The Second Best is a Formal Order

The desires of the heart are as crooked as corkscrews
Not to be born is the best for man
The second best is a formal order
The dance’s pattern, dance while you can.

~ W.H. Auden

If you’re a close friend and had a conversation with me yesterday, you probably heard me talk a lot about British history — you probably even heard me express some ineffable sense of gravity at the death of a British monarch. Parts of Twitter have been unfailingly funny in mocking those who believe in such an archaic mechanism as monarchy. And who can blame them? Being the symbolic head of a state which has repressed and killed populations around the world is unlikely to earn Elizabeth II a lot of beatifying eulogies from erstwhile conquered peoples.

However, while the British empire does not need to be offered deference, there is another reason we might feel gravity and respect, and want to pay tribute to their constitutional culture and its resilience. The UK has a successful constitutional system, the rule of law, and real democratic accountability. In order to appreciate how rare this is, one must recognise that constitutions are fragile illusions, and their sole source of strength is a sense of gravity, of belief in tradition. More than politics, what animates this moment is ceremony, these are matters of custom and style — the remnants of an archaic constitutional settlement of extraordinary longevity whose forms still retain some of their old power to inspire respect and awe.

Why do I feel so strongly about this? As Matt Levine puts it, principles — like constitutionalism, the separation of powers, or the freedom of the press — do not enact themselves. They persist “because the people constrained by them believe themselves to be constrained by them.”

[These principles are] checks on power only as far as they command the collective loyalty of those in power; they require a governing class that cares about law and government and […] tradition, rather than personal power and revenge. Their magic is fragile, and can disappear if people who don’t believe in it gain power.

And remembering this is doubly important in India, where constitutionalism is still a facade over the fundamental failings of the rule of law. Daily, we receive reminders that the only laws that truly exist are the physical laws of the universe. Everything else is merely an arrangement of convenience. If different people held power, things would be different — including the constitutional order.

Legal realists throughout history have understood this. As Holmes said, the life of the law has not been logic, but experience, and "[t]he substance of the law at any given time pretty nearly corresponds, so far as it goes, with what is then understood to be convenient; but its form and machinery, and the degree to which it is able to work out desired results, depend very much upon its past." What law officers in India today argue, and what governments do, is a compromise between convenience and ideology — but they must make those arguments in the constitutional courts, in the language of rights, and with the respect that is appropriately due to the law lords.

Perhaps you would feel a little more respect for English tradition if you understood how steeped we are in it. When you make a claim before a constitutional court, what you are really doing is invoking history. When you claim the principles of equity and fairness, you are calling upon the product of a tradition that began with the curia regis and the Lord Chancellor. If you learn the history of the criminal law, you will learn that the transition from blood vengeance to the burden of proof took a long time, and that virtually none of it was certain, and all of it was hard won.

Absent these traditions, it takes embarrassingly little for the rule of law to be replaced by a fight for a knife in the mud. We must cherish these principles and the tradition and history that they represent. The moment we stop believing in them, the mirage will shimmer and dissipate. But as long as they persist, they can be summoned in the face of reaching claims from ambitious statesmen, whether they are progressive or regressive. ‘No,’ we can tell them, ‘you cannot wish away or dissipate this recent past — constitutionalism and all the rest — so easily.’ As long as we live by the common law and its progeny, we are bound in an inexplicable sense of mutuality, parties to a shared network of obligation. This bond is the physical feeling of malaise at the thought of a man, however dangerous, being imprisoned without trial, or the flutter that arises from the English dictum that a judge shall put aside all other business and take up first the matter involving the liberty of a subject.

Perhaps you derive those principles from less archaic forms. But it helps, sometimes, to have talismans and tokens and a sense of history. It lets us summon ancient curses and a cerebral stampede against the person who suggests that rights-based systems should be replaced by an economic cost-benefit analysis; or against the craven lawyer who argues that bulldozing homes without fair notice is required in the national interest. In the face of bulldozers, there are no philosophical debates about first principles and anarchism and empathy. No, our best and only hope is to teach people a litany to ward off demons: “Because the Magna Carta, because the common law, because the Constitution, because the oath of office, because कानून.”

Mere days ago, we celebrated the grant of bail to a political prisoner who had been detained for far too long. That grant of bail was the direct result of the ascent of a new Chief Justice. Gentle reader, it is not for me to say that this is not the rule of law; it is for you to say that. So, to answer your derision, perhaps my love of ceremony has something to do with the fact that I am a citizen of the Republic of India, where so little is stable, where so little can be taken for granted, where so little is governed by constitutional ceremony,  and where so much is decided by apathy and force.

I hope you will forgive, meanwhile, my goosebumps and my awe as I watch a system go through royal succession — as the Queen’s Counsels plead allegiance to a new King, as Regina becomes Rex, and as the First Lord of the Treasury offers her condolences to a functioning Parliament whose sovereignty was only recently defended by an independent Supreme Court.

And so the rule of law carries on, held up by a collective Atlas of brave lawyers, scholars, activists and politicians, bureaucrats, businessmen, and citizens who refuse to accept that the Constitution is only a parchment promise. I will not begrudge you if you think me naive — I probably am — to aspire to a system while detesting its colonial history, or to think that there could be anything to feel as the colonialists grieve. To paraphrase Auden, perhaps I believe, in the absence of perfect justice and the settlement of all wrongs, that the second best is a formal order. And while the tune is not quite catching in our republic, we can only whirl harder, and dance, dance, dance until we drop.

What I've been reading (September 2022)

Book Haul

  • Daniel Kahneman, Olivier Sibony, and Cass R. Sunstein, Noise: A Flaw in Human Judgment (2021)

  • Abhijit V. Banerjee and Esther Duflo, Good Economics for Hard Times (2019). Banerjee and Duflo are really, really good popular writers. While this is not *unheard of *among economists, it is really quite rare. Whatever you think of the policy positions, you’ll enjoy reading the book.

  • Rukmini S., Whole Numbers and Half Truths: What Data Can and Cannot Tell Us About Modern India (2020)

  • Stuart Russell, Human Compatible (2019). I want to thank Impact Books and Effective Altruism.org for shipping me a free copy of Russell’s Human Compatible. AI alignment research is an area I’ve neglected completely and it should be fun to dig in!

It’s been a long time since I went shopping in a physical bookstore - highly recommended. If nothing else, I got a sense of what’s being published, what’s new, and what the space in various genres looks like. They’re going to be a hassle to transport, but it’s the kind of hassle that’s easy to romanticise.

HPMOR

I’ve also been reading a lot of fiction. Howeve, instead of rereading my sparse collection of literary fiction or picking up a new Murakami, I regret to inform you that I have uncharacteristically plunged headfirst into Elizer Yudkowsky’s Harry Potter and the Methods of Rationality (link for mobile users). It’s a fanfiction where Harry Potter is a very, very annoying but *funny *hyper rationalist eleven year old with ambitions of remaking the world. I don’t know what the general standards for writing in fanfiction are, but this is not impressive. Part of me regrets this - part of me is enjoying the guilty pleasure. I feel like I will give up midway, but I’d recommend you at least try it - though you need a *lot *of tolerance for pretentious characters.

New Labour

I *really *enjoyed getting into British political documentaries. Particularly, I love reading about New Labour. I got through sets of memoirs — Tony Blair’s My Journey; Gordon Brown’s My Life, Our Times; David Cameron’s For the Record — over the last month. I also enjoyed watching documentaries. Particularly, a series with footage from inside Gordon Brown’s team when he was Shadow Chancellor and when he became Chancellor. The New Labour Revolution series from the BBC is also worth watching if you want a couple of perspectives.

Academic Reading

  • I’ve been curious about the research on social mobility for a long time — and the weekend gave me some time to get started with Raj Chetty’s very famous Where is the land of Opportunity? The Geography of Intergenerational Mobility in the United States (Chetty et. al., 2014). (“We use administrative records on the incomes of more than 40 million children and their parents to describe three features of intergenerational mobility in the United States.”)

  • I enjoyed reading Joseph Freer’s If I was the minister of health: democratising healthcare (Freer, 2021). Freer is opposed to the pro-market, privatising impulse in UK Health Policy. If he were health minister, he would change the constitution, establishing a separately elected legislature, along with a separate and expanded executive for health. Well, not just for health; under Freer's constitutional structure, the Ministry of Health would subsume three or four portfolios in the modern cabinet, with ministers under it having separate responsibilities for housing, welfare, social care, the NHS, public health, and patients.  Each of these seven "health" ministers would now have a seat in cabinet. 

    Now, I am somewhat suspicious of those who tell me that their policy goals require a permanent constitutional revolution. Since Freer does not want to go to the trouble of securing the health budget and ensuring more collaboration between ministries, he has decided that he will turn over the table instead. Freer would be running in an election in which the sole purpose was the promotion of health, instead of a budget that balances investment, growth, or defence with social spending.

    One must appreciate Freer's candor; unlike many other first-time ministers, he is open about his desire to tell the Prime Minister to sod off and to consolidate all available power under his portfolio. I am only surprised that he did not bother to annex the Ministry of Defence; what with cruise missiles and landmines being somewhat deleterious to a healthy and balanced lifestyle. 

    But this is expected. Freer is, of course, being modest when he suggests that he would consolidate in the Ministry of Health every aspect of human life from conception to death. He has small, incremental ambitions, like creating a legislative assembly separate from Parliament. I sometimes suspect that if they made a lepidopterist the minister for endangered species, he would quickly abolish the Magna Carta to preserve some speckled blue wing-flapper of unknown origin. 

    "Now, come, soyons raisonnables," you say? Alright. Let us be reasonable. 

Math

I’ve slowly begun to realise that my math skills are atrocious. I thought I could proceed straight into enough statistics for the social sciences. Naturally, I put out a call on Twitter.

@annihalated: Are any of you good with discrete math or stats? please do DM - would love to talk.

Various people were kind enough to reply, but talking to them quickly made me realise that I needed to revise starting all the way back to algebra. If anyone wants to teach me math, send me their favourite textbooks, or tell me about how they started relearning math in their twenties, do let me know! For now, I’m starting with AP Statistics and Youtube videos. Also, while this may not be particularly useful to me, I’m really enjoying reading about set theory!

Other Links

This analytical approach to style is so common that it can almost feel natural. On menswear message boards such as StyleForum, nearly every discussion feels like it’s part of The Dialectic, where members argue like Athenian philosophers or Tibetan monks over whether blue pairs with black, or if a shoulder seam is sitting in its “correct place.” If you look below the surface, however, you’ll find this approach has some important underpinnings that date back to the Enlightenment. Immanuel Kant, at first glance, seems like an unusual figure to reference in menswear. He was not particularly interested in clothes and had a generally negative view of fashion. Among his three critiques, he’s most famous for his first book, The Critique of Pure ReasonThe Critique of Judgement, sometimes called the “third critique” because it came last, is the one that concerns itself with aesthetics. It seems like a diversion for a German idealist who primarily wrote about epistemology and ethics. However, Kant’s contemporaries Schelling and Hegel considered it one of his most important works (Schelling once advised students to read the three critiques in reverse order). Widely regarded as a seminal work on modern aesthetics, The Critique of Judgement has influenced how we view everything from paintings to pinstripes.

Government Health Spending in India

This is a strange graph. Usually, governments spend more on healthcare as they become richer. Between 2000-2018, India’s GDP grew from $468 billion to $2.7 trillion. In the same period, Chinese Government Health Spending (GHS) grew from one percent to nearly three percent of GDP. In India, however, GHS stagnates at around one percent. Relative to GDP, India has one of the lowest public health budgets in the world.

Government health spending (the Union and the States combined) makes up less than a third of total health expenditure in India. And formal insurance schemes make up less than a tenth. Most healthcare costs are paid by patients out of pocket, and most of that goes to medicines, diagnostics, and outpatient care.

Why isn’t more money going to health? Health and education, Amartya Sen keeps telling us, are central to sustained economic growth.1 This is, of course, a product of the slightly important fact that people end up living longer, healthier lives. Why wouldn’t India want a thriving, healthy middle class and profit from that demographic dividend everyone keeps talking about?

Potential Causes

One explanation is that healthcare, as an issue, has not become a persistent electoral demand.2 While India is not particularly spendthrift – government spending was only about 18% of GDP in 2021 – we are capable of significant social spending when the electoral incentives align, such as when we fund massive food and fertiliser subsidies to “cushion the pain” as the Indian economy went through structural transformation. In healthcare, there hasn’t been a huge electoral incentive to spend on health.

After independence

The Congress party was committed to social spending and enjoyed unparalleled electoral dominance. Sujatha Rao’s Do We Care? (2016), which we will rely on extensively, blames economists for this. The post-independence Nehruvian Model emphasised economic planning and development, and particularly focused on self-sufficiency and reducing imports. The government focused aggressively on irrigation, agriculture, and power plants and neglected education and health in the process. While China was launching massive campaigns for behaviour change, hygiene, and sanitation, India stuck to a narrow public health agenda limited to family planning and malaria prevention.

After liberalisation

The private sector can provide healthcare, and they fill a massive gap in healthcare provision, but not at a low enough cost to meet the needs of India’s poorest. And the private sector can’t do massive public health programmes or invest in preventive care. But this isn’t a reason to discount them entirely.

Contrary to popular perception, private healthcare is not merely available to the wealthy. In rural India, “most providers are in the private sector (86 per cent)”, though they are not what one imagines when one pictures expensive private hospitals. These private providers are usually unqualified – with no formal training. However, it turns out (from a 2010-11 study in rural Madhya Pradesh and urban Delhi) that “private practitioners with no formal training were as likely to diagnose correctly as qualified doctors in government hospitals.” But if government doctors are as bad as unqualified providers, that might as well be a failure of medical education, not the success of the market.

Why haven’t the States invested heavily in healthcare?

Some have, and they’re mostly southern states like Kerala and Tamil Nadu. You can’t give social democracy all the credit - these states had serious advantages and still incurred serious costs. Most people in Kerala are in small towns which are somewhat proximate to each other, making it much easier to get over physical distance and reducing inequalities between urban and rural areas, one of the biggest barriers to healthcare access. Kerala’s government was willing to throw out fiscal discipline, take on debt, and aggressively invest in people’s well-being all the way until they ended up in a multi-decade fiscal crisis. By that point, however, infrastructure had developed sufficiently, an epidemiological transition had taken place, and the private sector could take it from there.

Poverty

In some states, like Bihar or Uttar Pradesh, the answer is just poverty. On average, according to Rao, states need to “almost treble their spending from the current level of 2.4% to 8%.” This is difficult, because the states that are bad at public health also don’t have enough money. Rao writes: “Three-quarters of disease burden is concentrated in about nine states that also account for an equal number of the poor.” Additionally, the “per capita income ratio between them and the better-off states is 1:5, making it impossible for any central government to bridge the divide.” Those who most need to spend cannot and those who can really don’t need to.

You simply cannot get around poverty. You cannot redistribute your way out of your problems unless you get to a minimum level of GDP-per-capita. Whatever that minimum is, it’s higher than Uttar Pradesh’s measly $860. For reference, the Indian average in 2019 was $2100 and Kerala’s in 2021 was $3100. Rao says that the capital investment necessary to bridge this gap would require a hike in the tax-to-GDP ratio by at least 20 percent. And the government can’t raise taxes or introduce copayments or fees because almost everyone (93%) works in the informal sector and about 40% of them have “no assets or steady incomes.” There’s also an enormous failure of medical education. Credentials are not predictors of quality in poorer states: qualified doctors in Bihar scored lower than unqualified providers in Kerala.

Division of powers

Rao blames the federal division of powers for this. While the States and the Union can both legislate on relatively inexpensive areas like drug regulation or statistical collection, only the States are empowered to deal with public health, sanitation, hospitals, and dispensaries. This division of powers condemns the States to perpetual fiscal insecurity and makes them dependent on the Union for grants. Some revenues are collected by the Union and shared with the States, and the precise split is managed by the Finance Commission, which has almost never made health a priority. If the Union doesn’t make health a priority, the States will have to do so. And as we have seen, there are various reasons why the States can’t, or at least find it difficult.

Organisational capacity

Indian bureaucracies, notorious for their centralisation and slowness, delay the release of funds and withhold approved budgets. Rao describes, with evident frustration, how short-termism is baked into the operating protocols of the Indian state. In some instances, approval would be granted by a bureaucrat who would, minutes later, call up the finance department and tell them not to sanction the necessary funds.

Conclusion

To sum up, It’s not just expensive, but also incredibly hard to spend on health in a way that moves the needle. Policymakers and administrators face a complex, labyrinthine bureaucracy, as well as an inflexible constitutional structure that is allergic to long-term thinking. These factors condemn parts of India to generational poverty, illiteracy, and ill health.

Pradyumna PrasadAkshayNithyaAkshay Dinesh, and Sanjana reviewed early drafts and improved this post substantially with their helpful comments.

If I haven’t linked to a fact or statistic in the body text, it’s from one of the following books:

  • Rukmini S., Whole Numbers and Half Truths: What Data Can and Cannot Tell Us About Modern India (2021) (amazon)
  • Sujatha Rao, Do We Care? India’s Health System (2018) (amazon)

Addiction Aesthetic

Nicotine is an addiction that has been profoundly normalized in our culture. You could plausibly hope to not remind yourself of your addiction to meth at the workplace, but you can’t escape cigarettes. The reminders that you could always grab another smoke aren’t the rare neon of the drug den, they’re toasted and wispy and everywhere.

In the years I have been a smoker, I have managed to philosophize about the carcinogen. Cigarettes have great meaning. With their great meaning, I coughed up phlegm and walked through dark streets in a confused daze trying to find an open shop. With great meaning, I racked up a three thousand rupee tab while I was living on a stipend of five thousand. It was with great meaning that I put off sobriety by debating well-meaning friends, adding rhetorical question after rhetorical question, hypothetical after hypothetical – nicotine’s cerebral stampede.

Philosophy, of course, comes easily to the addict. Part of the philosophizing is nihilistic: you could die at any time, what’s the point if you aren’t living the way you want to, you can always put it off. Some of it is economic: oh, it’s just another one, the difference is marginal, what’s another thirty rupees. Nicotine’s arguments are endless. I’ll tell you what it feels like now as I’m convulsed with withdrawal, trying to study the bankruptcy code while there’s a nagging catch in my throat like I’m about to break down in a flood of tearful grief, watch it slip over the ramparts, break on the rock, and flow down my face. It’s hellish and self-negating, my preferences, and my common sense being shredded by neurotransmitters and their primal longing for stimulation. Nobody wants this.

Aesthetics is also a branch of philosophy, and the aesthetics of the cigarette have terrible beauty. And you could not know it if you haven’t spent many hours in the company of tar and tobacco. You will miss wispy smoke and the way it billows and spreads and diffuses against the dark sky, how the light filters through it and pierces the emptiness where the smoke isn’t. You will miss the weight of the cigarette in your hand, how it looks starkly utilitarian, world war one, architects and engineers and writers staring at canvases and notebooks, marginalia in one hand, your deadly embers in the other.

Even moments of solitude acquire a social relevance. There are few moments in the modern day where one simply exists and takes a moment to ponder existence, to take in aesthetics as a part of the workday. But you inhale, and you exhale, and in the moments between drags, you have philosophical thoughts, and you notice how the wall has a bit of graffiti on it, and how the sun looks against that particularly dark cloud. It provides a place for meeting, a space where you need no introduction: can I borrow your light? Thank you. Now let’s look away into the distance.