April 2012

Re: “Why We Can't Afford Poverty,” by James Hughes

Yes, a gram of prevention probably is worth 16 grams of cure. In his lively review of a new report from the National Council of Welfare (will someone please explain why it is “of” rather than “on” welfare”?), The Dollars and Sense of Solving Poverty, James Hughes leans on this old adage, which most of us learned in its pre-metric version, and also on a once-famous TV commercial: “You can pay me now [for a Fram oil filter] or you can pay me later [for a new engine],” which undoubtedly costs much more than 16 times even the high-end Fram filter.

The trouble is, as is often the case in trying to do evidence-based social policy, the exact ratio is damnably difficult to determine. It does make sense, for instance, that homeless people’s bad teeth can make it hard for them to get jobs—although that may not be the main obstacle to their regular employment. Okay, let’s say we provide full-service dental care to everyone who’s homeless. What does that cost per person? How do we define who’s homeless? And how long does the deal last (as we presumably don’t want to cut people off as soon as they do find housing)? Also: how much does it cost to administer, since someone or something—invariably a relatively expensive public bureaucracy—will oversee the program?

Cost calculations are hard enough but how do we estimate the payoff? How many homeless people really do get jobs because of their better teeth? And how much does public spending on emergency care, police services and all the rest of it really decline because the newly employed homeless no longer require these services? Even among those who aren’t ideologically hostile to publicly funded dental care there’s ample room for skepticism about the true rate of return. Moreover, hostility to the idea that the state should provide housing, dental care, family counselling and so on reflects, not ideology, but Canadians’ traditional and perfectly reasonable belief that most of the time most of us should take care of ourselves.

Of course, the main reason there is less support for preventative spending than the NCW thinks there should be is that many Canadians believe their governments, unlike Fram, are in the business of “pay me now and pay me later.” Hughes clearly understands this concern that the returns to social-policy investments will be seized by politicians, bureaucrats, public sector unions and interest groups, but offers no convincing reason why taxpayers should lower their guard.

William Watson
Montreal, Quebec

Re: “Click to Judge,” by Tom Slee

We thank Tom Slee for his kind words about our 2004 article, the “ambitious and opinionated ‘Manifesto for the Reputation Society’.”

Our new book, The Reputation Society: How Online Opinions Are Reshaping the Offline World discusses principles for online reputation. It focuses on asking ourselves the right questions today, so that reputation is used better in society tomorrow.

Slee rightly notes that our book is not focused on detailed case studies of negative recent developments on the internet. Instead we chose to concentrate on longer-term challenges of reputation systems.

To take one example: if online reputation weights all perspectives similarly, it may devolve into simple majority rule. At the other extreme, if online reputation takes only similar users’ opinions into account, “echo chambers” may arise where like-minded people reinforce each others’ views without being open to outside perspectives. The chapter by Paolo Massa discusses balancing these two extremes.

As Massa notes, this issue can be traced back to political philosophers such as John Locke, and even to the writings of Aristotle and Plato. We believe it is a fundamental design issue for reputation infrastructure—an issue that will still be important 10 or 20 years from now, long after today’s ephemera are forgotten.

Other authors in the book also take the long view. The questions they consider include: can reputation mitigate discrimination? How does open access shape the reputations of academics, and of research itself? What might happen if individual government policies and projects are rated by citizens? Can we make better choices about which scientific paths to pursue?

We agree with Slee’s concern about the dark side of internet reputation. From our introduction:

Several authors have expressed grave reservations about what reputation systems may lead to in the long run: a mob mentality, vigilantism, a pitiless collective memory that never forgets a past misdeed … Could the Reputation Society be nothing more than a conformity-enforcing Panopticon—one that could be hijacked by authoritarians as a more effective means of social control?

We hope that our book contributes to avoiding these dangers, and achieving the positive potential of reputation systems for improving social progress and personal living standards. This will require sustained engagement by society at large.

This is not a book of easy answers. It is a book of hard questions. Engaging with these hard questions is necessary. Only in this way can we achieve the insight necessary to guide the development of online technologies in a humane direction.

Hassan Masum and Mark Tovey
Toronto and Waterloo, Ontario

Re: “Citizen Khadr,” by Reg Whitaker

Reg Whitaker says my book about Omar Khadr was motivated by my “vindictive aggression” and my “unhinged hatred.” He has made an amateur psychiatric diagnosis of me and called it a book review.

But as to Khadr himself, a confessed murderer and terrorist who actually has undergone psychiatric evaluation, Whitaker refuses to accept that he’s evil. Whitaker says it’s just me who “ascribes malevolent intentions” to his little lamb.

This is actually what I meant by my book’s title. The Enemy Within: Terror, Lies and the Whitewashing of Omar Khadr doesn’t just refer to Canadian-born terrorists. It’s the media-legal industrial complex that is so devoted to their theory that Khadr is an innocent young pup that they will discard any facts that conflict with their theory. Whitaker personally demonizes me because I don’t share his views.

But you don’t have to be a psychiatrist to be afraid of Khadr. His own lawyer has twice called for Khadr to be deradicalized. Whitaker might call that hatred. It’s actually a rational fear of an unreformed jihadist who believes killing Jews and Gentiles will get him to heaven, and has at least one murder under his belt.

Michael Welner isn’t an amateur shrink like Whitaker. He has worked on landmark cases ranging from Matthew Shepard to Andrea Yates to Elizabeth Smart. He’s the best-regarded forensic psychiatrist in America. The Depravity Scale he developed is now a part of the FBI’s crime classification manual. But because this top expert thinks Khadr is dangerous, Whitaker calls it “junk science,” and tries through a very complex theory of guilt by association to imply Welner must be racist.

Nothing will change Whitaker’s mind, not even Khadr’s own confession to everything. Whitaker implies it was a forced confession. Does Whitaker seriously mean that Khadr’s own lawyers, who approved the confession, were in on the fix? That’s a 9/11 Truther level of conspiracy theory.

Whitaker can have his own opinions about me, or even Michael Welner. But he ought to restrain a book review to what I actually wrote. I have never written nor said that I’d like to see “the entire Khadr family stripped of its citizenship.” It doesn’t even make sense, given that Omar Khadr was born here.

Whitaker says my book “simply tosses aside the issue of Khadr’s age.” But I devote all of Chapter 5 to that subject.

It is true that I end the book with an appendix called “73 Reasons Omar Khadr Is Dangerous According to Dr. Welner.” But Whitaker strategically leaves out the next sentence: these were undisputed facts, facts that Khadr and his lawyers conceded.

Reg Whitaker thinks he’s rebutted my thesis. He hasn’t. He’s proved it: Canada’s liberal elites love Khadr with a love that no facts or arguments can shake.

Ezra Levant
Toronto, Ontario

Re: “Who Controls North America?,” by Isabel Studer

In our recently published Dependent America? we raised an entirely new question—to what extent does U.S. power derive from its relations with other countries—and chose a particular case to find an answer. In the words of our subtitle, our book explains How Canada and Mexico Construct U.S. Power.

So it was gratifying to read that, in her review last month, the highly qualified Mexican analyst Isabel Studer completely got our main point. Although the Canadian and Mexican economies would only be the world’s fifth largest when taken together, they constitute—and by far—the United States’ largest external source of economic strength and physical security.

These empirical findings raised a second issue. Does the United States’ “dependence” on its neighbours for so much of its wealth and safety make it vulnerable to its neighbours’ political influence? That we found little evidence of such policy dependence led to a puzzle: how can Canada and Mexico be simultaneously so important to the United States yet impotent in Washington? We concluded that, because the United States has been able to shape the policy space within which Canada and Mexico relate to it, Washington has both fostered Canada’s and Mexico’s contributions to its power and forestalled their constraints on it.

Apart from a few minor niggles, our differences with Studer centre on two analytical issues.

She chides our argument for being circular, but in reciprocal political relations, any action by one party that causes a significant effect on another soon becomes the cause for a response. Studer herself acknowledges that the one-way treatment of U.S. influence on Canada has always been problematic. In this regard we do not maintain an Uncle-Sam-always-wins stance as she alleges. In fact, we disavow this perspective explicitly in our introduction.

More fundamental is her rejection of state power as a concept for analyzing the complexities of the three North American countries’ interdependencies. To the contrary, we show that the U.S. government’s response to 9/11 reaffirmed the role of the state both by Washington doubling its own security systems and by forcing Canada and Mexico to do the same—on pain of blocked borders. We demonstrate time and again the persistence of power asymmetries that shape even cooperative behaviour among the three governments.

It may be “traditional,” to observe that Canada and Mexico have little influence in Washington. It is novel to counterpose this chronic impotence with the continuing importance Canada and Mexico display in actually constructing U.S. power. Why Canada and Mexico so regularly punch below their weight in Washington remains a legitimate subject for debate.

One final point: Studer claims we do not consider how American protectionism and border securitization affects U.S. prosperity. In fact, this is precisely the criticism we level at Washington’s policy makers. To show how the United States is undermining its own power by literally and electronically walling itself off from its neighbours is central to understanding this once-magnificent country’s sad decline on the world stage.

Stephen Clarkson and Matto Mildenburger
Berlin, Germany, and New Haven, Connecticut

Re: “High-Tech Hopes for Global Health,” by Amir Attaran

We are pleased that the LRC chose to review our book The Grandest Challenge: Taking Life-Saving Science from Lab to Village, which we wrote to share personal thoughts and reflections on our journey with others trying to help address some of the most pressing global health challenges. We were, however, perplexed at the choice of Amir Attaran as your reviewer. His well-known negative views on many of the initiatives and institutions we discuss might give one pause to question his impartiality. We do find ourselves in good company, however, since Attaran, seemingly a professional critic, has criticized Jeffrey Sachs and the United Nations Millennium Development Goals, and the Bill and Melinda Gates Foundation’s malaria program—both of which have saved or will save many lives.

Attaran’s review can only be described as Orwellian: if he says we believe something, it is very likely we believe the opposite. We believe innovation is critical to improvements in global health because without it we are stuck in the unacceptable present with women more than 100 times as likely to die in pregnancy and childbirth, and children ten times as likely to die under five years of age, if they are in the developing world. We define innovation broadly and believe in integrated innovations combining science and technology, social innovations (such as health policies, health systems reforms, and social determinants of health) and business innovations. And we believe that innovators in developing countries are best situated to solve their own problems.

While we are open to constructive criticism, we feel it is important to respond to some of his more egregious inaccuracies and misrepresentations.

We thank Attaran for correctly identifying a typo in Chapter 1 (where 94 percent should read 84 percent). Unfortunately he then uses this single typo to question the intellectual underpinnings of the remaining 251 pages of our extensively fact-checked book.

When Attaran describes the process of identifying Grand Challenges as “something like an academic parlour game” and calls them our “grand challenges,” he is belittling the incredible efforts of the more than a thousand scientists and experts in the developed and developing world who contributed to these endeavours. While he dismisses these challenges as “Grand Arbitrariness” and says they are built on “shifting sands,” many of these same scientists are now working hard to solve these challenges and save lives. Attaran’s criticism manages simultaneously to ignore their contribution while unfairly and inaccurately condemning their work.

A particularly troubling aspect of Attaran’s review is his penchant for quoting small excerpts from the book out of context to support misleading conclusions. For example, he states that “when Daar and Singer dismissively write ‘after all, what did legal issues have to do with the billion people living on a dollar a day, people who lacked the most basic health care, clean water or even adequate food,’ their disdain is shockingly ahistorical.” Looking at this passage in full, we were actually criticizing the ethics program of the Human Genome Project for largely ignoring inequities in global health and focusing instead on narrow issues that were largely the interest of ethics scholars in North America. In context, it is clear that we were not in any way discussing public health law in general as Attaran implies.

Another of Attaran’s criticisms is that we give “short shrift to social interventions.” In fact, two of the eight chapters in our book focus on global health ethics—in particular, community engagement and trust building—and another two are devoted to commercialization. In our final chapter we conclude that “looking ahead at the next ten years, we believe that genomics and other, related, life sciences will enable advances in global health, in tandem with progress in addressing the many social determinants of health.”

Attaran uses his review as a platform to criticize Grand Challenges Canada. It was only beginning when we published the book; it has since supported many innovators who are dedicated to saving and improving lives.

Abdallah Daar and Peter Singer
Toronto, Ontario

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