Free Will, Sharing and Facebook

Facebook has been in the news a great deal lately. Early this week, they made some changes to their site design. Yesterday, they announced Facebook Timelines which is essentially a digital representation of your life that will be available on the web unless you choose for it not to be. Neither of these changes have been received well by Facebook users. If you’re on Facebook, I’m sure you’ve seen many posts related to the topics, specifically the new UI design. There are a couple of ideas I want to discuss that are related to these changes. The first is the idea, often seen in the threads like those I just mentioned, that you don’t pay Facebook anything and you don’t have to use the app. You can choose to not use Facebook. I think this is incorrect for a large number of Facebook users. The second idea is the biggie from Facebook, the idea of frictionless sharing. Both are connected through the idea of choice.

I chose to give up Facebook for Lent this year. I’m not a huge Facebook user but it’s a convenient way to stay in touch with people and as it turns out, get invited to things by people I don’t regularly see, typically former coworkers. We have a private group that we use to announce happy hours, football watching and other group events. During the 40 days of Lent, I received not a single invitation to events thrown by Facebook friends because I wasn’t on Facebook. This isn’t entirely due to my absence as I live out in the boonies and am kind of a hermit. However, what happened when I gave up Facebook for 40 days was the default situation changed. Instead of the default being that I got invited and could choose whether I attended or not, I just didn’t get invited. This is because Facebook is the default social application on the web. I had little recourse to change the default while not on Facebook short of just calling people randomly to see if something was going on. While this is how the world worked in the past, the world has changed. The merit of the change is certainly up for discussion but in certain cohorts, Facebook is the default. Without access to Facebook, you lose access to those people.

This idea that we don’t have to be on Facebook sits on the concept of free will. Free will is the idea that as human beings we have the ability to make any decision we want, carte blanche, free of outside constraints. Free will has long been an active topic in philosophy and religion. Most people believe that we truly do have free will, that given a choice between A and B, you can just as easily choose one over the other. This is the core of the argument that “You don’t have to be on Facebook.” For example, someone who believes I have free will thinks that I can make the choice to walk into a crowded theater and yell “FIRE!” at the top of my lungs. However, I believe (as does most of society thankfully) that free will is constrained by social determinism, the idea that the choices you have are limited based on your desire to remain a citizen in good standing in society. Because I don’t want to go to jail, I can’t yell FIRE! in a theater. My choices are constrained by the social mores of the community I live in.

What does all this have to do with Facebook? When someone says “stop complaining, you don’t have to be on Facebook”, it is really just an argument in favor of total free will as it relates to how that person interacts with his friends, family and cohort. However, because Facebook is THE default social application and because so many of our interactions are becoming digital in nature, not being on Facebook is tantamount to not having friends. Many of us are constrained by the social choices our friends and family make, assuming we don’t want to become hermits. Extreme? Possibly but I am not a huge Facebook user and I didn’t get invited to events for 40 days when I left Facebook. Someone for whom Facebook connects the many people in their lives do not have the easy choice to give up Facebook.

Additionally, Facebook will now have something called “frictionless sharing.” This was announced in the f8 conference by Mark Zuckerberg this week. Frictionless sharing is the idea that when you watch a movie or read a link or listen to a song, that activity will be posted to your Facebook timeline if you have authorized the app that controls it. For example, if you authorize the app for Bob’s XYZ Health Service, every time you visit a link at Bob’s XYX Health Service, it will get posted to your news feed. Perhaps you think you’d never do something like that? Think about the last time you encountered a Terms of Service for software you bought or installed. Did you read it entirely? Or did you just click “Agree”? The request for authorization could be as arcane and difficult as a Terms of Service and many people would just click “OK”. Or people won’t think through what they are actually clicking.

There are two fundamental things wrong with frictionless sharing. First, it’s one very huge step on the slippery slope towards the destruction of privacy. Once you authorize an app, there is almost no telling what will get posted to your timeline if it remotely involves that app. Let’s say for example I authorize the hypothetical Bob’s service above. One day, many months later, I go into Google and search for “colon cancer symptoms and treatments”. The second link in the results happens to be a sponsored link from Bob’s. Not thinking anything about it, I click on that link. The link gets posted to my feed but because I’m busy looking up colon cancer treatments, I don’t notice. 12 months after that, I’m diagnosed with colon cancer. My insurance agency denies coverage because they found my search online and ruled it must have been a pre-existing condition. It matters not that at the time I was looking up information for my dad. I still get denied coverage. Or what if it’s a picture sharing app and one day you download some erotic pictures from your camera that you took with your significant other? The examples go on and on. People will make mistakes and in our increasingly connected digital world, a mistake of this nature can be absolutely life changing.

The second thing wrong with frictionless sharing is the idea itself. Throughout time, we have been a social creature. Even before the Internet, we shared our lives, our joys, our griefs with each other. But sharing is necessarily full of friction. The most important friction in sharing is the very act of it being explicit. The concept of sharing revolves around the idea that I chose to share something with you. The phrase “frictionless sharing” is an oxymoron, one created by a company whose single overarching goal is to get you to put as much information about yourself and your life online in manner that gives them the most access to it. Frictionless sharing should terrify you.

Even before the latest changes, we were probably at the point where you should assume everything you do in regards to Facebook is public. These latest steps by Facebook move us down a path where even actions you take outside the application may become public. Don’t ever forget that you are not actually a user of Facebook. You are the product, the thing that they are selling to their actual users, the people who buy ads and invest in the company. Because you are not a user, you should assume that your desires and needs are not considered in almost anything Facebook does. You are the product. They are trying to sell you. Keeping that at the foremost of your mind when you are making decisions regarding sharing data with Facebook will go a long ways towards protecting your privacy.

Geithner Says Europe Will Follow Our Lessons, God Help Them If They Do

This week, Timothy Geithner made comments in the financial media regarding how he thought Europe would get out of the mess they are in.

“I think you’re going to see them draw on the lessons of our crisis, draw on the lessons of things that worked here in the United States,” Geithner said in a Bloomberg Television interview today in Washington. “I think you’ll see that reflected in some of the choices they make.”

God help them if they do. Unless they learn by doing the opposite. Three years on after the 2008 meltdown in the US financial system, does Geithner really think anything has changed at all? Are the financial firms under any more regulation? Have the banks been restrained at all? If he thinks the answer to either of those two questions is yes, he’s more deluded than I thought. Or captured by the very industry he’s supposed to be regulating. Nothing has fundamentally changed the financial world since the crisis. Banks are still holding tons of bad debt on their balance sheets, praying the economy will turn around. Consumer credit is largely a joke. Housing starts are a disaster. The real economy of the US is stillborn. Any lessons the Europeans can learn from us would be examples of what not to do.

When Obama was elected, he had the mandate to make sweeping changes to how things are done. Coming into office during the crisis gave him almost carte blanche ability to fix the problem. Instead, we threw trillions of dollars down the tubes bailing out banks that have since resumed extravagant management bonuses and continued to chase yield in highly risky investments. Instead of nationalizing the biggest banks and treating them as utilities, Obama and Geithner and crew took the money of the real economy in the US and handed it to Wall Street. Three years later, we are seeing what that bought us: zero job growth, a financial industry that still makes up 30-40% of GDP and the rich of Wall Street getting richer while America languishes.

On top of that, the lessons of the US are so drastically different from what is going on in Europe that it’s ludicrous to suggest they learn from us. They tried to create a monetary union without a corresponding political union and have discovered that won’t work. Or if they haven’t admitted it yet, they soon will possibly by the force of the bond market. The issues of the countries in Europe are not unlike the issues of the states and municipal governments in the US where they are constrained in their response to financial catastrophe. To suggest Europe react in the way the US did to the 2008 crisis is to fundamentally misunderstand what is causing Europe’s troubles.

The United States can always pay off any dollar denominated debt at any time by printing more money. This gives us the flexibility required to negotiate when things go south. The countries of the EU do not have this luxury since they signed onto the monetary union of the euro. When the debts of Greece come due, Greek politicians can’t devalue their currency by printing more of it to pay off the debts. Their only possible response is the one we’re seeing, that of austerity and devaluation at the cost of decades of low wages and growth. The citizens of Greece rightly see this as a bad move. To fix the problems in Europe, the EU members will need to have some way of unifying their fiscal policy across member states. Based on the responses we’re seeing from Germany, good luck with that ever happening.

From the beginning, it felt like the members of Obama’s financial team were under-experienced and unable to see how to effectively navigate us out of this crisis caused by years of easy money. Now, those same team members are making suggestions to the rest of the world on how to handle their own problems, problems that are sufficiently different in kind as to make comparison unwise. Our only hope is that not only do they ignore our advice but find a way to solve their problems before the financial world solves the problems for them via a market collapse. These days, it’s seems like that hope is named either Slim or None and both are on their way out of town.

Book Review – The Great Cholesterol Con

Let’s go on a little journey. Imagine if you will the following situation. A US pharmaceutical company, always on the outlook for ways to improve people’s lives, creates a drug that is exceptionally good at treating patients with chronic and acute pain particularly in cases of arthritis. The drug is submitted to and approved by the US Food and Drug Administration (FDA), that bastion of public protection, created to protect and promote public health. The drug gains worldwide acceptance among physicians who are treating patients with chronic pain. Over 80 million people worldwide prescribed the drug at some time. The pharmaceutical company has sales revenues of $2.5 billion in the fourth year of its acceptance because of its amazing success. This is clearly a story of the system working correctly, no? The research and development of a drug that is widely accepted, approved safe by the governmental agency designed to protect the public from rogue agents has to be a great success story.

Unfortunately that’s not the case. The drug described above is Vioxx. After 5 years on the market, it was voluntarily withdrawn by Merck after data in multiple studies showed that there was a dose-dependent increased risk of myocardial infarctions (heart attacks) among users of Vioxx. Over the course of its 5 year usage, it is estimated that Vioxx caused between 88,000 and 139,000 heart attacks, 30 to 40 % of which were fatal. There is some evidence that Merck either withheld data or reported it in a suspiciously favorable way that showed an increased rate of overall mortality from the FDA. At the very least, what we have here is an incident where a major pharmaceutical company had a drug that was exceptionally profitable. That drug was on the market for 5 full years before anyone managed to notice that it was definitely causing an increase in cardiovascular events and possible reducing the overall mortality of people taking it long term. The system does not protect us and can be easily manipulated by those most likely to profit.

This incident occurred through the usage of selective reporting of data in studies sponsored by the pharmaceutical company. Unfortunately, this is the norm in our current health environment. Studies and study authors are often directly sponsored by the pharmaceutical industry. Many times, the study data is directly interpreted by the industry. Since it is in their interest to present their products in the most positive light possible, it should come as no surprise that an incident like the Vioxx one came to be.

As it turns out, it’s entirely possible that another incident is ongoing except that it is 10 times as large as the Vioxx one above. Statins are a class of cholesterol lowering drug that had total sales revenues in 2009 of over $25 billion. They are led by atorvastatin (Lipitor) with a sales revenue in 2008 of $12.4 billion. The current thinking in the health industry today is that cholesterol is associated with cardiovascular disease (CVD) and thus, statins are prescribed to lower cholesterol in an effort to lower the risk of CVD. Unfortunately, the evidence to support such a conclusion is mixed at best and quite possibly not supportive of the conclusion at all.

That’s the thesis of the book The Great Cholesterol Con. The book’s author, Dr. Malcolm Kendrick, goes into great detail about the studies that have been used to support the cholesterol causes heart disease theory. He very clearly shows that the data is not nearly as ironclad as the pharmaceutical industry says, especially as it relates to cholesterol causing heart disease.

The main principle under discussion is the Diet-Heart Hypothesis which says that if you eat too many foods with saturated fat and cholesterol, the level of cholesterol in your blood will rise which will be deposited in the arterial walls causing them to thicken and harden which over time will lead to a heart attack or stroke due to a blockage in one of the arteries. This has been the main hypothesis for heart disease for many years. Unfortunately, it’s completely wrong.

It is Dr. Kendrick’s assertion that the hypothesis is flawed in two ways. First, the level of cholesterol in your blood has nothing to do with what you eat. The second, and more important, is that that doesn’t matter because cholesterol doesn’t cause heart disease. In support of the first point, the book uses a two pronged approach in support. The first is an analysis of what happens in individuals who have Smith-Lemli-Optitz Syndrome (SLOS) which is a an abnormally low cholesterol level. If you go to the above link, you’ll see that having abnormally low levels of cholesterol is horribly bad for us. And yet, we are being prescribed medicines by the millions to artificially lower our cholesterol. The second prong is explaining what the body actually uses cholesterol for. As it turns out, cholesterol is in high demand in the body, such high demand that you can’t possibly eat enough cholesterol to provide your body with the requisite amount. So the liver synthesizes 4 to 5 times the amount you eat just to keep up. If you eat less cholesterol, your liver has to make more. If you eat more, your liver makes less. This is called downregulation. It makes no sense at all that by eating less saturated fat and cholesterol, we’ll have less of it in our bloodstream because the liver is always going to produce the amount the body needs to function properly.

Regarding the idea that cholesterol and saturated fat don’t cause heart disease, Dr. Kendrick presents multiple examples of instances where either the saturated fat and cholesterol intake of populations drop but the rates of heart disease increase or vice versa. The two main studies here examine the effects of rationing on WWII Britain and the French Paradox. In WWII Britain, rationing forced the population of the UK to eat much less saturated fat and more vegetables and fish were eaten. During the 12 years this happened, the rate of heart disease trebled. The French Paradox is obviously one that most people are aware of. The French eat lots of meat, lots of cheese, lots of things that, if the diet-heart hypothesis were true, should mean an increase in heart disease across the population. Instead, the French actually have a much lower incidence of heart disease relative to other populations. There is other evidence presented in the book but these two alone provide data that how we are treating heart disease is wrong.

Returning to statins, the book argues that statins actually act not through a cholesterol lowering mechanism but through some other as yet unknown mechanism. Several studies are presented that show statins have an effect on heart disease regardless of cholesterol level in the study participants. In other words, even if you already have a low cholesterol level, statins occasionally protect you from heart disease. The presents a problem in the theory that the cholesterol lowering effects of the statin are responsible for the lower incidence of heart disease. Dr. Kendrick does believe that statins have some positive effect on the incidence of heart disease but that it is not because they lower cholesterol and the evidence he presents is compelling.

However, while you might be thinking that since they have a positive effect, it shouldn’t matter whether they act on cholesterol or some other mechanism, the reality of the situation is much less positive. Here are three facts supported by multiple studies concerning statins:

  • Statins do not reduce overall mortality in women.
  • Statins do not reduce overall mortality in men without heart disease.
  • Statins do not, therefore, reduce overall morality in >95% of the adult population.

What does all that mean? It means that even if you take statins and even if they reduce the incidence of heart disease, overall mortality is unaffected in 95% of the population. In other words, taking a statin will change what they write on your death certificate under “Cause” but the “Date” portion will remain unchanged. That means that while statins lower the incidence of death by heart disease, they increase the incidence of death by other factors. What you get out of years of paying through the nose for a statin prescribed to prevent heart disease is not a longer life but just a different kind of death.

Additionally, statins have a list of side effects and contraindications long enough to scare practically anyone that reads them closely. Remember how the body needs cholesterol to function properly? There are multiple incidences of people taking statins who suddenly have acute memory loss. This would make sense because one of the uses the body has for cholesterol is in the brain synapses. Statins are known to cause muscle pain and even rhabdomyolysis. The reduction of cholesterol in pregnant women may lead to very serious birth defects. The list goes on and on. And yet there are leading “experts” out there who think we might ought to put statins in the drinking water.

The pharmaceutical industry has a vested interest to the tune of over $25 billion in revenues in keeping statins at the forefront of the fight against heart disease even though it is abundantly clear that they have an almost negligible effect on overall mortality. This book goes into great detail the problems with statins, their minimal benefit to the greater part of the population and the grave dangers that are being overlooked in the widespread use of them. As in the Vioxx case, just because the pharmaceutical industry and the FDA says it’s good for you doesn’t actually mean it is. If you are on a statin or have been told by your doctor that you should be taking one, you owe it to yourself to read this book to see what you’re actually getting yourself into.