Social spending - where will money come from?

Sep 04, 2012
 
Eye on the Economy
 
By Aaron Low Economics Correspondent
 

THE debate on increasing Singapore's social spending centres on two questions.

The first is: How much more to spend? The next: How to fund it?

On the first, the Government has already started to commit itself to significantly higher spending. This has come about in response to two key trends. Singapore's ageing society and widening income inequality mean the Government will have to spend more on health care for the elderly; and on social spending to level up the playing field and to redistribute income.

As Prime Minister Lee Hsien Loong said in his Aug 26 National Day Rally speech, "nothing falls from heaven". So taxes will have to go up eventually to fund higher social expenditures - "not immediately" but within the next 20 years.

Annual health-care spending will double to $8 billion over the next five years. This year, the Government introduced the permanent GST Voucher, which pays out a combination of cash, conservancy rebates and Medisave top-ups, with more for older and lower-wage Singaporeans, to offset increases in the goods and services tax. This will cost the Government $680 million this year.

Also formalised in 2007 is the Workfare Income Supplement, which supplements low-wage workers' income with cash and Central Provident Fund (CPF) top-ups. This cost the Government $260 million last year.

Plans are also under way to spend $60 billion over the next 10 years to improve the transport system.

All that adds up to rising expenditure for the Singapore Government. In the last financial year, the Government collected $50.5 billion in tax revenues and charges. It spent $47.5 billion, resulting in a primary surplus of about $3 billion.

But the Government also spent $8.58 billion of special transfers on programmes such as Workfare, and top-ups to various endowment funds, such as the Medical Endowment Fund.

To make up the shortfall, the Government tapped $7.91 billion of returns from investment income from its reserves. This is known as Net Investment Returns (NIR).

After deducting and adding all the elements, the Government had an overall net surplus of $2.32 billion last year.

At a time when developed countries in Europe and the United States are drowning in sovereign debt, Singapore's fiscal position is much envied and admired.

But what happens when spending has to go up in the years ahead? Just one item of higher expenditure already promised - raising health spending by $4 billion - would have wiped out last year's $3 billion primary surplus.

So where will the money come from?

Some analysts think the current framework of allowing the use of NIR gives the state access to enough funds for the medium term. NIR now makes up 14 per cent of total government expenditure.

Citigroup economist Kit Wei Zheng notes that it is unclear whether the Government has even drawn down on the full 50 per cent of returns available under the Constitution.

In any case, why should the cap be at 50 per cent? Why not allow a higher portion of the returns to be used?

Mr Kit points out that the NIR contribution is a draw on the flow of new returns on the reserves, not the capital stock itself. In other words, it's only part of the interest that is used, and the principal is untouched.

"Even if the NIR contribution were to be raised to, say 60 per cent, that still leaves 40 per cent of the existing returns to be re-invested to grow the capital stock further," he said.

He adds that "the calculation of the NIR contribution could be subject to some discretion, especially what the projected real rate of return is".

For example, in 2008, the Government changed the Constitution so that the NIR it can use includes returns from capital gains, interest and dividend income. It also takes a longer-term, inflation-adjusted perspective when calculating returns.

Tweaks in either of these will have an impact on the actual amount available to the Government.

But the NIR can at best provide a buffer. Deputy Prime Minister Tharman Shanmugaratnam has previously said that the NIR will go towards education, research and development, and major programmes to expand infrastructure. Although there are no legal limits on its use, that statement imposes a discipline on the Government to fund its operating expenditure out of tax revenues, not from NIR from past reserves.

As the tax base dwindles and social spending pressures increase, the Government will face mounting pressure to use more of its reserves before raising taxes.

Citizens may refuse to accept taxes while the state maintains vast reserves. This leads to the question of how much the state should save for tomorrow, rather than use what it has for the needs of today.

In other words, how much reserves is enough?

No one outside the highest echelons of government knows how much the state has in reserves. The reserves are managed by the Monetary Authority of Singapore (MAS), the Government of Singapore Investment Corporation (GIC) and Temasek Holdings.

MAS, or the central bank, manages Singapore's foreign reserves, which amounted to $304 billion as of April 30.

Temasek, which is wholly owned by the Government and set up in 1972 to hold and manage the Government's investments and assets, reported in July that its portfolio stood at $198 billion as at March 31.

Apart from its deposits with MAS and its stake in Temasek, the rest of the Government's assets are mainly managed by the GIC.

GIC has said in the past that it manages well over US$100 billion (S$125 billion) of Singapore's reserves, but foreign think-tanks such as the Sovereign Wealth Institute have estimated that the figure is closer to US$250 billion.

If you add the three pools of reserves up, you get about $800 billion. A very modest 2 per cent return on that comes up to $16 billion a year.

The NIR contribution last year was $7.91 billion. And even if we assume that the NIR contribution last year had hit the 50 per cent cap, activating the other 50 per cent of NIR would mean an additional $8 billion to the Government.

This is around 14 per cent of last year's total government expenditure and social transfers of $56.12 billion.

How much to save and set aside for the future without compromising the present is a delicate and important decision.

The Government for now understandably prefers to tilt the balance towards preserving more for the future, mindful that Singapore's ageing demographics portend a slower growing, and slower revenue-generating economy, at a time when Asian tigers leap ahead.

But it will have to contend with demands from those who want the state to lighten its coffers first, before tapping taxpayers.

After all, today's taxpayers will argue, the reserves were accumulated from the hard work of this and previous generations.

It is thus equitable to use at least the returns or the interest from those savings, to pay for the social and health expenses of the same generations who built up the reserves.

Some will go further and say it is justified to not only use the returns, but also to draw down a small portion of the capital.

The trouble with such arguments is that they may seem reasonable in isolation, but will spell big trouble down the road. If the country spends all its tax revenue, plus all the interest from past reserves, the reserves will never grow. If the country dips into the capital, the reserves will dwindle.

And when Singapore's economy slows - and it will, due to ageing demographics and limits to returns on productivity - the Budget will go into structural deficit, which means the country will spend more than it can collect (in taxes and interest from past savings) every year.

At some point, the inevitable result will be the state having to borrow to fund its operations. That's like a worker spending more than he earns every year, and borrowing to cover the shortfall.

Unless he gets a huge pay rise; a windfall; or his children take over the debt, the only sure outcome is more debt until he declares bankruptcy.

That prospect admittedly sounds remote, given Singapore's healthy annual surpluses and vast reserves today.

But as the troubles in today's euro zone countries and the United States tell us, the slide into fiscal perdition is all too easy - and hard to reverse.

aaronl@sph.com.sg

Welcome to the American Republic, Mr. Eastwood

By Gary Hart

Huffington Post 08/31/2012

Tempting as it is to send the iconic movie-maker Clint Eastwood a copy of Plato or even one of my books on the Republic, it would probably not make his day. But the past week, with its attempt to focus on economic issues, despite candidates telling their life stories or auditioning for national office in 2016, totally ignored the very nature of our nation. We are a republic, instituted as such by our Founders using the ancient republican ideal and classical model, and launched with the hope, and even expectation, that future generations down to the present day would live up to that ideal and its principles.

Partisan politics, so wrapped up in creating an antagonism between capitalism and government, misses the point. If we are to maintain ourselves as a republic, certain foundational principles of a republic must be upheld regardless of our economic structures. They are: popular sovereignty (power to the people, not Wall Street or Washington); resistance to corruption (placing special interests ahead of the common good); a sense of the common good (all those things that we own and hold in common); and most of all civic duty, citizen responsibility, and citizen participation.

Mr. Eastwood, being a dramatist, could have made quite a discussion with that chair concerning these qualities and whether we all, not just the president, live up to them. The convention arena would have been even more dumbfounded, doubtless to the point of silence. Any lingering suspicion regarding his sobriety or mental state would have fled. He would have had to revert to Dirty Harry to keep them from storming the stage. For they were there to belabor the president for not fixing the mess he inherited from He Who Shall Not Be Named and to rescue poor, misunderstood bankers from presidential, and public, scorn.

Leaving the quadrennial struggle for power aside for the moment, at risk in the 21st century isn't capitalism. It is republicanism. Though we elect our government, we do not have power because this republic is massively corrupt. Special interests dominate the executive and legislative process, even more so now thanks to the judicial branch. They do so by controlling campaign contributions. And any effort to defend the common good, our public resources and facilities, the systems of education, transportation, and even communications, that make us a national community, are met with Tea Party chants of "socialism".

We are left, then, with what makes a republic a republic -- civic virtue, citizen duty. A number of state officials are hellbent on making voting more difficult. A surprising number of people say that jury duty, which many seek to avoid, is one of the most interesting and rewarding experiences they have ever had. We celebrate our volunteer warriors as we send them off to war, whether necessary or not, but too often forget those who return wounded in body or spirit. But few citizens attend regular community meetings unless their immediate interest is involved. Oscar Wilde said socialism would never work because it involved "too many evenings." That's not socialism; that's republicanism.

I wish Mr. Eastwood's chair had held not a phantom Obama, but a live Jefferson.

A future of our own making

by Devadas Krishnadas

Todayonline  Aug 30, 2012

Prime Minister Lee Hsien Loong's National Day Rally speech not only hit notes of humility and sincerity, its positive reception was reinforced by his indications that some long sought-after policy adjustments, such as paternity leave, would be finally forthcoming.

This willingness to shift was underscored by the announcement of a national conversation. This is intended to feed input to the general review of policies to be headed by Minister Heng Swee Kiat. Such a step signals a new "co-creative" model of policy making.

For such a model to work, Singaporeans must play their part. It begins with participation. As one cliche goes, "decisions are made by those who show up". Today, "showing up" can be done virtually as well as physically. However, participation alone is an insufficient threshold to ensure that this experiment succeeds.

It is critical that the signal-to-noise ratio in communication is well managed. If not, we will have to make sense of a cacophonous crowd rather than a sonorous symphony. There are three requirements for this to be done well.


MANAGING EMOTION

First, filters to separate picture from static. This should be the responsibility, not only of the Government but also community and civic leaders as well as responsible social media activists. Filters are needed to mediate the process of engagement and help sense of the emergent narrative.

Second, Singaporeans need to educate themselves on the issues and perceive them not through the monocle of self-interest, but with a binocular lens which balances self-interest with the larger considerations of community and nation. The focal length of these lenses must be sensitivity to the longer-term, not merely immediate preoccupations.

Third, we need to manage our emotions in this national conversation. There is considerable pent-up passion behind the varied grievances of Singaporeans. That emotional energy will need to be managed with maturity by all.

Emotion can be valid justification for a point of view. But emotion is not a good process with which to deal with it. Input should be thought through and presented soberly, with due consideration and respect to differences of view.


A WATCH NO MORE

The Prime Minister also had a sober message about being open to change.

He alluded to how radically things had changed over the past 20 years, and cast forward to how different things could be in 20 years hence. In so doing, he signalled a transition in the Government's perspective: From one that viewed society as complicated, to one which views it as complex. Let me explain.

Complicated systems are those which may have many moving parts, but which all function together in a predictable manner - like a mechanical watch. A part of the frustration felt by Singaporeans in recent years was the sense that the Government acted as watchmakers, maintaining a society they treated as nothing more than a complicated precision watch in need of occasional tuning.

A complex system, such as a society, is one in which all the constituent entities are interdependent and interconnected. What one entity does creates ripple effects affecting all others and in difficult to predict ways. Vitally, unlike complicated systems, complex ones are capable of adaptation.

Complex systems can be unpredictable and can eventuate in large outcomes, such as financial meltdowns. This unpredictability does not mean that complex systems cannot be somehow managed. It just means that managing it is a much more involved process than that of a watchmaker tuning a watch.

In a complex system, the watch tends to have a mind of its own.


ADAPTIVE RESILIENCE

Poorly adapting complex systems not only throw up negative large-scale events but also respond badly to shocks. Conversely, a complex system that exhibits adaptive resilience thrives despite shocks, sometimes even because of them. The societies which possess adaptive resilience have confidence in their identities.

Is Singapore a poor or resilient adaptive complex system?

Our own history is strong indication that we are good at adaptation. We have thrived through tumultuous change. Just because we are getting even more complex, does not mean that we cannot match up to the higher ante of adaptation required.

The moral compass of the nation lies within each of us, magnetised by the warmth of shared values and not steered from the outside by the grim iron of economic numbers. Knowing this, we need not fear losing ourselves even as the frequency and amplitude of change increase.

This conviction must be of a shared attitude of mind and a spirit of heart. It should not require a government department to cultivate; it must be an autonomously activated, self-sustaining chain reaction of positive energy. It must be real, not manufactured.

To facilitate this, we have to have more trust that people have the intelligence and maturity to be self-regulating in their social and political conduct. Not all will live up to this standard, but the deficiencies of a few should not be determinant of the standard for all.

This trust needs to be both between government and people, and among the different constituencies of people within the community.


TEMPERING EXPECTATIONS

Successful adaptation does not mean that every challenge can be defeated. It means also learning to come to terms with changes which cannot be avoided.

During the process of the national conversation, we should be prepared to make some reality checks on our expectations of just what can change and what cannot.

First, it is our lot in life to be a geographically limited country. The implication is that density of urban environment can only continue to intensify. No amount of conversation will change that.

But coming to terms can be a positive process of self-awareness of the things that matter more, over the things that matter less. In other words, we work on the things we can change, such as building our social harmony amidst the density, and fret less about the things we cannot, which is the density itself.

Second, we are an ageing society and that is a persistent driving force of social change. While some may be resistant to the placing of aged centres near them now, they will likely change their minds when they themselves are turning aged.

Realistically, with ageing being so pervasive, we face a future where infrastructure for the aged will permeate every part of the community. Introducing this infrastructure progressively allows us to stay slightly ahead of demand.

Third, we are becoming more diverse. As Shakespeare has Hamlet observe, "there is nothing that is either good or bad but thinking makes it so". I suspect that adjusting to this new reality of social diversity will be the greatest test for most Singaporeans.


A BLIP, NOT A BOMB

Fourth, our existing public infrastructure is ageing. The MRT and the main highways are now some 25 or more years old. We have the means to recapitalise and extend them.

The occasional failure is, on the grand scale of things, a blip not a bomb. So let us take a deep breath and cut ourselves some slack even while insisting, justifiably, on high standards. Cutting slack simply means not over-interpreting the meaning of occasional failures and consequently growing despondent that we are systemically decaying.

Fifth, and most importantly, let us mature to accept that the Government is not our parent and the people are not its children.

To expect the national conversation to be a binary one, where complaints flow in one direction and solutions flow from the other, is naive and self-defeating. For the experiment of co-creation to work, solutions have to come from the community and individuals as well as the Government.


SHAPING THE NEW NARRATIVE

Complex systems are capable of the phenomena of emergence. This is where macro reality is created by, but is distinct from, the action of the micro activity. The wonder that is consciousness, generated from the chemistry of neural activity, is an example.

Similarly, the new narrative for Singapore will emerge from the activity of a multitude of conversations, iterations of discussions, resolutions of tensions and, yes, even clash of ideas. We should be willing but patient enough to see this process through.

The future is not certain. We are not in full control of events and some driving forces of change are fixed. What is flexible is our attitude towards these driving forces. We may not be able to fully recognise our future before it is here, but we can do much to make it the way we want it to appear.

We can give deliberate attention to the things we can control and take ownership of the process by which we do so. We already have a good start. We have a leader who has the wisdom to know that it is better to change while we can, and not when we must, and the courage to acknowledge that the need for change applies to himself and his team as much as it does to the people and the nation.


Devadas Krishnadas is Director and Principal Consultant for Future-Moves, a foresight consultancy. He has extensive policy and operational experience in Singapore's public sector.

Autism - Father's contribution; Autoimmune Disorder?

New York Times

Father’s Age Is Linked to Risk of Autism and Schizophrenia

August 22, 2012

By BENEDICT CAREY

Older men are more likely than young ones to father a child who develops autism or schizophrenia, because of random mutations that become more numerous with advancing paternal age, scientists reported on Wednesday, in the first study to quantify the effect as it builds each year. The age of mothers had no bearing on the risk for these disorders, the study found.

Experts said that the finding was hardly reason to forgo fatherhood later in life, though it might have some influence on reproductive decisions. The overall risk to a man in his 40s or older is in the range of 2 percent, at most, and there are other contributing biological factors that are entirely unknown.

But the study, published online in the journal Nature, provides support for the argument that the surging rate of autism diagnoses over recent decades is attributable in part to the increasing average age of fathers, which could account for as many as 20 to 30 percent of cases.

The findings also counter the longstanding assumption that the age of the mother is the most important factor in determining the odds of a child having developmental problems. The risk of chromosomal abnormalities, like Down syndrome, increases for older mothers, but when it comes to some complex developmental and psychiatric problems, the lion’s share of the genetic risk originates in the sperm, not the egg, the study found.

Previous studies had strongly suggested as much, including an analysis published in April that found that this risk was higher at age 35 than 25 and crept up with age. The new report quantifies that risk for the first time, calculating how much it accumulates each year.

The research team found that the average child born to a 20-year-old father had 25 random mutations that could be traced to paternal genetic material. The number increased steadily by two mutations a year, reaching 65 mutations for offspring of 40-year-old men.

The average number of mutations coming from the mother’s side was 15, no matter her age, the study found.

“This study provides some of the first solid scientific evidence for a true increase in the condition” of autism, said Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine, who was not involved in the research. “It is extremely well done and the sample meticulously characterized.”

The new investigation, led by the Icelandic firm Decode Genetics, analyzed genetic material taken from blood samples of 78 parent-child trios, focusing on families in which parents with no signs of a mental disorder gave birth to a child who developed autism or schizophrenia. This approach allows scientists to isolate brand-new mutations in the genes of the child that were not present in the parents.

Most people have many of these so-called de novo mutations, which occur spontaneously at or near conception, and most of them are harmless. But studies suggest that there are several such changes that can sharply increase the risk for autism and possibly schizophrenia — and the more a child has, the more likely he or she is by chance to have one of these rare, disabling ones.

Some difference between the paternal and maternal side is to be expected. Sperm cells divide every 15 days or so, whereas egg cells are relatively stable, and continual copying inevitably leads to errors, in DNA as in life.

Still, when the researchers removed the effect of paternal age, they found no difference in genetic risk between those who had a diagnosis of autism or schizophrenia and a control group of Icelanders who did not. “It is absolutely stunning that the father’s age accounted for all this added risk, given the possibility of environmental factors and the diversity of the population,” said Dr. Kari Stefansson, the chief executive of Decode and the study’s senior author. “And it’s stunning that so little is contributed by the age of the mother.”

Dr. Stefansson’s co-authors included C. Augustine Kong of Decode, and researchers from the University of Iceland, Aarhus University in Denmark and Illumina Cambridge Ltd.

Dr. Stefansson said it made sense that de novo mutations would play a significant role in brain disorders. At least 50 percent of active genes play a role in neural development, so that random glitches are more likely to affect the brain than other organs, which have less exposure.

In the end, these kinds of mutations may account for 20 to 30 percent of cases of autism, and perhaps schizophrenia, some experts said. The remainder is probably a result of inherited genetic predisposition and environmental factors that are the subjects of numerous studies.

Dr. Stefansson and other experts said that an increase in the average age of fathers had most likely led to more cases of autism. Unlike other theories proposed to explain the increase, like vaccinations, it is backed by evidence that scientists agree is solid.

This by itself hardly explains the overall increase in diagnoses, at least in the United States. The birthrate of fathers age 40 and older has increased by more than 30 percent since 1980, according to government figures, but the diagnosis rate has jumped tenfold, to 1 in 88 8-year-olds.

And it is not clear whether the rate of schizophrenia diagnosis has increased at all in that time.

Nonetheless, if these study findings hold up and extend to other brain disorders, wrote Alexey S. Kondrashov of the University of Michigan, in an editorial accompanying the study, “then collecting the sperm of young adult men and cold-storing it for later use could be a wise individual decision.”

That very much depends on the individual. “You are going to have guys who look at this and say, ‘Oh no, you mean I have to have all my kids when I’m 20 and stupid?’ ” said Evan E. Eichler, a professor of genome sciences at the University of Washington in Seattle. “Well, of course not. You have to understand that the vast majority of these mutations have no consequences, and that there are tons of guys in their 50s who have healthy children.”


[And then there is this article that suggests that autism is sparked off in the womb during an inflammatory infection.]

New York Times
August 25, 2012

An Immune Disorder at the Root of Autism

By MOISES VELASQUEZ-MANOFF

IN recent years, scientists have made extraordinary advances in understanding the causes of autism, now estimated to afflict 1 in 88 children. But remarkably little of this understanding has percolated into popular awareness, which often remains fixated on vaccines.

So here’s the short of it: At least a subset of autism — perhaps one-third, and very likely more — looks like a type of inflammatory disease. And it begins in the womb.

It starts with what scientists call immune dysregulation. Ideally, your immune system should operate like an enlightened action hero, meting out inflammation precisely, accurately and with deadly force when necessary, but then quickly returning to a Zen-like calm. Doing so requires an optimal balance of pro- and anti-inflammatory muscle.

In autistic individuals, the immune system fails at this balancing act. Inflammatory signals dominate. Anti-inflammatory ones are inadequate. A state of chronic activation prevails. And the more skewed toward inflammation, the more acute the autistic symptoms.

Nowhere are the consequences of this dysregulation more evident than in the autistic brain. Spidery cells that help maintain neurons — called astroglia and microglia — are enlarged from chronic activation. Pro-inflammatory signaling molecules abound. Genes involved in inflammation are switched on.

These findings are important for many reasons, but perhaps the most noteworthy is that they provide evidence of an abnormal, continuing biological process. That means that there is finally a therapeutic target for a disorder defined by behavioral criteria like social impairments, difficulty communicating and repetitive behaviors.

But how to address it, and where to begin? That question has led scientists to the womb. A population-wide study from Denmark spanning two decades of births indicates that infection during pregnancy increases the risk of autism in the child. Hospitalization for a viral infection, like the flu, during the first trimester of pregnancy triples the odds. Bacterial infection, including of the urinary tract, during the second trimester increases chances by 40 percent.

The lesson here isn’t necessarily that viruses and bacteria directly damage the fetus. Rather, the mother’s attempt to repel invaders — her inflammatory response — seems at fault. Research by Paul Patterson, an expert in neuroimmunity at Caltech, demonstrates this important principle. Inflaming pregnant mice artificially — without a living infective agent — prompts behavioral problems in the young. In this model, autism results from collateral damage. It’s an unintended consequence of self-defense during pregnancy.

Yet to blame infections for the autism epidemic is folly. First, in the broadest sense, the epidemiology doesn’t jibe. Leo Kanner first described infantile autism in 1943. Diagnoses have increased tenfold, although a careful assessment suggests that the true increase in incidences is less than half that. But in that same period, viral and bacterial infections have generally declined. By many measures, we’re more infection-free than ever before in human history.

Better clues to the causes of the autism phenomenon come from parallel “epidemics.” The prevalence of inflammatory diseases in general has increased significantly in the past 60 years. As a group, they include asthma, now estimated to affect 1 in 10 children — at least double the prevalence of 1980 — and autoimmune disorders, which afflict 1 in 20.

Both are linked to autism, especially in the mother. One large Danish study, which included nearly 700,000 births over a decade, found that a mother’s rheumatoid arthritis, a degenerative disease of the joints, elevated a child’s risk of autism by 80 percent. Her celiac disease, an inflammatory disease prompted by proteins in wheat and other grains, increased it 350 percent. Genetic studies tell a similar tale. Gene variants associated with autoimmune disease — genes of the immune system — also increase the risk of autism, especially when they occur in the mother.

In some cases, scientists even see a misguided immune response in action. Mothers of autistic children often have unique antibodies that bind to fetal brain proteins. A few years back, scientists at the MIND Institute, a research center for neurodevelopmental disorders at the University of California, Davis, injected these antibodies into pregnant macaques. (Control animals got antibodies from mothers of typical children.) Animals whose mothers received “autistic” antibodies displayed repetitive behavior. They had trouble socializing with others in the troop. In this model, autism results from an attack on the developing fetus.

But there are still other paths to the disorder. A mother’s diagnosis of asthma or allergies during the second trimester of pregnancy increases her child’s risk of autism.

So does metabolic syndrome, a disorder associated with insulin resistance, obesity and, crucially, low-grade inflammation. The theme here is maternal immune dysregulation. Earlier this year, scientists presented direct evidence of this prenatal imbalance. Amniotic fluid collected from Danish newborns who later developed autism looked mildly inflamed.

Debate swirls around the reality of the autism phenomenon, and rightly so. Diagnostic criteria have changed repeatedly, and awareness has increased. How much — if any — of the “autism epidemic” is real, how much artifact?

YET when you consider that, as a whole, diseases of immune dysregulation have increased in the past 60 years — and that these disorders are linked to autism — the question seems a little moot. The better question is: Why are we so prone to inflammatory disorders? What has happened to the modern immune system?

There’s a good evolutionary answer to that query, it turns out. Scientists have repeatedly observed that people living in environments that resemble our evolutionary past, full of microbes and parasites, don’t suffer from inflammatory diseases as frequently as we do.

Generally speaking, autism also follows this pattern. It seems to be less prevalent in the developing world. Usually, epidemiologists fault lack of diagnosis for the apparent absence. A dearth of expertise in the disorder, the argument goes, gives a false impression of scarcity. Yet at least one Western doctor who specializes in autism has explicitly noted that, in a Cambodian population rife with parasites and acute infections, autism was nearly nonexistent.

For autoimmune and allergic diseases linked to autism, meanwhile, the evidence is compelling. In environments that resemble the world of yore, the immune system is much less prone to diseases of dysregulation.

Generally, the scientists working on autism and inflammation aren’t aware of this — or if they are, they don’t let on. But Kevin Becker, a geneticist at the National Institutes of Health, has pointed out that asthma and autism follow similar epidemiological patterns. They’re both more common in urban areas than rural; firstborns seem to be at greater risk; they disproportionately afflict young boys.

In the context of allergic disease, the hygiene hypothesis — that we suffer from microbial deprivation — has long been invoked to explain these patterns. Dr. Becker argues that it should apply to autism as well. (Why the male bias? Male fetuses, it turns out, are more sensitive to Mom’s inflammation than females.)

More recently, William Parker at Duke University has chimed in. He’s not, by training, an autism expert. But his work focuses on the immune system and its role in biology and disease, so he’s particularly qualified to point out the following: the immune system we consider normal is actually an evolutionary aberration.

Some years back, he began comparing wild sewer rats with clean lab rats. They were, in his words, “completely different organisms.” Wild rats tightly controlled inflammation. Not so the lab rats. Why? The wild rodents were rife with parasites. Parasites are famous for limiting inflammation.

Humans also evolved with plenty of parasites. Dr. Parker and many others think that we’re biologically dependent on the immune suppression provided by these hangers-on and that their removal has left us prone to inflammation. “We were willing to put up with hay fever, even some autoimmune disease,” he told me recently. “But autism? That’s it! You’ve got to stop this insanity.”

What does stopping the insanity entail? Fix the maternal dysregulation, and you’ve most likely prevented autism. That’s the lesson from rodent experiments. In one, Swiss scientists created a lineage of mice with a genetically reinforced anti-inflammatory signal. Then the scientists inflamed the pregnant mice. The babies emerged fine — no behavioral problems. The take-away: Control inflammation during pregnancy, and it won’t interfere with fetal brain development.

For people, a drug that’s safe for use during pregnancy may help. A probiotic, many of which have anti-inflammatory properties, may also be of benefit. Not coincidentally, asthma researchers are arriving at similar conclusions; prevention of the lung disease will begin with the pregnant woman. Dr. Parker has more radical ideas: pre-emptive restoration of “domesticated” parasites in everybody — worms developed solely for the purpose of correcting the wayward, postmodern immune system.

Practically speaking, this seems beyond improbable. And yet, a trial is under way at the Montefiore Medical Center and the Albert Einstein College of Medicine testing a medicalized parasite called Trichuris suis in autistic adults.

First used medically to treat inflammatory bowel disease, the whipworm, which is native to pigs, has anecdotally shown benefit in autistic children.

And really, if you spend enough time wading through the science, Dr. Parker’s idea — an ecosystem restoration project, essentially — not only fails to seem outrageous, but also seems inevitable.

Since time immemorial, a very specific community of organisms — microbes, parasites, some viruses — has aggregated to form the human superorganism. Mounds of evidence suggest that our immune system anticipates these inputs and that, when they go missing, the organism comes unhinged.

Future doctors will need to correct the postmodern tendency toward immune dysregulation. Evolution has provided us with a road map: the original accretion pattern of the superorganism. Preventive medicine will need, by strange necessity, to emulate the patterns from deep in our past.

Moises Velasquez-Manoff is the author of “An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases.”

You, I and Us: The politics of birth

by Devadas Krishnadas
TODAYONLINE

Aug 23, 2012

Mr Lee Kuan Yew recently commented that Singapore would "fold up" if we did not raise the birth rate.

Mr Lee's remarks were made against the backdrop of an announcement that the Government would conduct another review of the Marriage and Procreation policy.

First off, whatever value judgments Singaporeans may make about his interpretation, no one can argue with the demographic facts.

We do have an abysmal birth rate, consequently we are dependent on population augmentation, and this does have undesirable and uncomfortable consequences; but if we do not reverse the first and if we reject the second, we will face population decline within a generation. There should be no dispute here.

Predictably, however, Mr Lee's point of view provoked a volley of comments from Singaporeans. I have categorised the protestations into three buckets.


POINTING FINGERS

The first bucket contains two strands of criticisms. One, that the Government is being hypocritical because of the culpability of its "stop at two" policy in causing the low birth rates.

Proponents of this view do not dispute the legitimacy of the argument that the birth rate needs to increase, but absolve themselves of the responsibility of doing anything about it because they view themselves as victims of a past policy decision.

The second criticism is that the Government's emphasis on growth has shaped a mental model of prioritising careers over family. The proponents of this school of thinking are convinced that if the Government reduces the priority it places on economic growth, the problem would remedy itself over time.

The second bucket is made up of the interesting critique that the exhortation to increase the birth rate constitutes an intrusion into the private space of individuals.

Quite rightly, birth is an intimate and personal decision. But it is a logical stretch to use this truism as a basis to detect an authoritarian intent to conscript the bodies of women to the national cause. This school of thinking perceives the case for individual autonomy as trumping any call for collective burden sharing. Although not fully embracing the idea of population augmentation, the proponents of this view, by logical default, accept it as a necessary evil.

While not offering any solutions, this view does move the discussion beyond finger pointing to the tensions between individual choice and national interest.

The third bucket of criticism is from those who feel that high costs and inequality are the impediments to procreation. They call for a more redistributive social model as a response, not only to falling birth rates but also to close the inequality gap.

The virtuous amongst this group even preemptively volunteer to pay higher taxes. Only proponents of this perspective recognise the systemic nature of the problem and propose a systemic response. Now let us take a closer look at these buckets.


THE 'YOU' PEOPLE

I think of the first bucket as the "You" people. "You", because their criticisms typically commence with that word, meaning the Government or some Minister of the same. However sincere the motivating angst, there are several problems with the case of the "You" people.

First, even if and where policy was misjudged, was there malicious intent and what effect did the policy really have? The "stop at two" policy was driven out of a fear that the population was growing faster than economically viable. It reflects the sober and conservative expectations for future economic performance in the midst of the global economic shocks of the 1970s.

It is hardly fair to indict past decision makers with the benefit of 20-20 hindsight. Did the policy makers in the past miscalculate? Perhaps, but not in the way the "you" people think.

A close study of the correlations between our birth rates and level of economic development reveals that we followed a well-established pattern of inverse correlation.

In other words, even without the "stop at two" policy, we should have expected to see the birth rate fall as it did, as we became more affluent and our people, particularly women, became better educated. So the argument for policy hypocrisy is debatable.

Second, the view that the emphasis on growth is a major causation is a weak argument. It is too much to suggest that an economy of our size and nature can function independently of global economic events.

Quite the opposite, we are almost wholly dependent on these events to dictate our economic performance.

The Government can only use policy to best position our economy for growth and to cushion it when growth is absent. Notions such as "growth calibration" are misguided. (A more valid criticism within this bucket is that the Government has been quick to credit itself for growth but attributes to global conditions the causation for its lack.)

Further, this bucket presents a too simplistic picture which casts the Government in the role of the antagonist while the people are cast as helpless victims absolved of responsibility for their future.

Perhaps the most limiting quality of this bucket is that it offers no ideas on what to do next. So while the "you" bucket makes the most noise in social media, it is probably because it conforms to the old axiom about empty vessels.


THE 'I' PEOPLE

The "I" people, in the second bucket, think about themselves as almost wholly distinct from the collective.

Admittedly, the tension point between individual and the collective space would seem an important determination. But while no one can deny that the decision to procreate is a personal one, this does not make it mutually exclusive with a discussion of aggregate procreation.

The State cannot force the individual course in the matter of procreation. What is clear, after more than a decade of affirmative policy action, is that promoting procreation with targeted policies has proved to be spectacularly ineffective.

We have also reason to suspect that the targeted policies to limit procreation were probably less effectual than is commonly assumed.


THE 'US' PEOPLE

The third bucket is composed of the "Us" people, those who believe in social models having determinative power over individual action. Of all the buckets, only the "Us" people think in system terms.

Their main idea is that a different social safety net model would influence personal behaviour. There have been many eloquent advocates in favour of changing to a "Nordic" model characterised by higher taxation, a more interventionist and deliberate redistributive model and greater State presence in the social space.

The motivations for promoting such advocacy range from a desire for less inequality, more inclusiveness and belief that if the costs of child rearing were socialised, then the individual proclivities could be positively influenced in favour of procreation.

The problem is that we will never know for sure whether moving in this direction will work until we try it. But trying it has a very long tail, for we will need at least a generation to judge the effects.

The fiscal costs of the "Nordic" model should not be underestimated. But neither should these cost projections be considered sufficient argument not to go in this direction. The matter is ultimately not one of whether we can afford it, but whether we want to afford it. What is required is a deliberate, protracted and participatory discussion as to the full meaning and potential implications of such a systemic move.

Given the importance of the issue, the conversation should take place over a substantial period of public and parliamentary debate which should include as many voices as possible. The general public and civic groups should activate themselves to participate as stakeholders in Singapore society. There need not be a rush to consensus, we should take the time to get this right.


PATH TO PROGRESS

We need to move the debate forward, and out of the state of policy stasis. All parties should be open to possible different futures. How do we do this?

First: Confront the facts.

Second: Distinguish between the fatuous and the fair criticisms.

Third: Recognise that targeted policies have not worked, thus leaving us with the implication that only a systemic adjustment would be of the scale and dimension to match the nature of the problem.

Fourth: Accept that individual choices have a collectivised expression, but also that a collectivised decision may well ultimately stand the best chance of influencing individual choice.

Fifth: The process of arriving at a decision on a social model is important to the legitimacy of that decision. And by social model, I mean more than a system of redistribution but also a reconsideration of traditional notions of family and the legitimacy of single mothers. A mark of social maturity is the acceptance that while one may not adopt, or even approve, a social choice, this does not give us the right to deny that choice to another.

It is an unsettling truth that we will not, for a long time, be certain of the outcome of any decision to change. But this should be contrasted with the more disturbing certainty of knowing the result of continuing as we are.

We need to enter into a national conversation about the kind of future we want, and commit ourselves to the price to be paid for the choice that we as a people make, and which the Government then should implement, not the other way around.


Devadas Krishnadas is Director and Principal Consultant for Future-Moves, a foresight consultancy. He has extensive policy and operational public sector experience in Singapore and, as a Fulbright Scholar, read for a Masters of Law and Diplomacy at the Fletcher School, Tufts University.

NParks decided on wild boar culling method

Aug 20, 2012

Animals to be rounded up, sedated then euthanised through injections

By Grace Chua And David Ee

Court tells Aussie 'Robinson Crusoe' to leave island

Aug 20, 2012

 
By jonathan pearlman
 

SYDNEY - After living alone on a remote tropical island for almost 20 years accompanied only by his dog Quasi, David Glasheen is usually referred to as the Australian Robinson Crusoe.

Since losing his fortune in the 1987 stock market crash, Mr Glasheen, now in his late 60s, has lived off fish, crab, bananas and coconuts. He grows his own vegetables and brews his own beer. "I am contented and happy, and in the modern-day world that's a precious thing," he has said.

But his days of solitary idyll may be over. An Australian court has ruled that Mr Glasheen must leave the island.

The latest court order is one of several key differences between Mr Glasheen and his literary forebear.

Mr Glasheen has encountered no native cannibals, though he has been visited by yachtsmen and kayakers passing his small island in the Great Barrier Reef, about 2,000km north of Brisbane.

And Mr Glasheen has not yet found a companion - a "Friday" - though he did make international headlines several years ago by placing an advertisement on an online dating agency. "It gets lonely out here," he told a reporter at the time. "My only hope is for a mermaid to turn up on the beach."

The long-haired frequently bare-chested isolato, who has access to a solar-powered Internet connection, received hundreds of responses. Sadly, he had no luck. "Half of them were crazy," he said.

Finally, unlike Crusoe, Mr Glasheen was not shipwrecked and is in no hurry to escape.

He decided to move from Sydney to the 40ha Restoration Island in 1993 after losing A$10 million (S$13.1 million) in a single day of share trading and then losing his marriage and his homes. He initially moved to the island with a girlfriend, but she found life there too difficult and left.

He still receives visits from his son and still flutters on the stock market using an online trading account. But he shows no regret for his decision to leave behind his fast-paced city life.

"I was in the office before my children woke up and I was home when they were asleep," he told an Australian reporter in 2009.

Mr Glasheen said he revels in the tranquillity and privacy and has described himself as "the luckiest bloke in the world".

"I suppose I am a hermit, just because I live here on my own," he said last year. "I see myself as a social hermit, and I've played host to all sorts of interesting people from all over the world here."

The former businessman and a business partner had been subleased 15ha of public land on the island on condition that he build a resort.

According to a 43-year lease which commenced in 1996, he is supposed to develop tourist accommodation and fishing facilities valued at least A$200,000.

But the Queensland Supreme Court has ruled that he has not taken steps to develop the resort and that the land should be repossessed. On his website, Mr Glasheen claims he has received approvals to develop a resort and invites investors interested in funding a project which could include private guesthouses and a health spa.

"There is nothing more exclusive and sought after in the world than having your own private island," says the website. But with no resort in sight, the court ruled that Mr Glasheen and his business partners were "trespassers".

"The development was never materially advanced beyond the preparation and planning stage," the court said. "The defendants have wrongly deprived the plaintiff of its asset for over a decade during which time they have enjoyed its benefits."