Here are three interesting links I came across recently. Though they are apparently about three different fields, namely, drug discovery, higher education and establishment liberalism- all three are about manifestations of the same underlying trend. And what is that trend? Well.. let me put it this way. The rather disappointing results for what was hyped as the next multi-billion dollar drug, the role of credential inflation in the success of for-profit colleges and the willingness of supposedly ‘liberal intellectuals’ to spout ideas that are conservative in all but name are three aspects of the same problem.
They are all examples of what happens when large centralized systems are run by people who want to live in their manufactured reality- even when it has no connection to the real world. Putting hundreds of millions into a drug discovery program based on the trendiness of the idea is really not that different from hiring people based on paper credentials or ‘liberal intellectuals’ spouting dubious conservative talking points about race and class. They are different manifestations of the so-called ‘meritocratic’ elite repeatedly fooling themselves to the detriment of others without suffering any personal negative consequences.
Link 1: PCSK9: Real World Data Arrives, Unfortunately
This morning we have three-year data from Amgen and their drug Repatha (evolocumab), an announcement that has been eagerly awaited. And it’s honestly not all that impressive. There’s a 15% relative reduction in cardiovascular risk (heart attack, stroke, etc.) relative to placebo, but investors were looking for something more over 20%. Insurance companies were probably looking for that, too, and given the price they’d have been happier to see something more like 25%. Amgen is defending the data (as quotes in this Adam Feuerstein piece show), but I don’t think that’s going to do the job. The numbers shouldn’t have to be interpreted and spun; in a three-year study with over 13,000 patients in each arm, the numbers should be able to speak for themselves, and they don’t.
Link 2: Credentials, Jobs and the New Economy
That kind of professionalization and educational inflation falls under the “declining internal labor markets” rubric of the new economy. Unlike in the past, when experience and subsequent licensures might be obtained through an employer — in this case, a hospital — the expectation now is that workers will increase their human capital at personal expense to “move up” the professional ladder. Janice’s choices for promotion were limited: she could hope for favorable reviews from a sympathetic management culture (a risky proposition) or earn a bachelor’s degree in nursing.
Political wrangling over job statistics looks like action, but it is mostly a distraction. Sociologist David Brown has shown that credentials can be created without jobs to justify them. We produce risky credentials when how we work changes dramatically, and the way we work shapes what kind of credentials we produce. If we have a shitty credentialing system, in the case of for-profit colleges, then it is likely because we have a shitty labor market. To be more precise, we have a labor market where the social contract between workers and the work on which college has previously relied has fundamentally changed and makes more workers vulnerable.
Link 3: Liberals and diversity
More and more, it seems like liberals in The Discourse agree with this basic conservative assessment of how diversity affects society. But, despite that underlying agreement, they somewhat bizarrely resist the conservative conclusion. Despite telling you that they think increasing diversity will result in children going hungry, as well as the mass incarceration and widespread discrimination of minority groups, they nonetheless support it. If liberals are going to adopt the conservative view on how diversity operates in society, then they really do need to also work out what they think the implication of it is. Conservatives are very clear: diversity has all these problems and so it should be restricted. But the liberal view — that diversity has all these problems and yet it should be expanded without restraint — is just incoherent on its face.
Beauchamp’s article gives a clue as to where liberals will go with this. Since they believe 1) diversity is incompatible with justice, and 2) that diversity is important and good, they will reach the conclusion that 3) justice should be sacrificed in order to “beat” right-wing populism. As Beauchamp notes, pursuing a more economically just society “could actually give Trump an even bigger gun” because it flies in the face of the immiseration of racial minorities that majority groups in diverse societies necessarily demand. Thus, it would seem the only way forward is to give in to the bloodthirst a bit in order to stave off an even bigger atrocity.
What do you think? Comments?