now have higher middle-aged death rates than black Americans

From today’s NYT Health section:

Death Rates Rising for Middle-Aged White Americans. Gina Kolata Nov 2, 2015

… middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling…

… two Princeton economists, Angus Deaton… and Anne Case. Analyzing health and mortality data from the Centers for Disease Control and Prevention and from other sources, they concluded that rising annual death rates among this group are being driven … by an epidemic of suicides and afflictions stemming from substance abuse: alcoholic liver disease and overdoses of heroin and prescription opioids…

… the declining health and fortunes of poorly educated American whites. In middle age, they are dying at such a high rate that they are increasing the death rate for the entire group of middle-aged white Americans…

… The mortality rate for whites 45 to 54 years old with no more than a high school education increased by 134 deaths per 100,000 people from 1999 to 2014.

The article falls apart a bit here. What we want to know is how the absolute death rate for non-college middle-aged white Americans in 2013 and in 1999.  We want to know how the Long Stagnation has changed vulnerable Americans, but Kolata’s article mixes all white Americans with the no-college cohort.

Fortunately the PNAS article PDF is freely available, but unfortunately it explains Kolata’s problem — the data we want seems to be buried in an unlabeled parenthesis in Table 1. From that I think I can reconstruct the key information: [1]. 

Year	White no college	Black (all)	White some college	White BA+	White All
1999	601	797	291	235	381
2013	736	582	288	178	415

For the no-college White American 1999 was a pretty good year; probably the best ever. That was the era of NASCAR America and the candidacy of GWB, champion of the “regular” white guy. Employment demand was high and wages were rising. Yes, as a white guy without any college you had a shorter lifespan than the minority of white (Americans) with a college degree, but at least black Americans were even worse off. It’s always comforting to have someone to look down on.

After 16 years of the Great Stagnation though, things are different. Suicide and substance abuse have pushed no-college white mortality to the level of 1999 black Americans, yet during the same period black American middle-aged mortality has fallen substantially. White no-college Americans are now at the bottom of the heap [1].

This is why we have the inchoate white rage that thunders through the GOP. This is why we have Donald Trump.

A large and culturally powerful part of America is in crisis. A cohort with lots of guns and a history of violence. Maybe we should pay attention. Trump is a signal.

- fn - 

[1] There was no breakdown of black death rates by education; a 2012 census report said 29% of whites and 18% of blacks had a BA or higher. Since 80%+ of black Americans have no BA it’s likely no-college whites now have higher middle-aged mortality than no-college blacks.

See also

• Gordon's Notes: Donald Trump is a sign of a healthy democracy. Really. 8/2015

Update 11/4/2015

There’s been considerable coverage of this story, but it’s been disappointing. Both DeLong and Krugman missed the college vs. no-college white middle-age cohort, and I think that’s the important story. There’s also been some discussion of anger as a defining trait of the GOP base, but no connection to the extreme distress of their core voter.

I’ve seen speculation that this is all about narcotic overuse. I find that very hard to believe, but I admit the use of narcotics for pain relief in America has exceeded my expectations. I remember in the 90s when “pain is the new vital sign” and family docs were berated for inadequate use of narcotics. I guess my peers responded well to that feedback.

It has occurred to me that there’s a potential bias we’re missing. Over the past 40 years colleges have gone from predominantly male to predominantly female. The big story here is increasing mortality in the no-college white cohort. But if there’s been a gender shift in that cohort, say from 55% female in 1999 to 45% female in 2013, that will make the no-college numbers even more dramatic. Since mortality has increased even when college grads are included this isn’t the entire story, but it will make the no-college effect more dramatic.

Perspective - 20 year family reunion probabilities

For at least two good reasons I’ve been doing a bit of planning. More on those reasons later, but first a digression to answer a relevant question.

What is the probability that, estrangement aside, our nuclear family will be able to do a reunion in 20 years? Let’s assume for simplicity’s sake, no major disruption of civilization and no major changes in US mortality rates by age. I’ll also exclude Kateva, who is healthy at age 10 but unlikely to break canine longevity records.

It’s not hard to do the rough calculations, unadjusted for gender, wealth, education or health, using a basic Life table. I'm looking for 

tPx: probability someone aged x will survive for t more years.

and the formula based on a Life Table is:

Lx+t/Lx where Lx is the number surviving to age x

Lx can be found in the US 2010 Life Table. (Excel version can be downloaded from: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/NVSR/63_07/Table01.xlsx)

For my family the relevant values are:

Which gives survival probabilities for 20 years beyond current age as:

Where Product All is the product of each more-or-less independent probability. That is only about 50%, which is not so great. On the other hand, in the event of the cosmic calamity of my demise, I won't have much skin in the game. So the interesting number is the probability that Emily and kids make it assuming I do, which is Product “Impt” (important). That’s 71%.

Which is a useful number for my planning purposes and that future post I promised.

PS. I can remember when 20 years felt like a long time. It’s not.

Baumol's disease and the demographic transition: Productivity asymmetry means children are increasingly expensive

There have been a flurry of articles lately on the cost of raising an American child, including a NYT blog post. This old news to students of demography, I remember reading about this back in the 80s. In agricultural societies children are a net economic gain, in industrial societies the gain is less, and in post-industrial societies they are a net negative for parents.

I should add, by the way, that traditional evaluations of the cost of children underestimate the cost. They assume a healthy neurotypical child. A special needs child is vastly more expensive, and approximately 5-10% of post-industrial children are relatively disabled by 'autism' (whatever that is), low average IQ, schizophrenia, affective disorders and the like.

So this is old material, but I don't recall a theoretical framework explaining why child raising takes a larger and larger proportion of income as a society becomes wealthier. The answer, of course, is Baumol's cost disease.

Child raising is one of those tasks with minimal productivity increases. Indeed, as output requirements rise to meet the narrowing demands of a post-labor economy, productivity may be negative over time. Certainly much of the cost is related to education and health care, two domains with notoriously slow productivity growth. Baumol's work teaches us that as overall productivity and wealth increase, relatively low productivity labor will consume increasing fractions of total income.

This seems to be an obvious insight, but a cursory Google search didn't find any articles or posts connecting demographic transitions with Baumol's Cost Disease. Until now.

Median net worth stasis: health and demographics?

Salmon of the Trinity [1] notes that Median net worth has actually been static for about 30 years. So we can either fund social security, or learn to live with elderly beggars, or invest in Soylent Green.

It's a fascinating result; seemingly consistent with other studies on long term wage stagnation. I'm looking forward to more discussion, including ...

1. What is the effect of demographics, in particular what is the mean age of the median net worth over the past 30 years? We know our population is aging, and we know net worth increases far faster in one's 20s than in one's forties.
2. What is the relationship to savings? (Presumably, other than "housing", it means we're not saving - see "social security")
3. How much of this is because of health care and education costs? How much more expensive is it to raise a child in 2010 than it 1980?
4. Is there an "occult inflation" contributor?
5. Is it coincidental that this stasis corresponds with the widespread dissemination of programmable technologies?

[1] Krugman, Klein and Salmon

Boomers and modern medicine - the economic impact of ailing parents

It seems like all of my friends and colleagues are managing ailing parents - all at once.

Coincidence? Probably not. The 'baby boomers' were a big demographic bulge and we're now between 50 and 60 years old. Our parents are between 70 and 90. Modern medicine has compressed mortality, so a good percentage of boomer parents are still alive. In ten years most of them will be dead.

I wonder what the economic impact of this concentrated elder care will be?

Investment in a whitewater world

During the last half of the 20th century retail investors earned positive returns with some mixture of stocks, bonds, real estate (personal) and cash. Mutual funds, and especially index mutual funds, made middle class investing possible.

Then came the great market bubble of the 90s, the real estate bubbles of the 00s, and the rise of IT enabled economic predation. The vast flow of growth returns was diverted from the middle class investor to corporate executives and sharper, faster, players. Corporate financial statements became less and less credible as new ways were found to obfuscate financial status. In a world of IT enabled complexity, risk assessment became extraordinarily difficult. Where growth opportunities were strong, as in China, the markets were corrupt and inaccessible.

Maybe we'll return to the relative calm of the 1980s, or even the slow growth of the 1970s. Oil prices may stabilize around $150/barrel. China's economy may make a soft landing and the Chinese nation may follow Taiwan's path to democracy. The GOP may shift away from the Tea Party base and, once in power, raise taxes substantially while implementing neo-Keynesian policies by another name. North Korea may go quietly. The EU may hold together while gradually abandoning the Euro. Cultural shifts might make personal integrity a core value. Disruptive innovations, like high performance robotics and widespread AI, may slow. The invisible hand and social adaptation may solve the mass disability problem of the wealthy nations. Immigration policy, a breakthrough in the prevention of dementia, or the return of ubasute may offset the impacts of age demographics. We may even ... we may even look intelligently at the costs of health care and education and manage both of them.

If these things happen then some economic growth will return, stock prices will reflect fundamentals, bonds will become feasible investments, and interest rates will be non-zero.

Or they won't happen.

In which case, we can look forward to more of the same. The best guide to the near future, after all, is the near past. In this whitewater world then, in which financial statements are unreliable and wealth streams are diverted, what are the investment opportunities? We cannot recover the lost returns of the past 11 years, but it would be nice to be less of a chump.

Real estate seems a reasonable option, though there we face the problem of untrustworthy investment agents. There is not yet a John Bogle of 21st century real estate investment. (This, incidentally, suggests something government could do -- engineer a trustworthy investment representative for American real estate.)

The other option is to switch from prey to predator.

During the 20th century retail investors could only make one way bets. We basically had to bet on economic growth and prosperity. For a time we could shift a bit. If we thought near term growth looked bad, we could shift to bonds. If we thought a crash was coming, we could shift to cash. Basically, however, we could only get good returns by investing in stocks and betting on growth. This worked under conditions of economic growth and relatively integrity. Under the conditions of the past decade this made us prey.

Predators don't make one way bets. They make bets on downturns, on upturns, on volatility, on stability, on irrationality, on continued fraud, on reform. They make bets on bets. They play the options and straddle options games that brought down the world economy. It's too bad they won, but, with a bit of help from our AI friends, they did.

So I'm learning about options. It's not what I like to do, but I don't make the rules.

Geezepreneurs and the depression - we're not dead yet

America is a dog that's been beat too much.

Our publicly traded corporations can't get much pull from America's dwindling middle class. Their growth and future is abroad. The vast compensation of their executives will build higher walls around the estates of the new aristocracy.

Left Behind, we are the Detroit Windows 7 of nations.

So now what?

Now we need to climb out of of the ruins. Because we're not dead yet.

We could use some help. Roosevelt style investments in infrastructure and schools would be a good thing, but they are not enough and the Tea Party is too powerful to allow them.

So instead we need lots of small to medium privately held businesses [1]. It would be great if we could get something like a national small business generation service, but good-enough health insurance, an accelerated and expanded loan program for small businesses, reduction of the tax and accounting scams that favor large corporations [2], rationalizing regulatory frameworks and providing startup education programs would all help.

Who will start these businesses? The usual suspects - the young, the immigrants [3], the restless. They're not enough though. This time America needs geezer entrepreneurs - geezepreneurs. In a global economy where talent is plentiful and cheap, we have a surplus of the undead gray without hope of retirement. Might as well use 'em.

The forty plus set aren't going to do all nighters any more, but we have learned a lot about leading and managing people, and about how the world works. I admit, even as a geezer myself, I'm surprised by how productive 60+ software engineers are. Maybe it's selection bias -- perhaps by that age only the very best are still coding. Whatever, these guys are really good, even if they need flexible schedules to help their kids, grandkids, and parents.

Small business growth driven by geezer entrepreneurs and the underemployed young. It's different. Try it.

--

[1] In theory these measures are GOP friendly. Alas, that's confusing rhetoric with reality; to the extent that the modern GOP has any guiding philosophy it would be directing short term benefits to its voters, donors, and office holders. They are at least compatible with past GOP rhetoric, so that might help a bit.
[2] Removing those advantages from large corporations helps level a currently very uneven playing field. On the other hand, they will never surrender the fruits of their political investments. So, perhaps disguised as deficit reduction, we try for reduction rather than removal.
[3] Canada mitigated its social security problem largely by importing wealthy and/or highly educated citizens. I'm amazed this isn't talked about in the US.

Update 8/17/11: See also - Tillman and Phelps, National Bank of Innovation

Roots of the irrational in American politics: pre-dementia and religion

I've written recently about the role of religion in the reasoning of the GOP base. This is an elephant in the room; pundits will discuss the role of American's exceptional fundamentalism in the context of abortion politics, but not in the context of debt politics. The mainstream media is missing an important ingredient in our political paralysis.

There's another elephant out there, and it will grow over the next ten years. The average American voter will become increasingly demented. Demented people rarely vote of course, but most dementia is the end stage of a very long process. Before a voter is disabled, they will lose the ability to process information, recall all but the most recent events, and adjust their beliefs based on evidence. They will, in other words, become less rational.

How big a factor is this?

We can make some estimates by starting with the end-stage state of clinical demential ...

Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study

... The prevalence of dementia among individuals aged 71 and older was 13.9%, comprising about 3.4 million individuals in the USA in 2002. The corresponding values for AD were 9.7% and 2.4 million individuals. Dementia prevalence increased with age, from 5.0% of those aged 71–79 years to 37.4% of those aged 90 and older...

... The elderly population (those aged 65 years or older) in the USA is expected to double from approximately 35 million today to more than 70 million by 2030...

Of course these numbers are only a start. What we really want are numbers expressed in percentages of voters, and we want the average disease duration from judgment impairment to disability. Personally I suspect that's about 20 years, but the best data I could find was on a relatively rare and aggressive form of early dementia ...

Pre-dementia clinical stages in presenilin 1 E280A... [Lancet Neurol. 2011] - PubMed result

... Pre-dementia cognitive impairment was defined by a score 2 SD away from normal values in objective cognitive tests, and was subdivided as follows: asymptomatic pre-MCI was defined by an absence of memory complaints and no effect on activities of daily living; symptomatic pre-MCI was defined by a score on the subjective memory complaints checklist higher than the mean and no effect on activities of daily living; and MCI was defined by a score on the subjective memory complaints checklist higher than the mean, with no effect on basic activities of daily living and little or no effect on complex daily activities. De

... Median age at onset was 35 years (95% CI 30-36) for asymptomatic pre-MCI, 38 years (37-40) for symptomatic pre-MCI, 44 years (43-45) for MCI, and 49 years (49-50) for dementia. The median age at death was 59 years (95% CI 58-61). The median time of progression from asymptomatic to symptomatic pre-MCI was 4 years (95% CI 2-8), from symptomatic pre-MCI to MCI was 6 years (4-7), from MCI to dementia was 5 years (4-6), and from dementia to death was 10 years (9-12). The cognitive profile was predominantly amnestic and was associated with multiple domains. Affected domains showed variability in initial stages, with some transient recovery in symptomatic pre-MCI followed by continuous decline.

In this disorder asymptomatic pre-MCI started at age 35, and disability (dementia) at age 50. So the aggressive form has a 15 year course. I would expect less aggressive forms have a longer course, so I'll go with 20 years.

So by these very rough guesstimates about 15% of 50 year old voters will be impacted by "asymptomatic pre-MCI", an early form of cognitive disorder that will impact their judgment. That prevalence will go up with age. Since GOP voters are much older than Dem voters, this, like religious fundamentalism, will be concentrated in the GOP base and it will strongly impact GOP politics.

If you don't understand the two factors of religious fundamentalism and pre-dementia cognitive impairment you will have a hard time understanding the future of the GOP.

Why is the modern GOP crazy?

The GOP wasn't always this crazy. Minnesota's Arne Carlson, for example, wasn't a bad governor. Schwarzenegger had his moments.

Ok, so the modern GOP has never been all that impressive. Still, it wasn't 97% insane until the mid-90s.

So what happened?

I don't think it's the rise of corporate America or the amazing concentration of American wealth. The former impacts both parties, and not all the ultra-wealthy are crazy. These trends make the GOP dully malign, but the craziness of Koch brothers ought to be mitigated by better informed greed.

That leaves voters. So why have a substantial fraction, maybe 20%, of Americans shifted to the delusional side of the sanity spectrum? It's not just 9/11 -- this started before that, though it's easy to underestimate how badly bin Laden hurt the US. It can't be just economic distress -- Gingrich and GWB rose to power in relatively good times.

What's changed for the GOP's core of north-euro Americans (aka non-Hispanic "white" or NEA)?

Well, the interacting rise of the BRIC and the ongoing IT revolution did hit the GOP-voting NEA very hard, perhaps particularly among "swing" voters. That's a factor.

Demographics is probably a bigger factor. I can't find any good references (help?) but given overall population data I am pretty sure this population is aging quickly. A good fraction of the core of the GOP is experiencing the joys of entropic brains (here I speak from personal white-north-euro-middle-age experience). More importantly, as Talking Points describes, this group is feeling the beginning of the end of its tribal power. My son's junior high graduating class wasn't merely minority NEA, it was small minority NEA.

This is going to get worse before it gets better. The GOP is going to explore new realms of crazy before it finds a new power base; either as a rebuilt GOP or a new party.

It's a whitewater world.

Update 7/8/11: Coincidentally, 538 provides some data on GOP craziness ....

Behind the Republican Resistance to Compromise - NYTimes.com

... Until fairly recently, about half of the people who voted Republican for Congress (not all of whom are registered Republicans) identified themselves as conservative, and the other half as moderate or, less commonly, liberal. But lately the ratio has been skewing: in last year’s elections, 67 percent of those who voted Republican said they were conservative, up from 58 percent two years earlier and 48 percent ten years ago.

This might seem counterintuitive. Didn’t the Republicans win a sweeping victory last year? They did, but it had mostly to do with changes in turnout. Whereas in 2008, conservatives made up 34 percent of those who cast ballots, that number shot up to 42 percent last year...

... the enthusiasm gap did not so much divide Republicans from Democrats; rather, it divided conservative Republicans from everyone else. According to the Pew data, while 64 percent of all Republicans and Republican-leaning independents identify as conservative, the figure rises to 73 percent for those who actually voted in 2010...

Aging boomers and the coming Golden Age of Cyberfraud

Just one recent example: Aggressive Social Engineering Against Consumers

As we boomers age, there will be a rich supply of weakened herd members for online predation. The Golden Age of Fraud is coming.

This is why you will live in an iOS world.

Care of special needs adults in post-employment America

The Dow is doing very well, though some expect that to change shortly. For most Americans, however, the Great Recession grinds on. The percent of employed adult Americans (employment-population ratio) is now back to where it was in 1976, when most women weren't in the workforce. The annual incomes of the bottom 90% of US families has been flat since 1973.

Against this, we see about 50 million Americans with a disability and 24 million with a severe disability. Looking forward, barring US adoption of Canada's brilliant solution, intractable American demographics means fewer workers supporting more disabled persons -- even as those workers are faced with decreasing employment options and stagnant or falling wages.

So it's not surprising that societal care for the weak is being withdrawn ...

When Children With Autism Become Adults - Goehner 4/13/11 - NYTimes

... As the explosion of children who were found to have autism in the 1990s begins to transition from the school to the adult system, experts caution about the coming wave.

“We estimate there are going to be half a million children with autism in the next 10 years who will become adults,” said Peter Bell, executive vice president for programs and services of the advocacy group Autism Speaks.

Services for adults with autism exist, but unlike school services, they are not mandated, and there are fewer of them. Combined with shrinking government budgets, the challenges are daunting.

“We are facing a crisis of money and work force,” said Nancy Thaler, executive director of the National Association of State Directors of Developmental Disabilities Services. “The cohort of people who will need services — including aging baby boomers — is growing much faster than the cohort of working-age adults that provide care.”

To help parents navigate this difficult journey, in January Autism Speaks introduced a free Transition Tool Kit for parents and their adolescent children with autism. The kit includes information about such critical issues as community life, housing, employment and developing self-advocacy skills...

... Many young adults with autism have transitioned into large residential systems, whether group homes or institutions, offering round-the-clock services. But waiting lists can be long. And increasingly, in an effort to stem costs, states are moving away from the group home model into family-based care, a trend that started about 10 years ago.

... Nationwide, 59 percent of people who receive autism services are living with their families, according to Mr. Lakin.

Living with one’s family may not always be best for a person with autism. Nor is it what many families, who assume their grown child will move into a group home, for example, envision for their future. But options are limited, and given the high demand for out-of-home residential services, Mr. Lakin said, “families really need to think about a longer and more central involvement in their adult child’s life than they have in the past.”

The good news is that many states are providing more support for people with autism who live with their families. They are also giving families greater flexibility and control over budgets with so-called consumer-controlled services, which reimburse families that hire friends or relatives, rather than outside caregivers, for regular care.

Connecticut and Arizona, for example, pay for care provided by family members, a growing trend. Other states, like Pennsylvania, have programs in which contracts are issued for people with autism to live with other families. And Vermont and New Hampshire pioneered a model of providing funding directly to families.

Some families have pooled their own money and entered into cooperatives with other families, a challenge that can take years...

.. Among the most powerful advocates are siblings of those with developmental disabilities. “Sibs have always played a really important role; we just haven’t identified them as sibs,” Mr. Lakin said. “We’ve identified them as agency leaders and social workers occupationally. But the real impulse of their work is that they were a sibling.”

Don Meyer, the founder and director of the Sibling Support Project and the creator of Sibshops, a network of programs for young siblings of children with special needs, said: “Parents need to share their plans for their special-needs child with their typically developing kids. After Mom and Dad are no longer there, it is likely it will be the brothers and sisters who will ensure their sibling leads a dignified life, living and working in the community.”...

It doesn't require a lot of imagination to predict how this will turn out. Among other things, we should expect a return to orphanages (esp. for special needs children) and the return of longterm institutions for the destitute disabled.

This might be a good time to consider the Canadian Solution for immigration. Maybe we should even take a look at where America's trillions are going. Just saying.

Median male earnings - declining since 1969?

(via DeLong and Leonhardt)

Interesting results when one looks at median (not mean) inflation adjusted wages for men aged 25-64 over the past 45 years ...

Have Earnings Actually Declined? - Up Front Blog - Brookings Institution

The red line looks only at employed men. The blue line includes men who are not working [1], so there are more people with 0 wages.

The post-industrial age has not been kind to most men. This is why I call our time the age of mass disability.

PS. Man, the late 90s were good times.

[1] Some will be be earning money they don't want to admit of course.

See also:

• Unemployment and the new American economy - with some fixes (1/2011)
• Mass disability and Great Depression 2.0 (3/2008)
• Employment in the Great Stagnation (8/2010)

Why you will live in an iOS world

Five years ago, just before Microsoft Vista was released, our household CIO made a strategic decision. We would move to OS X.

It wasn't a hard decision. The cost of supporting both XP and OS X was too high, XP's security, debugging and maintenance issues were intractable, and OS X had a much more interesting software marketplace. Moving to OS X would dramatically reduce our cost of ownership, which was primarily the CIO's opportunity cost. Time spent managing XP meant less time spent on my health and on family joys and obligations. [6]

It worked beautifully. One of my best strategic decisions. Yes, I curse Apple with the best of them, but I know the alternatives. I'm not going anywhere.

Except I am going somewhere. I will fade. So will you, though there's a bit more hope for the under-30 crowd. We might be able to slow the natural deterioration of the human brain (aka "Alzheimer's" and its relatives [4]) by 2030. It's too late for the boomers though, and probably too late for Gen X.

Sure, I'm still the silverback of the geek tribe. I may have lost a step, but between experience and Google I still crush the tough ones with a single blow.

Not for long though. I give myself ten years at most. I won't be able to manage something like OS X version 20, and I don't want to be reliant on my geek inheritor - son #2.

We will need to simplify. In particular, we'll need to simplify our tech infrastructure (and our finances [1] and online identities [7] too).

So our next migration will be to iOS - a closed, curated, hard target, simpler world.

You'll be going there too -- even if you're not fading (yet). The weight of the Boomers [2] will shift the market to Apple's iOS and its emerging equivalents. Equivalents like ChromeOS, now turning into iOS for desktop device with its own App Store [5].

I still have a few years of OS X left, including, if all goes well, the 11" MacBook Air I've been studying. The household CIO's job, however, is to think strategically. Our future household acquisitions will shift more and more to iOS devices, possibly starting with iPad 2.0 (2011) [3].

I expect by 2018 we'll be living in largely iOS-equivalent world, and so will you.

-- footnotes

[1] I miss Quicken 1996 -- before Intuit went to the DarkSeid.
[2] The 2016 remake of Logan's Run will be a smash hit. 
[3] I bought iPad 1.0 for my 80yo mother -- same reasons.
[4] 1989 was when the National Institutes of Health needed to launch a "Manhattan Project" style dementia-management program. I wasn't the only person to say this at the time. 
[5] If their first netbook device doesn't come in under $150 with batteries Google is in deep trouble. Android is not an iOS-equivalent, it's a lot more like XP. 
[6] Pogue's 10 year tech retrospective is a beautiful summary of the costs of making the wrong household tech decisions. He misses the key point though. The real costs are not the purchase costs, or the immense amount of failed invention, or the landfill costs -- it's the opportunity costs of all the time lost to tech churn. I've a hunch this opportunity cost is important to understanding what happened to the world economy between 1994 and 2010. That's another post though!
[7] Digital identities proliferate like weeds. Do you know where all your identities are?

Another nail in the coffin for the Alzheimer's amyloid hypothesis

Researchers bet careers, and pharmas bet billions, that amyloid plaques caused neuronal dysfunction in Alzheimer's disease. If the plaques could be prevented, you could prevent the disease.

Those bets have been going bad over the past four years. Today Lilly lost another bundle ....

Lilly Halts Alzheimer’s Drug Trial - Prescriptions Blog - NYTimes.com

... semagacestat, did not slow progression of the disease and was associated with a worsening of cognition and the ability to perform the tasks of daily living....

... The failures, and particularly this newest one by Lilly, could raise questions about the validity of the prevailing theory about Alzheimer’s, which is that the disease is caused by the accumulation of so-called amyloid beta plaques in the brain. 

 Lilly’s drug was designed to reduce the body’s production of the plaques by inhibiting the activity of an enzyme, called gamma secretase, that is believed to play an important role in formation of the plaque...

The contrary hypothesis was that the characteristic amyloid plaques of Alzheimer's disease were either a consequence of the disease process, or perhaps even some sort of protective measure. That hypothesis has been getting more support.

This latest result is just one example of all the recent bad news on delaying age-related dementia in general, and Alzheimer's disease in particular. We now know that "mental exercise", "social prophylaxis" and so on don't delay disease onset. We have shown that most treatment medications are, at best, marginally effective and poorly tolerated. We have no preventive meds -- estrogen, statins, non-steroidals and so on all are unimpressive.

We do know that head injuries are bad - worse than we imagined. Not only are concussions associated with Alzheimer's dementia, they're also associated with motor neuron disease. Most contacts sports, including American football and "soccer" will look very different in 10 years.

We believe, bizarrely, that exercise really does preserve the brain. We don't have a solid mechanism for that.

We also have tests that can diagnose Alzheimer's early, which is a good way to ensure you'll never be able to buy long term care insurance. Otherwise the tests look pretty pointless.

We need some good news. Forget the blather about social security -- that's not the crisis. That's just a GOP distraction. The crisis is pre-dementia and dementia in an aging post-industrial America.

History and demographics - notes from a long commute

I've driven from the Great Lakes region to Montreal about twenty times over the past thirty years.

The route has changed.

Two years ago we stopped traveling along the old Erie Canal route. The northern US border, from the Lakes to Vermont, had become too depressing. There were too many signs of dying communities. History moved on eighty years ago, but the post-9/11 collapse of Canadian tourism and the the lousy US economy of the past decade have accelerated the long decline.

This year we're seeing the same changes along the Canadian route. Businesses are vanishing, gas stations are closing, communities are disappearing. In the towns we visited we saw almost no children. I suspect the causes are similar to the American changes, but the demographic decline seems even more marked. Some of these northern communities depended on the lumber trade; they would have had good years before the housing crash, very bad times now.

Fifteen years ago we thought that the net might allow these communities to prosper. I was a small town physician for five years in the 90s, and I liked where I lived. Maybe that will still happen, but there's a lot of competition from places with better airports and milder climates.

It's a story as old as the ghost towns of the old west. These communities are small enough that a few energetic people will keep a few of them alive, but most will fade away.

Update 8/26/10: Three of the cities on the list of the top 10 dying American Cities were related to the old Erie canal and NE manufacturing route: Cleveland, Buffalo and Albany.

Deficits, climate, BP and immigration: Saving America is suspiciously easy

I wasn’t smart enough for my undergrad, but the financial support was so good I couldn’t quit. Poverty is the mother of persistence. So I worked the system. I got credits for hanging out at USC [1] and learning “student advocacy” in a class full of beautiful women.

Man, I was good in those days.

During one particularly delightful class “retreat” we played prisoner’s dilemma. Course we didn’t know that’s what we were playing; we were supposed to defeat ourselves and learn valuable lessons. Except I figured it out, and, miraculously, I was able to convince my team to sabotage the game by always cooperating.

The retreat leaders were not happy.

These days it feels like America is in a game like that. A game we could win, except we choose to lose. The game masters must be getting desperate, because they keep making the answers easier.

We have serious problems with our demographics (hence health care costs, declining tax base), our CO2 production, our energy policies, and badly behaved corporations.

We can solve all of these problems, and win the game, with a few obvious moves.

Surely you can guess?

They are …

1. Canadian-style immigration policy.
2. Carbon tax.
3. Percentage fines for corporate malfeasance rather than fixed dollar fines.
4. End tax deductibility of corporate fines.

Obvious, ain’t it? I tell you, this game is rigged. The answers are so obvious I’ll just talk about the first one.

Sometime in the past twenty years a group of freakin’ geniuses in Canada ran the numbers. They didn’t look good. Canada’s demographic transition [2] was particularly quick, the government pays for health care, and Canadians had stopped smoking.

So they tried to figure out Canada’s value prop. It ain’t the climate or the wealth opportunities. They decided it’s the society. Relatively diverse, fairly peaceful, very secure from invasion, not much of a terrorist target, decent albeit rapidly decaying infrastructure, and all located on the border of a vast money machine.

Canada started selling citizenship. It worked brilliantly. Canada skimmed the cream of the world in the prime of their life, without having to educate most of them.

We could do that. That takes care of our demographics problem.

Four obvious fixes. Problems solved. Easy.

That leaves only the interesting question. Who’s running this rigged game?

[1] Didn’t cost a thing. USC had an “exchange” relationship with us. I never saw a USC student at tech, so it was all to our advantage.

[2] Quebec went from families with 10+ kids to 1-2 kids in about 10 years. Fastest demographic transition in history, and a marker for how quickly a society can change without quite blowing up.

See also:

• American crisis – imagining a way out (similar post, but wordier)
• Carbon tax tagged posts

Good news on social security: Obesity

My family spent the afternoon at the neighborhood pool on a hot new-climate spring day. From the looks of things, we'd all do well in a famine. Minnesota has an average obesity rate, so I was seeing America.

We're not going to live as long as we expect. I wouldn't be surprised if average life expectancy began to fall over the next twenty years.

That's good news for social security of course. Now all we have to do is encourage smoking.

Civilization is stronger than we think: Structural deficits and complex adaptive systems

The more humans you know, the harder it is to imagine that civilization can endure. Billions of consumers. Environmental collapse. Climate change. Peak Oil. China's gender wars. The falling cost of havoc. The GOP. Skynet, sooner or later.

It looks hopeless, but on the other hand it's been 58 years since the first fusion weapon was detonated - and we're still here. That's surprising.

It's not just technology that we've survived. It seems impossible that democracies can manage their finances, but they do ...

Adam Smith's Money World - Onc is not Enough

... Greece has its debt bail-out, or appears to have, but there’s still that riot-inducing issue of government budget cuts. Is it even feasible for a government to cut its budget by as much as the International Monetary Fund has demanded of Greece? Yes it is very possible -- all too possible, in fact -- according to the IMF’s own study. In the past three decades there have been at least nine instances in which developed nations have cut their structural deficits by at least 10 percent of GDP...

It's true that some nations do better than others, but it's impressive that, faced with doom, even troubled nations like Greece and the US draw back. For example, to our great shame we reelected George W Bush and Richard Cheney. We did not, however, elect John McCain (now sadly demented) and Sarah Palin.

How does reason emerge from chaos?

We don't know, but many suspect it has something to do with the properties of a complex adaptive system. In our case it's a system built of economics and politics and the noise of the disconnected and, perhaps, the cumulative influence of the rational individual. It's a system that is self-sustaining, a system that "wants to live".

The system is hard to measure, but it's strong. It's also a fractal response -- just as civilization is surprisingly robust, so too are its components. Consider the digital economy. Perfect, near zero cost replication was very disruptive -- but the systems is responding. The iPad, the Flash wars, Google TV, "curated computing" -- it's all about the system responding to the disruption. It's all about the Digital Rights Management (DRM). Of which I will say more ...

--My Google Reader Shared items (feed)