Wednesday, September 27, 2017

Noah Smith — Handwaving on health care


Noah Smith on Greg Mankiw and John Cochrane. Mankiw actually comes off quite well. Cochrane, not so much.

I think that Noah has it right. Health care is not as much an economic (positive) issue as it is a moral (normative) one. This is the ground on which it will ultimately be decided politically.

Noahpinion
Handwaving on health care
Noah Smith | Bloomberg View columnist

21 comments:

MRW said...

I think that Noah has it right. Health care is not as much an economic (positive) issue as it is a moral (normative) one. This is the ground on which it will ultimately be decided politically.

I haven’t read Noah Smith’s article, but I absolutely agree with your statement (if it’s not Smith’s) that health care is a “moral (normative) one.”

Matt Franko said...

"health care is a “moral (normative) one.”

Its a technical issue... most people are non-technical so they think in the normative terms (libertarianism vs. Robin Hood-ism) so its ofc all f-ed up....

Noah Way said...

It's a technical issue only in terms of treatment. It's a political issue in every other respect. Which means it's an "economic" issue in every respect.

Morality has no place in economics. Or politics.

Tom Hickey said...

Morality has no place in economics. Or politics.

Read George Lakoff. He argues based on cognitive science that this view is why Democrats have lost the majority of political offices in the United States and will continue to do so unless they wake up. Republicans understand it quite well.

Matt Franko said...

Right because economics is about material outcomes and the materially competent are more attracted to the GOP...

Matt Franko said...

Noah the management/regulation of our healthcare industry is (should be) a technical discipline... Including the basic acquisition strategy such as 'single payer', subscription, etc or any other business approach...

Noah Way said...

Right because economics is about material outcomes and the materially competent are more attracted to the GOP.

Economics is about economic outcomes.

Tom Hickey said...

Matt, like many if not most technocrats you are confusing means with ends.

Values (norms) > policy (ends, prioritized objectives) > strategy (planning use of means to achieve objectives) > tactics (execution of plan using means).

Matt Franko said...

Tom the established norms are already fine....

The norm is "all US persons should have access to quality healthcare".... there you're done... nobody disagrees with this ...

Now the rest is technical...

Matt Franko said...

Don't tell me now you guys think the "neoliberal conspiracy!" has now expanded to include the denial of care to a cohort of our society .... please....

Tom Hickey said...

The norm is "all US persons should have access to quality healthcare".... there you're done... nobody disagrees with this ...

Nonsense. The GOP position is that everybody has access to health care through the emergency room, which s FALSE. If you show up at the emergency room with an acute condition that does not qualify as an emergency you will not be treated. And if you have a chronic condition, forget it.

Tom Hickey said...

BTW, hospitals are not being mean in turning people away from emergency rooms that don't require emergency treatment. They are not set up for it and would be flooded with non-emergency cases. They rank priority based on need for treatment. If you have an acute condition that doesn't require emergency treatment you will be directed to consult your health provider for treatment.

The whole presumption that emergency rooms provide universal health care isn't even wrong; it is a lie.

Tom Hickey said...

Search on is health care a right or a privilege.

A lot of people on the right claim it is a privilege (free market commodity rationed by price and ability to afford it), and that universal access to quality healthcare is neither a human right nor a constitutional right of citizenship.

Matt Franko said...

Right it is non technical people involved they are libertarians or RobinHood-ians (Philosophers) who don't have the technical expertise in Finance/Accounting to know how to do it...

The whole debate Monday night on CNN was a farce...

Matt Franko said...

Trump has at least offered everybody a $4k annual tax credit .... while someone Canadian here posted something that they only spend 4800 annual up there the way they do it ...

So you take Trumps $4k and come up with another 800 bucks somewhere and you can have the Canadian sysytem at least ... if you set it up the right way...

Matt Franko said...

Finance is a science degree:

https://en.m.wikipedia.org/wiki/Master_of_Finance

"The degree is often titled Master of Finance or Master in Finance (abbreviated M.Fin., MiF), or Master of Science in Finance (abbreviated MSF in North America and MSc in Finance in the UK and Europe)"

It's a science degree...

MRW said...

What good is a $4K tax credit if you earn $20-25Gs a year? That's approximately $100/day at minimum wage.

Noah Way said...

Economics is known as "the silly science" because there is nothing scientific about it. It is essentially a set of ideologies described as theories, used for control.

MRW said...

while someone Canadian here posted something that they only spend 4800 annual up there the way they do it ...

So you take Trumps $4k and come up with another 800 bucks somewhere and you can have the Canadian sysytem at least ... if you set it up the right way...


(1) That’s not the Canadian system, and they don’t spend “4800 annual” either.

(2) Every province has a different healthcare system, managed according to provincial rules with different sign-up rules. One province charges $69/household (family) per month. Another doesn’t charge anyone anything but does charge exhorbitant prices for tobacco and alcohol (eg. $20 for six pack of beer) to pay for it.

(3) Doctors set their own prices, often own their own medical groups, and real estate.

(4) What is universal in Canada is that health care insurance was nationalized. That was the chokehold on costs. It was the Progressive Conservative government that spread Tommy Douglas’ provincial health care system in Saskatchewan (circa the 30s?)—the Progressive Conservative PM Diefenbaker (50s) had grown up in the province of Saskatchewan. Tommy Douglas (Kiefer Sutherland’s grandfather, and Donald Sutherland’s father) had revolutionized health care by nationalizing health insurance in the province, and the system worked for two decades with great success until the federal government adopted it.

Canada does not have ‘socialized medicine’. It has nationalized health insurance. No way would they allow a bunch of private insurance groups to set the monthly premiums and get away with setting the rules, or determining who could get care and who couldn’t. The federal government monitors health care costs as a result, and sets the price of drugs. (Isn’t that what Medicare does?) Until that happens here, another $800 is not going to get you the “Canadian system.”

MRW said...

Tom,

I would arrange your sequence a little differently, but with the same elements:

Values (norms) > strategy (planning use of means to achieve objectives) > tactics (execution of plan using means) > policy (ends, prioritized objectives) .

I also don’t think society’s future changes until society’s values change. We’ve been carrying the same ones Grandpa Reagan promoted, and society is still in the same pickle.

Tom Hickey said...

The US military arranges it like I have. Not that they are the last word, but militaries have been in the forefront of organization for millennia. They know what works.

You can't have an effective strategy without policy goals and policy goals are based on values. Moreover, values prioritize the policy objectives.

For example, in a capitalist system policy objectives include optimizing growth, maintaining full employment and keeping the price level stable. Groups with different sets of values prioritize these aims differently. Keynesians prioritizes full employment, over growth and price level. Neoclassicals prioritize growth over full employment and price level, and the financial sector prioritizes controlling inflation over growth and employment. Within these groups there are different schools of through regarding strategy (application of theory) and tactics (specific policy initiatives) for doing so.