Welcome to Free Thoughts from Libertarianism.org and the Cato Institute. I'm Aaron Powell. And I'm Trevor Burris. Joining us yet again is Peter Van Dorn, he's Senior Fellow at the Cato Institute and Editor of Regulation Magazine. Welcome back to Free Thoughts. Thanks for having me. We should just call these like Trevor and Aaron go to school with Peter Van Dorn as our guest. What we're going to be learning today from Peter. Today, we're going to be learning about health insurance. Healthcare economics, I think generally speaking. What is insurance? At least how do economists tend to think about insurance? Let me give you a definition and some terms in it and then I'll unpack those terms. Insurance is a, well, all markets involve gains to trade. So remember that, we've talked about that, 170 podcasts have talked about that. So people don't tend to think of insurance in terms of the basics of that it's gains from trade. All right. So it's gains from trade from between whom? The answer is insurance contracts or contracts between risk averse people and risk neutral companies. So I needed to find risk aversion and risk neutrality and I'll throw in risk seeking as a third bonus definition. But before that, to do that, I need to introduce the term expected value statements, which is in economics statistics, expected value is the probability of an event times the value of the event if it occurs. So getting hit by a bus, so the, how much that would cost times the 0.013%, what are some sort of probability we can come up with that would produce a expected net value, current value of getting hit by a bus. So I want to compare two expected value statements. The first is you have a choice of a 10% chance of a $10,000 accident happening to you in a given year or you have with certainty the 100% probability of paying $1,000 every year. Okay. So to repeat, these are two equivalent expected value statements, which is the probability times the cost that the two, the products in these two statements are equal, which is 0.1 times $10,000 is $1,000 or $1,000 times 1.0 is $1,000. So you can pay $10,000 every 10th year when you have an accident or you can pay $1,000 every year. What I want to do now is ask each of you, Trevor and Aaron, to tell me are you indifferent between those two things? Do you prefer one to the other? I probably prefer paying $1,000, but there's no accident in that situation, right? I haven't revealed all that yet. Basically what I'm doing, well, go ahead, Aaron. I guess I would need to know how much money I already have. So do I have enough money sitting in my account to cover the $10,000 if that already happens? The smart student always adds complications. Hey, I'm smart too. I'm asking you to compare two states of affairs with a given budget. The budget constraint is constant. And so to go to reveal what I'm trying to get at with my little inquiry here is if you prefer to pay $1,000 every year rather than paying $10,000 every 10th year, then you are defined as risk averse. It's just a definition. You prefer one expected value statement over the other. If you prefer to pay $10,000 every 10th year, if you prefer that, you are defined as risk seeking. If you are indifferent between these two statements, then you are risk-neutral. So an insurance contract is a trade between a risk averse person and a risk-neutral company. The insurance company has data on population level damages, how often people run into things, how often people get sick. And given that data, they can calculate the average for the whole population, for any subset of the population. And they can then charge those averages called premiums to the whole population or any subset of it and then sign contracts with all those folks. Now there are some specific concerns that are difficulties that arise with insurance because of the incentive structures that it produces that concerns economists. What are some of those? There are two terms often called their market failures. They occur and I'll describe them. One is called moral hazard and the second is called adverse selection. Moral hazard is a shift in the pop in the... So make believe all these folks that I described sign up insurance contracts. And because they are insured, they then change the frequency with which damages occur because they are insured, i.e. they get more careless because they now are insured. That increase, that shift to the right if you're visually inclined, that shift to the right of the entire population level of damages is called moral hazard. Is that something that we tend to see in, I don't know if the data is that granular but do we see, we ask people what they're expected with this basic question and then we insure them and we see actually it's shift a little bit to them being a little bit more risky than before they were insured. Some of it comes from health insurance data actually and it comes from universities. Harvard University had a health insurance plan that had a low option, high deductible coverage and then for a not very higher price you got zero deductible and so they did an experiment and what they found is once people were insured against everything, the level of illness and damages in that population in the health insurance pool at Harvard went up dramatically. And when I taught at Princeton, Princeton had the same kind of setup and I had a shoulder injury from college hockey and I was uninsured as a gradual student and once I got my first job I immediately signed up for the high, the low deductible plan got my shoulder repaired and then left the low deductible plan for the other. So you're part of the problem. Is that the adverse selection problem? That's it. So now we're on the second part. So adverse selection is what Peter Van Doren did when he was in graduate school. I, people who sign up or don't sign up based on personal knowledge of their own condition relative to what the insurer has, that's adverse selection. And it's a Nobel Prize winning set of articles, Joe Stiglitz and Mike Spencer and Akerlof from Berkeley. The Lemons problem is a popularized version of adverse selection. So why would we buy insurance then if, so let's say that I already, I think that I'm going to spend this $10,000, there's a $10,000 accident possibility, the one in ten chance. So if I already have the $10,000 and I could just squirrel it away somewhere, is there any reason for me to buy insurance or is insurance always about I don't already have enough to cover the cost so this is like an easier way or a cheaper way to get into coverage? To go back to the basics. The choosing to become insured stems from your preferences about two kinds of states of the world which have equivalent expected value. If you are risk-neutral, if all people were risk-neutral, there'd be no insurance, there'd be no gains from trade. Risk-neutral people wouldn't make trades with risk-neutral companies. It's just a nonsensical statement. So if you are risk-seeking as a person or risk-neutral, then you both normatively should not buy insurance and then positively we predict you will not buy insurance because you are indifferent between paying large sums of money every now and then for bad things that happen versus paying every year a smaller amount which more or less adds up to the same thing over any long period of time. Now let's get into the ... We're not going to be talking about automobile insurance and stuff. I mean that's not specifically the topic although some of these concerns might be equal but as shared between the two but in the American healthcare market and specifically the insurance side of this market which has come up again because the Republicans are looking back at the Affordable Care Act and thinking about what they're going to do with it. So let's get the lay of the land first about the American health insurance market. How much do we spend on it? What does that spending look like? Just let me lay out some of the stylized facts from ... Oh, stylized facts. This is our bad name by the way. The three of us would be the stylized facts. You're on Pickle Aware. I'm not going to participate in that. I used that adjective again, didn't I? In 2015, take all the healthcare expenditures in the United States and divided it up by 325 million people. The per capita expenditures on healthcare in the United States in 2015, $99,000, $9,990. It's a lot per capita. It's a family of three, $30,000. In effect, I know I'm a reductionist but all healthcare fussing is about whether each of us pays more than $99.90 or less than $99.90, i.e., which set of people do we pool with for insurance purposes?  Remember, the insurance is the average, the premium will be the average of the people I share expenses with through contract. If we could know ex-ante, which people spend a whole lot more than $99.90, consensually I'm not going to sign a contract with them at the same price. You mean so, basically you're saying that if someone is particularly accident-prone in your group and then they actually end up costing $100,000 in a year, that means that you have to pay more to cover them in this sort of basic ecosystem we're talking about? Correct. If we knew that ex-ante, if everyone knew ex-ante, whether you'd be above or below $99.90, you wouldn't sign contracts with them at that price. When I taught my class, I used to bug my students and put ... I wanted to push them into a corner and say, you love your grandparents and you care for them dearly, but I said, would you voluntarily sign a health insurance contract with them, which said, take your expenses, the student's health care expenses each year, and one of your grandparents' expenses each year. And share them. And share them by dividing by two. And they go, oh no. And I'm putting them in a moral dilemma, which is they care, but would they voluntarily sign such a contract? The answer they regretfully had to tell me was, no, I'd want ... No, I would not. I'd want to lower premium for me and a higher premium for my grandparent. And so that's the rub, and health care is we're playing of a long, complicated, sometimes bitter debate about who will share costs with whom under a totally free market style health insurance system, and is coercion or force necessary to deal with the sickest individuals. And today we'll talk about ... My claim is that guaranteed renewable individual health insurance did exist and can exist, and that coercion, i.e., what's called community rating in the central part of the Affordable Care Act, is one method of dealing with this dilemma. But it is not the only dilemma. It is the claim that individual guaranteed renewable health insurance cannot exist, and therefore we need to have community rating. That I want to argue in today's discussion is not true. So what type of groups are we talking about that you can select between? So you gave the example of your grandparent, so that would be, are you going to be stuck in a group with people who are much older than you and therefore likely to spend more versus someone who's younger? So that's an age one, but does this, do the groups vary also, say, geographically, like realistically when we're picking, because you said we might choose, but what kind of choice is there in those groups right now? Well age, age is certainly an indicator. I'll give you some numbers. The per capita expenditure is very predictably by age, and these are 2012 numbers. Less than 19 years of age, the average is 3550 a year. Between 19 and 44, it's 4458 a year. Between 45 and 64, it's 9500 more or less. Above from 65 to 84, it's almost $17,000 per capita. And above age 84, it's 32,400 a year. So healthcare expenditures rise predictably with age. They also increase with what are called high cost conditions, cancer, diabetes, et cetera, et cetera, et cetera, the usual horribles. And part of the key to guaranteed renewable individual health insurance contracts is that from the data, we know the incidence of those conditions by age, and we can precisely design premiums for everybody that's normal by age. And then we can through, because we know the probability of these high cost conditions and how long they persist, we can price out what high cost insurance would add on to the normal premium for people at every age. Because these guaranteed renewables, would this be something where I buy a plan when I'm I guess 26, my parents have kicked me off their plan, and I'm healthy, I buy it at some amount, and then I keep paying that some amount for the rest of my life? The schedule of premiums would rise with age, but it would not rise as fast as if you bought a series of term insurance contracts for each year for that same number of years. In other words, by you saying I'm going to keep paying this company over a long period of time, the company in turn can then predictably smooth the rate at which the premiums rise and the increase would be smoother than if you bought a series of single year, non-renewable single year health insurance contracts. Given this concentration of cost, we have this difficult issue, as you said, about most of it seems to be concentrated in most healthcare costs, it'd be concentrated in a certain segment of the population toward the end of life care. Therefore, on one level, the problem is it would make some sense for young people to just not go insured if they just don't have that risk. If they have their own risks, assessment is they're riskier people and they're okay with the possibility of getting some problem, but looking at the numbers here you have, you say that the top 1% of healthcare users account for, in 2014, 22.8% of healthcare costs and the top 5% of healthcare users account for 50.4% of everything that we spend on healthcare in this country, so just 5% of people accounts, and then you think you might get there. I mean, most people are like, if I get old, then I'll become one of those high healthcare users, but before then, why should I be insured? Let me just piggyback on that question so I can understand these numbers a bit more.  It's kind of just a random, I don't know if I'm making a lot of sense, but a random selection of all of us. They become sick. Possibly. They become sick or they get hit by a truck or, so it's not, we can't point to a population and say, yes, those guys, the way that we can say people who are really old might be the problem. All right. If I hear you right, I think you're asking, can I know ex ante, which people will fall in the high cost category? We know ex post and I think you're asking ex ante. In general, we know that if you're over age 85, you're more likely to fall in that category, although ironically, if you make it to 85, actually healthcare costs go down slightly because the set of people, they're non-random that end up being that old are in fact extraordinarily healthy on average. The short answer to your question is, no, we cannot predict ex ante. So yes, the incidence of high cost things in any given year makes you in this very sick category. So again, 330 million people in the United States. So 1% is 3 million, right? 3 million people, the sickest 3 million people in the United States. We spent over $100,000 a year on their healthcare. Now, the papers that underlie this discussion, one by Mark Pauley, shows that the persistence of these high cost conditions, the median persistence is about four years.  So that's what makes guaranteed renewable health insurance possible because the median sick person, it doesn't go on forever. So that's how the insurance company can come out not broke in this is because they can say, yes, we're locking ourselves into potentially getting far less in premiums than this person's going to cost us, but we know they're probably not going to cost us a ton for very long. So four years is the median in the data underlying the... If they paid us premiums for a very long time before that, we still think we'll come out ahead basically on some level. Correct. If we locked them in at a slightly rising premium at 18 or something, then looking at our actuarial tables, when they're 74 and they have a very expensive disease for four years, we will be able to afford that and make a profit. Now, to be precise, the data in the paper, in fact, most health care papers only study the 19 through 64-year-old population and they just, sadly, from Kato's purposes, there is the argument about individual guaranteed renewable health insurance assumes that Medicare exists and that Medicare takes over after age 64. So I don't want to overclaim that somehow we have... That by starting at age 18, we can take care of things at age 90. That has not been studied. And so I don't want to overclaim that, but conceptually, there's nothing that strikes me that's not impossible about that, but it would be more expensive at every age because you're having to, in effect, start paying for those things that inevitably, and to answer Aaron's, in the data that are in this paper, approximately a quarter of males and females who are initially low risk at age 18 will develop a high risk condition by age 55 and almost 40% are high risk by age 64. So if we go to age 75, it'd be a much higher number, it would be in one of the so-called high-cost conditions. So you, Aaron, asked why, if I'm young, again, would and should, and I want to keep those statements separate, why would it be rational? Let me use that term. Why would a rational person who's young, who knows that the incidence of high-cost conditions for his or her age group is very low, why would such a person buy the kind of policy that I'm describing? And again, I go back to the definition, it's because they're risk-averse. If, because when you're young, you don't make that great money, you don't have much savings. So if you have a car accident or a bus accident, or you get leukemia or whatever, you would be wiped out and you would be denied care because you would not have enough resources to pay for it. So you, in fact, what's odd about the uninsured young is the people who should be most interested from an economist's point of view in being insured are young people without much wealth or access to wealth because they have no buffer to pay for things that go wrong. And yet, oddly, kids don't seem to care as much about that as economics would predict and often are subsidized by their own parents to be forward-looking. Well, let's take a step back then because I know it's like you don't like to think about these questions about justice and deserve it. These are words that don't usually enter into what you're thinking, but healthcare really charges people up. It makes people very upset. They have a view of what everyone deserves, how people deserve healthcare as a matter of right. All these sort of things, which I know is not your field. But it's more of a broader set.  How do you hear that? I feel like you decode that in your head as a certain kind of claim about distribution. Well, we'll go... With the free market. I mean, all these things that you hear, I feel like you probably hear those claims in different ways. Well, let's talk about it in the Affordable Care Act way, which is to talk about community rating as a normative solution to the underlying data that we've been talking about. And that's just a part of the law that says that the price can't vary between people except for, I think, five characteristics, like age, smoking, geography, maybe a couple others. But even those are ceilings in that, that is the premiums can vary so much by age, whether or not that is the real difference by age, right? In effect, political limits have been put on the variation. The central insight of economics in my view is that it says, let prices do whatever they need to do and deal with distributional issues separately and transparently. So if you, because of your conditions, in effect require very high-cost care and you don't have the resources to fund that care, we have two choices, well, three choices. One is we can appeal to charity to pay for those things. Or two, we can explicitly subsidize the care for that person. And economists tend to favor, if we're going to transfer resources, do not transfer to institutions, transfer to people.  And then if they don't choose to use the resources we give them for healthcare or education, the things we hope that they would invest in, if we give them transfers, if they do not do that, then from a libertarian standpoint, then our job is done. Which is if they've made, if their lives continue to not go well, despite the, either the charity or the, and again, libertarians would differentiate between a charitable contribution and a tax and transfer scheme. But economists' least favorite thing would be setting up a publicly subsidized thing that's separate for those who need care, i.e., in the old days, we used to subsidize city hospitals, right, there would be hospitals where middle-class people would go and then an interest, and then a so-called city hospital that was publicly funded and had a predominantly poor population. Well, that confines, that puts poor people who need care in a very terrible position because they don't have any choices. We confine, we, in effect, they're not only poor, but we also say, if you're going to get anything, you have to go here. We don't give them choice. Whereas food stamps, right, is a redistribution of economic resources, and we don't say in order to get the food, you have to go to this provider that's government-sanctioned. So the, so having a Medicaid program, right, having an explicitly publicly provided insurance program for poor people would strike most economists, I think, as kind of odd because it restricts their choices. We should separate the, are we going to transfer resources to people or not? And if we do, we shouldn't second-guess all their choices. We shouldn't engage in the stereotype, it seems to me, that poor people are whatever don't make proper choices. And so we all have all this hand-ringing over, you know, our food stamps overused or underused for junk food or whatever. And it's like, I personally am not interested in those discussions, and I don't like engaging in them because it, to me, it demeans the individual. We're giving them money. That's the end of discussion. And then let's stop second-guessing everything they do because I don't want people second-guessing everything I do. I'm going to push us into that discussion just a little bit. I'll put on, I have to put on my friends on the left hat, but this time I'll put on my friends on the right, the more conservative hat. That, so if the goal, you know, what we want to stave off and the reason why we would be worried about not having any sort of subsidy is that we want to prevent people from having their lives destroyed by bad things happening to them. We don't want to watch people die on the street. We don't want to watch people die of illnesses that could be cured and so on. There's a compassion angle to it. And it seems like, I mean, we can say like, yes, it's maybe paternalizing or not respecting them to say, you know, all these people practice poor judgment, but it does seem like poor judgment does play a role to some extent in some level of poverty, goes back to the marshmallow test and whatnot. But so do we, it seems like, yes, it's more respecting of them to say, we're going to give you this chunk of money and you can spend it however you want. But then if we're, I guess, naive about the degree of poor judgment that exists. And poor judgment seems like another thing that may decline maybe related to age too, like the very young people who were saying, you know, they're the ones who have to make this decision about whether they need insurance or not because they're the ones who are least likely to get sick and so it's this harder call than the older person who's like, yeah, I better have this thing, are also the ones who are most likely to practice poor judgment because judgment typically improves with age. So our kind of libertarian desire to let people have the resources and then leave them alone to make the choices seems like it could lead us back to the very situation we were trying to avoid in the first place with the subsidies, which is people leading, you know, having awful things happen to them and then suffering the consequences. True. So in the end, this is an empirical question which is what in Peter's world of transfers and no centrally provided programs, what percent of bad behavior would exist and we could find out, we could do experiments and two, then there's just type one and type two errors which is, so of the set of people we're helping, if we centrally provide things through explicit programs and say, if you want healthcare, you have to go to Boston City Hospital or Washington General and that's the only way you get help, otherwise you don't get any or think of education. The only way you get subsidizes if you attend public schools, if you want to do something different, you're on your own. So I'm making a voucher-like argument for healthcare that's equivalent to what people on the right often describe in education and then there's an empirical question of if the ratio of people that Aaron describes is a large portion of the population we're trying to help, then his concerns clearly strike me as important and my arguments would diminish in importance because my giving the 5% of people who need to be subsidized, the freedom to make better choices given that they would do it, whereas 95% of the people we're helping would make poor choices, let's say, if that's true, then my stance seems to be while very principled, might be described as a waste of taxpayers' money, whereas if the percentages were reverse, then the, and again we can think of food stamps, right, people on the right. They're just a study released recently on the barcode data has finally been released by the Department of Agriculture and we now know how many, what percent of food stamp monies are used for, you know, snacks and soda and things like that and it's higher by a bit than the normal retail non-food stamps subsidized purchasing population. Is that bad enough so that I want to go back to, you know, stored cheese in the cheese storage thing which then was sent to food banks, which then was handed out to poor people who had to show up at the right time in the right place to get cheese? Do I want to go back to that system? I have tasted government cheese and nobody wants to. When have you tasted government cheese? I knew someone whose grandfather received, and I don't quite know why or how government cheese and it was ... There's our first album name, by the way, Stylized Facts, first album is going to be called Government Cheese. So I think we could agree maybe that we need an empirical answer would inform our value choice about which kind of error is worse, they screw up error or we want to give them freedom kind of perspective. Well, let me ask a question about the guaranteed renewables that kind of impact on this but also might be something someone listening to would be concerned about, which is ... So the idea would be that I make the decision when I'm young and healthy to buy insurance. Well, just the poly paper actually said you can buy guaranteed renewable insurance at age 55. It would just be more expensive. Right, but the idea is that I buy it not knowing what the future holds and I'm sick, my premiums don't go through the roof, so I've done okay. And that's my incentive to keep with that policy going forward. So that seems to work for people who are in the position to make a decision about whether to buy insurance or not and what kind but how does it handle, say, sick kids? We have a neighbor whose son, 18 month old son, has cancer and they're spending a ton of money. There's a lot of healthcare costs involved which is presumably on their insurance but that 18 month old probably was never in a position to buy insurance for himself and if he had parents who chose not to buy it for themselves or for him when he was born, is he now stuck either not being able to buy it or getting it only ever being able to buy it at this extraordinary cost because he's now in this much higher bracket. The only fool proof logical way to deal with the questions you raise is to drive the discussion we're having all the way back to age zero. So in other words, you're correct that if so one cannot insure against something that is known, right, so the poor children or children who through no fault of their own end up with very costly childhood diseases that's already known, we know that and so what could insurance do for them and the answer is it could simply share the variance in the cost among that population of very sick people. I want to just clarify some people like so some leukemia people would be slightly higher cost than others and one can insure against that variance but one could not insure against the fact that they have leukemia. Making sure that we're using the right words here because some people might be listening to what you're saying and saying they can absolutely get insurance if you made it the law. I'm saying in the hypothetical. But also on some sort of definitional level, that's not insurance anymore. The law is just saying that a third party has to pay for this thing. It's not actually insuring it's an uncertain future risk. One can insure against only the unknown variance of some distribution. Well, it's known at the population level but you don't know where you're going to fall in it. If you know where you're going to be and then you're demanding someone else pay for it, it's not insurance. It's called subsidy. Which is kind of how some of this stuff worked. I think that with the Affordable Care Act for example part, it was about cross subsidizing between groups of people and not calling it a welfare payment. Correct. Again, we remember 10 minutes ago I said the economist's tendency is to let all prices be transparent and let all facts be known and then deal with the need to subsidize or not subsidize completely separately. In the real world there is a perception particularly among Democrats and that the public because America is even though not a Cato kind of into free markets they're into it more than because of culture and tradition, more than maybe we give them credit for here at Cato that the resistance to explicit redistribution is rather large in the United States so political forces that lead to redistribution have to be hidden, particularly in the views of Democrats who generate these programs think that the public support for them would be much, much less if the transparency that I prefer were and did in fact exist. So the only way to redistribute is to have something called community care, everyone gets a policy at the population average but then to avoid adverse selection we have to have an individual mandate, we have to use force to get everyone to sign up because people who are 23 know that their costs probably are not going to be 99.90 the per capita average that year and so to charge them that premium they won't buy it unless they're forced to and so that's, so in the real world there's lots of cross subsidies in American policy programs but it's all very hidden and if you go out and ask voters are they being subsidized most of them will probably say no because they don't realize that they're being subsidized. I want to talk about and maybe actually we've already covered it to some extent but one of the papers that you cite in the outline you gave us for today is by John Cochran who I think is Chicago he was he's now gone to Stanford to Hoover Hoover yeah his idea of health status insurance which you write is a product that mimics the guaranteed renewability portion of an insurance from a community rating kind of thing well Cochran basically read the Pauly paper and said oh I wrote a paper like that only in a completely different journal way before Pauly did actually to summarize because we glad we touched on it the Pauly paper says what is it what is the general because we kind of mentioned it a few times but we actually haven't what Pauly did and this is a paper that's 2003 so it's 14 years ago way before the Affordable Care Act it said it examined the medical expenditure panel data it examined healthcare expenditures in the United States at the individual level a big big sample of those it then said what would guaranteed renewability oh well prior to this paper Pauly actually investigated corporately provided employee your provided health insurance and realized that the premiums don't rise as much with age as one would think they would well the healthcare costs rise by age we know what that is and the premiums that companies charge their employees and in turn that companies charge insurance companies charge employers don't rise as much with age as actual health expenditures rise with age which is honest it's confusing so Pauly scratched his head and said hmm what's up with that and so he then went on to say well what would a guaranteed renewable world look like and he said it would at every age have a very low cost component for the majority of people that don't get any health care at all in a year then there are 12 high cost conditions and he figured out what those were and he said these occur with the following incidents at every age group let's add that to the very low cost like cancer like that kind of thing actual conditions condition and he added that actually fair amount to the low cost premium at every age group and then went out and said how do health insurers what prices do they charge for guaranteed renewable health insurance and he found that the calculations he made more or less mimicked what companies actually charged so first of all there's an important point which you said a little bit but we can make very clear guaranteed renewable health insurance did existed before Obamacare so you kind of at least one of the things many policy proposals claim that it was impossible to free market to have this kind of my view state something that like the current concern we now have for facts they stated something that good reputable research in my view refuted which is that this market that you say can't exist did exist it did exist now many people didn't buy it in part because most people have employer coverage so the set of people that need individual health insurance in the United States 10% of the adult population something in that range and then Cochrane's paper said ah what I'm going to provide is a portable present value contract that sits with you because all the horror shows that we that led to Obamacare right I'm I can't get insurance I have a pre-existing condition those largely were transitions from employer they've been employed or something and then they were laid off and then during a recession after 18 months they still don't have a job or then they're out of luck so Cochrane said let's just extend the polly notion of can we write a financial derivative for the transition from back and forth between an employer provided plan and an individual plan because in the United States people flop back and forth but once you have a condition and it's known quote the individual market doesn't want you because you haven't they now know it and so you're just going to share risk with other people who have cancer and it turns out that premium is $40,000 a year so Cochrane said can't you design a probabilistic financial derivative whose cash goes with you so that as you cycle between employer and individual coverage no one will discriminate against you because yes you'll face a high premium in the Cato world because that's what you need to pay on average but you'll come with this pile of cash because you've paid for the derivative that pays for this low probability but high cost health transition that you've gone through does the paper mention or do we have a sense of how much such a thing might cost like is this in order to have health status insurance am I going to have to be paying an extra $500 a month or is it $20 a month well remember go back to the data I gave you about the incidence of high cost conditions is very very low at young age and it increases linearly well non-linearly actually with age so by age what did I say before 64 was one of the we had 16,000 but that's what we currently pay oh right here a quarter a quarter of both males and females who were initially all low risk at age 18 would be high risk by age 55 so every year as you age the probability of being in a high cost condition increases and depending on the high cost condition as that probability approaches 0.5 times a $50,000 a year you could yes the premium would be could be high if you don't start out when you're young but in fact try to get guaranteed renewable insurance at age 55 because half of you by next year right the data I just gave you if you're 55 and you join 40% of those people who join at that age next year could be in a high cost condition so there's not that that gets expensive it seems that some people they have a problem with the fact that we're talking about the economics of people's lives right now which strikes me is I mean a sentiment that I understand we're seeing a fight club where he's doing the calculation about whether to issue a recall for the cars based on how frequent it is or show yeah it's a sentiment I understand and but I nothing is free and and how do you react to this sort of like to this why are we talking about nickels and dimes with people's lives kind of attitude because someone has to pay I mean we can make I mean by not wanting to talk about this we've healthcare has gone from you know 8% of GDP to 17% do you think that's part of this thing that we don't like to talk about the nickel and dimes with people's lives and then we politically do things if everyone says it's immoral to talk about a budget constraint then this is a problem there is a budget constraint so yeah that does seem to be a problem it's we can make believe there isn't a budget constraint and so when we do that we end up spending a lot of money on this thing I mean Robin Hansen at CMU says in his view a lot of healthcare expenditures are to assuage guilt over death and things related to it and it doesn't really stop it it doesn't do it just it's we're in a fluent country and we spend a lot of money to avoid these well I mean we go into interesting discussion is Medicare now allows one to spend a lot on one's death clarify what you mean by that Medicare covers everything until you die and we know the data show that I'd have to go back and look I can't say off the top of my head but a non-trivial percent of Medicare expenditures occur in the last six months of life you know that now we're not very good at predicting that six months that's so we can't go to a complete game in which I'm about to describe but what if families were given the following choice you can spend $200,000 on me in the next two years or I could stop healthcare treatment and the government would split the savings with you and your relatives many many people find this discussion absolutely abhorrent they would think I mean no we should not this is econ gun nuts we should not go down this path econ gun nuts gone nuts you just described an Agatha Christie novel okay a will exactly grandma wanted us people I know a family because they know they chose the diagnosis with pancreatic cancer the survival rate is very very low for that they chose to do no care none because they said oh they know the treatments involved would probably not do much and make life the quality of life not very good so this family conscientiously decided way before any symptoms were horrible to just forgo all treatment well that family saved the nation a ton of money now they did not do it to save money they did it because of their own healthcare decisions but if lots of families did that we'd save lots of money the question is should we is there any reasonable way in which some of those savings right now those savings aren't shared with the family in question that seems to me that the real moral the real moral quality of the healthcare debate needs to come in about the actual cost of these procedures because if you make things cheaper questions about distribution change so if you actually make if you made treating cancer $20 a $20 pill because of some sort of innovation then your discussion of how much we spend and how much distribution is changes suddenly one libertarian example that should be near and dear to our listeners hearts is dialysis is the one treatment kidney dialysis is the one treatment that's 100% funded by Medicare regardless of age regardless of age it's not just old anybody on dialysis in the United States that is free kidney transplants are not and a market for kidney a market to incentivize a donation of kidneys is illegal this to the libertarians this is crazy right so we will spend a gazillion dollars on dialysis so you're hooked up to a machine for three days a week for the rest of your life or we could give money to somebody to create more supply of kidneys for transplant purposes that's one side but also innovation for actually coming up with better ways of doing things that are cheaper I mean is this also seems to be a thing that we can't ignore in the discussion that maybe we can lower that $9000 by coming up with cheaper ways of doing things or is it always to be the case that people are spending I mean is that is there sort of a thing where does it always fill the amount of money allotted to it or could we actually bend that down and like and spend $8000 a person and save as many lives and make as many people happy or does it just the money fill what is allowed to it again it's an empirical I mean many on the right claim that because of government involvement in healthcare because of the extensive government involvement in healthcare that Moore's law governs the IT world I rapidly decreasing costs from because of technological innovation that that does not arise in healthcare because of government involvement and if there were more market forces the miracle of cost reduction that we see with computers and smartphones would also show up to a much greater extent in healthcare I think that's a fair way of putting the claim in the end it's testable but hard because we don't have government involvement in healthcare is so extensive everywhere in the world in the United States is an outlier for our lack of we're on the low end of government involvement that it's very hard to test and find a place or a set of circumstances in which we can see whether or not this claim is true but it seems like if I mean you mentioned that we're a lot of the healthcare expenses are like Trevor mentioned but it's kind of paying for guilt around death and guilt around death is not is something we can innovate our way out of and so it may simply be that like yes if we can cure cancer it just means that now that last little bit of whatever is going to kill the person or old age we're still willing to spend up to our level of guilt or if it's on you up to your level of fear of death there's a good way of putting what I was asking because let's say we do come up with a $20 pill for treating cancer and so a lot of people in their 60s you get cancer take that pill cancer is gone now they live to 95 keeping someone alive at 95 for you know one day more six months more in some situations is very expensive so now we just spend it at that point and so we always we used to heart disease has gone down right smoking rates are down among men so compare 1970 to now the expenditures on heart attacks heart disease etc etc that's that's gone down over time now we spend it on hip replacements right I mean we've in the price of those is going on so there I mean the the literature in healthcare economics tends to argue that because the subsidies exist the money flows into healthcare companies find technological breakthroughs that are very expensive that will do stuff for health even though it's marginal this op-devo you've seen a ad on television for op-devo say divo op-devo I think I'm got the pronunciation right notice all pharma all drugs have three syllables I think they just draw op-devo okay it's a can a lung cancer drug late stage and it it says it gives people longer life blow it did the trial right it was approved it's three months three months extra life three months and it's expensive okay so right now Medicare approves at well even insurers approve everything not because the marginal benefits are greater than the marginal cost but as long as the marginal benefit is greater than zero regardless of the cost okay it's almost like environmental policy it's like can we reduce air pollution at great expense yes we can do it same same thing with healthcare I mean we so here's the hard to say no here's a good I guess final question on that how much should we spend on healthcare and how would we know the answer to that question is that a big enough one for you yes believe it or not there is there's a literature that tries to say what a the price of a statistical life year ought to be and the answer is about a hundred thousand dollars now in the United States so that that's the economist answer I kept this goosey kind of exactly this comes from how much do people in high risk occupations except in wage rates to deal with the possible mortality risk and it's nine million dollars per statistical life saved and then when you work it out to a year it's about a hundred thousand dollars and so that's one way of I mean if you want to use market indicators based in people's choices about the value of their lives and the risk they put forward then we should never spend in a public sense and when taxpayers money is is at stake we should never spend more than a hundred thousand dollars per statistical life year saved and there is a literature that talks at length about what cures do and do not pass those tests et cetera et cetera thanks for listening this episode of free thoughts was produced by Test Terrible and Evan Banks to learn more visit us at www.libertarianism.org


When working with documents that need downloading it can be useful to signal colleagues that you are editing a file. This can be done with file locking in nextcloud. When you are done editing the file, you upload the new version and unlock it again. Let's see what your colleague would have seen. They will have to wait until you are done with the file, but they could of course contact you and ask what you are up to.


Hello, I'm Mike Guio, editor of Strategic Studies Quarterly, and welcome to another edition of Issues and Answers. Today, the issue, U.S.-China Relations. My guest is Dr. Dawn Murphy, assistant professor of international security at the Air War College. She specializes in Chinese foreign policy, Northeast Asia, and international relations. Her current research analyzes China's interest and behavior as a rising global power. Dr. Murphy holds a BS degree in industrial and labor relations from Cornell University and a master's degree in international affairs from Columbia University. She earned a PhD in political science from the George Washington University. Dawn, welcome, and thanks for being here. Thank you so much for having me here tonight. It's my pleasure. So to begin, I want to ask you if you could, big picture-wise, characterize current U.S.-China relations overall. So Mike, I think the best way to look at the current state of U.S.-China relations is to think about it as both interdependence and competition. So from an interdependence standpoint, if you really think about it, China is the number one source of imports for the U.S. economy and the number three source of exports for the U.S. economy after Mexico and Canada. We also have a lot of investment going back and forth between our economies, and we cooperate on a number of different issues related to peace and security throughout the world. So we cooperate, we're interdependent, but we also have competitive aspects to our relationship with China as a rising power and with different interests between the two states. Well, I'm glad you mentioned economic issues because that's a follow-up question. How would you give us a perspective of the size and power of China's economy versus the U.S., or relative to the U.S. economy? Right. So today, China has an overall gross domestic product of about $11 trillion, compared to the U.S. at $18 trillion or so. So essentially, in absolute terms, you can think of China's economy being about 60 percent the size of the U.S. economy. That said, and over the next, between five and 10 years, that gap will narrow. You also have another metric that you could examine, which is gross domestic product on a purchasing power parity standpoint. And when you look at those numbers, China's economy has actually surpassed the U.S. economy by that metric. Another way you could look at the size of the economies is gross domestic product per capita, which means per person. And when you look at those numbers, China's economy is about $8,000 per person compared to the U.S. at $55,000. So China's a much poorer economy per person than the U.S. at about 15 percent. And finally, when you look at China as a source of foreign direct investment, globally, increasingly, it's becoming a major player in that realm. And over the last 30 years or so from 1978 to today, China's gone from being a minimal autarkic economy to being the second largest economy in the global system. So if you look at any area of economic interaction, manufacturing services, finance, construction, they're becoming a major player across the board. So it has been a stunning rise. And if you look at the beginning of their opening, they were growing at 10 percent a year or so. Now they've slowed down to closer to 6 percent a year. But that's still a very high growth rate compared to many developed economies. Well, it sounds like under the status quo in Asia and most parts of the world, the Chinese economy and the Chinese society writ large is really progressing. So do you think the Chinese are interested in maintaining the status quo, particularly in Asia? Or are they really more interested in changing that status quo that seems to have led to very great success? I think when you ask that question, when you think about that question, you have to look at specific functional areas and specific issue areas. So what is the status quo, for example, from an economic standpoint? You could argue that the current status quo is interacting through the World Trade Organization, free trade agreements, having strong bilateral economic relations with partners throughout Asia. And essentially, I think for the most part, China wants to maintain the status quo from an economic interaction standpoint with the rest of Asia, as it continues to grow in power. But when you start to look at other issue areas, there may be more or less comfort with what the status quo is or disagreements on what the status quo is. So for example, Taiwan, what is the status quo associated with Taiwan? From a Chinese perspective, even though it may be the status quo, they've never agreed with having a separate Taiwan. Or if you look at claims in the East China Sea, South China Sea, China's assertion is that it is making claims that it has historically for a very long time and that it's wanting to preserve the status quo rather than change it. So those are just a few examples. Okay, well, I'm glad you mentioned those because I want to shift focus now to some of those issues, particularly more security related issues. And ask the question, what does China see as its greatest national security threats? I think it's important when you look at China to think about what China's interests are overall from a national security standpoint. And number one is maintaining power of the Chinese Communist Party. So that is a bit different than other systems. Considering the fact that, for example, in the US, that's not the first thing the current administration thinks about when they wake up is preserving their party's dominance over the system in the way that you have in a Leninist authoritarian political system. So number one is that. So what threatens their security the most is any sort of internal stability, any issues with legitimacy associated with the party, those type of issues. Their second most important interest is territorial integrity and sovereignty. So what falls into that bucket would be, as I already said, Taiwan, Tibet, Xinjiang, some minority areas within China that they worry about breaking away and having secessionist activities, Hong Kong and Macau. And then increasingly, when you look at territorial claims in the East China Sea and South China Sea, those are included as some of China's more core interests within that realm. So that would be the number two interest and threat. The third would be China being able to continue to grow its economy and provide a better life for its citizens overall. So anything that would threaten that. So if you look at conflict in regions, whether it's the Middle East or in Asia Pacific, that potentially could damage China's ability to continue to grow its economy. That's also a national security threat. And they have other interests as far as a voice in the international system, advocating for developing country causes. But from a national security standpoint, I would say it's maintaining the power of the Chinese Communist Party, territorial integrity and sovereignty. So the ability to defend themselves and to keep their country from breaking apart. So is that the extent of what the Chinese would consider the ideal situation in Asia? Again, I think this is one where you really need to think about how that's framed. So I say big picture, the ideal situation within Asia would be an environment where China could keep its party in power and maintain its territorial integrity and grow its economy. So a peaceful environment within Asia Pacific. But I think there's a lot of disagreement within the scholarly community regarding what that looks like. Because if you think about it from an international relations perspective, they are a growing economy, right? They're a growing power. And together with growing economic power comes other aspects of power, military, political. And as you know, a classic security dilemma is that you never know a state's intentions and that states build up their capability in order to protect themselves at a minimum, right? And that as a result, you need to plan for various contingencies associated with that. So does China want to be a hegemon within Asia? We don't know that. I don't think there's a way to actually know that given the lack of transparency in their system and the fact that they don't claim that as a desire at this point. But you could look at certain behavior that indicates in the longer term they could potentially become a hegemon. Do they want a hierarchical system within Asia? There's nothing tangible that indicates that. But you look historically in the region and China has played a different role at different points in time than it does today. And there's been different relations between states than what you have today. So I think it's very hard to say what China wants other than China wants to protect what it sees as its sovereignty and to continue to grow its economy. Yeah, OK, so the things you mentioned early in an earlier question. You mentioned a key word in my next question and that has to do with the fact that no relationship survives friction, no international relationship among nations survives or exists without some friction. So I would ask you to give us some examples of some of the greatest disagreements between China and the United States. I would say some of the major disagreements, one would be associated with trade. So I think the audience is very familiar with a lot of the critique right now of the trade deficit in relations with China. And as China's economy grows and as it is more incorporated into the international border and trades more with the U.S., as there's domestic dissatisfaction within the U.S. regarding growth rates, regarding unemployment and other aspects. I do think there's growing domestic pressure within the U.S. to have a more level playing field in relations, in economic relations with China. So that's one potential point of friction. Another point of friction, as I've already said, is East China Sea, South China Sea. But an important dynamic to remember in that is for the East China Sea issues and the Senkaku Diaoyu Islands, the other claimant in that is a country, Japan, that the U.S. has a mutual defense treaty with. So we have security obligations associated with that. In the South China Sea, when you look at the various claimants there, whether it's the Philippines or Malaysia, Indonesia, we have strong security relationships and partnerships with those countries as well. So it's more complicated than just those territorial disputes. And especially on the South China Sea, that really brings up a lot of issues associated with freedom of navigation, what is the global commons, what norms are we going to conform to in our behavior? And there are disagreements regarding that as well. So the major points of friction I would say between the U.S. and China right now are some trade issues and economic competition. I do think that as China's economy grows and as it surpasses the U.S. in absolute size, those conflicts will likely increase, right? You've got East China Sea, Senkaku Diao Yu, you have South China Sea, you have Taiwan that's been an enduring point of contention, and in many ways China sees the U.S. as having played a major role in that issue obviously from the beginning during the Cold War, but even today. And that's calmed down a bit in recent years, but that is a potential point of conflict. And then finally, I would say North Korea in, you know, especially I would say over the last year or so as North Korea's capability increases and as it becomes apparent that China and the U.S. have different interests associated. We've known this for a very long time, but obviously it's become a higher priority from a U.S. perspective and China and the U.S. have differing views regarding how to resolve that issue. So I think that could be a potential point of stress. The President just came back from the Far East yesterday, and I'm wondering if you saw some signs in that trip that would lead us to think that China and the U.S. could actually reconcile some of our differences in Asia. Do you think that's possible, or is it already happening? From this trip itself, I think it will take a while to see what the actual results of the trip are. On the surface of it, all that I've seen tangible come out of the meetings in Beijing are announcements regarding a few hundred billion dollars of some trade deal, not trade deals, I'm sorry, a few hundred billion dollars of business deals that have been in the works for quite a while. And I don't, you know, if you think about compared to the overall deficit and compared to the overall relationship, I think that's a minor win, but that could be seen as a positive result of the trip. But, and I don't know what happened behind closed doors, obviously, but if you look at the speech that President Trump gave in China, it was still echoing the same sentiments regarding concerns over the deficit and concern over those trade frictions. And then you look at the speech that he gave a few days later at APEC, the Asia Pacific Economic Cooperation Forum. In that speech, there continued to be the rhetoric associated with concerns about the international economic order and concerns from a U.S. perspective regarding trade partners that are not providing a level playing field for U.S. companies. So I have not seen any tangible results of the trip yet, but it's still early days, he just returned and most of those discussions occur behind closed doors. So I wanna ask you to look in a crystal ball and give us a couple of examples where the U.S. and China can and should cooperate more, specifically in Asia, or maybe even in other parts of the world. What should we be working to do together? I think the most probable areas of cooperation would be issues on which we have a shared interest that's it's clear cut as a shared interest. So basically, for example, global climate change, that's something that we could cooperate on. We both have an interest in preventing that from occurring in the longer term and that's something in the past we have cooperated on in a certain way. So that would be one, developing green technology. Another potential area of cooperation would be in foreign aid provision or providing assistance to developing economies. In many cases, we play within that realm together from the standpoint of we're both providing foreign aid to individual countries, we're both providing various levels of technical assistance for economic development and I think many countries would be able to learn quite a bit from both of our experiences. So that's something that I think we could do in a non-competitive way. Another example would be antipiracy. We've seen this in the past with the Gulf of Aden we have cooperated on those issues. Another would be United Nations peacekeeping operations which China has been heavily involved with over the years.  I mean, I think we have opportunities for cooperation but we really need to focus on those areas where we have a shared interest and there's not these debates over territorial integrity or over values that may not be the same between the US and China. Over the last, over the past few years we've seen some instances where things had a potential to escalate and I'm wondering if there are some, you have some specific recommendations that would give us some examples of the kinds of things the US and China should be either doing to sort of eliminate these potential conflict areas should we be doing on things that we should be refraining from doing. I think the best advice to give on that would be that we need to increase communication as much as possible. So we need to have as much military to military cooperation that we can have that still obviously protects US interests and isn't threatening our national security but ultimately more communication is better because where I see the most likely areas of conflict would be for example on the East China Sea a mis, not necessarily a misunderstanding but a miscommunication or a very minor incident that then escalates into a crisis and we don't have the proper communication between our militaries in order to de-escalate that in time. So that would be one example. So I do think we need to increase in that way. That said, many of our tensions are the result of an actual difference of interests, right? So how that's addressed in the longer term I think is difficult in that our US interests in the region gonna change. Are China's interests in the region gonna change? Perhaps, I mean those are strategic decisions we make as a country over time but assuming that those don't change we have a situation where China is an authoritarian communist, politically communist regime that there are sincere differences of opinion regarding how they govern their society and how the US governs ours. So I mean I think that's a fundamental difference and the reason I bring that up is I think one of the discomforts with China as a rising power is not just that it's rising. It's that it's a rising power that doesn't necessarily share the same norms as the US and the West on a number of key issues regarding governance of their population. So that will continue. I don't anticipate that that is going to change in a dramatic way in the future and as China's economic power grows those tensions may escalate and on territorial integrity. I don't think that the US should be backing down from our commitments to allies in the region. I don't think that we should be allowing China to operate in a way that we don't think is a proper interpretation of international law. So I don't think we should back down on that but I also think we need to increase communication so we can avoid a minor dispute turning into something much more serious. That's a very well description of the situation I think, a very helpful description of the situation, the things we should and should not be doing. Last question. Again, I wanna ask you to speculate a little bit. What would you assess is the probability that conflict would erupt between the US and China within the next 20 years? I think it's a relatively low probability and you have to look at different functional areas. So on the military side, for me the most likely areas of conflict again would be East China Sea, South China Sea. There are scenarios under which North Korea could potentially become a conflict scenario between our two countries because China still has a mutual defense treaty with North Korea and has recently re-articulated their commitment to that to specify that if North Korea is aggressive towards another country and initiates conflict, China will essentially restrain itself and not become involved in that conflict but that if North Korea is attacked that China would contribute to the mutual defense of North Korea. So there are scenarios where if the US engaged in a preventive or preemptive action against North Korea that you could have a militarized dispute between China and the US. So there is potential. That's a relatively small probability. I think it's a higher probability today than it was a year ago or two years ago just because of escalating tensions and more because of the US approach to the situation rather than the Chinese approach. So I think that's a growing area. Taiwan as I said before is always there's the potential for that. So the military realm, I think it's unlikely but could happen due to a relatively minor incident escalating. But I think that the more likely tension areas would be more of a Cold War type of environment that potentially could emerge either through China's actions or through US actions. So if the US continues to withdraw itself from the international order and China takes a leadership role and we continue to have these frictions regarding trade and especially if either side takes trade action that then results in a trade war you could have a ruptured US-China economic relationship with China having a sphere of influence economically with certain countries and the US. So basically breaking up into blocks. I think that's much more likely than any sort of militarized dispute. And again, that really depends on both the actions of the US and China. So that could happen. We also I think could have some breakdown of the overall international order due to many factors globally associated with nationalism and the downsides of globalization. So we may be seeing a fraying of the overall international order. So you may have an economic order that China leads in the longer term and one that the US and the West leads and have kind of more similar to the actual Cold War rather than just having regional blocks having full-fledged systems that have different norms that govern them. So we may be at this turning point. So I think that's more likely than any sort of militarized dispute. Okay, so low on the military side and maybe higher in the economic realm, okay? Dr. Murphy, you've given us a lot to think about over this very short period of time. So on behalf of the team SSQ and the entire SSQ audience, I wanna thank you for sharing your experience with us and also sort of leading us to think strategically about this very important relationship between the US and China. Thank you very much. Thank you again for having me. Appreciate it.


Hello everyone. Welcome to the session. I'm Srishti. I work in the technical collaboration in the media foundation and I'll be giving you a very quick and high level overview of technical areas in the media sphere. So it's mostly likely going to be like a refresher of what you have already heard in the opening but if you are still not sure what you want to work on at the hackathon or you are new to our technical areas or you consider yourself as an newcomer then it might be useful for you. But if it's not the case then you still have 30 seconds to decide whether you want to be in the session or not. All right so these are some of the technical areas that I want to talk about. And as I introduce you to these areas I will give you one example of a project that is you could do an area languages that you would need if you want to get involved and mentors who are related to these areas are present at the beginning of the hackathon and will be happy to know that you get started. I want you to start out with those areas first which we think are suitable for your comments and are most recommended ones. So we start with we have media beauty extensions. Basically the extended functionality of media beauty software which is the core software that comes with basic functionality. And when it comes to media beauty I mean the problem that you might have seen already that powers the content of beauty media and other beauty sites. Each extension serves some kind of purpose it's most recommended area for newcomers to get started. You can help in two ways either you can help develop a completely new extension or improve existing extensions. And any of you which is media beauty related that I believe share in my presentation for that you would need php, jquery, javascript, css, less, myseql and myubd for the next time. It's called echo which provides a notification system that can be used by other extensions as well. And what I need to add is so if you have used media wiki you might have noticed that you get notifications for all kinds of things there. When your user rights were changed or when somebody mentioned you want a beauty page or you created a topic or someone created a topic on your page. So for all those things you get notifications and they are being handled by this extension. So mentors Mario and Matt they attended wiki media hackathon. So you can get in touch with them they are again similar to extension there are two ways you can help either by creating a new notification right or help improve existing ones. And we have mobile apps which are available for wiki media and wiki media comments. How many of you don't know about wiki media comments? Wiki media comments is a project which is supported by media foundation. It is a shared repository of multimedia files images audio videos etc and there is a mobile app as well which is maintained by community members. So basically you send us app you can upload pictures from your from your mobile phone and view near biasing pictures. So it's like really cool in a way if you're on a vacation and you see a nearby spot for which there is a missing picture you can straight away upload it on your phone. So this is also a very informative project and mentor Roykesh is an ending wiki media if you're interested in contributing I can help you connect with him. And for mobile comment you would need objectives for iOS development and Java for it. Then we have desktop apps and I want to give you example of two such apps one is e-mix which is a third party offline content reader. It allows access to wiki media content to Zim which is an open standardized file format. It's being used in a lot of places where there is poor internet connectivity and there are a lot of organizations that have tried to get schools to use qx for example. There are different versions of qx for example there is a browser extension there is a desktop app there are again ios and android apps as well. All the three mentors are present at wiki media and depending on what version of qx you want to contribute to you will need different kinds of skills so this is also one space to work in. Then there is another desktop app which is hardware it is an anti-vandalism tool that helps to work edits which are problematic. Again a project that you think is suitable for developers for this you would need c++ and qt framework which is a cross-platform and graphical user interface for c++ so you would need skills like that. Mentor writer is at wiki media again. There is also an area which is machine learning and this an example of this you have already heard from Aaron today in the opening ceremony so i want to just quickly highlight this again so it's gave up service and API that allows you to store and edit and then help evaluate in the sense that whether an edit made on a wiki is a bad quality edit or a good quality edit so if you're interested in this space you can contact Aaron and Aaron and these are the skills that you need. There's also an autist extension so if you ended up on you're doing the extension side then you would need the same skills you need to contribute together. Cloud services this again you got from Brian in the opening ceremony so cloud services team is a team of volunteers and staff members whose work is basically to empower the work of technical contributors. They provide a hosting environment for running tools and bots and mostly when they think that your tool and bot in a way is going to add value to the wiki media ecosystem and what i mean by that is i'll show you by example in my next slide. Besides that it also supports not only lets you post these tools but also support the operational creation and maintenance of these tools and there are like more than 1000 tools posted via these services. So an example of a project that is leveraging cloud services is wiki app dashboard and this again you got in the opening ceremony from mentor sage rose wiki app dashboard is a web application that supports wiki media education assignments provides data enforcement management for instructors and students. There are a lot of community members all around the world who use this platform to run edit cons. This is also a very newcomer family project mentor sage rose is present and we need for this to be javascript and actually which is a templating system. So far what i mentioned was the projects and technical areas for which i know that we are featuring projects for your developers or at least are documented on our developers page the link to which i will share later. From now on i'm going to share areas for which at least i'm not aware of we are featuring any specific task or project but i'm sure if you're if you're interested in that space we'll be more than happy to help you connect with folks here. So when you're seeing the eyes you can use them to look things up or write for or create tools or visualizations and when you use these apis to query then you get data in xml or json format and then it's totally up to you how you want to use the data. So kind of stuff that you can do with these apis is create or edit a page or view revisions or list citations or the leader merge pages basically what you can do using the interface you can do things collaboratively. So an example of this is listen to which media project listen for two seconds. It is leveraging software web APIs. I think they're using recent changes web API and they use it to visualize real-time edits happening on the media. So the large circle that you've seen in this video it shows large chunk of edit made and then small circular presents smaller and smaller edit speed and vice versa. Then we have media wiki skins so this is about look and feel of media wiki and there are two I will show it. So as a user you can use your favorite skin from music preferences the default one is that is called vector that you see the default interface but there are four or five options from which you can choose. There's also a way to write your custom CSS by simply creating a page as a sub page of your user page and then what that does is it overwrites the default functionality of the record skin and as a developer you can either help improve existing skins or write a new one. There is Isara who might have heard talking in the opening she does a lot of work with skin so you're interested in the space you can each other work. Then we have templates which are standard wiki pages embedded in the side. So basically the idea behind templates is to allow them to reuse other people's work and help avoid a complicated content. It's pretty easy to create them you just create a page and name it as template called name of the template and then you can use it in any of the other wiki pages by using the syntax which is on the right side of the site in other places you want it. You can use a variety of skins to write templates with wiki text as you normally do to edit a page or you can use HTML, CSS, and JavaScript. There's also a scripting language that we use to write complicated templates which is new work and there are a lot of people at the hackathon who are meant to be really expert in new work programming so if you're interested in that space I think that will help. Then we have gadgets and user scripts. They are JavaScript code snippets that extend the functionality of media wiki. They're pretty much like extensions that I was the first to mention on my slide but what I think they're different from them is that the code for user scripts live on wiki but extensions are sort of in wiki and whenever a user script a site admin things is going to be useful for a lot of people then that gets promoted to gadget. So an example of gadget is navigation popups. So if you have ever noticed a popup showing up and you hover on a link on the media then that's something about a gadget working behind the scenes and the cool thing about it is that you can actually see the code what is inside the code for a gadget by going to the corresponding page on the media itself. Then we have bots which are a lot, we have a lot of bots and they are automated tools that help you perform, make changes that are tedious or are repetitive. A lot of things for example in the help of spelling mistakes or grammatical errors or vandalism or upload images from somewhere to commons. An example of bot is 5-e-t bot which is very lovely thing I believe in comparison to other bots. For this you would need a 5-1 program in my computer with 5-1 and then other 4-5 keys. These are mostly all the technical areas that I talked about. There are 4-5 many which I will tell you quickly but do we have any questions so far? Are there some sites like where I can use all the extensions which are available or all the tools that we would like for you to find in this program? Yes so in my data in my site I have a link to a page that you can go and find out about a technical area. I have some questions. For example when there is a new extension like eco where do I get the news about that you will have a great new extension maybe you want to participate maybe you want to just submit your ideas where is this like the main channel where this is published you want to follow technical news? At least there is a tech news in Mecca you can subscribe there to go to Mecca This is a weekly newsletter quite well designed and it gives all the technical knowledge. It's not an idea if you are only looking for that but we are trying to implement the news that their extension would allow us to create more specialized news about their support in this Since we have this time remaining I would like to tell you about some other areas so site operations again there is a dedicated team that is becoming a server infrastructure and there are about 800 plus wikis that they support. They also take care of a bunch of other things like resource allocation or hardware and software finance and they rely on a contribution management system like we are profit so if you are interested in the space it is also one area to look into. There is another which is quality shortness and continuous integration so if you want to help test our projects to manual or automated testing help write some browser unit tests and there is also one space then translation design and documentation are the best ones because based on all our technical areas you can either make a technical or non-technical contribution in the sense that for example with translation you can either help translate documents or you can contribute to extension translate extension and things like that and same applies to documentation so you can either help with documentation or media making or you can help with technical documentation write documentation for things that are missing in our core base and stuff like that. You asked about the resources page so these are the two where you will find the information which I shared in my slides. How do you want to do is to have information about all the technical areas and then the new developer stage on which you will find all the projects that I mentioned are suitable for newcomers and for which we have mentors present at Wikimedia and these mentors they are they are going to be present at the session which is right after this one so you if you're interested in any of those projects you can have more business conversations with them right after this. If you have any questions since we don't have time I think right we have two minutes of time but that's not enough so if you have any questions you can take me on IRC or comment on the team in person. My IRC is another, it is also Casina's and the different other and yeah that's pretty much it. Any questions? You have three minutes. You are interested in attending the session right after this. Okay so I would encourage you then to maybe in human and start moving to the hacking room, the main room and then participate in that. Which is the second round for this please? What is the second round for this? Oh so the session is a personalized matching ceremony where newcomers who want to work want to work on projects or want to learn new skills they can talk to specific people who will be there at the session to learn more about the projects.


All they seek is pleasure. That's the whole point of their existence. All they seek are possessions. That's the whole point of their existence. All they seek is power. That's why they wake up in the morning. Don't be like that. To prioritize those things, to make that your entire life's pursuit, that is to miss that which is truly worth anything. Spiritual, do not sacrifice the eternal for the temporary. Do not sacrifice the spiritual treasures or worldly treasures.


My name is Lee Provist, I'm from the UK and I've been playing VGC for 14 years. It's funny because my parents used to get me a Nintendo subscription for Christmas every year and it was in one of those magazines that there was a tiniest little article in the corner saying about the Pokemon World Championships and testing yourself against the best trainers in the UK. So I decided to dig out my DS at the time and my Pokemon copy of Pearl, which actually had the cellophane still on it. And with two weeks preparation I tried to hecticly prepare for the tournament, learn the new metagame, new format, new Pokemon and went in attended. And as you can imagine with that much preparation I didn't do too well but that really was the starting point of my VG career and pushing me on and kind of lighting that fire to strive to do better in something that I really loved doing. I think the event that really sticks out to me is the World Championships in 2013. That year was the first year that I'd actually won a paid-in invite to the World Championships and my preparation that year was good running up to the event. I tested a bunch of teams, they all did really well in online tournaments but getting to the event itself I really backtracked on all of my preparation and went back to my nationals team that I did so well with and I really regret doing that because it was almost a little bit fearless for me to go forward with something that should have maybe done a lot better in that tournament and it really sticks to my mind as a big regret and I always approach events now looking back at that event and remembering that and trying to be a bit braver going in with my decisions rather than kind of falling back onto something that I maybe might be a bit more comfortable with. It gets tougher every single year to stay relevant and kind of keep your skills up to a point where you can compete with other players. New player base coming in all the time makes it more difficult and like I say the ceiling on the players kind of skill level gets higher and higher so it is really difficult to stay relevant and finding the time as well when you're kind of getting older you're getting jobs, you've got family and things like that to actually put into honing your skills and trying to get good is really difficult but you do make do. If you've got the passion there to do it there's resources online like we've never had before when I first started out you never had the amount of resources to help you as a player kind of stay up to date with new meta trends and what Pokemon is being played more than others and things like that so you've got that as a really good base and obviously talking to and counting on friends is a massive help and something I would always advise players of all kind of calibres to do when trying to stay relevant and honing those skills for future tournaments position or just clenching their spot, this is a really important match well I mean like we've seen how well Lee played today Alejandro obviously is a dedicated poker player I think one of the best things I can advise new players coming in is taking advantage of all the great resources we have online now you know you've got articles, you've got websites, you've got content creators that are providing a great bunch of information for you to get up to speed with what trends are happening in the format and what to expect when you go to tournaments, just utilize those and then also try and get in contact with other players if you're new to the scene, you don't know other players, make friends and then you can bounce ideas off each other, don't do it alone it's something I did for a long time and it didn't help me and it wasn't until I started kind of communicating and speaking and making friends that really kind of elevated my play to the next level and that's something I advise all new players to do Welcome, thank you so much Aaron and welcome trainers to the Pokemon 2022 World Championships here in London Casting Worlds in London was an incredible opportunity I feel super privileged to have been even asked to be part of that production we had a great crew that made the event and doing it extremely easy as tiring as it was but it was just one of the most amazing experiences that I've ever had and honestly the peak of probably my casting career and I don't think it'll ever be topped again doing it in my kind of hometown as well was just amazing and seeing new players coming in and having great runs as well as some other players that have known for a long time have an amazing time in the world so it was a real highlight and you can see even without the Iron Defence we're not taking too much damage from that initial acrobat Pokemons give me so many opportunities which is weird to say really thinking just playing competitively and how many opportunities I've had and how many countries I've visited and casting that I've done and it also gives me the opportunity to become a content creator really in 2017 when I started creating content I had the idea of just helping new players get into competitive Pokemon and give them a little kind of helping hand and hopefully that's what the channel did it's evolved so much from there and although since Sword and Shield I took a little bit of a step back from primarily doing competitive content it's been the best thing for me because now I've got an idea of where I want to take competitive content and also what we've got planned for the future as well which is really exciting so I can't wait to get into what we'll be doing going forward with Scarlet and Violet