by Tyler Cowen
on December 10, 2009 at 1:39 pm
1. Sniping vs. squatting, on eBay.
2. Boycott pink?
3. Road map for the next stimulus: federalize Medicaid.
4. Lowering health care costs without a central plan.
5. What do philosophers think?
6. Critique of the Nook.
7. Does wine advertising in magazines bias wine product reviews?
3. First, almost no numbers in the whole article. Second, why should The Feds take over? Is it because they more effectively collect taxes?
“Pinkstinks says the “pinkification” of little girls causes them to choose less challenging careers and pass up opportunities as they grow up.”
I was going to say that’s the gayest thing I’ve ever heard, but it’s hard to level that charge at a group so antithetical to pink.
Boycotting pink is overboard, but it is a legitimate point that our female children have to buck the system to be a tomboy. I think we are too socially conservative in our indoctrination of our children, male and female, into traditional gender roles.
We do this not because we’re nazis but because we are fearful that our children will be low-status if they have an expansive notion of gender identity. But that’s a stupid fear. We should be more focused on indoctrinating truth and judgement into our children and less focused on indoctrinating currently fashionable social mores.
Based on my experience with the details of one state’s budget, the #3 article makes several accurate and important points. The fundamental argument, and I believe it to be true, is that state and local governments have generally reached the political limits on their ability to levy taxes as a fraction of state GDP, but Medicaid costs are growing faster than their economies and crowding out other services. Without the feds picking up the entire program, or greatly lowering the statutory floors on coverage and reimbursements, I anticipate (and have for some years) that we will see some states withdraw from the Medicaid program. State participation is NOT mandatory.
At that point, we will probably see a variety of state experiments with health care for the poor, ranging from none at all to expanded networks of public clinics to state purchase of private insurance with limited benefits (assuming such remain legal) and so on. Such experiments may, in fact, result in better care for routine things: kids with sore throats won’t go to the emergency room, they’ll be seen in a neighborhood clinic.
OTOH, Grandma may be coming to live upstairs because neither she nor her children can afford nursing home care.
First, almost no numbers in the whole article. Second, why should The Feds take over? Is it because they more effectively collect taxes?
No, because, as Greg Anrig writes:
“Some advocates will no doubt object that withdrawing Medicaid from the laboratories of democracy would stifle the innovation that has long been touted as one of the virtues of our decentralized system of governance. But particularly with respect to programs that are geared toward low-income beneficiaries like Medicaid, the lion’s share of research has found that states don’t actually seek out and emulate the best practices of their counterparts.”
Now I’m sure you are going to argue that the government should get out of the way and let the for-profit private sector deliver low cost health care. But to that point Greg Anrig writes:
“The business community has supported Medicaid enhancements to help relieve pressure on employers to provide coverage for low-wage workers. The insurance industry also has generally favored expanded Medicaid eligibility over other health care reform approaches in order to sustain the existing, profitable framework rather than more radical changes. In addition, as employers have dropped health insurance coverage over time, more low-income workers have become eligible for Medicaid.”
In other words, the private sector wants the government to get out of the way of their profits, by having government take care of the poor and chronically ill.
One of the points I would add is the terrible cost-performance of the US health care mess, as one can’t call it a system. In comparing the historic costs of health care in the US to dozens of other nations, the thing I note is the US spent circa 1981 right at the high end of a dozen other nations: 8% of GDP; the last data I saw put the current figure at 16% of GDP with the high end of those other nations is around 10% of GDP, except for Switzerland that didn’t adopt a universal coverage policy until 1994. The article gives the current figure as 18% of GDP, but I think that’s the result of the economic contraction.
No one has pointed to any aspect of the US health mess that outperforms the other nations with much lower costs, unless you are pointing to the dual system where the poor suffer poor service in the US in order to pay for slightly better care for the wealthier. To argue their is no rationing in the US says the poor in the US don’t deserve to exist in the US.
The problem with Greg Anrig’s proposal is it resigns the US to a for-profit sector progressively shifting more and more people to government budgets in order to control private sector costs while supporting a for-profit delivery system that seeks to shift the cost on innovation to the government while privatizing profits.
The true “innovation” needed in health care is system engineering, as best defined by W. Edwards Deming. Japan made Deming a hero, while in the US, the focus was entirely on creating a magic bullet product that could be sold in the US for a profit; common names are TQM, Black Belt, Six Sigma, blah blah.
Deming tried to get Americans to think like the Japanese who understood and adopted his ideas to their great fortune. In the 70s, one of his bullet points was
when people and organizations focus primarily on costs, costs tend to rise and quality declines over time.
That describes US health care to a T.
check this out:
“One of the reasons I changed careers to biomedical engineering is the belief that engineering solutions is one of the only real improvement possiblities.”
2008, by guess who.
And do you really not believe this whole debate is about government costs?
Sniping vs. squatting, on eBay.
You other eBayers, PLEASE keep squatting. PLEASE.
Boycotting pink is overboard
Schtoopid is the word.
but it is a legitimate point that our female children have to buck the system to be a tomboy.
Give me a break. Maybe with YOUR daughters. My 2 daughters loved pink and purple when they were younger and they are both physically active and very aggressive and competitive in team sports. And one was definitely a tomboy, and I didn’t ever see her having to buck any “system”.
Sheesh, what world are you living in? Pakistan?
My youngest enjoys more physical soccer play with boys, but she isn’t as fast as they are. Not many girls are as fast as boys at the same level of play.
The problem as I see it is forcing your children to do certain activities to satisfy your political beliefs or to satisfy your own childhood fantasies or parental ego.
Hey, you helicopter parents, stop trying to live your life through your children. And please, please, please stop presuming to know and tell us about the best way to raise our children.
An economist with no kids likes to dream that they can micromanage an entire society with technocratic incentives. Their supposedly superior intellect has them imagining their fellow man as mere lab rats.
An economist with kids realizes that it takes a helluva battle just to get your own damn children to wear shoes outside in 40 degree weather.
My kids can be pretty damned stubborn(maybe your genetically inferior kids are gullible and easily tricked), but if they sense they are being pushed in one direction they are actually MORE likely to go and investigate the other direction or at least figure out why the black arts of deception are being aimed at them.
My girl likes dolls more than my boys. She still likes to participate in “wrestle war”, but she also can play for 30 minutes with a basket of shoes. Girls are different than boys, don’t let a bunch of lesbians and testosterone defficient girly men convince you otherwise(god lovem). I hope my girl plays rugby, soccer and tennis, but I’m not going to force her and I’m not foolish enough to think I could.
Perhaps many here will say I am a horrible symptom of what is wrong with this country: “Anti-intellectualism”. Perhaps you should check some of your assumptions and biases. Many of us are not religous, we attended the best universities, we have a deep desire to decrease human suffering and we love people of all sexes, religions, countries and sexual orientations.
When you smugly dismiss our desires with some PC-approved-smear it only confirms our biases that you have no idea what your talking about but you’d love to be the rulers of people who are your superiors.
It’s true that many gender differences are biologically derived and thus immutable. Parents shouldn’t force their kids to do anything, including rejecting or accepting predominant social mores. Of course parents should force kids to eat their vegetables and that sort of thing.
The most important thing to do, as I see it, is to provide space for the child to come to their own decisions about their lives and not be railroaded by the messages on TV or from other kids [and in turn, not to railroad kids as parents]. Those messages are strong and not always positive. E.g. “Math is hard” Barbie (yeah it’s a 10 year old example).
Surely kids left to their own devices will make choices that partially reflect existing customs, because the customs aren’t totally arbitrary. Every kid will be a mix. And it is completely obvious that there’s nothing wrong with that.
Oh yeah and as for all the invective: blah blah blah, insert generic flame response.
Isn’t it ironic that the people who want to boycott pink gave us princesses and queens and other figures that little girls fantasize about? Are they doing this to absolve their guilt?
Not sure where this goes, maybe the department of uh-oh, but check out the non-profit altruists doing well for themselves.
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