Friday, August 23, 2019

The Green New Deal

A funny thing about the green new deal. It includes:
1. “a job with family-sustaining wages, family and medical leave, vacations, and retirement security”
2. “high-quality education, including higher education and trade schools”
3. “high-quality health care”
4. “safe, affordable, adequate housing”
5. “economic security to all who are unable or unwilling to work”

I read those and I say they are technically easy to do with less Government spending than today (Of course they are politically impossible until and if the t-bond market goes south dramatically.)

To do it:

  • Replace Social Security, minimum wage SNAP and TANF with a negative income tax
  • Force state and local gov to allow any residential building increases density.
  • Replace medicare and medicaid with a plan with a very high deducible based on income that only cover care that has strong evidence of dollar efficacy.
  • Cut defense spending in half.
  • Quality education can be done for 30% (at least) less than is spent now and many go to school longer than they should. And USA schooling is already good. We could make it even better by using some existing money to pay for low cost tutors.
  • Cut enrollment at state schools in half and we'll be fine
  • Cut university spending per student in half and we'll be fine. We spend a lot.
  • People can live well on less than many think see.

The Democrats and AARP will not lat any of that happen except defense spending cut and the republicans will not let that happen.

So do they really think AGW in an existential danger. I think not. Nor do they think much of the above are really important.

My Problem with Bernie Sanders

My problem with Bernie Sanders.

Judging from the communists that I spoke to back in the 1970's, Bernie's language seems to me to be colored by his communist past.
He doesn't say not we should be more charitable to our poor people, which I can buy, rather he sounds like the old communists who liked to say, you made it you deserve it, the capitalists stole what was yours.

He doesn't say that Healthcare is not something we should provide for everyone, he says it's should be a right.

He likes to talk about Millionaires and billionaires rigging the system against you and me. He talks like millionaires and billionaires getting a cut in taxes is stealing form you.

High Deductible and Delays in Getting Care

I've been confronted about my very high deductible healthcare plan with a challenge that people with high deductibles delay care after diagnosis costing more for the insurer, be it Government or Insurance companies.

Here is the research:
And once diagnosed, women in high-deductible plans waited longer to start chemotherapy: an average of almost nine months among lower-income women, and nearly six months among higher-income women.
Diagnosis of breast cancer at early stages is associated with better clinical and survival outcomes. How the costs of care vary depending on the stage at which breast cancer was diagnosed has not been thoroughly examined.
Here is some research that goes the other way on screening and preventive care:
Sweeping statements about the cost-saving potential of prevention, however, are overreaching. Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs
But the question is, can and will people learn if we were to implement a plan with very high deductibles? 

One data point that I go to is the Peltzman effect, how does the Peltzman effect work with safer cars? It may be by people hearing about someone being in an accident. Another is to consider the that the salience of terrorism has caused a huge overreaction in the USA. 
These lead me to believe that people can and will learn such things and that may tend move toward about or above the optimal reaction to a diagnosis healthcare regardless of the higher deductibles.

On a personal note I have paid a deductible of $10,000 in one case and of $30,000 in another and in neither case did we delay treatment. 

Also if the problem does persist, one way to combat delays might be to have health saving accounts. And there are many other potential ways to address the problem at low cost.

The USA Needs a More Positive Message on Immigration

The USA Needs a More Message on Immigration here is my attempt:

Americans descended from a bunch of rejects. Religious rejects including the puritans, baptists, Quakers, Anabaptist, English Catholics, Russian and Polish etc. Jews. The bottom of Irish society from during the potato famine, a little latter economic migrants from the bottom of Italian society and blacks from the bottom of African society, mostly war captives which tend to skew low stats, brought here in chains. More lately Mexicans and Central Americans .

They have all given us great things and made the USA great.

The religious rejects gave us our moral and governmental foundations.

Blacks brought here in chains, gave us and the whole world great music; gospel, jazz, blues, rock and roll. The world would be a poorer place without such and they added great grace, skill and style to athletics.

Italians and Mexicans improved our food. (Food in the UK is bland and bad.)

The Jews have excelled in science giving the world great things.

The Irish built up our police and fire forces.

Even those who just work blue collar increase the division of labor and help us cover our national defense.

Education and PISA

If this is accurate it is quite an indictment. 
But, the kind of classes they set up, they were like 30 people signing up for a job retreat[?] to teach you have to be a lineman for one of the utilities. Well, okay, so they go through the training and they get certified; and it turns out maybe there's maybe 2 jobs available for the 30 linemen, that all these people have put in the time, the money, the effort--

I'm a believer in Arnold Kling's null hypotheses on schooling, we have been trying to teach students more and largely failing. I think we should rather try to teach students more valuable stuff. In the above example had they taught the students plumbing, electrical, auto-mechanics. carpentry, cooking, home design, etc. at least the students would have been better able to maintain there own stuff and live on less money.

If what is taught  is more important than how much is taught, how do we measure success?
If the USA performs best in schooling which it might, maybe we have room to maneuver?

What does this say about charter schools and private schools, home schools and school vouchers? They seem to not produce better scores on the PISA and other standardized tests.

I Almost Cannot Believe How Bad the Questioning was in this Interview of Bernie Sanders by Joe Rogan

Here's what I object to.

Let's start with the drug stuff:

First, I am a patent skeptic. It seems me that the patent system might not be worth the costs and especially now in pharmaceuticals, but I found the discussions of pharmaceuticals to be one sided.

The people who invested in developing pharmaceuticals (and that includes those who invested in stock of pharmaceutical companies and pharmaceutical companies in research and marketing) with the understanding that they would be allowed to charge what the market would bear, get no mention. And it real does not matter how much or how little they I put into development, the agreement was what it was. But no questions in that direction form Rogan.

Now I believe that we should discuss ending patents, that would be no more giving of patents after some date but no questions about that either.

Sanders says that the new drugs are mostly me too drugs. If the new drugs are mostly me too drugs, as he says, then people should buy the generics that are off patent, and the current system is fine. That's somewhat contradictory, you'd think an interviewer would ask about that.

BTW Drug prices usually fall when drugs go off patent. Over 84% of drugs that Americans buy today are off patent.The prices often fall 80% or 90% when the drug goes off patent.

Deaths of Despair

Sanders talks about deaths of despair due to low earning opportunities.
New Hampshire was the highest earning state in 2016 AND number 2 in opioid OD deaths. Dear Angus Deaton with all due respect you might consider reassessing your deaths of despair theory. It never made much sense to me, there is in fact some evidence that people drink and drug more when they have more income and therefore access to booze and drugs, which is BTW a problem for my advocacy of legalization but I think the positives would out weigh the negatives.  
New Hampshire is one of the wealthiest sates and low in inequality too, if it's deaths of despair, how is New Hampshire is number two. You would think an interviewer would ask about that gaping hole in Sanders' story.

College Debt

Sanders goes on about college debt.

College debt is federal Government created problem. As far as college debt if you treated college loans like other, loans dischargeable in bankruptcy, have the Government stop guaranteeing them:
  • Then no one will lend eighteen year olds so much money
  • Then colleges will reduce spending and lower tuition
  • Then fewer marginal students will go to college
  • Then culture will change and students will live four to a room. 

But none of that in the line of questioning. 

US Schools
Because the selection effect is so powerful in education we don't see it but a stron rational argument could made that the USA has best education in the world (See: The Amazing Truth About PISA Scores: USA Beats Western Europe, Ties with Asia) and BTW Florida has the best education among the USA states (Florida Number One in School Measure).

Rogan let's Sanders say just clearly wrong stuff through the interview almost everything else Bernie says is wrong and no follow up. Rogan kisses up to Sanders like he wants to the next Barbara Walters, who got interview powerful people because she would not ask though question except those that the powerful people knew that they needed to answer.

Bernie used to be a communist, now he is just a guy trying to get elected. He is one of the few national level politicians who are worse than Trump. 

Tuesday, August 6, 2019

Student Debt

To address student debt we need to move toward a point where we treat college loans like other loans. That is make them dischargeable in bankruptcy and stop Government from guaranteeing them. Then no one will lend students so much money, then colleges would reduce spending and lower tuition, then fewer marginal students would go to college, then culture will change and students would live 4 to a room (oh the horror).

Colleges could spend much less per student , some already do, and would if the money was not there.

In 2015–16, total expenses per full-time-equivalent (FTE) student were higher at private nonprofit 4-year postsecondary institutions ($56,401) than at public 4-year institutions ($44,009) and private for-profit 4-year institutions ($16,208).

Thursday, August 1, 2019

They Have Always Lived Longer than Us

Advocates of single payer heath insurance for the USA often tell us that life expectancy is greater in the Scandinavian countries where they have universal health insurance but some of those countries had higher life expectancy that the USA before they had universal health insurance. The evidence that I've seen indicate that non-medical factors contribute much more to life expectancy that do medical care above the cheap basics of vaccinations and antibiotics and trauma care.

The global average life expectancy today is 71 years. In 1950 the global life expectancy was 46 years. And only two countries had a life expectancy higher than today’s average (Iceland and Norway with 72). My post:

Life Expectancy Globally

Link to tweet