Fears and Symbols

Fears and Symbols

“Its a natural human instinct to turn our fears into symbols, and destroy the symbols, in the hope that it will destroy the fear,” writes Johann Hari in his book Chasing the Scream. Hari writes this to explain the ways in which American culture has responded to drug use and addiction. We have demonized drugs and cast out drug addicts as moral failures. Our mindset is that the eradication of drugs and the expulsion of addictions will solve many of our countries ailments. If only there were not dangerous tempting chemicals to hook our brains, and if only people were more strong to resist the temptations to use use drugs, we could all be happy, productive, and united again.

 

In reality, drug use and societal ailments are more complicated than this paradise lost narrative. Hari’s quote continues, “It is a logic that keeps recurring throughout human history, from the Crusades to the witch-hunts to the present day. It’s hard to sit with a complex problem, such as the human urge to get intoxicated, and accept that it will always be with us, and will always cause some problems (as well as some pleasures). It is much more appealing to be told a different message – that it can be ended. That all these problems can be over, if only we listen, and follow.”

 

I think it is really interesting that we have such a tendency to turn our fears into symbols. We take the things we are afraid of, the things that disgust us, and create symbols to represent that evilness and reprehensible aspect of the world. The symbol could be a president you dislike, a foreign religion or character, chemical substances, or personality traits (laziness, close-mindedness, selfishness). This gives us a heuristic for addressing the thing we don’t like. It creates a less complicated version of the thing we fear, and allows us to draw a moral line in the sand, separating us (the good ones) from them (the bad ones associated with the evil symbol).

 

As Hari’s quote reveals, these symbols, and our efforts to destroy these symbols, can be problematic themselves. The Crusades were costly wars waged on outsiders, witch-hunts wrap up innocent people and threaten lives, and political polarization fueled by the hate of one political party or candidate only increases the gulf between us and our fellow citizens and human beings. Fears and symbols might be useful for galvanizing action, but they can have a wide range of negative externalities, and they can be misunderstood and over-generalized. Additionally, our fears and symbols can be captured by actors and institutions which seek to further their own ends, deliberately harming others in pursuit of their own agendas.

 

I don’t think Hari would tell us to abandon all of our symbols for our fears. He might agree with me that it is likely impossible to do so. The alternative seems to be to recognize when you are using such symbols and to understand how you are reacting to them. Are you allowing a symbol to stand for something you will avoid in your own life, or are you allowing a symbol to stand as a marker of your own righteousness? If you are using fears and symbols for self-control and discipline, you might be ok, but if you are using them simply to judge others and to justify avoiding or out-casting them in an effort to signal your virtue to others, you may be more of a problem than you realize. When these symbols and our efforts to destroy them start to harm others, we have a problem and need to redirect our energy to find real solutions to the real problems that underlie the fears and symbols in our lives.
Buying Insurance

We Don’t Buy Insurance for Ourselves

Why do we buy insurance of any kind? Is it really for ourselves and our own benefit, or is there something else going on with insurance decisions? According to Venture Capitalist Chris Brookfield, as quoted in Dave Chase’s book The Opioid Crisis Wake-Up Call, there is something beyond our own self interest at play when we decide to buy insurance.

 

Brookfield is quoted as writing, “Persuading individuals to buy insurance is kind of backwards. I saw this in India all the time. Individuals do not value their own risks – their relatives and neighbors do.” 

 

Buying insurance is actually more about our loved ones and our responsibility to our community than it is about ourselves. It is about protecting the financial standing of our relatives and those who would help us if we were down as much as it is about protecting our own financial standing. The standard story tells us that insurance shifts risk from ourselves to a group of individuals, but as Brookfield continues in the book, it really shifts risks from our immediate known allies, into a broader group of people that we don’t necessarily know.

 

If I don’t have health insurance or auto insurance and die in a terrible car crash, I am not the one who will bear the costs of the accident. My loved ones and other people in the community involved with the crash (other drivers or the owners of any private property that was damaged) are the ones who will face the costs. On their own it would be hard to manage the costs, but pooled together, the costs and the risk could be shared. In a situation where my death occurs, it is other people who derive the value of the insurance.

 

I’m sure there are some insurance products that are pretty solidly just about the individual buying the isurance, but it doesn’t seem to always be that way. Buying insurance seems to be an act of signaling, as Robin Hanson discusses in his book The Elephant in the Brain. Buying insurance isn’t all about sharing risk, it is also about showing others how much you care about them and about showing the community how responsible you are.
Healthcare Safety and Data

Hospital Safety & Data

One problem with healthcare in the United States is that consumers don’t control their data and the information about them. Even the employers of healthcare consumers, who are paying for the services provided to patients and often responsible for whether patients have healthcare coverage at all, don’t have access to any of the healthcare data of the employees they pay to cover. Healthcare information is protected by providers and guarded by insurers.

 

A troubling result is that consumers and employers often don’t know much about the quality of care provided at a hospital or from a given provider, and don’t know about the safety record of providers and hospitals. Outcome measures are sometimes protected by law, and are other times hidden behind complex systems that prevent employers and consumers from finding and understanding the information.

 

Dave Chase compares the problem this creates to airline travel in his book The Opioid Crisis Wake-Up Call, “No corporate travel department would allow an employee to fly on an airline that suppressed its safety records (even if the FAA allowed it). In the same way, it’s unconscionable to blindly send an employee to a hospital with little or no information on its safety record. If the hospital suppresses that information, go elsewhere and tell your employees why.”

 

There are many ways in which we treat the healthcare system differently than other sectors for no apparent reason. I wrote about the way we don’t consider healthcare broker’s conflicts of interest in the same way we consider financial adviser’s conflicts of interest. In a similar example as above, we heavily scrutinize any spending by employees for lunches or hotel stays on trips, but we don’t apply the same scrutiny to hospital billing. Our failure to consider safety the way we would for employee travel, even though many employers spend more on their employees healthcare than on their travel, is a failure of how we think about the system.

 

I think that Robin Hanson and Kevin Simler explain a little of why this is in their book The Elephant in the Brain. We don’t know what medical care is effective and we don’t know which systems and providers are safe, but we do know when someone took time off work for care. We can signal our support for that individual with cards, balloons, and messages about how much we value them and hope they recover quickly. Much of our healthcare system and how we treat it is based on signaling. Accessing care shows others that we have resources and powerful allies who care about us. We also use healthcare to signal to others how much we care about them and what a valuable ally we would be to them. The result is costly, in terms of dollars and health and safety problems.

 

We have to get beyond this signaling mindset and approach to healthcare if we want to rein in prices and have a safe and effective system. If we want our healthcare to be sustainable for the long run, it can’t be built around signaling, but must actually be built around effective solutions. Employers have an important role to play by demanding the information they need to be accountable in providing valuable health benefits to employees. Hospitals, providers, and insurance companies can’t continue to monopolize and hide patient data, preventing employers and patients from making smart and economical healthcare decisions.
Guidance Toward High Value Care

Guidance Toward High Value Care

In his book The Elephant in the Brain, Robin Hanson explains that a lot of medical care and healthcare services are more about signaling than about the value they bring to the patient in terms of improved health and effective management or treatment of a given condition. Healthcare has a lot of signaling, showing others that we make enough money that we can go do something for our health, pushing others to get care to show how much we value having them be healthy, and giving us or others a chance to show how much we know and understand the human body. However, not a lot of what we push people toward really demonstrates that it adds a lot of value.

 

This is a problem that Dave Chase thinks is a big contributor to our nation’s healthcare woes in his book The Opioid Crisis Wake-Up Call. Chase is critical of unnecessary services and a medical system that pushes people toward care, without providing means to ensure that the care we push people toward is actually valuable. He recounts a conversation he had with Dr. Martin Sepulveda, “indiscriminate provision of health care services – absent efforts to help people understand how to use those services – leads to voracious appetites from both patients and providers for services that add little value but add a lot of cost to the individual, company, and society.”

 

When a child runs to their mother for a kiss on a bruised knee, the kiss doesn’t actually add any value in terms of helping heal the child’s bruise. But the care provided by the mother does signal her love for her child, signals to the child that they are valuable and important, and signals to others that the child has allies who will aid them during a time of need. The example is extreme, but if you look close enough, you will see some of the same aspects at play in many of our healthcare interactions.

 

Increasing access to healthcare without helping people understand what care they should seek, without helping people understand what options they really have, and without guidance toward high value care, means that we will use healthcare in a wasteful manner. Paying providers just by the number of procedures they do, and not by how much they help patients, encourages unnecessary medical procedures. Telling patients that if they value themselves they will go to the doctor every time they feel a little off will lead to patients overusing primary care. And pushing people to the emergency room every time they say they don’t feel well could crowd our ERs and delay care for those who really need it. The problem is difficult to solve, and I want to acknowledge that it is hard to know what care is really appropriate and what is wasteful signaling. That is the point that Chase makes. Without more transparency and clarity in the system, we won’t really know what medical services we should and should not pursue, and we (along with providers) will likely overindulge in high-signaling low-value care rather than medical treatments that are really useful and meaningful.

The Magic of a Name

I remember that as a child I was really good with names, but not that good with faces. I could remember all 30 names of the kids in my elementary class, and in the other classrooms, but I could not always remember a face to go with the name. This kept up through about high school, but at some point it switched, and I became better at remembering faces than names. I remember growing up hearing people say they remembered faces but not names, and thinking that I must have been different for being the opposite. I’m not sure exactly what caused the change, but I suspect that somewhere along the line I started paying less attention to people, especially people I would only know for a semester in college before moving on, and as a result I only vaguely remember faces and never really got their names down.

 

In general day to day life, this probably isn’t a big deal for me. But if I am trying to build meaningful relationships with people who will be bigger parts of my life than just someone I saw at a party once or someone who made my coffee one day, then remembering names is important. Dale Carnegie explains why in his book How to Win Friends and Influence People:

 

“We should be aware of the magic contained in a name and realize that this single item is wholly and completely owned by the person with whom we are dealing … and nobody else. The name sets the individual apart; it makes him or her unique among all others. The information we are imparting or the request we are making takes on a special importance when we approach the situation with the name of the individual.”

 

Part of the power in remembering a name is just signaling. It tells the other person that we actually paid attention to them when we interacted with them in the past, enough to where we at least remembered their name. Going back to my opening paragraph, part of my suspicion of why I forget names is because I stopped paying as much attention to other people, focusing instead on my studies or class discussion, or on other trivial things like what I was going to eat for dinner.

 

Remembering someone’s name signals to them that they are valuable enough to be remembered. That you truly listened to them in the past and cared enough about them to take them seriously. Forgetting their name shows that you instantly forgot them, and that you never really cared about them in the first place. Building relationships requires that you actually like the other person you want to build a relationship with, or minimally at least respect them, and remembering their name helps make a public display of your level of sincerity in terms of your relationship building.

Countersignaling Today Through Clothing

I’m a big fan of stoicism and I also try to think about the recommendations from The Minimalists in my daily life. I try not to let material goods control me, and I try to stay away from overtly status seeking behavior. I try to be pretty content with an average used car and try not to feel a need to have very expensive clothing. I think these are meaningful ways to live and approach life, but part of what I might be doing is a substantial amount of countersignaling.

 

Tyler Cowen writes about this kind of countersignaling in his book The Complacent Class. He writes, “American’s at the top have become the experts in countersignaling, because they don’t feel they have to impress anyone. Everything is now casual, because the new aristocracy of talent enforces all the conformity that is needed.”

 

I started at a Bay Area tech company after college. We all wore hoodies and only a couple of our top sales executives ever wore slacks or a suite. The emphasis was never on what you owned or how you dressed, but on how smart you were and how many impressive ideas you could come up with. This came pretty natural to me, and it aligns with the stoic and minimalist ideas I frequently engage with.

 

At the same time, I think it is valuable to pull everything apart to look at my behaviors more closely. I hate the time and energy that goes into dress clothes. I like the relaxed feel of casual wear and the fact that I can easily pack casual clothes in a gym bag without them becoming a wrinkly mess. I’m uncomfortable with expensive clothing, knowing that I could use the $140 for a solid pair of dress slacks on more meaningful causes than just me looking good. From many standpoints, I think the shift toward casual dress is a good thing, for worker health, comfort, and for how we use resources.

 

Simultaneously, there is still a lot of signaling that is going on with the way we dress, even when we are dressing casually. It says, “I’m so good I don’t have to worry about looking the part—my work speaks for itself.” Dressing casually says, “The older generation that set the rules is irrelevant, we are defining things how we want.” In some senses these signals are direct attacks against the generations that came before us and built the business world and culture that allowed my generation to come along and invent innovative tech. There is something dismissive in the attitude presented and something that might be more inclusive for younger more diverse workforces, but simultaneously prejudiced against older workers. In the end, I think the trend is a good one, at least if it can live up to its inclusive potential. Slacks, dress shirts/shoes, and ties are terrible, and we shouldn’t have to suffer through them and spend all our free time and money hassling over our clothes. We should be comfortable with a minimal set of clothing, and focus on doing great work. Simultaneously, we should be respectful of the business culture that helps us be professional and get good work done. Somewhere in the middle lies a reasonable blend of both, and all along the spectrum is a lot of signaling and countersignaling.

Three Factors That Push In Favor of Religious Belief

In The Elephant in the Brain by Kevin Simler and Robin Hanson, the idea that many of the ways we act and behave have little to do with our stated reason for our actions and behaviors is explored in great detail. The authors’ thesis is that our self-interest dominates many of our decisions. The authors suggest that our beliefs, our social behaviors, and our interactions in the world are reflective of our self-interest, even if we don’t admit it. One area the authors examine through this lens is religious belief.

 

Simler and Hanson identify three factors that tend to push people toward belief, even though the factors have little to do with evidence for or a belief in a deity. They write:

 

“1) People who believe they risk punishment for disobeying God are more likely to behave well, relative to nonbelievers. 2) It’s therefore in everyone’s interest to convince others that they believe in God and in the dangers of disobedience. 3) Finally, as we saw …, one of the best ways to convince others of one’s belief is to actually believe it. This is how it ends up being in our best interests to believe in a god that we may not have good evidence for.”

 

The argument the authors put forward is that people believe that people of faith will be better people. That they will be less likely to commit crimes, more likely to have high moral standards for themselves, and more likely to be an honest and trustworthy ally. In order to be seen as a person who is trustworthy and honest, it becomes in one’s best interest to display religious faith and to convince other people that our beliefs are sincere and that we truly are an honest, trustworthy, and moral ally. These social factors don’t actually have to be related to religious beliefs, but the beliefs can create a structure that allows us to demonstrate these qualities.

 

These factors then push us toward belief. It is hard to always convince people that you are authentic, but it is not hard to simply adopt a belief, even if there is a shaky foundation for the belief you adopt. This occurs today with political beliefs about specific governmental decisions and interventions. It happens with climate change denial, and with fad diets. We convince ourselves that we are doing something because it is correct, and we can then better defend our decision and better defend our actions which might be signaling something else about ourselves.

A Simple Quid Pro Quo

Have you ever thought about how we treat people who are sick? We have an entire economic system (trillions of dollars in the US) set up around treating people who are sick. When we have family members who are ill we often take time off work, help make sure their pillows are comfortable, and make them hot tea or soup. We will put ourselves at risk of catching whatever illness they have, or if it is not contagious, we will sacrifice large parts of our lives to be there in support. I’m not suggesting that caring for the ill is a bad thing, but it is curious that humans would develop a drive to help those who are sick at great personal risk and cost to oneself.

 

In The Elephant in the Brain authors Kevin Simler and Robin Hanson suggest that helping those who are sick is actually less about helping the sick person, and more about making sure we will have someone to help us if we are in a similar situation in the future. There is a quid pro quo taking place where we make a sacrifice so that others will sacrifice for us if we get sick.

 

The authors write, “in part, it’s a simple quid pro quo: I’ll help you this time if you’ll help me when the tables are turned. But providing support is also an advertisment to third parties: See how I help my friends where they’re down? If you’re my friend, I’ll do the same for you. In this way, the conspicuous care shown in our medical behaviors is similar to the conspicuous care shown in charity; by helping people in need, we demonstrate our value as an ally.”

 

We all want people to see us as nice, generous, caring individuals. To make sure people see us that way, we seize upon opportunities to demonstrate those qualities in the real world, even if there is a cost to us. The authors would argue that it is precisely when there is a cost to us that we are most likely to be charitable or to help those who are ill, at least if there is a sufficient audience. It often feels like we are just doing something nice for another person out of the goodness of our heart, but often there is another layer at play that is more self-interested than we would want others to see. We hide that part of ourselves and make an effort to not see that part of ourselves in who we are, or in the people we care about. That part of ourselves is the elephant in the brain which is dictating a lot of our interactions with the world, even though we won’t acknowledge it.

Signaling Work Potential

“In 2001, the Nobel Prize was awarded to economist Michael Spence for a mathematical model of one explanation for these puzzles: signaling. The basic idea is that students go to school not so much to learn useful job skills as to show off their work potential to future employers. In other words, the value of education isn’t just about learning; it’s also about credentialing.”

 

The quote above is from Kevin Simler and Robin Hanson’s book The Elephant in the Brain when the authors talk about why we go to school and what purpose education is serving for our society and for us as individuals. Education costs have been rising and we continue to encourage everyone to go to college. Several presidential candidates on the Democratic side have even put forward plans for free tuition. The idea at play as college tuition rises, as we push everyone toward college, and as our candidates outline plans for everyone to be able to afford college is the idea that higher education is all about learning useful and valuable knowledge that will help every individual and our entire society become more productive and better functioning. We want smart people with extensive education to drive our society forward, and college is the way to make that happen.

 

However, if much of our education is about signaling, then what will happen if we push everyone to go to college? Some students will learning useful information, important skills, and will develop in ways that they could not if they hadn’t pursued higher education, but will it benefit all students? If much of our higher education is about attaining credentials to stand out and show off, then won’t we simply diminish the status and credentials of those who do go to college? There are arguments to be made for and against free college tuition and it is important to understand what is happening with each to develop a better argument and discussion around higher education.

 

First, we must admit that sometimes college is just about signaling and getting a piece of paper to check a box on a job application. By acknowledging that piece, we can start to move forward and think about what opportunities we want to help provide to people. It seems to me that everyone should have a chance to move forward and pursue the education benefits we applaud, but it also seems reasonable to say that we should not overly subsidize what is often just signaling behavior.

 

For those who simply want the credential and don’t care much for the knowledge opportunities along the way, perhaps a greater development in training and education specific to a technical trade or craft would be a better option. Perhaps a less costly signal that focuses more on doing than learning is a valid alternative to the standard higher education model. With an alternative avenue in place, perhaps we can appropriately decide what level of subsidy should be provided to those who do want to go the traditional college rout. Perhaps existing colleges can also adjust to make their signals stronger, while also encouraging more learning as a side goal.

 

I’m not sure what a perfect path forward looks like, but I know we won’t move in the right direction if we believe that education is only about learning and growth. Some of us will learn a lot and demonstrate clear growth in college, but many of us will simply lose time as we strive for more credentials and attempt to signal to future employers that we are the kind of person they should hire.

The Argument That College Isn’t About Learning

In The Elephant in the Brain, Kevin Simler and Robin Hanson make an argument that we create stories and narratives around how our world operates that make us look as good as possible. We have systems and structures in place that provide us with convenient reasons for behaving the way we do. These convenient reasons are socialable, put us in the best possible light, and make us feel good about ourselves. Simler and Hanson argue that below this surface lie our true reasons and our hidden motives for our behaviors.

 

One area they look at is education. Nominally, we tell everyone that we are going to school to learn something, to prepare ourselves for the future, to build new skills, to make new connections, and to gain new experiences. What we don’t say is that we are going to school to check a box, to gain a credential, and to simply look more impressive to other people. Education is supposed to be about learning and information, not about padding a resume and trying to simply gain something in a personal and selfish manner. Their argument about education relies on a lot of research that is also discussed in Bryan Caplan’s book The Case Against Education, which I have not read but is referenced in The Elephant in the Brain and who I have heard on several podcasts. To suggest that education is about something other than just the learning we are supposed to do, the authors write,

 

“Consider what happens when a teacher cancels a class session because of weather, illness, or travel. Students who are there to learn should be upset; they’re not getting what they paid for! but in fact, students usually celebrate when classes are canceled. Similarly, many students eagerly take Easy A classes, often in subjects where they have little interest or career plans. In both cases, students sacrifice useful learning opportunities for an easier path to a degree. In fact, if we gave students a straight choice between getting an education without a degree, or a degree without an education, most would pick the degree-which seems odd if they’re going to school mainly to learn.”

 

Sometimes we do learn useful things in school. Sometimes we really do gain new perspectives, have new and meaningful experiences, and grow though our coursework. But students don’t seem as focused on the learning in most areas (some technical degrees at the university level might be different) as simply getting through and getting a diploma. Education includes a lot of signaling aspects that are just as important (if not more important) than any learning we might do.

 

Education tells people we are the kind of person who can earn a degree. Good grades tell potential employers that we are the kind of people who can figure out what is demanded of us, and we are the kind of people who will then do what is demanded. Much of what we learn we will forget, and once we get on the job we will be expected to do a lot of training to learn how to do the actual thing we were hired to do based on our education. We learn a bit in school, but we also signal a lot about ourselves in the process.