Category: Law
How dangerous are cell phones when driving?
Maybe not as much as you think. Here is the abstract from a new paper (AEA gate) by Saurabh Bhargava and Vikram S. Pathania:
We investigate the causal link between driver cell phone use and crash rates by exploiting a natural experiment induced by the 9pm price discontinuity that characterizes a majority of recent cellular plans. We first document a 7.2 percent jump in driver call likelihood at the 9pm threshold. Using a prior period as a comparison, we next document no corresponding change in the relative crash rate. Our estimates imply an upper bound in the crash risk odds ratio of 3.0, which rejects the 4.3 asserted by Redelmeier and Tibshirani (1997). Additional panel analyses of cell phone ownership and cellular bans confirm our result.
Here is another way to put the puzzle:
Cell phone ownership (i.e., cellular subscribers/population) has grown sharply since 1988, average use per subscriber has risen from 140 to 740 minutes a month since 1993, and surveys indicate that as many as 81 percent of cellular owners use their phones while driving—yet aggregate crash rates have fallen substantially over this period.
I don’t want you to start or continue this practice, as numerous other studies do find significant risk. Still, maybe this matter is not quite as settled as many people think.
Here is a non-gated version of the paper (pdf), and the official ungated version is here.
Will Uruguay legalize marijuana?
Members of Uruguay’s House of Representatives have passed a bill to legalise marijuana.
If it goes on to be approved by the Senate, Uruguay will become the first country to regulate the production, distribution and sale of marijuana.
The measure is backed by the government of President Jose Mujica, who says it will remove profits from drug dealers and divert users from harder drugs.
Under the bill, only the government would be allowed to sell marijuana.
There is more here, and reports indicate that approval for the bill is expected.
The new Baptists and bootleggers?
Activists fighting to legalize marijuana in states across the country are running into an unlikely opponent: people who make a living in the medical marijuana industry. Politico calls it “Big Marijuana,” noting that those who form part of the billion-dollar industry are fighting hard to keep competitors out of the game. In its fight against full legalization, the medical marijuana sector has joined some unusual allies. The Medical Marijuana Caregivers of Maine, for example, joined law-enforcement groups and social conservatives to fight against a bill that would have legalized possession of small quantities, reports Politico.
Medical marijuana is good business not just for dispensaries but also the doctors who agree to prescribe the drug. Finding a doctor willing to recommend the drug “can take months,” reports Market Watch. In Massachusetts, for example, some 3,000 people are on the waiting list to see a doctor.
The link is here.
Off-label prescribing vs. RCT
Incidentally, another thing that’s fascinating to me is that, there’s a very funny saying when it comes to the ethical review of science, or an anecdote, which is that if a doctor wakes up in the morning and decides that, for the next 100 patients with cancer that he or she sees that have this condition, he’s going to treat them all with this new drug because he thinks that drug works, he can do that. He doesn’t need to get anyone’s permission. He can use any drug “off-label” he wants when, in his judgment, it is helpful to the patient. He’ll talk to the patient. He needs to get the patient’s consent. He can’t administer the drug without the patient knowing. But, he can say to the patient, “I recommend that you do this,” and he can make this recommendation to every one of the next 100 patients he sees.
If, on the other hand, the doctor is more humble, and more judicious, and says “you know, I’m not sure that this drug works, I’m going to only give it to half of the next 100 patients I see,” then he needs to get IRB approval, because that’s research. So even though he’s giving it to fewer patients, now there’s more review.
That is from Nicholas A. Christakis, via Jim Olds. The discussion is mostly about Big Data.
How Medicare payments are set
It’s never a bad idea to bring this point up yet again:
Reporters Peter Whoriskey and Dan Keating have opened Post readers’ eyes to the fact that Medicare pays for physician services — a $69.6 billion item in 2012 — according to an arcane and little-known price list, over which doctors themselves exercise considerable and less-than-totally-transparent influence.
Known as the Relative Value Update, the process consists of a 31-member committee of the American Medical Association (AMA) recommending what Medicare should pay for some 10,000 procedures — with the fees based in part on how long it takes to complete each one. This time-and-motion study often fails to take full account of changing technology and other factors affecting physician productivity, so anomalies result: For example, Medicare pays for a 15-minute colonoscopy as if it took 75 minutes.
Here is a bit more, here is the longer article.
By the way, there is also this new result:
In one of the study’s notable insights, Dr. [Joseph P.] Newhouse said, “we did not find any relation between the quality of care and spending, in either Medicare or the commercial insurance sector.”
That is from a new study of regional variation in Medicare expenditures. The study itself is here, and it seems to imply that regional discrepancies in Medicare expenditures cannot be easily rectified by rewarding the more cost-efficient regions. For one thing, cost variation among providers, within a region, is large, which makes it hard to apply incentives on a regional basis.
Aid for disabilities should look more like the EITC
Don’t forget this:
An estimated 23 percent of people with cognitive disabilities were employed in 2011, according to the U.S. Census Bureau.
Many do not seek employment, in part because of concerns about losing federal subsidies.
Again, insofar as it is possible, we should pay people to work, rather than paying them not to work.
By the way, I am not suggesting that bad policy is the only reason for unemployment in this context.
The article is here.
Eminent domain and the decline of Detroit
Ilya Somin reports:
Detroit’s sixty year decline, culminating in its recent bankruptcy, has many causes. But one that should not be ignored is the city’s extensive use of eminent domain to transfer property to politically influential private interests. For many years, Detroit aggressively used eminent domain to promote “economic development” and “urban renewal.” The most notorious example was the 1981 Poletown case, in which some 4000 people lost their homes, and numerous businesses were forced to move in order to make way for a General Motors factory. As I explained in this article, the Poletown takings – like many other similar condemnations – ended up destroying far more development than they ever created. In his prescient dissent in Poletown, Michigan Supreme Court Justice James Ryan warned that there was no real reason to expect that the project would produce the growth promised by GM and noted that Detroit and the court had “subordinated a constitutional right to private corporate interests.”
Here is a bit more.
Drug Shortages are Killing
The shortages of injectable drugs that I have been writing about since 2011 (e.g. here and here) are continuing and they are extending to ordinary nutrients needed by premature babies:
Because of nationwide shortages, Washington hospitals are rationing, hoarding, and bartering critical nutrients premature babies and other patients need to survive.
..At the time of this writing—some shortages come and go by the week—Atticus’s hospital is low on intravenous calcium, zinc, lipids (fat), protein, magnesium, multivitamins, and sodium phosphate; it’s completely out of copper, selenium, chromium, potassium phosphate, vitamin A, and potassium acetate. And so are many other hospitals and pharmacies in the country, leading to complications usually seen only in the developing world, if ever.
The article in the Washingtonian covers problems with GMP regulations and the FDA, as I did earlier. The article also makes the following point. Many of these products, especially the simpler ones, are available in Europe but it is illegal to import them to the United States.
Many doctors are pinning their immediate hopes on Congress’s forcing the FDA to form a global pipeline to import an emergency supply. “I have friends in other countries who could get me some, but that would be illegal,” one doctor says. In fact, pharmacists note that the phosphorous Europe uses is a better product than that in the US because it’s organic and doesn’t interact with calcium in the PN, meaning more phosphorous could be included in the IV bag.
When Miguel Sáenz de Pipaón, a neonatologist at a prominent hospital in Madrid, arrived in the US for a research visit, he was stunned by the nutrition shortages.
“It’s crazy,” he says. “That doesn’t happen in Europe.” He noted that the US relies on a 25-year-old lipid emulsion, which is in shortage, while European hospitals use a newer version that’s readily available. Rather than import the newer emulsion, the US has left many patients without any lipids at all.
Hat tip: Kurt Schuler.
Bounty hunter markets in everything?
The farming and ranching town of Deer Trail, Colorado, is considering paying bounties to anyone who shoots down a drone.
Next month, trustees of the town of 600 that lies on the high plains, 55 miles (34km) east of Denver, will debate an ordinance that would allow residents to buy a $25 hunting licence to shoot down “unmanned aerial vehicles”.
…”We don’t want to become a surveillance society,” he [Phillip Steel, the architect of the proposal] told Reuters in a telephone interview.
He said he had not seen any drones, but that “some local ranchers” outside the town limits had.
Under the proposal, hunters could legally shoot down a drone flying under 1,000 feet with a 12-gauge or smaller shotgun.
The town would also be required to establish a drone “recognition programme” for shooters to properly identify the targeted aircraft.
“In no case shall a citizen engage an obviously manned aerial vehicle,” the draft proposal reads.
It is admitted that the idea is a symbolic one and may not pass. But perhaps teachers in particular should be encouraged to participate? The story is here, via Michelle Dawson.
Here are Alex’s earlier posts on bounty hunters.
How does insurance eligibility affect labor supply?
There is a new paper by Craig Garthwaite, Tal Gross, and Matthew J. Notowidigdo, the abstract is this:
We study the effect of public health insurance eligibility on labor supply by exploiting the largest public health insurance disenrollment in the history of the United States. In 2005, approximately 170,000 Tennessee residents abruptly lost public health insurance coverage. Using both across- and within-state variation in exposure to the disenrollment, we estimate large increases in labor supply, primarily along the extensive margin. The increased employment is concentrated among individuals working at least 20 hours per week and receiving private, employer-provided health insurance. We explore the dynamic effects of the disenrollment and find an immediate increase in job search behavior and a steady rise in both employment and health insurance coverage following the disenrollment. Our results suggest a significant degree of “employment lock” – workers employed primarily in order to secure private health insurance coverage. The results also suggest that the Affordable Care Act – which similarly affects adults not traditionally eligible for public health insurance – may cause large reductions in the labor supply of low-income adults.
The NBER version of this piece is here, ungated here. Craig writes to me:
Applying our estimates to the ACA, this would mean a reduction in labor supply of about 0.3 to 0.6 percentage points (or about 500-900K people) just from this feature.
Is this a feature or a bug? Reihan adds comment.
The Property Rights of Private Communities
I am one of the amicus curiae, along with Richard Epstein, James W. Ely, Donald Kochan, Adam Mossoff, and Ilya Somin, in an amicus brief urging the Supreme Court to hear Mariner’s Cove Townhomes Association v. United States. The case is about whether the right that a homeowner’s association has to collect dues is a compensable right in a government taking. The U.S. Court of Appeals for the Fifth Circuit held that “the right to collect assessments, or real covenants generally” is not a compensable right under the Takings clause. The brief, consistent with many lower court rulings, argues that it is a compensable right. The case is important as Ilya Shapiro and Trevor Burrus explain:
The U.S. housing market has seen a major shift in the past 30 years: the rise of the community association. In 1970, only 1 percent of U.S. homes were community association members; today, more than half of new housing is subject to association membership, including condominium buildings.
…Such associations often shoulder the burden of providing and maintaining infrastructure, services, and utilities, which allows for more diverse and customizable amenities for homeowners than if those decisions were left with remote municipal governments. Because of these benefits, and because they increase the tax base, local governments are increasingly requiring developers to structure developments as community associations.
…The perverse implications of the Fifth Circuit’s ruling are clear: it would allow for local governments to require the creation of a community association, benefit from the resulting private delivery of services while collecting taxes from its members, and later take the property without even paying back the very fees that enabled the government’s benefit.
…The ruling also clashes with the Supreme Court’s recent decision in Koontz v. St. John’s River Water Management District: that an income stream from real property is a compensable interest under the Fifth Amendment. For these reasons, we urge the Supreme Court to take the case and to recognize the compensable property rights of the Mariner’s Cove Townhomes Association and the millions of other Americans choosing—and paying—to live in a community association.
Why isn’t health care employment slowing?
We’ve all heard a lot about the slowing of health care cost inflation. Yet, coming from Dan Diamond of The Advisory Board, here are some very interesting points of relevance to the topic:
“A lot of people have noted that health care spending has slowed,” Amitabh Chandra, an economist and the director of health policy research at the Harvard Kennedy School, told me last week.
“Many of us would like to think that this is a more permanent slowdown,” he added.
“[But] we see absolutely no slowdown in employment growth in health care. And if that is not slowing, then it’s very difficult to believe that there will be a sustained slowdown in health care spending.”
Health care gained more than 320,000 jobs in 2012—the sector’s strongest year in five years.
…”One hypothesis is that only lower-paying jobs in health are growing,” the Altarum Institute’s Ani Turner told me via email. But “we don’t think that’s true.” Altarum researchers have reviewed BLS data and found “stable growth” for the most highly paid health care workers—i.e., doctors and nurses—if somewhat lower growth for health care support roles.
And the University of Texas’s Richardson took a look at two other potential culprits: whether the wages paid to health care workers had fallen in recent years, or if their hours worked had declined. But neither scenario had come to pass; in fact, Richardson found that hourly wages had only climbed, while weekly hours worked have remained essentially flat.
The full article is here, and the entire discussion is of interest. You will note for instance that capital spending does seem to be down.
File under “The Puzzle Deepens.”
Patent Thugs
From the NYTimes:
In the last five years, IPNav has sued 1,638 companies, according to a recent report by RPX, a patent risk management provider, more than any other entity in the patent field. “To get companies to pay attention, in some percent of the market, you need to whack them over the head,” Mr. Spangenberg said. “In our system, you can’t duel, you can’t offer to fight in the street, which would be fine with me.”
…Mr. Spangenberg is likely to open the conversation on a diplomatic note, but if you put up enough resistance, or try to shrug him off, he can also, as he put it, “go thug.”
He demonstrated what that sounds like in a brief bit of role-play recently, sitting in the apartment he is renting for the summer in Paris near the Arc de Triomphe. His voice dropped, the curse words flowed, and he spoke with carefully modulated menace.
“Once you go thug, though, you can’t unthug,” he explained, returning to his warm and normal tone. “Actually, you can unthug, but if you do that, you can’t rethug. Then you just seem crazy.”
Hat tip: Donald Marron (twitter).
Debt forgiveness in Iceland
Iceland’s expanded debt relief programme in Iceland is targeting too broad a demographic, the OECD has warned.
By the end of 2013, Iceland’s banks will have forgiven almost €250 billion kronur (€1.6 billion) in consumer debt, equal to more than 14 per cent of gross domestic product, according to estimates from the Icelandic Financial Services Association.
Here is a bit more.
New Zealand Meow Meow
Instead of trying to ban new drugs as fast as they are
created, New Zealand has taken a different
approach, it will allow synthetic drugs to be sold so long
as they pass safety trials.
It’s the first nation
to take a dramatically different approach to psychoactive
substances like party pills and synthetic marijuana… [that] go by names like bath salts, spice or
meow-meow.
In a 119-to-1 vote on Thursday, the country’s parliament
passed the Psychoactive Substances Bill, establishing a framework
for testing, manufacturing and selling such recreational
drugs.
The law does not overturn existing bans
such as on marijuana although that issue is likely to be revisited.
File this sentence under the culture that is New Zealand:
The drug law enjoyed broad support although there
was debate over whether animal testing would be required in the
clinical tests.