Public Policy Review #1

Feat. Echo chambers, narratives, medical device regulations, and radically networked societies

Oct 27, 2019

Insight: Echo Chambers are Positive Feedback Loops

First, I should mention that people use the term ‘positive feedback’ incorrectly. Unlike what it conveys in ordinary English, positive feedback is terrible for policymaking. Positive feedback, in fact, makes a system unstable.

An example of a positive feedback loop is an online echo chamber. A partisan view receives positive feedback from others who think on similar lines. What remains in the steady-state is an extremely polarised opinion. In contrast, negative feedback stabilises a system. A professional newspaper’s editorial board, for example, will tone down the rhetoric of all political sides.

India Policy Watch: Regulating Medical Devices

Johnson & Johnson’s faulty hip implants are now having policy-level fallouts (read this explainer). Livemint reported that the Ministry of Health and Family Welfare plans to bring in all medical devices under the purview of the apex drug controller effective December 1.

What unintended consequences can we anticipate?

Dinesh Thakur writes that:

This attempt to deliberately retrofit medical devices into the Drugs and Cosmetics Act will lead to a toothless regulatory framework for devices, similar to what exists for drugs today.

He gives two reasons for this claim:

The Drugs and Cosmetics Act cannot be used to penalise manufacturers of sub-standard medical devices. A second-order effect being that ‘companies that make defective products will recall them from foreign markets while continuing to sell the same product in India, and comply with the law.’
The new regulation will not benefit the aggrieved patients as there is no provision for a confidential patient register to record all details of implants. Notably, in the J&J case, more than 3,600 of the 4,700 patients could not be traced as hospitals had no incentive to disclose this information and open themselves up to more scrutiny.

My present view is that reason 2 is the more serious one and as Thakur writes, a patient register can help solve this information asymmetry problem. Reason 1 itself is a transient-state problem and fixing it is not impossible.

The March of Radically Networked Societies

Tyler Cowen has an article on the violent demonstrations that have rocked cities in more than two dozen countries just this year. What’s changed is the nature of protesters. Specifically, Tyler writes:

protests of workers seem to be becoming less important, and protests of consumers are becoming more important. And the internet crucially is making it possible to mobilise these consumers.

My hypothesis is that this structural shift has been made possible precisely because the internet allows consumers with dispersed interests to mobilise at lower costs and higher scales. We call this concept Radically Networked Societies at Takshashila, defined as:

a web of connected individuals, possessing an identity (imagined or real) and motivated by a common immediate cause.

The conceptual framework is illustrated below:

What’s interesting is that though RNS existed in the past, the internet as a medium has thoroughly changed the scalability, speed and depth (the technological aspect), making it easier to bring latent identities and causes to the fore in some cases, or to create entirely new causes and identities.

What we see today is a clash between contemporary hierarchically ordered states and their radically networked societies. The information flows much faster in a network than in a hierarchical structure. Hence, states are struggling at counter-mobilisation against RNS.

For more on RNS, a couple of papers here:

Reading for the Week

This paper by Philip Zelikow elucidates the concept of ‘Policy Engineering’. He first likens policymaking to engineering as applied disciplines concerned with getting things done. He then goes on to say that unlike engineering, courses in public policy do not equip students with the tools that can help them in the real world.

His solution for doing and teaching policy engineering then? Here:

I break the engineering methods down into three interacting sets of analytical judgments: about assessment, design, and implementation. In teaching, I lean away from new, cumbersome standalone degree programs and toward more flexible forms of education that can pair more easily with many subject-matter specializations. I emphasize the value of practicing methods in detailed and more lifelike case studies. I stress the significance of an organizational culture that prizes written staff work of the quality that used to be routine but has now degraded into bureaucratic or opinionated dross.

Narratives in Public Policy

I found it interesting that climate change is now being used as a metaphor to describe wicked problems in public policy. ‘Issue X is the climate change of sector Y’ is a formulation to indicate that solutions to issue X require a change in the behaviour of a large number of individuals.

See one version of this from the MIT Technology Review’s special issue on old age:

The aging population is the “climate change of health care,” Kennedy says. It’s an appropriate metaphor. As with global warming, many of the solutions rest on changing people’s behavior—for example, modifications to diet and lifestyle. But, also as with global warming, much of the world seems instead to be pinning its hopes on a technological fix.