If you haven’t noticed I have less than no interest in the outcome of the Iowa caucuses. Their structure is so eccentric nothing reasonable can be deduced from them. So Trump won’t be competing with Ramaswamy for the nutcase vote any more. Surprise.

I don’t know if I’ve said it before but to my eye the worst case outcome is a rematch of 2020 with Trump’s supporters 100% angrier than in 2020.

I found this article at Nature by Mariana Lenharo interesting:

An artificial intelligence (AI) system trained to conduct medical interviews matched or even surpassed human doctors’ performance at conversing with simulated patients and listing possible diagnoses on the basis of the patients’ medical history1.

The chatbot, which is based on a large language model (LLM) developed by Google, was more accurate than board-certified primary-care physicians in diagnosing respiratory and cardiovascular conditions, among others. Compared with human doctors, it managed to acquire a similar amount of information during medical interviews and ranked higher on empathy.

“To our knowledge, this is the first time that a conversational AI system has ever been designed optimally for diagnostic dialogue and taking the clinical history,” says Alan Karthikesalingam, a clinical research scientist at Google Health in London and a co-author of the study1, which was published on 11 January in the arXiv preprint repository. It has not yet been peer reviewed.

I had several reactions. First, this is exactly what I have been saying for decades. If the skills required are rote memorization and using clinical findings to diagnose conditions, a properly designed algorithm will beat human physicians. But the finding that the the LLM chatbot had greater empathy is the key one.

Which leads to my second observation. I don’t know whether physicians will fight the encroachment of machines on their turf but they shouldn’t. The effect of AI on medicine will be to make human physicians more productive and accurate. But that’s not all.

AI in medicine will change how prospective physicians are selected. We won’t need rote memorization and using clinical findings to diagnose conditions as much anymore. Gone will be the days when you doctor is frozen to a computer screen. What will be needed is human physicians who can work in collaboration with these chatbots to achieve better outcomes more quickly than human physicians alone.

Among those skeptical about our ability to deter the Houthis is Dianne Pfundstein Chamberlain. She expresses her thoughts in a piece at The National Interest. Basically, she thinks we’re trying to deter the Houthis on the cheap. A sample

In the early hours of Friday, January 12, the United States and the United Kingdom launched strikes against the Houthi rebel group in Yemen. The first strikes were aimed at more than sixty targets across sixteen different sites and were focused on missile, radar, and drone facilities controlled by the Houthis. A second wave targeted twelve additional sites, while a follow-on attack in the early hours of Saturday, January 13, struck a Houthi radar site. Although the strikes damaged or destroyed ninety percent of their targets, the Houthis retained approximately three-quarters of their drone and missile capabilities.

At this point our strikes have had the opposite effect if any. She explains:

In my book, Cheap Threats: Why the United States Struggles to Coerce Weak States, I examine why the United States struggles to coerce weak states like Iraq, Afghanistan, and Libya. The argument draws on the logic of costly signaling, which asserts that signals must be costly for the sender in order to effectively signal high levels of commitment; by contrast, “cheap talk” cannot convince the receiver that the sender is highly resolved. In other words, signals that are cheap and easy to send do not convey any information about the sender’s underlying resolve or motivation.

While I agree with her conclusion I don’t agree with her reasoning. I don’t believe that the problem is that we’re not spending enough. The opposite, if anything. What we’re doing isn’t cost-effective. As I see it the problem is similar to the one we faced in Afghanistan. The Houthis have no centralized command and control. For an airpower strategy to be effective we’d need to strike a lot of worthless targets and kill a lot of people who don’t have much to do with the attacks on Red Sea shipping. Not only would an air-sea-land invasion of Yemen be horrendously expensive, we’d need to be prepared to occupy the entire country to eliminate the attacks on shipping.

And, as I’ve pointed out before, one of the effects of our attacks is to boost their repute which attracts money not just from Iran but from others in the Gulf who hate us and there’s no lack of those.

To use an analogy I’ve applied before in a different context, when a neighbor’s dog bites your kid, don’t talk to the dog. Talk to the neighbor.

At Project Syndicate Carla Norrlöf outlines what she refers to as the “requirements of global economy and security”. Here’s a sample:

As recent years have shown, geopolitics can profoundly affect the global economy, reshaping trade, investment flows, and policies sometimes almost overnight. Aside from their devastating human toll, wars like the Russian invasion of Ukraine and Israel’s campaign in Gaza often reverberate far beyond the immediate theater of conflict.

For example, Western-led sanctions on Russia, and the disruption of Ukrainian grain exports through the Black Sea, caused energy and food prices to soar, resulting in supply insecurity and inflation on a global scale. Moreover, China has deepened its economic relationship with Russia following the mass exodus of Western firms in 2022 and 2023.

concluding:

All governments will need to grapple with these tensions as they develop a new economic-security agenda. The world is quickly becoming more adversarial and fraught with risk. To maximize both security and prosperity, we will have to understand the complex interplay of forces that are creating it.

I see her article as a lament for the Pax Americana which is truly gone. We shouldn’t be too surprised. As much time has elapsed since World War II and today as did between the American Civil War and World War II.

In my view we should stop longing for a return of the Pax Americana because it isn’t coming back and turn our attentions to our own security and economic needs. For my part I think we should focus on our interests in Central and South America and ignore the Middle East. Note that at present our trade with Mexico exceeds our trade with China.

If, on the other hand, we remain committed to being a world-spanning superpower, we need to reindustrialize and do it quickly. You can’t be a world-spanning superpower while dependent on other not necessarily friendly countries for defense procurement.

I’m going to restrict the three scenarios outlined by Philip Breedlove in Brendon Cole’s interview of him at Newsweek to just one:

“If the West chooses to give Ukraine what they need to win, Ukraine will win this war,” the four-star general said. “This war is going to end exactly how Western policymakers want and desire it to end.”

because that’s the only one that doesn’t result in outright victory for Russia. Let me translate it for you. Since neither the United States nor Germany nor France nor the United Kingdom nor all of us put together have sufficient inventories of what Ukraine needs to win or the basic industrial productive capacity to produce them, we must abandon green fantasies and start building up our productive capacity and making more munitions. That’s what “choosing” that alternative requires.

Since this is an election year, President Biden does not have the political capital, and, let’s be frank, he has shown few signs in his political career of being a sufficient “profile in courage” to abandon thoughts of re-election to promote rapid reindustrialization at the expense of support from the progressive wing of his own party, that appears very unlikely until 2025 at the earliest.

On the occasion of the Martin Luther King holiday, I thought it appropriate to pass along this interview by Francesca Block at The Free Times of Clarence Jones, Dr. King’s key speechwriter and confidante. If you’re disinclined to read the whole interview Mr. Jones’s message is:

1. Dr. King’s messages of “radical nonviolence” and cultivating allies across ethnic lines have been forgotten.
2. Scholars, black or white, who claim that America has not made progress on race are lying.
3. We should not be “colorblind” but equality should not be conditional on race.
4. America is not irredeemably racist.
5. School curricula that make marginalization of black, Hispanic, Native American, and Asian American peoples central are a step in the wrong direction.

He concludes:

“Commit yourself irredeemably to the pursuit of personal excellence,” he says emphatically. “Be the very best that you can be. If you do that. . . our color becomes more relevant, because we demonstrate ‘black is beautiful’ not as some slogan, but black is beautiful because of its commitment to personal excellence, which has no color.”

You will note that is completely consistent with what I have been saying around here and is also consistent with what figures like Dr. King and Booker T. Washington have said.

The Houthis continued to attack ships passing through the Red Sea subsequent to U. S., U. K., etc. counter-attacks on Houthi positions. Their claim has been that they are attacking ships that are “affiliated with Israel”. Judging by the reports by Ambrey Analytics, that’s a stretch. In practice it seems to mean any ship other than a Russian or Chinese ship regardless of destination or cargo.

I continue to be puzzled about the tactical or strategic objective of our attacks on Houthi positions. If it’s to end Houthi attacks on Red Sea shipping it certainly looks like a flop. If it’s to show resolve, that’s not a tactical or strategic objective but a message intended for domestic audiences.

In his Washington Post column Jason Willick questions some prevailing wisdom about immigration policy:

In the early 2010s, as tea party Republicans bitterly clashed with President Barack Obama, political scientists and pundits popularized a comforting theory to explain America’s growing partisan divide. “Asymmetric polarization” held that while it might seem as though the parties were drifting apart simultaneously, that was an illusion: The Democratic Party was holding more or less steady while the GOP radicalized.

“We should be careful not to equate the two parties’ roles in contemporary political polarization: the data are clear that this is a Republican-led phenomenon,” wrote four political scientists in 2012.

It’s time to retire this conventional wisdom, which distorts debates about U.S. politics. The latest evidence comes from a study of immigration opinion in Public Opinion Quarterly, an academic journal published by Oxford University Press. Immigration has been perhaps the most polarizing issue of the past decade: It was the subject of Obama’s most boundary-pushing uses of executive authority and the key issue in Donald Trump’s outsider bid for the Republican nomination in 2016. Now border security is roiling Congress and could prove decisive in the 2024 election.

Partisan opinions on immigration have indeed polarized, as these events suggest. But it’s Democratic opinion that has driven the partisan divorce, as Trent Ollerenshaw of Duke University and Ashley Jardina of the University of Virginia show in their paper, “The Asymmetric Polarization of Immigration Opinion in the United States.” They write: “Among Republicans, opinion on immigration has remained mostly stable” since the 1990s. Meanwhile, “the marked liberalization in immigration opinion among Democrats has left partisans more divided on immigration than at any point since national surveys began consistently measuring.”

Americans’ average feelings toward immigrants who are in the country illegally, for example, “have grown warmer” since 1988 — from 37 out of 100 in 1988 to 42 in 2004 to 49 in 2020. But “these warming trends emerged only among Democrats,” the authors note, so that “the partisan divide in evaluations expanded from 8 points in 1988 to 28 points in 2020.”

This morning on one of the talking heads programs I heard Illinois Gov. JB Pritzker laying the blame for our immigration problems solidly on Republican intransigence. He, apparently, has never heard the expression “poisoning the well”. Democrats have supported what they refer to as “comprehensive immigration reform” and somehow their version of comprehensive immigration reform always includes the legalization of those already here illegally.

It’s not a coincidence that Republican views have remained stable since the 1990s. That was when it had become clear that Reagan era immigration reform which included what was then referred to as “amnesty” had not reduced illegal immigration and, if anything, had increased it. Gov. Pritzker has also, apparently, never heard of the idea of moral hazard.

The editors of the Washington Post react to our attacks on the Houthis who have been attacking shipping in the Red Sea:

The U.S.-led airstrikes against targets in the Houthi-controlled parts of Yemen represent a new level of American involvement in the Middle East upheaval that began Oct. 7. Some regional analysts are already warning that the action plays into the Houthis’ hands, and risks igniting a wider Middle East conflagration, without much chance of having their intended effect: to deter further Houthi attacks on international shipping.

Precisely the opposite is true. The Houthis already escalated the regional conflict, by using the pretext of Israel’s war with Hamas to launch unprovoked attacks against commercial ships traversing the Red Sea. The United States and its coalition allies — Britain, Canada, Australia, the Netherlands and Bahrain — had little choice but to mount a strong response. And this coalition employed just the right amount of proportionate firepower. If the Biden administration could be faulted for anything, it is that the same effort taken sooner might have had greater effect.

and

The Houthis’ leadership has made its strategic objective clear from the start; its goal was to draw the United States into a fight, ostensibly to show solidarity with Hamas. Having taken over Yemen’s capital, Sanaa, in 2014 and endured a civil war and a bloody Saudi Arabia-led bombing campaign, the Houthis survive — and thrive — on never-ending conflict. Actual governance is not their forte, as their official slogan indicates: “God is the Greatest, Death to America, Death to Israel, Curse Upon the Jews, Victory to Islam.”

concluding:

We have no illusion that these airstrikes mark an end to the conflict, and the Houthis have already vowed retaliation. But the United States, with wide support, open or tacit from other countries, has sent a strong message. Let’s see how it’s received, by the Houthis and their patrons in Tehran.

I haven’t argued that our attacks on Houthi positions were unjustified or disproportionate but I do question whether they are achieving any tactical or strategic objective. The very fact of our attacks prove that the Houthis have been successful in achieving their military objective in harassing Red Sea shipping—it has drawn us into the conflict. Whether that’s prudent of them or not is another question.

I wish the editors had made a case that our attacks on Houthi positions were reducing support for them in the Gulf region. That, at least, would have provided evidence that we were achieving a reasonable objective. Alas, they did not.