Tyler Cowen on single-payer healthcare; Kohn vs. Sumner; Wesley Yang on pushback against gender transitioning ideology; Jay Bhattacharya and Mikko Packalen on economists' silence on COVID policy
‘single payer systems are working far less well than they used to, including during the pandemic but not only. ‘
There is only one true single payer system, the UK’s NHS and it has NEVER worked - which is why nobody else does it that way. Since all resources are scarce, where medical care is free at the point of delivery, absent a price system medical care in the UK is rationed by waiting lists. Fixed budgets encourage delayed testing and treatments to push expense into the next budget period, thus ever growing waiting lists. Government targets to reduce waiting lists, encourage gaming the system by selecting the easiest and cheapest to test/treat from the waiting list. The result is the list shortens, targets met, politicians boast, but the proportion of serious cases most needing early treatment increases. The good news is a fair proportion will die waiting, or if finances permit some will elect for private medical care. Both eventualities are a win for the NHS establishment. The NHS - described by one senior politician as a national religion - is a political football, kicked about particularly at election time, with little to do with providing medical care. The CoVid Fakedemic just high lighted how useless and self-serving it is. 6 million people on the waiting list, estimate to be about 8 million next Spring - if everybody doesn’t freeze to death this Winter thanks to the UK’s genius energy policies.
Re Sumner (on Kohn): You seem not to grasp Sumner’s point, that the market’s forecast of future NGDP—supposing that NGDP is, or is a proxy for, the most important economic magnitude—is vastly more important for the Fed’s purposes than what actual future NGDP turns out to be. The Fed’s action today is aimed at affecting the actions of market participants today and tomorrow. The Fed should be looking not at “forecasts,” but at *the market forecast*, as reflected in such things as TIPs spreads and, ideally, a futures market in NGDP. In fact, this market forecast will be more accurate (about what future NGDP will actually be) than the various private forecasts, but that is not why it is so important. What it reflects are the attitudes of market participants *now*, which determine their *present* actions; and that is the Fed's proper focus.
And I think you should be more impressed by Sumner’s further point, that a credible regime of level targeting would immensely improve the market’s confidence that future NGDP will be (nearly) on-course. The Fed’s job is to instill such confidence; anything else—such as the actual accuracy of various predictors of future NGDP--pales into insignificance.
Agree! Much, not all of course, of the supply chain shocks of 2021 were the result of firms mistakenly believing that the Fed would allow another period of inadequate demand similar to 2009-2020. [At least that is the story of automobile chips.] In fact TIPS DID collapse in early 2020 indicating that nominal demand was falling even faster than supply. The fact that the initial supply shocks showed up as 'shortages" rather than higher prices was another indicator that monetary policy was initially too restrictive. Fortunately, this time the Fed reacted quickly and started providing more stimulus, but the damage of expectations of a long recession was done.
"Or will the progressives have to retreat even further, leading to sexual binaries and marriage with children becoming cool again?"
I feel like the very core of progressivism is thinking marriage with children is uncool. You couldn't come up with a stronger statistical predictor of ideology.
You must know different Progressives than I do. The core thinking of the ones _I_ know is that recent history has been a lot better for majority upper income groups than for minority lower income groups and that "something should be done." [Unfortunately. many of their "somethings" are either counterproductive or not cost effective.]
I don't really know any progressives. I know some strong Democratic supporters on my wife's mothers side. They are too old and not educated enough to be proper progressives, but they fit a lot of stereotypes of progressives. Childless, kind of bitter with a chip on their shoulder, somewhat chemical dependent, unsocial, don't do much with their lives.
I've also known younger secular people. I don't know how any of them voted and wouldn't have pegged any as progressives though in some passive sense maybe some were. Nearly all would probably call themselves socially liberal and I bet they supported gay marriage. They were like the older individuals I described but a bit more vigorous and trying to get laid. Life consisted of either going out to a bar or party, drinking, and hoping to hook up. This was true for both sexes. Nobody seemed that happy about it, but they didn't make an effort to change.
The only individuals I met that made any attempt at a serious relationship before their 30s were conservative christians.
The most telling skin in the game difference between liberals and conservatives to me is family. Amongst our set (above average IQ, that's what wordsum score is below) the difference between a liberal and a conservative is about an entire kid. At 0.63 TFR, progressives would die out on their own in a few generations.
I think this is more important than theoretical stances on race. I don't even see Black Lives Matter posters anymore, but when I did it was in a super rich 90% white neighborhood literal blocks from a 90% super poor black neighborhood. Other then put out the sign and perhaps empower some beuracrats with some bad ideas, the passion seemed to fade relatively fast without the rich liberals doing all that much of anything really at a personal level.
But this sex/gender stuff, this really does seem to impact their lives. They impose it on their children if they have them and themselves, which has a real cost. They are pretty passionate about it. The women at least.
The negative power of being uncool has long been understudied even while, with increasing absolute wealth (=lower poverty), the social status desire to avoid being uncool has been increasing.
I agree with that. If someone were to reach out to a handful of the panelists and ask a few simple open-ended questions I suspect it would be much more informative. Maybe I'll do it.
Getting the 'cool factor' back in a traditional family setting and yet making it a social norm is basically impossible. The idea that it is a luxury good, but also attainable, is inherently contradictory.
All talk about healthcare that fails to support MORE Med Schools is missing at least half of any possible solution.
Counter-factual inflation "What if Trump won 2020"?
a) continued high US production of oil & gas, possibly even increasing - low prices (far less cash for Putin)
b) Trump talking to, but not running away from Afghanistan (he wants to leave, he refuses to lose)
c) Russia does NOT invade Ukraine - most 2022 disruptions due to that war don't happen
d) Trump supports voluntary, not mandatory, mask & vaccine guidance - ends all Federal gov't vax requirements, allowing more Fed workers
e) Trump ends COVID stimulus, so consumers have less cash
f) Each small supply chain problem is highly publicized, with great anti-Trump criticism, so Trump does something to solve the problem*
*g) Each problem gets solved, or effective action to reduce it occurs under intense (and unfair) criticism. Big Media is much more critical of Republicans, making it easier for them to know about more problems, sooner. And maybe solve them.
Result: continued low Consumer Price Index inflation, slowly increasing US manufacturing, continued increase in stock prices and house prices and complaints about increasing inequality. (Plus more conservative judges.)
Many Democrat leftist policies were inflation inducing/ triggering. There's no way to prove that there would have been less stimulus, and far less inflation, under Trump - but that's because economics depends on human behavior, which is not scientifically reproducible in the Big Decisions.
"There was no need to warn about inflationary fiscal policy as long as monetary policy was available as a solution. Only a few of us departed from that view." The high US deficits, combined with reasonably & relatively good policy, led to Investor inflation (of stock prices & house asset prices), but were increasingly unstable. Instability means questionable business plans that are only good if conditions stay good for that plan, tuned to that plan. Such plans remain more profitable in the short term as long as the stability continues, leading the more robust but less efficient plans to squeeze out the "fat".
This increasing efficiency AND fragility seems inevitable in any profit measured economy, and will lead to times of multiple "only works if everthing works" plans failing.
a) US oil and gas production did not decline after Jan 2021. Biden's misguided supply side climate policy was of hugely limited scope.
c) Agree. Putin would not want to embarrass Trump who was doing as much as possible to weaken NATO and Ukraine as politically possible, and more would have been possible if he were re-elected. He could have put off the invasion until he thought Ukraine was weaker or maybe think he would have been able to just bully it into regime chance w/o invasion.
As always Scott Sumner starts his analysis after Lehman collapses, while ignoring that all the metrics that he cites leading up to Lehman Brothers show that money was to loose, with those metrics going back for multiple years. The 5 year breakeven rate, for one example, was > 2% (the Fed's implied target) from 2003 onward averaging ~2.5 in that span and had just popped to 2.7% which was a 2 year high in June 2008, and the CPI print in mid 2008 was 5%+, and the 2 year inflation rate for 2008 and 2009 was 1.8%, and the three year rate for 2007-09 was 2.1%.
So if you drop a memory wiped clone of SS onto the federal reserve board in 2007 and told him what the total inflation/NGDP growth rate was over the next 3 or 4 years he would be pleased as the fed nailed their 3 year average within 0.03% per year. Arguably the 2007-2009 period is actually the closest that the Fed has gotten to 3 years of level targeting in the last 25 years.
"On the cost-benefit issue, I think that this reflects the way the left views government, which is as a rational, benevolent provider of public goods."
If one thinks one sees a problem that the ordinary workings of the market economy does not appear to be solving (the accumulation of CO2 in the atmosphere is my favorite example) one might wish for a rational benevolent government to use cost benefit analysis to design the highest net present value policy to del with that problem (a net tax on CO2 emissions, in my opinion). [I wish that were a good description of thught processes of "the Left."]
Even if one does not view governments as perfectly rational, benevolent actors and that the policy is unlikely to be designed to achieve the highest net present value outcome (in fact so far zero governments have enacted taxes on net CO2 emissions), it still seem like the best place to start one's advocacy is for that highest net present value policy AS IF the recipient of the advocacy was a rational, benevolent actor . How can ONE do any better?
There is an obvious retrospective to so many current events. Protests and riots to the 60's. Inflation to the 70's. Even some fashion trends and some new music sound like they came out of the 80's and 90's.
There seems to be a number of people looking at the uptrend in Trans identification and tying it to therapeutic culture or social contagion, neither of which is at all wrong, but I can't help but view the full surgical route as akin to the lobotomy. Just reading the wikipedia on lobotomy it was performed on women more than men, and children too. It wasn't without high complication rates and had fierce critics and slavishly devoted unquestioning followers. It was also banned overseas long before the US, just as Europe is pulling back on "gender affirming care."
Warning about inflation in 2021: They would have been good as long as the warning about the size of the relief packages worked through a warning about how the Fed was going to fail to take account of those packages and supply shocks in setting it's monetary policy instruments. It's hard to say the Fed was wrong before the September surge in TIPS inflation expectations.
The Fed in 2008: "Let the Fed?" The entire punditocracy should have been screaming at the Fed for letting inflation expectations collapse! If we had had a NGDP futures market, the Fed's policy failure would have been more evident.
On two tier health insurance. OK, but let's make sure that having employers pay for converge (with the added insult of getting to decide on the converge according to there religious views!) with individuals not having to declare the cost of the courage as income, with the result that it is proportionately more costly to hire a low wage or part time worker, is not the main way that we subsidize health insurance.
Very few Canadians (go to the US " for health care because of bad care. A few go for expensive treatment that don't work ( we were told by the Mayo Clinic that could charge us for an operation that my father had less than 5% chance of surviving but as long as we pay, they were ok). The rest are tourists going for emergency care.
But what's a little disinformation between friends?
Do you have a link or other citation for that? In 2018 the Fraser institute did a survey of Canadian specialists asking how many of their patients traveled outside Canada for medical treatment due to long wait times (or other reasons presumably) and came up with about 65,000 in the past year. That's a pretty impressive number https://www.healthvantis.ca/2018/10/15/how-many-people-in-canada-travel-for-medical-care/.
‘single payer systems are working far less well than they used to, including during the pandemic but not only. ‘
There is only one true single payer system, the UK’s NHS and it has NEVER worked - which is why nobody else does it that way. Since all resources are scarce, where medical care is free at the point of delivery, absent a price system medical care in the UK is rationed by waiting lists. Fixed budgets encourage delayed testing and treatments to push expense into the next budget period, thus ever growing waiting lists. Government targets to reduce waiting lists, encourage gaming the system by selecting the easiest and cheapest to test/treat from the waiting list. The result is the list shortens, targets met, politicians boast, but the proportion of serious cases most needing early treatment increases. The good news is a fair proportion will die waiting, or if finances permit some will elect for private medical care. Both eventualities are a win for the NHS establishment. The NHS - described by one senior politician as a national religion - is a political football, kicked about particularly at election time, with little to do with providing medical care. The CoVid Fakedemic just high lighted how useless and self-serving it is. 6 million people on the waiting list, estimate to be about 8 million next Spring - if everybody doesn’t freeze to death this Winter thanks to the UK’s genius energy policies.
Re Sumner (on Kohn): You seem not to grasp Sumner’s point, that the market’s forecast of future NGDP—supposing that NGDP is, or is a proxy for, the most important economic magnitude—is vastly more important for the Fed’s purposes than what actual future NGDP turns out to be. The Fed’s action today is aimed at affecting the actions of market participants today and tomorrow. The Fed should be looking not at “forecasts,” but at *the market forecast*, as reflected in such things as TIPs spreads and, ideally, a futures market in NGDP. In fact, this market forecast will be more accurate (about what future NGDP will actually be) than the various private forecasts, but that is not why it is so important. What it reflects are the attitudes of market participants *now*, which determine their *present* actions; and that is the Fed's proper focus.
And I think you should be more impressed by Sumner’s further point, that a credible regime of level targeting would immensely improve the market’s confidence that future NGDP will be (nearly) on-course. The Fed’s job is to instill such confidence; anything else—such as the actual accuracy of various predictors of future NGDP--pales into insignificance.
Agree! Much, not all of course, of the supply chain shocks of 2021 were the result of firms mistakenly believing that the Fed would allow another period of inadequate demand similar to 2009-2020. [At least that is the story of automobile chips.] In fact TIPS DID collapse in early 2020 indicating that nominal demand was falling even faster than supply. The fact that the initial supply shocks showed up as 'shortages" rather than higher prices was another indicator that monetary policy was initially too restrictive. Fortunately, this time the Fed reacted quickly and started providing more stimulus, but the damage of expectations of a long recession was done.
At the end of the day, we've got 8% inflation and a 3% fed funds rate.
Through any footnotes you want out there, that's the bottom line.
What should I spend the random $500 stimulus the state deposited in my bank account this morning?
"Or will the progressives have to retreat even further, leading to sexual binaries and marriage with children becoming cool again?"
I feel like the very core of progressivism is thinking marriage with children is uncool. You couldn't come up with a stronger statistical predictor of ideology.
You must know different Progressives than I do. The core thinking of the ones _I_ know is that recent history has been a lot better for majority upper income groups than for minority lower income groups and that "something should be done." [Unfortunately. many of their "somethings" are either counterproductive or not cost effective.]
I don't really know any progressives. I know some strong Democratic supporters on my wife's mothers side. They are too old and not educated enough to be proper progressives, but they fit a lot of stereotypes of progressives. Childless, kind of bitter with a chip on their shoulder, somewhat chemical dependent, unsocial, don't do much with their lives.
I've also known younger secular people. I don't know how any of them voted and wouldn't have pegged any as progressives though in some passive sense maybe some were. Nearly all would probably call themselves socially liberal and I bet they supported gay marriage. They were like the older individuals I described but a bit more vigorous and trying to get laid. Life consisted of either going out to a bar or party, drinking, and hoping to hook up. This was true for both sexes. Nobody seemed that happy about it, but they didn't make an effort to change.
The only individuals I met that made any attempt at a serious relationship before their 30s were conservative christians.
The most telling skin in the game difference between liberals and conservatives to me is family. Amongst our set (above average IQ, that's what wordsum score is below) the difference between a liberal and a conservative is about an entire kid. At 0.63 TFR, progressives would die out on their own in a few generations.
https://jaymans.files.wordpress.com/2012/05/lib-cons-tfr-30-43-iq.png
I think this is more important than theoretical stances on race. I don't even see Black Lives Matter posters anymore, but when I did it was in a super rich 90% white neighborhood literal blocks from a 90% super poor black neighborhood. Other then put out the sign and perhaps empower some beuracrats with some bad ideas, the passion seemed to fade relatively fast without the rich liberals doing all that much of anything really at a personal level.
But this sex/gender stuff, this really does seem to impact their lives. They impose it on their children if they have them and themselves, which has a real cost. They are pretty passionate about it. The women at least.
The negative power of being uncool has long been understudied even while, with increasing absolute wealth (=lower poverty), the social status desire to avoid being uncool has been increasing.
What did you make of the IGM finance panel?
https://www.igmchicago.org/igm-finance-panel/
the poll questions on these IGM panels are often poorly formulated
I agree with that. If someone were to reach out to a handful of the panelists and ask a few simple open-ended questions I suspect it would be much more informative. Maybe I'll do it.
Getting the 'cool factor' back in a traditional family setting and yet making it a social norm is basically impossible. The idea that it is a luxury good, but also attainable, is inherently contradictory.
All talk about healthcare that fails to support MORE Med Schools is missing at least half of any possible solution.
Counter-factual inflation "What if Trump won 2020"?
a) continued high US production of oil & gas, possibly even increasing - low prices (far less cash for Putin)
b) Trump talking to, but not running away from Afghanistan (he wants to leave, he refuses to lose)
c) Russia does NOT invade Ukraine - most 2022 disruptions due to that war don't happen
d) Trump supports voluntary, not mandatory, mask & vaccine guidance - ends all Federal gov't vax requirements, allowing more Fed workers
e) Trump ends COVID stimulus, so consumers have less cash
f) Each small supply chain problem is highly publicized, with great anti-Trump criticism, so Trump does something to solve the problem*
*g) Each problem gets solved, or effective action to reduce it occurs under intense (and unfair) criticism. Big Media is much more critical of Republicans, making it easier for them to know about more problems, sooner. And maybe solve them.
Result: continued low Consumer Price Index inflation, slowly increasing US manufacturing, continued increase in stock prices and house prices and complaints about increasing inequality. (Plus more conservative judges.)
Many Democrat leftist policies were inflation inducing/ triggering. There's no way to prove that there would have been less stimulus, and far less inflation, under Trump - but that's because economics depends on human behavior, which is not scientifically reproducible in the Big Decisions.
"There was no need to warn about inflationary fiscal policy as long as monetary policy was available as a solution. Only a few of us departed from that view." The high US deficits, combined with reasonably & relatively good policy, led to Investor inflation (of stock prices & house asset prices), but were increasingly unstable. Instability means questionable business plans that are only good if conditions stay good for that plan, tuned to that plan. Such plans remain more profitable in the short term as long as the stability continues, leading the more robust but less efficient plans to squeeze out the "fat".
This increasing efficiency AND fragility seems inevitable in any profit measured economy, and will lead to times of multiple "only works if everthing works" plans failing.
a) US oil and gas production did not decline after Jan 2021. Biden's misguided supply side climate policy was of hugely limited scope.
c) Agree. Putin would not want to embarrass Trump who was doing as much as possible to weaken NATO and Ukraine as politically possible, and more would have been possible if he were re-elected. He could have put off the invasion until he thought Ukraine was weaker or maybe think he would have been able to just bully it into regime chance w/o invasion.
e) Not his December 2020 position.
As always Scott Sumner starts his analysis after Lehman collapses, while ignoring that all the metrics that he cites leading up to Lehman Brothers show that money was to loose, with those metrics going back for multiple years. The 5 year breakeven rate, for one example, was > 2% (the Fed's implied target) from 2003 onward averaging ~2.5 in that span and had just popped to 2.7% which was a 2 year high in June 2008, and the CPI print in mid 2008 was 5%+, and the 2 year inflation rate for 2008 and 2009 was 1.8%, and the three year rate for 2007-09 was 2.1%.
So if you drop a memory wiped clone of SS onto the federal reserve board in 2007 and told him what the total inflation/NGDP growth rate was over the next 3 or 4 years he would be pleased as the fed nailed their 3 year average within 0.03% per year. Arguably the 2007-2009 period is actually the closest that the Fed has gotten to 3 years of level targeting in the last 25 years.
Right, but it was not enough for markets to know that it would not permit a collapse in NGDP and they were unfortunately right.
"On the cost-benefit issue, I think that this reflects the way the left views government, which is as a rational, benevolent provider of public goods."
If one thinks one sees a problem that the ordinary workings of the market economy does not appear to be solving (the accumulation of CO2 in the atmosphere is my favorite example) one might wish for a rational benevolent government to use cost benefit analysis to design the highest net present value policy to del with that problem (a net tax on CO2 emissions, in my opinion). [I wish that were a good description of thught processes of "the Left."]
Even if one does not view governments as perfectly rational, benevolent actors and that the policy is unlikely to be designed to achieve the highest net present value outcome (in fact so far zero governments have enacted taxes on net CO2 emissions), it still seem like the best place to start one's advocacy is for that highest net present value policy AS IF the recipient of the advocacy was a rational, benevolent actor . How can ONE do any better?
There is an obvious retrospective to so many current events. Protests and riots to the 60's. Inflation to the 70's. Even some fashion trends and some new music sound like they came out of the 80's and 90's.
There seems to be a number of people looking at the uptrend in Trans identification and tying it to therapeutic culture or social contagion, neither of which is at all wrong, but I can't help but view the full surgical route as akin to the lobotomy. Just reading the wikipedia on lobotomy it was performed on women more than men, and children too. It wasn't without high complication rates and had fierce critics and slavishly devoted unquestioning followers. It was also banned overseas long before the US, just as Europe is pulling back on "gender affirming care."
Warning about inflation in 2021: They would have been good as long as the warning about the size of the relief packages worked through a warning about how the Fed was going to fail to take account of those packages and supply shocks in setting it's monetary policy instruments. It's hard to say the Fed was wrong before the September surge in TIPS inflation expectations.
The Fed in 2008: "Let the Fed?" The entire punditocracy should have been screaming at the Fed for letting inflation expectations collapse! If we had had a NGDP futures market, the Fed's policy failure would have been more evident.
On two tier health insurance. OK, but let's make sure that having employers pay for converge (with the added insult of getting to decide on the converge according to there religious views!) with individuals not having to declare the cost of the courage as income, with the result that it is proportionately more costly to hire a low wage or part time worker, is not the main way that we subsidize health insurance.
Very few Canadians (go to the US " for health care because of bad care. A few go for expensive treatment that don't work ( we were told by the Mayo Clinic that could charge us for an operation that my father had less than 5% chance of surviving but as long as we pay, they were ok). The rest are tourists going for emergency care.
But what's a little disinformation between friends?
Do you have a link or other citation for that? In 2018 the Fraser institute did a survey of Canadian specialists asking how many of their patients traveled outside Canada for medical treatment due to long wait times (or other reasons presumably) and came up with about 65,000 in the past year. That's a pretty impressive number https://www.healthvantis.ca/2018/10/15/how-many-people-in-canada-travel-for-medical-care/.