Download Numbers - University of Florida

NUMBERS
Kiersten Adams
Jay Singerman
Jen Storch
Ashley Thomas
James Trinidad
Agenda
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Introduction
Numbers as Metaphors
Numbers as Norms and Symbols
Hidden Stories in Numbers
Making Numbers in the Polis
Numbers in Healthcare
Questions?
Problem Definition
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How do we know there is a disparity
between social goals and the current state
of affairs?
We must define a problem.
But, problem definition is not simple: it is
a strategic representation of situations.
Problem Definition Continued
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There are many ways to define problems
in policy discourse.
Each mode is a language which people
utilize to defend conflicting interpretations.
One common way to define a policyrelated problem is to measure it.
Elephant example
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Say I hire you to measure an elephant?
It sounds straightforward, but its not!
What information do you collect?
Weight?, height?, length?, volume?, intensity of
its color gray?, number of wrinkles?
The fundamental issues of any policy problem
are always contained in the question of how to
count the problem.
Counting Elephants
Round?
No
Giraffe
No
Square?
Yes
Green?
No
Lion
Yes
Snake
Yes
Primary
Color?
No
Gator
Yes
Red?
No
Yes
Monkey
Elephant
Counting As…
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Counting the problem involves a strategic
representation of the situation.
Every description of a situation is a
portrayal from only one of many points of
view.
So, counting always involves deliberate
decisions about counting as.
Counting must begin with categorization.
Categorization
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Notice how political counting sounds?
Counting must be about:
inclusion/exclusion: terms that suggest
community, boundaries, allies, enemies
 Selection: terms that imply privilege and
discrimination
 Important characteristics: terms that suggest
value judgments and hierarchy
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Numbers as Metaphors
Numbers as Metaphors
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To categorize in counting or to analogize
in metaphors is to select one feature of
something, assert a likeness on the basis
of that feature, and ignore all the other
features.
Counting requires judgment about
inclusion and exclusion.
Counting Schemes
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(1)
(2)
Counting schemes are subject to 2
possible challenges:
Asserting a real likeness where a
measure finds a difference (Including
something the measure excludes)
Asserting a real difference where a
measure finds a likeness (Excluding
something the measure includes)
Clear Rules
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Often times, conflict in policy is over what
legitimately counts as what
Numbers are used to settle the discussions
The need for clear rules drives
policymakers to establish thresholds as
dividing lines
Central theme
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There is no universal, scientific, or objective
method of problem definition.
Numbers are just one way problems are defined
in politics - and politicians employ several
different counting strategies to set the problem
Fancy manipulation of numbers equal claims
about similarities and differences
These are the ultimate basis for decisions in
public policy.
Numbers as Norms and
Symbols
Measurements
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Imply a need for action
Usually taken because we seek to change
them or to change our behavior
Creates pressure to do something about it
Unemployment
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1930s- no unemployment census
1950s and 60s- 4.6%
1970s- more than 6%
1980s- 7-9%
A Double- Edged Sword
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U.S. Navy saved 2.5 billion in shipping
costs
Show thrift, successful building, and good
management?
Show an excess of allocated funds that
could be cut?
Cost
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Generally think of high costs as bad
Sometimes, high costs= high quality
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Designer clothes, cars
Is a costly national defense system wasteridden or extra secure?
Efficiency
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Generally think the more efficient and
productive, the better
Not necessarily so with services
Middles and Averages
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Often the norm
Political campaigns promote to “middle
class”
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Depends on the categories
Hidden Stories in Numbers
Hidden Stories in Numbers
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Explicit Stories
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Used to authenticate a story
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Identify causal relationships
Implicit Stories
More Implicit Stories
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Frequent enough to count
Clear boundaries make numbers identifiable
Counting creates a community
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Numbers can stimulate conflict resolution
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Natural vs. Artificial
Political support
Dividing, weighing, balancing
Numbers are symbols of precision and accuracy
The Political Story
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In counting, decisions must be made
about inclusion and exclusion
Measuring creates norms about how much
is just right
Ambiguous numbers create room for
political struggles
Numbers tell stories, especially about
decline
The Political Story
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Numbers create illusions about complex
phenomenon
Numbers create political communities
Counting can help with negotiations and
compromise
Numbers create authority
Numbers in the Polis
Numbers in the Polis:
People as numbers
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People know when they are being measured
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Examples of people as numbers
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Social Security number, UFID, phone number, census
Bank account number and identity theft
Measurement triggers the natural desire to look good
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Examples: height, business portfolio, IRS & taxes
Therefore, if our measurements do not look good, we are
disappointed
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Does “15th best” sound good to you?
Giving people the option of being counted as something invites
people to consider choosing it
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Implies inclusion and exclusion
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“Check one” vs. “Please check all that apply”
Numbers in the Polis:
Counting
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Counting and measurement affect people’s
behaviors and perceptions
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Counting enables group (vs. individual)
discrimination/mobilization
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A formal count normalizes rare events
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Ex. Hate crimes
Ex. War-on-terrorism and American deaths
Counting/measurement can induce dissatisfaction and
change
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Ex. Weight, diet, and Healthy People 2010
Numbers & Polis:
Record Keeping
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Record keeping is more intense when the
records are under scrutiny or public attention
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Reformers try to show that the problem is big, new,
and not something that has been tolerated for a long
time
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Ex., Global warming
As tolerance for annoyances diminishes, then the
perception is that annoyances are growing
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Decreased tolerance: increasing inclusion of negatives
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Ex. Child abuse
Decreased tolerance: decreasing exclusion of positives
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Ex. Affirmative action
Numbers & Polis:
Reactivity and Power
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Measurement induces incentives
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Measures evaluate performance, rewards, and punishment
Ex. FCAT (“teaching to the test”)
The power to measure is the power to control
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The power to include is the power to exclude
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Marginal cost – the cost of producing the next item
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Ex. Police, clearance rate (police effectiveness), & crime rate
Ex. Political campaigning and measurement of issues
May mask the actual cost of production (e.g., Dept. of
Defense)
Measurers need the people/organizations they measure
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Ex. FDA and Big PhRMA
Likewise, sometimes the measured need measurement for
validity
Numbers in Healthcare
Numbers in Healthcare
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Alachua County Choices Program
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Health care coverage for thousands of lowincome people
Funding through ¼ cent sales tax increase
How much extra will the average consumer
have to pay each year?
Number manipulation from both sides
Numbers in Healthcare
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Insurance and Reimbursement Rates
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Reimbursement levels for Medicaid v. private
insurance
Doctors have an incentive to change their
behaviors to treat more private patients
Doctors can treat fewer Medicaid patients
 Doctors can spend less time with Medicaid patients
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Numbers in Healthcare
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Quality
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Number
Number
Number
Number
of
of
of
of
medical errors
procedures performed
malpractice suits
unexpected deaths
Numbers in Healthcare
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Quality- Number of medical errors
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“Countability”
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Do estimations accurately measure the number of
medical errors?
Attention is given to things that are measured
Reactive effectsNew York state report cards for heart care
 Once measured, doctor’s outcomes improved
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Numbers in Healthcare
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Quality- Number of Procedures Performed
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Measure of quality- more experienced doctors
should have better results
Measuring this could result in a change of
behaviors
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Doctors may perform procedures that aren’t
medically necessary just to increase their numbers
Numbers in Healthcare
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Florida’s Malpractice Crisis
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Counting normalizes and legitimizes problems
Attention to the problem increases the
number of reported cases
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Highly publicized cases/large award cases
Questions?