NUMBERSNUMBERS

Kiersten Adams Kiersten Adams Jay Singerman Jay Singerman

Jen Storch Jen Storch Ashley Thomas Ashley Thomas James Trinidad James Trinidad

AgendaAgenda IntroductionIntroduction Numbers as MetaphorsNumbers as Metaphors Numbers as Norms and SymbolsNumbers as Norms and Symbols Hidden Stories in NumbersHidden Stories in Numbers Making Numbers in the PolisMaking Numbers in the Polis Numbers in HealthcareNumbers in Healthcare Questions?Questions?

Problem DefinitionProblem Definition

How do we know there is a disparity How do we know there is a disparity between social goals and the current between social goals and the current state of affairs?state of affairs?

We must define a problem.We must define a problem. But, problem definition is not simple: But, problem definition is not simple:

it is a strategic representation of it is a strategic representation of situations.situations.

Problem Definition Problem Definition ContinuedContinued

There are many ways to define There are many ways to define problems in policy discourse.problems in policy discourse.

Each mode is a language which Each mode is a language which people utilize to defend conflicting people utilize to defend conflicting interpretations.interpretations.

One common way to define a policy-One common way to define a policy-related problem is to measure it.related problem is to measure it.

Elephant exampleElephant example

Say I hire you to measure an elephant?Say I hire you to measure an elephant? It sounds straightforward, but its not!It sounds straightforward, but its not! What information do you collect?What information do you collect? Weight?, height?, length?, volume?, Weight?, height?, length?, volume?,

intensity of its color gray?, number of intensity of its color gray?, number of wrinkles?wrinkles?

The fundamental issues of any policy The fundamental issues of any policy problem are always contained in the problem are always contained in the question of how to count the problem.question of how to count the problem.

Counting ElephantsCounting Elephants

Round?

YesNoPrimaryColor?Square?

Yes Yes

No No

Red?

GiraffeGator

Green?

ElephantMonkeyLion Snake

NoYes

No

Yes

Counting As…Counting As…

Counting the problem involves a Counting the problem involves a strategic representation of the situation.strategic representation of the situation.

Every description of a situation is a Every description of a situation is a portrayal from only one of many points of portrayal from only one of many points of view.view.

So, counting always involves deliberate So, counting always involves deliberate decisions about decisions about counting ascounting as..

Counting must begin with categorization.Counting must begin with categorization.

CategorizationCategorization

Notice how political counting sounds?Notice how political counting sounds? Counting must be about:Counting must be about:

inclusion/exclusion: terms that inclusion/exclusion: terms that suggest community, boundaries, allies, suggest community, boundaries, allies, enemiesenemies

Selection: terms that imply privilege and Selection: terms that imply privilege and discriminationdiscrimination

Important characteristics: terms that Important characteristics: terms that suggest value judgments and hierarchysuggest value judgments and hierarchy

Numbers as MetaphorsNumbers as Metaphors

Numbers as MetaphorsNumbers as Metaphors

To categorize in counting or to To categorize in counting or to analogize in metaphors is to select analogize in metaphors is to select one feature of something, assert a one feature of something, assert a likeness on the basis of that feature, likeness on the basis of that feature, and ignore all the other features.and ignore all the other features.

Counting requires judgment about Counting requires judgment about inclusion and exclusion.inclusion and exclusion.

Counting SchemesCounting Schemes

Counting schemes are subject to 2 Counting schemes are subject to 2 possible challenges:possible challenges:

(1)(1) Asserting a real likeness where a Asserting a real likeness where a measure finds a difference (Including measure finds a difference (Including something the measure excludes)something the measure excludes)

(2)(2) Asserting a real difference where a Asserting a real difference where a measure finds a likeness (Excluding measure finds a likeness (Excluding something the measure includes)something the measure includes)

Clear RulesClear Rules

Often times, conflict in policy is over Often times, conflict in policy is over what legitimately counts as whatwhat legitimately counts as what

Numbers are used to settle the Numbers are used to settle the discussionsdiscussions

The need for clear rules drives The need for clear rules drives policymakers to establish thresholds policymakers to establish thresholds as dividing linesas dividing lines

Central themeCentral theme

There is no universal, scientific, or objective There is no universal, scientific, or objective method of problem definition.method of problem definition.

Numbers are just one way problems are Numbers are just one way problems are defined in politics - and politicians employ defined in politics - and politicians employ several different counting strategies to set the several different counting strategies to set the problemproblem

Fancy manipulation of numbers equal claims Fancy manipulation of numbers equal claims about similarities and differencesabout similarities and differences

These are the ultimate basis for decisions in These are the ultimate basis for decisions in public policy.public policy.

Numbers as Norms and Numbers as Norms and Symbols Symbols

MeasurementsMeasurements

Imply a need for actionImply a need for action Usually taken because we seek to Usually taken because we seek to

change them or to change our change them or to change our behaviorbehavior

Creates pressure to do something Creates pressure to do something about itabout it

UnemploymentUnemployment

1930s- no unemployment census1930s- no unemployment census 1950s and 60s- 4.6%1950s and 60s- 4.6% 1970s- more than 6%1970s- more than 6% 1980s- 7-9%1980s- 7-9%

A Double- Edged SwordA Double- Edged Sword

U.S. Navy saved 2.5 billion in U.S. Navy saved 2.5 billion in shipping costsshipping costs

Show thrift, successful building, and Show thrift, successful building, and good management?good management?

Show an excess of allocated funds Show an excess of allocated funds that could be cut?that could be cut?

CostCost

Generally think of high costs as badGenerally think of high costs as bad Sometimes, high costs= high qualitySometimes, high costs= high quality

Designer clothes, carsDesigner clothes, cars Is a costly national defense system Is a costly national defense system

waste-ridden or extra secure?waste-ridden or extra secure?

EfficiencyEfficiency

Generally think the more efficient Generally think the more efficient and productive, the betterand productive, the better

Not necessarily so with servicesNot necessarily so with services

Middles and AveragesMiddles and Averages

Often the normOften the norm Political campaigns promote to Political campaigns promote to

“middle class”“middle class” Depends on the categoriesDepends on the categories

Hidden Stories in NumbersHidden Stories in Numbers

Hidden Stories in NumbersHidden Stories in Numbers

Explicit StoriesExplicit Stories Used to authenticate a storyUsed to authenticate a story

Identify causal relationshipsIdentify causal relationships

Implicit StoriesImplicit Stories

More Implicit StoriesMore Implicit Stories

Frequent enough to countFrequent enough to count Clear boundaries make numbers identifiableClear boundaries make numbers identifiable Counting creates a communityCounting creates a community

Natural vs. ArtificialNatural vs. Artificial Political supportPolitical support

Numbers can stimulate conflict resolutionNumbers can stimulate conflict resolution Dividing, weighing, balancingDividing, weighing, balancing

Numbers are symbols of precision and Numbers are symbols of precision and accuracyaccuracy

The Political StoryThe Political Story

In counting, decisions must be made In counting, decisions must be made about inclusion and exclusionabout inclusion and exclusion

Measuring creates norms about how Measuring creates norms about how much is just rightmuch is just right

Ambiguous numbers create room for Ambiguous numbers create room for political strugglespolitical struggles

Numbers tell stories, especially about Numbers tell stories, especially about declinedecline

The Political StoryThe Political Story

Numbers create illusions about Numbers create illusions about complex phenomenon complex phenomenon

Numbers create political Numbers create political communitiescommunities

Counting can help with negotiations Counting can help with negotiations and compromiseand compromise

Numbers create authorityNumbers create authority

Numbers in the PolisNumbers in the Polis

Numbers in the Polis: Numbers in the Polis: People as numbersPeople as numbers

People know when they are being measuredPeople know when they are being measured Examples of people as numbersExamples of people as numbers

Social Security number, UFID, phone number, censusSocial Security number, UFID, phone number, census Bank account number and identity theftBank account number and identity theft

Measurement triggers the natural desire to look goodMeasurement triggers the natural desire to look good Examples: height, business portfolio, IRS & taxesExamples: height, business portfolio, IRS & taxes Therefore, if our measurements do not look good, we are Therefore, if our measurements do not look good, we are

disappointeddisappointed Does “15Does “15thth best” sound good to you? best” sound good to you?

Giving people the option of being counted as something Giving people the option of being counted as something invites people to consider choosing itinvites people to consider choosing it

Implies inclusion and exclusionImplies inclusion and exclusion ““Check one” vs. “Please check all that apply”Check one” vs. “Please check all that apply”

Numbers in the Polis:Numbers in the Polis:CountingCounting

Counting and measurement affect Counting and measurement affect people’s behaviors and perceptionspeople’s behaviors and perceptions Counting enables group (vs. individual) Counting enables group (vs. individual)

discrimination/mobilizationdiscrimination/mobilization Ex. Hate crimesEx. Hate crimes

A formal count normalizes rare eventsA formal count normalizes rare events Ex. War-on-terrorism and American deathsEx. War-on-terrorism and American deaths

Counting/measurement can induce Counting/measurement can induce dissatisfaction and changedissatisfaction and change

Ex. Weight, diet, and Healthy People 2010Ex. Weight, diet, and Healthy People 2010

Numbers & Polis:Numbers & Polis:Record KeepingRecord Keeping

Record keeping is more intense when the Record keeping is more intense when the records are under scrutiny or public attentionrecords are under scrutiny or public attention Reformers try to show that the problem is big, new, Reformers try to show that the problem is big, new,

and not something that has been tolerated for a long and not something that has been tolerated for a long timetime

Ex., Global warmingEx., Global warming As tolerance for annoyances diminishes, then the As tolerance for annoyances diminishes, then the

perception is that annoyances are growingperception is that annoyances are growing Decreased tolerance: increasing inclusion of negativesDecreased tolerance: increasing inclusion of negatives

Ex. Child abuseEx. Child abuse Decreased tolerance: decreasing exclusion of positivesDecreased tolerance: decreasing exclusion of positives

Ex. Affirmative actionEx. Affirmative action

Numbers & Polis:Numbers & Polis:Reactivity and PowerReactivity and Power

Measurement induces incentivesMeasurement induces incentives Measures evaluate performance, rewards, and punishmentMeasures evaluate performance, rewards, and punishment Ex. FCAT (“teaching to the test”)Ex. FCAT (“teaching to the test”)

The power to measure is the power to controlThe power to measure is the power to control The power to include is the power to excludeThe power to include is the power to exclude

Ex. Police, clearance rate (police effectiveness), & crime rateEx. Police, clearance rate (police effectiveness), & crime rate Ex. Political campaigning and measurement of issuesEx. Political campaigning and measurement of issues

Marginal cost – the cost of producing the next itemMarginal cost – the cost of producing the next item May mask the actual cost of production (e.g., Dept. of Defense)May mask the actual cost of production (e.g., Dept. of Defense)

Measurers need the people/organizations they measureMeasurers need the people/organizations they measure Ex. FDA and Big PhRMAEx. FDA and Big PhRMA Likewise, sometimes the measured need measurement for Likewise, sometimes the measured need measurement for

validityvalidity

Numbers in HealthcareNumbers in Healthcare

Numbers in HealthcareNumbers in Healthcare

Alachua County Choices ProgramAlachua County Choices Program Health care coverage for thousands of Health care coverage for thousands of

low-income people low-income people Funding through ¼ cent sales tax Funding through ¼ cent sales tax

increaseincrease How much extra will the average How much extra will the average

consumer have to pay each year?consumer have to pay each year? Number manipulation from both sidesNumber manipulation from both sides

Numbers in HealthcareNumbers in Healthcare

Insurance and Reimbursement RatesInsurance and Reimbursement Rates Reimbursement levels for Medicaid v. Reimbursement levels for Medicaid v.

private insuranceprivate insurance Doctors have an incentive to change Doctors have an incentive to change

their behaviors to treat more private their behaviors to treat more private patientspatients

Doctors can treat fewer Medicaid patientsDoctors can treat fewer Medicaid patients Doctors can spend less time with Medicaid Doctors can spend less time with Medicaid

patientspatients

Numbers in HealthcareNumbers in Healthcare

QualityQuality Number of medical errorsNumber of medical errors Number of procedures performedNumber of procedures performed Number of malpractice suitsNumber of malpractice suits Number of unexpected deathsNumber of unexpected deaths

Numbers in HealthcareNumbers in Healthcare

Quality- Number of medical errorsQuality- Number of medical errors ““Countability”Countability”

Do estimations accurately measure the Do estimations accurately measure the number of medical errors?number of medical errors?

Attention is given to things that are Attention is given to things that are measured measured

Reactive effects- Reactive effects- New York state report cards for heart careNew York state report cards for heart care Once measured, doctor’s outcomes improvedOnce measured, doctor’s outcomes improved

Numbers in HealthcareNumbers in Healthcare

Quality- Number of Procedures Quality- Number of Procedures PerformedPerformed Measure of quality- more experienced Measure of quality- more experienced

doctors should have better resultsdoctors should have better results Measuring this could result in a change Measuring this could result in a change

of behaviorsof behaviors Doctors may perform procedures that aren’t Doctors may perform procedures that aren’t

medically necessary just to increase their medically necessary just to increase their numbersnumbers

Numbers in HealthcareNumbers in Healthcare

Florida’s Malpractice CrisisFlorida’s Malpractice Crisis Counting normalizes and legitimizes Counting normalizes and legitimizes

problemsproblems Attention to the problem increases the Attention to the problem increases the

number of reported casesnumber of reported cases Highly publicized cases/large award casesHighly publicized cases/large award cases

Questions?Questions?