Economism and healthcare

Dodgy economics is flying around left and right as the new GOP health bill is being piñata-ed from all sides this week. One particular strand is the charge of economism in the political rhetoric around healthcare. I want to talk a little about that since it relates to the teaching of introductory economics. In sum I want to claim that there is no great crisis in econ 101 being reflected here, but that there are reasonable grounds to suspect that marginal changes could have a big impact in how the median econ 101 student absorbs our material.

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What if legal permanent residents could vote?

According to the Department of Homeland Security, there are more than 13 million legal permanent residents in the United States. I’m one of them. U.S. politics matters a lot to me, since this is where I live my life, but my fellow green card holders and I have no vote with which to express our opinions on the future of our home country. Perhaps you can imagine how frustrating that is.

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From the campus to the ballot box

It’s amazing to me how much this presidential election reflects ideas and conversations that have been percolating around college campuses for the past several years. I often tell students that their movements have an uncanny way of being on the right side of history (OK, I see that I’m begging the question, sue me) and I think that this is being borne out in all caps this year.

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Mana from government

One sentence stuck out to me from an otherwise poignant article on healthcare and assistance for the very elderly:

Politicians are champing at the bit to cut back on Social Security and Medicare at a time when so many of us will depend on them.

I know this is just a throwaway shorthand and I shouldn’t get so worked up about it. But I find it incredibly difficult to believe that any self-interested politician wouldn’t lavish cash on the elderly (a.k.a. reliable voters) if it was feasible to do so. Even if I’m wrong about that, this is an example of an omission that sometimes bothers me: in some broad sense, resources have to come from somewhere. Slightly earlier in the article is this:

American political leaders are not preparing adequately for the huge demographic shift caused by the aging of the boomers, who began turning sixty-five in 2011. 

So surely the earlier quotation should really say that all else equal politicians will have to find a way to cut back on Social Security and Medicare? What would the preparation be? The proportion of the population that is working-age is going to fall. That means fewer people working to turn stuff into other useful stuff, and more people not working but hoping for a share of the stuff. Something must give. Either more stuff has to be foregone by the workers, or less stuff enjoyed by the non-workers.

Government, whatever it is, isn’t a grumpy gatekeeper protecting a bottomless barrel of stuff and saying “no, no, no”. We can disagree about what government should do, of course, but let’s not pretend that there aren’t constraints.

Strange quotations

I’m scratching my head at this one from Barack Obama:

He added, “Senator McCain – you can’t run away from your words and you can’t run away from your record. When it comes to this economy, you’ve stood firmly with George Bush and a failed economic theory, and what you’re offering the American people is more of the same.”

I struggle to even offer a guess as to what ‘economic theory’ he’s talking about. 

Sensible economic policy is not just found in textbooks

Standard caveat: I remain apolitical here. Hat tip to Economist’s View, whose discussion of Andrew Leonard’s Salon article on some current trade policy touches on a lot of interesting things.

Apparently there’s a “Trade Adjustment Assistance” program on the Senate radar. Now, this could be considered sensible economic policy, whether or not you agree with it.

“The Trade Adjustment Assistance program is designed to compensate manufacturing sector workers who are displaced by trade. It includes financial support for education and training, a health care credit, wage insurance and other goodies.”

It’s a well-worn argument that long-term benefits from trade with other countries might come with short-term costs for those workers who find employment in industries which produce goods most likely to be imported. Social justice might argue for support for such workers; help the worker, not the industry is not an original maxim. It can be applied equally to “dying” industries. If the typewriter industry is becoming obsolete, do you subsidize the typewriter producers or let them die and use your welfare state to support the people who are affected?

Maybe it’s too harsh to say that this is not a textbook argument, but one certainly can’t gloss over the negatives of any policy, no matter how positive the positives, and, recall, those pesky Principles of Economics said that Trade Can Make Everyone Better Off.

The Salon article refers to this, from The Atlantic, makes the forceful and obvious point (I will paraphrase) that a proper welfare state doesn’t ask why, just helps the needy while they need, and that this trade adjustment business is a band-aid, a facsimile of a real solution for the problems of the consequences of harsh and widespread unemployment in whole communities at a time.

Not to wade into the politics where I don’t belong, but I like this:

“Preaching the benefits of free trade without being willing to take care of the “losers” created by trade isn’t very bright in an election year when workers are feeling squeezed, and the opposition party controls Congress.”

Ignoring the electioneering stuff, the direct analog to an economics class or an economic policy debate would be to actually have a proper debate, an acknowledgment that everything isn’t always super-awesome. Similarly, the Economist’s View take:

“It seems to me that an administration that truly cared about the working class would be eager to find a way to help those who are hurt from trade, that they would make it a high priority and insist it get done, but there’s little indication – through actual action – that helping workers hurt from trade, or from economic conditions more generally, is a priority.”

This is perhaps one of the biggest economic policy questions: how big should your welfare state be? Design is one thing, but we have a fundamental philosophical question here, which is bigger than technicalities. Let’s brawl that one out, historically, globally, politically, morally, economically.

Except for poor old John McCain, who gets kicked again. Hard. I’m on record: I think he is an economist (for a suitable definition of economist). Not Economist’s View.

“I think a lot of people are missing the point about John McCain’s lack of knowledge about economics… Anyone who really cared about economic policy and its effect on households would have taken the time to become familiar with the basics. How will he know how best to help workers if he has no idea about the underlying economics? If he asked, there are very prominent economists who would be happy to spend an hour once or twice a week – kind of like a principles course – explaining how the economy operates. But he never bothered, never took the time, because he apparently doesn’t care enough to give up the time necessary to actually understand the polices he is voting on. I wouldn’t mind the ignorance so much if there was any indication at all that he had tried to over come it, any indication he thought it was important enough to learn about, but there isn’t.”

We’re going to give McCain the Principles of Economics course? I just got chills. Surely not the one we give the poor undergraduates? From me:

“A list of “principles” pregnant with loaded statements is not the right way to present our discipline.”

Let’s not indoctrinate John McCain too!

Getting what you want: when should politics invoke economics?

The health policy exchange during the Democratic debate on Thursday shows exactly where economics should fit into policy, and politics. I’m not in the business of policy analysis, so instead let’s ask how an economist could help Senator Clinton achieve the goal she stated in the debate:

“But if you don’t start by saying you’re going to achieve universal health care, you will be nibbled to death.”

As I said before, I think there are two places for positive economics in the formulation of policy. One is when we ask “what will happen if we do this?”, and the second is when we ask the question Hillary’s statement invites: “how can I achieve that?”. America is no technocracy, so there’s no way positive economics can tell us what to do; that question is for every person and every candidate to decide.

This doesn’t just apply to questions within the rules of the game. If we take the biggest possible economic question, “how should our resources be allocated?”, it’s still the case that positive economic science cannot tell us, for example, which of capitalist markets, socialist planning, or making decisions by rolling dice is “best”. It’s not even difficult – it’s impossible. The furthest positive economics can go is to say that if you want to achieve some particular objective then one of the systems might be the most successful, but that obviously relies on the purely subjective notion of what you want.

Even when our questions get more specific – for example, not “how should our resources be allocated?” but “what should we do about health care?” – exactly the same principle applies. So, with that in mind, Senator Clinton has taken the subjective position in support of “universal health care”. Let’s take a look at the second part of the quotation from the debate:

“But if you don’t start by saying you’re going to achieve universal health care, you will be nibbled to death.”

The argument there is that if you don’t define your normative goal well enough, even getting close to it becomes more difficult, which is probably true. Even more fundamentally, it’s impossible for a politician to be “wrong” when taking a normative position. Like I said, I won’t try a policy analysis asking whether Clinton’s policies will really achieve her goal, and I make no judgment on that question.

With that in mind: unfortunately, actual policy has to be made to try to achieve the normative goal. If there’s significant doubt that the policy will lead to the outcome stated in the goal, then the politician is misguided or, worse, lying. Political campaigns sometimes seem to promote either depressive pronouncements of how we’re all going down in flames, or their ideological counterpart, the Utopian “I can make it all better”, neither of which have much in common with the real goals of the candidate. Realism doesn’t often sell well, but noble aims without realism run dangerously close to fraud.

To put this in a real context, even if I don’t care about your immigration policy, I care about whether or not you are honest in presenting it. Again, positive economics can’t say whether you should close the borders; it can (perhaps) describe some of the likely consequences of doing so, and to convince me that your plan to close the borders is sensible you must convince me that, on balance, the many dimensions (moral, financial, political) of the problem favor your plan. If, in doing so, you fail to acknowledge or deny the consequences your argument is immediately bankrupt. That doesn’t only apply to whatever consequences economic science can help us figure out – it applies to everything.

Even though I believe that economics can be a tool for analyzing more than just financial consequences, it would be wrong to claim that economic science can tell us everything we need to do. If it could, we might as well just cede to a technocracy. What we can do is help set out the means to your chosen end (as in the example of achieving universal health care), or describe the consequences of your policy (as in the example of closing the borders). To argue that other things matter more than what economic science tells us is defensible; to lie about what economic science tells us is wrong.