Asked at the Paris book fair last week which book had made the greatest impression on him during his life, Lefebvre told the interviewer it was “without doubt” Zadig et Voltaire – the name of a French fashion chain. “It’s a lesson about life, and I reread it pretty often,” said the politician, at the fair to publicise his own book, Le mieux est l’ami du bien, an exposition of his political views. He actually meant to refer to Voltaire’s celebrated philosophical novel Zadig, about a Babylonian man subjected to the whims of fate.
The video of his mistake has now been viewed almost 200,000 times, and the French literati have been quick to mock Lefebvre for his slip, suggesting other combinations of consumerism and literature – from The Girl with the La Perla to The World According to Gap, Thus Spake Zara, Waiting for Gaultier and Victor Hugo Boss’s Les Misérables – on the trending Twitter hashtag #bibliolefebvre.
…His mistake follows Sarkozy’s criticism of Madame de Lafayette’s The Princess of Cleves two years ago, which prompted a literary backlash against the French president. Sales of the 17th-century novel soared, public protest readings of the book were held and the 2009 Paris book fair sold out of badges saying “I’m reading La Princesse de Clèves”. It is too early to say whether Lefebvre’s appreciation will provide a similar boost to Zadig by Voltaire – or even to Zadig and Voltaire.
Here is more.
2. Purple Health Care Plan (endorsed by five Nobelists).
I haven’t read this paper (pdf) yet, but the abstract is already a winner:
Recent advances in high-frequency financial trading have made light propagation delays between geographically separated exchanges relevant. Here we show that there exist optimal locations from which to coordinate the statistical arbitrage of pairs of spacelike separated securities, and calculate a representative map of such locations on Earth. Furthermore, trading local securities along chains of such intermediate locations results in a novel econophysical effect, in which the relativistic propagation of tradable information is effectively slowed or stopped by arbitrage.
The Democrats are on defense because they are unwilling to ask voters to confront the implications of their choices. Democrats seem to believe that most Americans want to preserve the 20th-century welfare state programs. But they are unwilling to ask voters to pay for them, and they are unwilling to describe the tax increases that would be required to cover their exploding future costs.
…Until they find a way to pay for the programs they support, they will not be serious players in this game. They will have no credible plans and will be in an angry but permanent retreat.
Here is the full column (NYT), worth one of your twenty. As this is the blogosphere, it’s worth noting that many bloggers, including many of the best ones, will come right out and advocate higher taxes on the middle class. But the Democrats more generally have painted themselves into a corner on this issue. People will look back and see the non-expiration of the Bush tax cuts as a turning point.
Via Ryan Jones, Ping pong paddle hotel, on the drawing board.
Via Daniel Lippman, you can now burn a paper iPad to honor the dead.
Moving in the other direction, the authorities are calling for a halt to the making of time travel dramas, because they “are treating the serious history in a frivolous way…” (via Chris F. Masse).
In absolute terms, Brazilian elections are second only to America’s in their costs, and relative to national income can exceed them by a wide margin. In 1996, Clinton spent $43 million to take the White House; in 1994 Cardoso laid out $41 million to secure the Palacio de Planalto, in a country with a per capita GDP less than a sixth that of the US.
That is from Perry Anderson, “Lula’s Brazil,” The London Review of Books, 31 March 2011.
Six Lufthansa employees, including four flight attendants, have been arrested after sneaking in more than 63,000 pounds of out-of-circulation, €1 and €2 coins from China back to Germany over the last four years.
Euro coins have two color tones, gold and silver, and when the German Central Bank takes the coins out of circulation, the two colors (see picture to the left) are separated then sent to China to be melted down into scrap metal.
A wily group in China reassembled the coins rather melting them, then sent them back to Germany with four LH flight attendants serving as “mules.”…The FAs would then take the coins to the Bundesbank (only the central bank in Germany accepts damaged coins) and turn them in for bills.
The story is humorous throughout, and for the pointer I thank none other than Air Genius Gary Leff. Here is further detail (NYT) as to how the arbitrage worked and relied on low Chinese wages to reassemble the coins in a cost effective manner.
1. Good profile of Eric Schadt, “he wants to be a “master of information” instead of simply a scientist.”
2. Diane Coyle reviews the new book by Dean Karlan and Jacob Appel.
I’ve now read it and here are a few comments:
2. Ryan nails our dysfunctional, “who is really responsible for paying for Medicaid?” structure. That said, I’ve long preferred the federalization of Medicaid. Block grants to the states may be better than the status quo, however (the size of those grants is a logically distinct question). Within state budgets, police and education are often the alternative to Medicaid costs. Are we so sure that Medicaid produces the maximum benefit for the money? Low-quality moralizing about the poor is not an answer to this question.
3. That said, Medicaid should be one of the last parts of the health care budget to cut. More of our health care aid should be like Medicaid, which is relatively cheap and also targeted at those who really need the assistance. The correct Medicaid decisions depend on other budget choices, but ideally Medicaid is low on the list of recommended cuts, even if it may require some cuts.
4. With either the block grants or the Medicare vouchers, I would urge maximum transparency. Health care costs are increasing by about five percent a year. That means a fixed value voucher loses about half its real value, in terms of command over health care resources, within fourteen years. (It’s a bit more complicated than that, since not all health care costs are proportional price increases to currently available services.) If that is the decision we are going to make, let us understand it as such. I would add that Ryan’s opponents don’t avoid this kind of dilemma nearly as much as they think they do.
5. It would be nice to have a scientific estimate of how much fixed value vouchers would lower the rate of growth of health care costs. I’m not convinced the effect here is large, but I’d like to see it studied more closely.
6. Ryan’s budget repeals ACA and thus in the semi-short run it could considerably increase Medicare costs. There is no reason why Ryan’s plan shouldn’t keep the most fiscally responsible aspects of ACA. Ryan exempts the current elderly from any Medicare cuts at all, see David Leonhardt’s remarks.
7. Over a ten-year time horizon, the Ryan plan increases the debt rather than decreasing it. Take that as a sign of how hard fiscal reform is going to be.
8. As I’ve already blogged, the vouchers idea won’t help cut health care costs. Let’s create some multiple public options within Medicare, some of which would allow people to trade health care benefits for cash. Democrats are supposed to be “pro-choice,” right? Or is that only for abortion?
9. I’m all for cutting the corporate income tax, but 35 to 25 percent isn’t impressive. Let’s eliminate it altogether.
10. There’s not nearly enough on reforming the dysfunctional supply-side of our health care institutions. Nor does science or basic research receive much discussion.
11. The plan does some strange things, such as repeal Dodd-Frank resolution authority, which most people, even Dodd-Frank critics, think is a good idea. Ezra summarizes the entire list of budget changes.
12. The more the Democrats criticize this plan, the more it helps Ryan and the more it hurts the Democrats. It reframes sticker shock, and the entire debate, simply to argue about $6 trillion in budget cuts.
13. #12 is the bottom line here, since the plan is not intended to be enacted into law. Points #1-11 pale in comparison to #12-13.
Basically not. Austin Frakt writes:
Why is the market-based Advantage voucher system not helping to control Medicare costs? The answer is that health care cost control is tough, technically and politically. Provider groups typically resist it. When it pertains to Medicare, beneficiaries resist it too. By adding another private-sector layer to the program–health insurers–the Advantage program invites a third source of political pressure. Rent-seeking by providers and insurers, as well as the power of the beneficiary constituency, align in their encouragement of higher Advantage payments. Congress, apparently, is willing to yield to that encouragement.
So, it’s really no surprise that Advantage plans have not, to date, been part of a Medicare cost control solution. Congress has not consistently been willing to say no to the combination of powerful interests that advocate for higher payments to private plans. Given the track record, it is also not unreasonable to conclude the mandatory voucher program Ryan advocates wouldn’t save money either. As Krugman suggests, it could even be worse because in time 100% of beneficiaries would be enrolled in vouchers, not the 24 percent that are enrolled today.
The politics of Medicare are such that Ryan’s idea, paying for care entirely through private plans, costs more. That’s not due to a market failure, but a political one. Congress likes to spend money; insurers, providers and beneficiaries like to receive it. Congress spends even more when it can satisfy those interests under the guise of a seemingly pro-market, pro-competitive program.
Yglesias and Krugman have a good public choice critique of this aspect of the Ryan plan. Ezra says the Ryan plan will end up reviving Simpson-Bowles, and more comment here. Here is praise for the Ryan plan from Chris Edwards. Here is Arnold Kling on morality.
The way to turn the Ryan plan into genuine cost control is to offer people a choice of 5-10 “public options,” some of which involve converting future Medicare benefits into current or future cash.
We have now successfully moved from Typepad to WordPress; most of the kinks of the move and the new design appear to have been worked out. Here is the place to report, however, any remaining issues that you may be experiencing. By the way, if you are interested in moving your own blog, see here.
Let’s say it’s 2027 and I’ve just turned 65. I fill out a Medicare application on-line and opt for a plan with superior heart coverage (my father died of a heart attack), not too much knee coverage and physical therapy (my job doesn’t require heavy lifting), no cancer heroics (my mother turned them down and I wish to follow her example), and lots of long-term disability.
Is that so terrible an approach? Is it obviously worse than having the Medicare Advisory Board make all of those choices for me?
Over the next few days you will read a lot of “downgrade and dismiss” directed at Paul Ryan and his plan and indeed it is quite possible his proposal is not a workable one (I haven’t read it yet). But don’t fall for the downgrade and dismiss bait, keep on returning to the question of how much individual choice should be allowed into health care cost control. Why not divvy up the cost control work between the Board and some degree of individual choice across Medicare benefits? You don’t have to combine that choice with the cost-increasing aspects of Medicare Advantage-like plans.
Many ACA defenders simply do not want to enter into a debate where the framing is “we’re all for cost control, when it comes to Medicare benefit selection it’s a question of government board vs. individual choice.”
I can think of a few reasons why individual choice will sometimes fail as a method of cost control:
1. Individuals have serious misconceptions about the science, or the badness of a particular condition, even in light of government or other third-party advice. Or perhaps individuals simply do not understand the nature of all of the choices at hand.
2. Perhaps an individual will choose “no coverage for lung cancer,” but the government cannot precommit to the outcome of no coverage. Of course as cost control becomes more pressing, we’ll have to learn precommitment for at least some issues, one way or the other, so this cannot be a decisive objection. The entire premise behind the discussion is that we cannot cover all treatments through government subsidy.
3. Over time, perhaps a government Board can rebalance the mix of coverage better than an individual can. People age, possibly lose some mental faculties, science advances, costs change, and so on.
Those are good arguments. They are good arguments for a mixed system. They are not good arguments for ruling out all individual choice of benefits. They are not good arguments for ruling out a scenario like that outlined in the first paragraph of this blog post.
It seems quite likely to me that vouchers are going to be better at controlling health care cost growth than a central committee. Every committee decision that cuts off a potentially useful treatment (and I’m afraid it can’t all be back surgery and hormone replacement therapy) will trigger a lobbying explosion from affected groups. Each treatment is a decision with a small marginal cost to the taxpayer; it’s in aggregate that they become expensive. Which means that the congressional tendency is always going to be to override–and while there are supposed to be structural barriers against this in the bill, they aren’t very strong . . .Whereas if you put the decision about what treatments to cover in the hands of the patient, the lobbying you face is to increase the overall value of the voucher. To be sure, this will have a larger (and therefore more powerful) group behind it. But it will also come with an enormous pricetag, making it much harder for our politicians to rationalize the decision.
There are lots of comments from Reihan here. Ezra associates the Ryan reforms with Medicare Advantage. Maybe so, and maybe that’s bad, but we return to how much individual choice should we allow into health care cost control, with or without the cost-increasing aspects of the Ryan plan.
We shouldn’t let “downgrade and dismiss” distract our attention from that fundamental question about individual choice.
1. There is no Great Stagnation (video).
2. Perry Anderson on Brazil (worth the free registration, one of the best articles this year so far).
3. I second Matt’s recommendation of What Hath God Wrought?