Tag Archives: inequality

Book Review: The Immortal Life of Henrietta Lacks by Rebecca Skloot

This was one of those books I just picked up almost at random as I was browsing round a Waterstones in Covent Garden one day. Having looked at the endorsements on the front cover, I was surprised as to why I hadn’t heard of it before. It seems to have garnered lots of praise and accolades yet I can’t recall a single reviewer ever mentioning it, nor had I seen it mentioned in the press. After buying it, it came back to mind recently when I noted it being mentioned in Adam Rutherford’s Creation.

What we have here is science told as a narrative. It is not only the narrative of the events and discoveries that were made, but also the narrative of the uncovering of the story. So while it starts out as a biography of Henrietta Lacks (prefaced by a personal story of how Skloot became interested in Henrietta) it expands its scope and becomes a part autobiography of Skloot’s battles to be able to tell Henrietta’s story, and that of her family.

Henrietta Lacks was a black American woman who died in 1954. The crux of the story is what happened shortly before she died. You see, she died young. She died of cancer. After her diagnosis a biopsy was taken from her cervix and the cells grown in culture. It is those cells that are the heart of the story. From here, we go back a short time and tell the story, as far as it is known of Henrietta’s life, growing up and getting married in the American state of Maryland.

The cells that were taken from her body were capable of being grown in a laboratory, something that scientists had been aiming for but had not been successful with. With these cells (named HeLa), it enabled labs across the world to be able to a variety of tests without doing them on living humans. After all, even though they were cancerous, they were still human cells and behaved as such. Skloot tells us the story of 20th century medicine from the cells’ point of view, both the good and the bad. Many of the greatest developments seen in the last 60 years have involved the HeLa cells in one way or another. Sometimes this was unintentional as it turns out that where other cells were grown in cultivation they were in fact contaminated by HeLa.

Coupled with this is the story of the Lacks family and their struggle to come to terms with Henrietta’s legacy. It was years before they even realised that her cells were being used for research purposes. When they did, this was around the time that details were emerging of the Tuskegee syphilis scandal where, if you’ve not heard it before (I confess I hadn’t), black people in America were deliberately infected with syphilis under the guise of free healthcare. So there was deep suspicion over what Henrietta’s cells were being used for and also who was profiting from them. Skloot’s role here was not only as someone researching a book but also of the one who helped the Lacks family, especially Henrietta’s daughter Deborah, understand what happened.

The book ranges over a number of diverse topics. One of those that I noted in particular was the development of medical ethics; not so much in theory, but the practice. For the descriptions (and yes, as a warning, they are quite graphic – particularly at the start of the book) may well strike you as particularly barbaric. The reason why this jars against a modern sensibility is that when the facts surrounding the lack of consent about what was done with Henrietta’s cells became more widely known within the medical community it spurred people into action.

As an aside, I encountered a slight confluence of issues as I read this, as I was also watching the American tv show, The Wire, during the same period of time as I was reading this (actually, I’ve been on The Wire all year; the book took about 3 weeks to read). But they are both predominantly based in the city of Baltimore and have a huge amount to say, in microcosm, of the state of racism in America in the last half a century or so.

One of the things that becomes clear, though whether this was the author’s intention, I’m not sure, was the sheer barbarism that still persists within what passes for a national healthcare service within America. One of the ongoing battles the Lacks has had, and a cause of their major gripes were that the vast leaps in scientific work as a result of Henrietta’s cells did not allow them the financial means to be able to pay for their healthcare. The USA remains a country so backwards that if you go to a hospital, they have the audacity to present you with a bill – which the rich usually pay for through insurance and the poor are made to go without. The concept of universal healthcare which is free at the point of need still hasn’t made the journey across the Atlantic.

The book has apparently become a standard text in some university courses on cell biology. That’s not because the science is overly technical, though what is there is excellently communicated, but because it is a story of one aspect of modern science that has rippled far beyond the Maryland origins of one bereaved family. C.P. Snow famously espoused the notion of the two cultures: humanities and sciences. Here, Skloot has woven the two together to make a fabric that is stronger than either and makes for a fabulous piece of writing. It is educating, enthralling and overall one of the best pieces of writing I have had the pleasure of reading. It was only because of the more immediate need to heed the words of Harry Leslie Smith that this missed out on being my top book of 2014.

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A Voter’s Manifesto (part 3 of 5)

Link to part 1

Link to part 2

Company Law

The current Companies Act 2006 states that directors must act in the best interests of the shareholders. It is a common maxim (though not stated quite as such in the law) is that the purpose of a company is to increase the wealth of a shareholder. I do not believe that this should be the highest priority. Instead I would propose writing the following two items into statute as the joint highest priorities a company can have:

  • A company should exist to provide a valuable good or service to its customers at a fair and reasonable price.
  • A company should exist to provide a consistent and reliable source of employment that pays a fair and reasonable wage.

The above two would entail some changes. For a few years now, there has been a growing call to improve upon the introduction of the national minimum wage by introducing a living wage. I would propose putting this on the statute book and would be subject to annual review in each budget, to ensure that the minimum wage is never less than the living wage.

I would also propose that companies should only make redundancies as a measure of last resort. At present, the law is far too lax about letting people go. Additionally, it is fundamentally wrong that anyone should be rewarded for making others lose their jobs, so directors should not be allowed to receive bonuses relating to years when more than 0.1% of the company’s workforce is made redundant.

Income inequality is a source of chagrin for many and has been shown to be linked to a wider number of negative social factors. Measures should be introduced to curb the increase in income inequality with the aim of ultimately reducing it. Therefore, on an FTE basis, upper pay restrictions should apply to ensure that the highest paid employees of a company or LLP shall not be paid more than 15 times what the lowest employee is paid. This is a generous allowance designed to ease the transition to a more reasonable pay differential, so the multiple shall be reduced by 0.5 each year for the course of the next parliament.

It is also recognised that there remains great gender inequality in senior management positions. To begin addressing this, it is tempting to propose quotas for a limited period of time, though I am no longer as convinced of the efficacy of this as I once was, so I propose something slightly different. Starting with public limited companies and large (>£100m revenue) private companies, any which have a gender split for directors and senior managers that differs by more than 15% from 50/50 for two consecutive years will be summoned before a parliamentary select committee to explain their recruitment processes. Any which are found to be inadequate will be subject to financial penalties.

Corporate Taxation

There are many changes that could be made to the current corporate tax structure. One of the greatest losses that the economy currently suffers is that of tax avoidance. Measures to reduce it have thus far lacked any teeth. One of the legal measures currently employed is that of transfer pricing, where, with agreement between companies and HMRC (usually with the aid of a professional accounting firm), charges may be made between companies which has the effect of moving profits around.

One simple measure to close the loophole would be to make any management recharge a non-deductible expense for tax purposes. They could still be used for accounting purposes to accurately reflect a true and fair view of the activities of a company. This is a tax adjustment only, with no changes to accounting.

This highlights the need for greater transparency in the relation between the corporate tax paid by a company and its accounting profits. As such, I would propose a change to the presentation of a company’s income statement. It should be presented in no less than 3 columns. A company may sometimes wish to present their accounts in more columns, with a middle column being adjusting items, with unadjusted and adjusted items on either side. The format I would propose would have the adjusted (i.e. statutory) results on the left hand side, with tax adjustments in the middle. The right hand column would then be the statutory results plus or minus the tax adjustments, thus showing the income statement as used for the tax calculation. All tax adjusting items should then be explained in the notes to the accounts.

The present tax system does not suitably recognise the vast differences in the kinds of businesses that operate in the economy. While it is right that tax be levied on the profits made, the current determining factor is the profit itself. To take into account the different scale of businesses, this should be changed to revenue. So I would propose the following rates:

On revenues less than £1m: 10%

On revenues of £1m-£5m: 20%

On revenues of £5m-£25m: 30%

On revenues of £25m-£100m: 37.5%

On revenues greater than £100m: 45%

To avoid jumps, this will apply on a tiered basis. To illustrate, let us say a company makes £120m of revenue and has a profit chargeable to corporation tax of £10m

The tax due then will be (with some numbers rounded):

(10 * 1/120 * 10%) + (10 * 4/120 * 20%) + (10 * 20/120 * 30%) + (10 * 75/120 * 37.5%) + (10 * 20/120 * 45%) = 0.008 + 0.067+ 0.3 + 2.344 + 0.75 = £3.469m or an effective tax rate of 34.7%

What this does is to raise additional tax revenues from the very large companies without putting unnecessary pressure on small businesses.

Personal Taxation

The single greatest improvement that the coalition government made was to increase the personal allowance at a faster rate than it had done beforehand. The personal allowance should be raised further to ensure that anyone on the minimum wage (recall, this will be increased to be no less than the living wage) should not be required to pay income tax.

Income tax should operate on the principle of ‘to each according their need, from each according to their ability’. On this principle, anyone who is not paid enough to live on should not be required to pay tax. Anyone who is paid more than they need to live on has a duty to pay a proportion to support the society they live in and from which they benefit in any number of ways, both financially and non-financially. Personal taxation should never be a penalty, though, so no one should ever be taxed more than they can afford. Those who are paid more than others should pay a higher proportion of taxation, just as structures in a building which are stronger should bear the greater load to support the building.

For those who are paid narrowly above the living wage, they can afford the least. So I would propose the reintroduction of the 10% tax band, for earnings in the first £7,500 above the personal allowance. Thereafter, the basic rate should be kept at 20% for the next £15,000, 40% for the next £20,000. The top rate of tax should be increased to restore the 50% rate and would be liable on earnings £60,000 above the personal allowance.

There has been some speculation in recent years about “recognising marriage” in the tax system. To specially favour one group of people is equivalent to penalising another. Therefore no group of people should be favoured or penalised by virtue of their marital status.

Loan sharks

The legal loan sharks should be recognised for the plague that are, an evil that scourges society. For all lenders, there should be a maximum lending rate. To begin with, that rate should be 10 times what the inflation rate is. The aim will be to bring that down, subject to an annual review.

Regionalisation

The recent Scottish independence referendum has shown that there is an appetite for greater regional powers. Yet the failure of the ‘Yes’ campaign to obtain a democratic majority also shows that nomatter how intense the feeling may be, such intensity counts for nothing in a democracy where widespread opinion is what matters. We also recall the ‘No’ vote made in a north-east referendum in 2004. As a result of these, I would not propose any further referendums on regionalisation over the course of the next parliament.

Coming out of this was the so-called West Lothian question. I have changed my mind on this recently. Previously I was in favour of the view that Scottish MPs should not be able to vote on matters which do not affect them. However, if one takes that as a principle and applies it to other situations other the cherry-picked example of Scottish MPs then one finds oneself in all sorts of knots. For example, I recall as a commuter working in London but living in Sussex I had no vote on the London mayoral elections, even though I spent the majority of waking hours in the city. Should one extend the vote to anyone who is significantly affected by the London mayoral election, then it becomes very tricky. And the maxim ‘English votes on English matters’ sounds good until you actually think about it.

So I would favour a limited move towards greater regional powers in order to address any existing inequalities, but this should be tempered by any prospect of creating inequality. This would entail an overhaul of the use of the Barnett formula.

Book Review: The Spirit Level Delusion by Christopher Snowdon

As I stated in my review of The Spirit Level, my intention was to read a counter-argument in order to get a more well-rounded view on the issues being discussed and thought through. As with that earlier review, I will also have to beware of my own potential bias, given my rather left-wing views. Having identified some flaws with detail of The Spirit Level, though whilst largely agreeing with the general drift, I approached this wondering if those same flaws would be picked up by Snowdon. Before purchasing the book, I didn’t do extensive research into the author’s background (neither did I do similarly with The Spirit Level), hoping, instead, that the evidence presented would be a sufficient basis upon which to build an informed opinion. Given the very premise of the book, I did not expect this to be in agreement with what Wilkinson & Pickett wrote, though I was interested in the approach taken, bearing in mind that it is probable that someone who sets out to write such a book has an existing prejudice against the values of fairness & equality which Wilkinson & Pickett are equally and oppositely biased towards.

Suspicions were first around before I even got to the first words of Snowdon. The foreword, written by someone called Patrick Basham from something called The Democracy Institute. This is a right-wing “think tank” that Basham founded and who appear to have been instrumental in getting this book written. The opening starts with praise for an earlier volume that Snowdon wrote in praise of the pro-smoking lobby. I have no hesitation in asserting that anyone who is in favour of smoking is seriously lacking in sound judgement. So the early impression of Snowdon and Basham was not positive. This was only the first paragraph. The rest of the foreword is a diatribe that seems to have been generated by some sort of ‘conservative clap-trap generator’.

Anyway, when Snowdon gets to writing, he doesn’t dive in straight away but looks at the methodology of the studies behind The Spirit Level. Key to the original book was the idea that economic growth had reached the limits of how it could benefit societies that were well-developed. In spite of the subtitle, Why Equality is Better for Everyone, the focus of the Spirit Level was not on all countries, but between economically developed studies. But Snowdon’s critique of the methodology results in him including some more countries than Wilkinson & Pickett used for their analyses. Interestingly, though, as a secondary measure in the original book, a comparison was made between different states of the USA. But Snowdon chooses to overlook this entirely and his book does nothing to attempt to discredit the evidence which came from this second set of data, relegating his ‘reason’ to an unconvincing footnote, inviting readers to visit a website which he set up.

He then progresses, chapter by chapter, to look at some of the specific studies carried out from The Spirit Level drew. Much of this is a fair enough critique, though as with the original, the conclusions reached are stated with greater affirmation than the evidence really justifies. So while Snowdon does a good job of casting doubt on some of the work done by Wilkinson & Pickett, he doesn’t get close to falsifying it. It is probably convincing for those who are already convinced, but it’s unlikely to win any converts.

Undermining his case is his misleading caricature of what The Spirit Level is all about. In several places, Snowdon tries to deceive his readers by supposing that Wilkinson & Pickett were proposing making societies more equal via tax-based wealth redistribution. In truth, they actually rule out progressive tax policies on the basis that they could be easily reversed by alternative governments. Snowdon even gives a partial quote which stated just this, but attempts to twist it to mean the opposite of what it does.

By about half way through, he clearly runs out of steam. His take on crime and imprisonment statistics is a mish-mash of non sequiturs with little coherence. Following this, he looks at infant mortality and spends 10 pages basically conceding the proposition put forward by Wilkinson & Pickett.

After this, Snowdon just goes to pieces. The last 60 or so pages contain little of any merit. Snowdon attempts to further mislead his reader by supposing that Wilkinson & Pickett’s primary aim was to put an end to economic growth, when in truth their idea was to recognise the limits of the good that economic growth may have and instead to focus on how to make societies more equitable. It might not be unfair to characterise Snowdon’s erratic rantings as those of a fundamentalist capitalist. He labours under the misapprehension that fairness and equality are the great evils that must be combated. While he attempts to placate his readers by stating forthright that he is not proposing greater inequality, everything else that he rambles on about belies this.

His final flourish is to look at the relation between correlation and causality. Though he is correct in stating that the former doesn’t necessarily imply the latter, he doesn’t actually engage with the argument (even though it was a vulnerable point in The Spirit Level) than Wilkinson & Pickett give. Instead, his argument, if followed through, would actually undermine the bulk of the better researched chapters of Snowdon’s own response. It seems he want to cross his bridges and then burn them behind him. What had some promise for being a revealing critique, with some good points made, ends up as the mad ravings of someone who is economically illiterate.

Book Review: The Spirit Level by Richard Wilkinson and Kate Pickett

To review this book requires some caution. Those of you who know me will be familiar with my politics, knowing it to be distinctly left-wing. As such, I came to this book with an acknowledged predisposition to agree with the premise, especially the subtitle, Why Equality is Better for Everyone. The caution needed then, is to attempt something resembling neutrality (an absurd concept, of course!) and avoid confirmation bias. From the outset, I will state that it is my intention to read a counter-argument to that presented in this book, much as I have done with my reviews of books relating to the New Perspective on Paul. To that extent, I have purchased, but not yet read, The Spirit Level Delusion by Christopher Snowdon.

The first thing that strikes you about The Spirit Level is the abundance of scatter graphs. If you don’t like these, then this book will annoy you. The authors have drawn together multiple studies (all of which are referenced) to demonstrate a number of different factors that are affected by inequality in society.

But how might one measure ‘inequality’? Though an intuitive concept, it seems like a hard one to make empirical – a bit like ‘justice’ or ‘faithfulness’. This is done by looking at the difference between the top 20% of incomes and the lowest 20% (presumably including those with no income, though this is not stated explicitly). The opening thesis is that in economically developed countries, economic growth has reached the limits of what can improve living standards. So by looking at 1st world countries (excluding tax havens) they look at how different epidemiological measures change with differing levels of income inequality within that given society. As well as looking at a list of roughly 23 countries (not all had data available for all measures), they also looked at the 50 states that make up the USA.

The text is basically a commentary and expansion on the scatter graphs, each of which has a line of best fit. What I noticed is how tentative some of them were. The samples included a lot of outliers, making the correlation far from convincing in some specific graphs. In others, the correlation was much stronger.

At the start of the text, the authors make the very correct point that correlation doesn’t imply causation; surely the mantra of any statistician. However, about 2/3rds of the way through, the book changes tone. It turns away from the giving of the evidence that developed societies with greater income inequality tend to have more social problems into a discussion on causality. This, however, was a bit a hand-wavey exercise. Though it makes for interesting reading, I don’t think the authors did the best job that they could have done and I am yet to be convinced of the causality argument, depending as it does on supposition and broad generalisations.

However, they carry on regardless, working on the basis of that correlation does correspond to causation. The remainder of the book is a sort of sketch manifesto on how to make society more equal. They are quick to rule out changes in legislation on the basis that any incoming government which is in favour of greater inequality could easily reverse any progress made. Instead they propose employee ownership of companies. The idea then is that executives’ pay would be easier to cap to a sensible multiple of either the lowest or the average wage of the employees. As interesting as this idea is, it does seem to operate on the level of a single company wholly operating in a single jurisdiction. Of course, most large companies are multinationals, with employees spread across the globe, being paid different rates and in different currencies. I think they were too quick to rule out progressive measures such a more equitable tax system or a maximum wage, but that’s just my view.

It’s well worth a read, whether or not you agree with the general premise. I don’t think they made the best case that they could. The end section where they respond to some of their critics is a little weak. That’s not to say the direction they’re headed in is wrong. I think there is an abundance of evidence presented to show that societies that have greater income equality do have more desirable qualities. I think it would be a total nonsense to argue for greater inequality, though there may be many less empirical ways of thinking of inequality which the authors have not considered.

This is not the answer to the problems in developed countries, but it is a step in the correct (i.e. left) direction.