Assorted links

Comments

In re: number 6: McDonalds doesn't belong on the list. Most McDonalds are separately-owned franchises.

The world's biggest employer list seems similar to the world's most inefficient employers list. e.g. Indian Railways.

RE link 8. Tim Worstall is claiming that with regard to poverty level analysis over time "Everyone, Just Everyone, Gets This Wrong." His argument is that due to changes in the mid-1970's, you can't compare numbers from before the mid-70's to numbers after the mid-seventies. In his "everyone just everyone gets this wrong" argument, he's pulling the whole "both sides do it!" routine. His example from the right is a piece by Dan Mitchell at CATO. Mitchell does indeed post the series back to 1950, so he is indeed "wrong" according to Worstall. But, his example from the "left" is a post at Angry Bear. This post only looks at data from 1975 on, concentrating mostly on data from 1983. That is, Angry Bear limited it's analysis to a span of time where Worstall's argument is no longer valid. According to Worstall's own argument, they aren't doing anything wrong. So how then is Angry Bear also part of this "everyone just everyone" that gets this wrong? Does he think that no one will actually click on the links he provides and realize that only one of the two sides is making this mistake that he claims "everyone just everyone" is making?

Time inconsistent budget agreements.

They all are. The "Grand Bargain" President Obama offered was no different, as is his jobs bill last week. It's always goodies now, paying for it later, no matter which party.

Or deals "balanced" in spending cuts and tax increases, but where one happens immediately, and the other over 10 years. Etc.

And suddenly, X years later, the paying for it later doesn't happen.

Similarly, all the health care cuts in PPACA/ Obamacare are time inconsistent. If history is any guide, plenty of Democrats will vote to rescind the cuts as soon as they start to bite, but the extra spending? Never.

Are we witnessing the twilight of functioning democracy? Maybe the system, so useful in developing, young countries, just can't cut it in larger, slowing ones?

RE link 8, he is not only claiming that the numbers are hard to compare across multiple decades, he is also claiming that they are not all that meaningful in the present ... that if all the otherwise poor people got enough EITC to vacation in Monaco 11 months out of 12, they would STILL be reported as poor. So even people that don't do comparisons to past decades will be making a mistake if they take these figures as a measure of misery rather than simply as a measure of how many people are being helped.

Michael,

The EITC did not just spring into action in 1975 and then remain the same over all of the intervening years. It has been expanded multiple times, under Presidents of both parties. The last expansion I know of (and I'm no expert) was under Bush II. And TANF, the cash part of welfare, was famously limited under Clinton in the 1990s.

It has been a general process these last 36 years, to replace cash handouts with tax system related and goods and services provision. Which means that as time goes on the comparison becomes ever less reliable.

So, Tim, any guess on whether support for the poor (state, local and federal sources) increased with the increase in the rate of poverty.

In addition, the census numbers from 2007 shouldn't have been affected, as you pointed out that the last changes you mentioned occurred during Bush II.

Well obviously reducing cash payments and replacing them with EITC etc. will in and of itself increase the "poverty level". If I had to bet, I would guess support has increased over the years. But why do we have to guess?

And how are the census numbers relevant?

#6: So, the world's three biggest employers are not unionized. But liberals only despise two of them. Interesting.

It's puzzling why China National Petroleum Corporation and State Grid Corporation of China are on that list. Modern petroleum and electric industries are hardly labor intensive. Highly mechanized and automated even in the third world.

4- Once again, international IM/LE comparisons are misleading. They use different standards of live birth, and studies have found suspicious gender discrepancies in Japan's reported stillbirths. If you look at outcomes from particular ailments, the U.S. generally leads the world.

8- Thank you, this is something that doesn't get nearly enough attention. The average income of the 1950s is about where the poverty line is today. People are shocked to hear this -- the most common response is "you must not be adjusting for inflation!" But in fact, the difference is even bigger than the (real, adjusted) numbers suggest, because they tend not to capture the much greater variety of food, clothing, entertainment, etc available to people today.

Great point about EITC not showing up. I was also interested to learn from that what the actual definition is, as I'd never run across that before.

Talldave,

Do you have any evidence for this suspicious gender disparity and evidence that it is due to not counting stillborn babies? Because we went over this before and this urban myth about other nations not counting infant mortality correctly was soundly debunked.

The study was linked over at Megan's, they found that baby girls tended to be recorded as stillbirths more often than boys. This suggests parents tried harder to save boys.

They do in fact count IM differently, because (in Japan and Nordic countries especially) low birthweight infants are considered "stillborn" while they are counted as live births in the U.S.. I don't know why you think this is "debunked," it is pretty obviously true -- the OECD itself warns about this problem in its own IM literature. In fact, some countries also use the same weight cutoffs to determine whether to intervene -- so, somewhat perversely, some countries with lower IM are actually letting babies die where countries with higher IM would be trying to save them.

http://classicalvalues.com/archives/2009/10/health_care_man.html

We debunked it here:
http://marginalrevolution.com/marginalrevolution/2011/08/the-sad-statistic-that-trumps-the-others.html

You can read the report at this link:

http://www.cdc.gov/nchs/data/databriefs/db23.htm

The idea that Nordic countries do not count low birth weight babies is a complete lie that you continue to report. All you have to do is look it up.

"The U.S. infant mortality rate was still higher than for most European countries when births at less than 22 weeks of gestation were excluded. " - BAM, DEBUNKED!

You keep using this word, "debunked." I do not think it means what you think it means.

Note the difference between IM rates gets sigificantly smaller with that exclusion. It also says this:

The United States compares favorably with Europe in the survival of infants born preterm

They say the major differences in IM are explained by the higher preterm rate:

The primary reason for the United States’ higher infant mortality rate when compared with Europe is the United States’ much higher percentage of preterm
births.

The rest of the difference is explained by the known recording differences, and poor compliance:

Although most countries require that all live births be reported, limits on birth registration requirements for some countries do have the potential to affect infant mortality comparisons, especially if very small infants who die soon after birth are excluded from infant mortality computations (7,8). There is also concern that birth registration may be incomplete near the lower limit of the reporting requirement, as the exact gestational age may not always be known. Differences in national birth registration notwithstanding, there can also be individual differences between physicians or hospitals in the reporting of births for very small infants who die soon after birth.

The countries that only adopted the standards recently presumably have lower compliance.

No, I know what debunked means. I also know what the phrase "shifting goalposts" means.

"They say the major differences in IM are explained by the higher preterm rate:"

And that means that there is a higher infant mortality rate in the US. It is explainable, but still higher despite what you claimed over and over and over again without evidence.

Do you even know what infant mortality rate means?

Again, your reading comprehension is poor. Please examine table 2 and the accompanying graf, the exclusion of low bw infants is not "a lie."

Again, reading comprehension. I did not say the U.S. IM rate was not higher, I said "Once again, international IM/LE comparisons are misleading. They use different standards of live birth" which is entirely accurate.

Excuse me, Table 1 is the table which shows how countries exclude low bw infants. Table 2 does show that the U.S. outperforms most other countries at different gestational ages, which suggests access to, or quality of, health care is not driving the issue, if the reporting differences and preterm rates were not sufficiently persuasive on their own.

There are several more links below. IM comparability has well-established problems.

See also, for instance here.

http://www.webmd.com/baby/news/20091103/preemies-raise-us-infant-mortality-rate

The CDC makes the additional point that, besides the differences in recording, the U.S. has a higher preterm rate which has little to nothing to do with health care.

I can understand why Soros outfits like Commonwealth would push the notion small differences in IM and LE between OECD countries are a proxy for health care, but I'm surprised how many people buy it, given such a relationship has never been evidenced, but is merely assumed despite a mountain of confounding factors.

I like how the link you provided says the opposite of what you claim it says:

"When births after less than 22 weeks are excluded, the U.S. and other countries show a drop in infant deaths in 2004. However, the U.S. still has an infant mortality rate higher than most European countries, with nearly twice the rate of Sweden and Norway. "

I'm not sure what Soros or LE has to do with you repeatedly making the false claim that differences in measuring infant mortality drastically skew the numbers against America, but here we are.

It says exactly what I claimed. Did the difference get smaller or larger with the exclusion? Were differences in IM attributable to the preterm rate?

Soros is the one most reponsible for pushing the LE/IM, which why people like you become so invested in it.

*the myth of IM/LE being a proxy for health care

You claimed that "They use different standards of live birth". You have also claimed that this is true of Nordic countries and that this under reporting of live births has skewed infant mortality statistics. And your link says the opposite.
"U.S. still has an infant mortality rate higher than most European countries, with nearly twice the rate of Sweden and Norway"

"people like you become so invested in it"

Excuse me? Who are "people like me"? And when did I push LE/IM?

No, it does not say the opposite, it says exactly what I said. Which part of "the difference is smaller" is confusing you?

Your reading comprehension is very poor. I did not say you pushed IM/LE, I said you were invested in it. Please try to actually read what things say.

Evidence of debunking? The problem with measurement errors is that it would be hard to debunk.

Besides, why do people use infants who by definition have the least exposure to medical services of anyone as a proxy for medical services? It seems like the only thing you are measuring is the penetration of the importance of well-baby care. I wonder how many times in Japan someone leaves a baby in a toilet or trash can. It happens a lot here. That doesn't tell me that a lot of our babies die in trash cans, but I do conclude that population density in homogeneous cultures makes some things much easier, such as enforcing cultural norms around well baby care.

and here is your evidence: http://www.cdc.gov/nchs/data/databriefs/db23.htm

Thanks for playing conservative myths from the echo chamber.

You should really read that link more carefully.

See also here

Ansley J. Coale; Judith Banister (December 1996). "Five decades of missing females in China". Proceedings of the American Philosophical Society 145 (4): 421–450. JSTOR 987286. http://www.jstor.org/pss/987286

See also here:

http://health.usnews.com/usnews/health/articles/060924/2healy.htm

See also here:

http://www.webmd.com/baby/news/20091103/preemies-raise-us-infant-mortality-rate

I don't understand why you are disputing birth statistics for Japan when the article focuses on the problems caused by rapidly aging from high longevity and low birth rate. Are you arguing Japan's low fertility is caused by massive infant mortality and poor prenatal care, and not by Japan's culture internalizing a small family mindset to focus all family resources on just one or two children?

What I find interesting is the Economist calls Japan's health care system inefficient because it cost just 8.5% of GDP - what does that make the US health care system? Bloated and dysfunctional for spending twice as much with poorer results?

I'm saying Japan's LE and IM should not be taken as evidence they have a great health care system, which the author appears to take for granted. LE is a very bad proxy for HC, IM is not comparable.

Also, the U.S. gets better results on actual HC outcomes. The U.S. has a less efficient health care system than most OECD countries, but that's somewhat misleading, because each marginal dollar is less effective than the one before -- we're less efficient because we'll give people care in situations other countries won't, esp. in diagnostics like MRIs where we give about twice as many, and expensive things like organ transplants (also 2x as many).

A really efficient health care system would be one that provided almost nothing but antibiotics and vaccines, because those actually produce something like 90% of the benefits from all health care, at <1% of the cost -- but I don't think you'd want to live there.

If I needed a worse comparison of the medical system I'd have to either go third world or outer space. The only comparison of actual health outcomes is the same population with a different system.

And why is this? It's pretty simple. It's because health involves things like biology.

4. I think the article makes a fundemental logical error. It evaluates Japan's healthcare system on two critera outcomes and cost. It then criticizes Japan for both things that lower cost but contribute to worse outcomes (lack of emergency rooms relative to smaller clinics, lack of the latest medical treatments) as well as things that increase costs but contribute to better outcomes. When you are a system that achieves excellent results at low cost it is insufficient to simply identify the downsides of various tradeoffs that they have made. In fact given the Japan's enviable position on the matrix of cost and bennefits it is likely that many of the things identified in the article as problems might represent wise decisions in allocating scarce resources.

I think the main point of the article is:

"Although it needs a growing workforce to pay the bills, Japan is ageing and its population is shrinking. Since kaihoken was established in 1961, the proportion of people over 65 has quadrupled, to 23%; by 2050 it will be two-fifths of a population that will have fallen by 30m, to under 100m."

The significance of the problems it mentions are that by keeping the cost low it forces doctors to find other ways to make money, (over testing, extended in patient care) that threaten to compromise the long term viability of the system.

Amazing how all these social safety net programs work well with a ever increasing population but start to fall apart when the demographics shift or population declines. It's as if they were all Pon... never mind.

Not so much Pon- as simply the inherent problem of capitalism requiring growth to function. I get fairly concerned thinking about how the entire world will be able to make it work when the global population levels off at around 9 billion, around the year 2050.

If we assume that societies care for their aged, how will that work when the entire world ages? Right now the developing world is full of young people and global capitalism will harness their energy to keep the aging first world afloat. But after 2050, how does it work?

If we assume that societies care for their aged... But after 2050, how does it work?"

The only way these programs survive is if they are financially sound to begin with, ie. self-sustaining based upon the contributions of the participants. You'll notice that none of our social safety nets actually are solvent on that basis.

It is not capitalism, but the welfare state which requires growth to function.

For capitalism, creative destruction would come into play - the elderly would be euthanized early enough for their organs to be sold for reuse.

No no no. Certain social safety net programs can safely be described as a ponzi scheme. Programs that require continued population and economic growth can reasonably, if imperfectly, get that label applied. But you are overextending the definition pretty severely. The problem described is not a failure to grapple with the absense of perpetual growth, the problem is a failure to grapple with an actual decline in growth. That's a different thing entirely. The problem with Ponzi schemes is that perpetual growth in the pool of participants is necessarily unsustainable. Likely the same is true for economic growth. It is not reasonable to label the inability to deal with a negative trend in participants paying in the same way. Unlike population growth there is no hard limit on the duration at which a populatioon can be held in equilibrium.

There's not actually any solid evidence that they have an enviable position re healthcare. People really need to stop assuming small differences in LE/IM are a proxy for healthcare effectiveness; they are fraught with confounding factors.

"The Japanese are only a quarter as likely as the Americans or French to suffer a heart attack, but twice as likely to die if they do."

This makes me wonder if diet/culture and genetics had more do to with favorable Japanese health outcomes than did its healthcare system.

Can we compare life span of Japanese Americans with Japanese? I bet they are quite similar.

But that isnt comparable if Japanese Americans have a typical American diet.

Some studies find they actually live slightly longer in the U.S.

Not all heart attacks are made equal. Maybe Japanese less frequent but face deadlier attacks. Hard to pin it on the healthcare system.

http://www.washingtonpost.com/business/economy/study-college-graduates-driving-increase-in-bankuptcy-filings/2011/09/12/gIQAmemtNK_story.html

Percentage of bankrupts with a college degree increased (a bit) ...

HELL YES KEEP THOSE PUFFIN LINKS COMING!!!

Re 6:

Why isn't Krugman lauding Bush's and Obama's achievement of crowding out the private sector and keeping people employed? Broken Windows validated?

Good draft paper with background of EITC.

http://www.econ.ucdavis.edu/faculty/hoynes/working_papers/Chicago-Fed-Final.pdf

From the paper, real EITC transfers for single mothers with one child increased by 40% between 1993 and 2006. Real transfers for single mothers with two children doubled in the same time period.

4. The next person who uses life expectancy as a measure of the quality of a nation's health care system will be strangled by his own large intestine!

Anyone who uses infant mortality will be strangled with their small intestine. I cant believe even The Economist sinks to this level of nonsense.

The US has among the highest survival rates for all types of cancer. THAT is an appropriate measure of health care quality. IM and LE are more a function of genetics and lifestyle choices than anything else.

And cancer prognosis isn't genetic? Everyone who uses metrics I don't like will be strangled and others line up for their cookies please. There simply isn't any one "good" measure.

Are you joking? By necessity, measured "cancer survival rates" are in large part a function of cancer screening. The more you screen, the more and the earlier cancer will be diagnosed, the better your "cancer survival rates" are going to look. Which is why many researchers agree that they should not be used to measure the quality of medical care. At all.

"The US has among the highest survival rates for all types of cancer. THAT is an appropriate measure of health care quality."

Really?

What about the large number of people who can't afford to pay to see a doctor to have their cancer diagnosed, and then can't get treatment until its too late because until all hope is lost, he's not sick enough to be covered by EMTALA.

And the US spends twice as much per person than Japan on health care, and the Economist deemed Japan's system to be inefficient.

That's more than offset by the number of people who are not given cancer tests in other OECD countries because of rationing. We do FAR more cancer testing.

To "not afford" medical testing in the U.S., you would have to have too much income to qualify for Medicaid, which means they are choosing to forego it.

You are misinformed about Medicaid. Until the ACA takes effect and creatse a single standard for coverage based on income, the statse set their own criteria. Not only do many of them set the income bar absurdly low, but they also have age and family status criteria so that in many (most?) of them a childless adult under 65 cannot obtain Medicaid coverage even if s/he is penniless and living under a bridge.

That's typically because they have other state-funded programs like free clinics, or things that are like Medicaid, or extensive private charities (often religious). Even failing all that, they can't be refused treatment.

There are not actually any states in which people living under bridges cannot get health care.

On 3 - Can anyone explain the economic argument for the young puffins that appear out of nowhere? I didn't realize exchange rates were that magical? Or can economics only explain why the birds stuck around longer than usual, which makes more sense given the shift in their food supply.

@Mike Cancer statistics are by far and away the worst thing to compare countries stats on, everything you've said about IM and LE applies to cancer statistics and moreover they vary highly with life expectancy itself and with the methods of screening and reporting used. See:

http://nhssense.tumblr.com/post/3047031746/a-brief-primer-on-the-unreliability-of-cancer

Cancer stats are difficult to collect and analyze, but they at least have a better chance of actually correlating to health care than LE.

This is interesting though:

There’s no way to tell through the screening program which are which, so many American women are having un-necessary treatment compared to Brits

Yes, but if you're the woman so diagnosed you probably want the treatment. This is a perfect example of why U.S. healthcare costs more -- it does more. I think it's fine to say the UK is more cost-effective, and you can argue this is a good thing, but this kind of rationing does mean they're going to have worse average outcomes, whether or not we believe the difference is large enough to justify the additional cost.

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