Tuesday assorted links
1. Have Irish IQs not seen such a radical Flynn effect in the last few decades?
2. Phyllis Wheatley.
3. The metaphysics of LLM, and yes Wittgenstein has been underrated.
4. Context is that which is becoming increasingly scarce?
5. Dwarkesh Patel podcast with Aella (note the language and some of the content is not safe for work).
Health Care Spending Growth Has Slowed: Will the Bend in the Curve Continue?
In large part yes:
Over 2009-2019 the seemingly inexorable rise in health care’s share of GDP markedly slowed, both in the US and elsewhere. To address whether this slowdown represents a reduced steadystate growth rate or just a temporary pause we specify and estimate a decomposition of health care spending growth. The post-2009 slowdown was importantly influenced by four factors. Population aging increased health care’s share of GDP, but three other factors more than offset the effect of aging: a temporary income effect stemming from the Great Recession; slowing relative medical price inflation; and a possibly longer lasting slowdown in the nature of technological change to increase the rate of cost-saving innovation. Looking forward, the
post-2009 moderation in the role of technological change as a driver of growth, if sustained, implies a reduction of 0.8 percentage points in health care spending growth; a sizeable decline in the context of the 2.0 percentage point differential in growth between health care spending and GDP in the 1970 to 2019 period.
That is from a new NBER working paper by Sheila D. Smith, Joseph P. Newhouse, and Gigi A. Cuckler.
What I’ve been reading
Ahmet T. Kuru, Islam, Authoritarianism, and Underdevelopment: A Global and Historical Comparison is one of the best books on why Islam fell behind Western Europe. I don’t think it solves the puzzle, but has plenty of good arguments in the “rent-seeking” direction.
Newly published is Daniel B. Klein, Smithian Morals, Amazon link here, some of the essays are with co-authors. Free, open access version is here.
Nicolai J. Foss and Peter G. Klein, Why Managers Matter: The Perils of the Bossless Company, is an interesting defense of corporate hierarchy, based on economic reasoning and also a dash of Hayek.
Jamieson Webster, Disorganisation & Sex. Lacanian, yet readable. Recommend to those who think they might care, but it will not convince the unconverted.
There is the interesting Plato Goes to China: The Greek Classics and Chinese Nationalism, by Shadi Bartsch. Here is my very good CWT with her, in which we discuss the topics of the book a bit.
Pretty good is Jon K. Lauck, The Good Country: A History of the American Midwest, 1800-1900.
There is Owen Ullmann, Empathy Economics: Janet Yellen’s Remarkable Rise to Power and Her Drive to Spread Prosperity to All.
And a new libertarian memoir, Murray Sabrin, From Immigrant to Public Intellectual: An American Story.
Dalibor Rohac, Governing the EU in an Age of Division is a classical liberal take on its topic.
Monday assorted links
Addendum to best books of 2022
First, there are two books I haven’t read yet — new translations — but they are almost certainly excellent and deserving of mention. They are:
Ovid, Metamorphoses, translated by Stephanie McCarter.
Alessandro Manzoni, The Betrothed, translated by Michael F. Moore.
From fiction I would add to my earlier list:
R.F. Kuang, Babel: An Arcane History,
and Olivier Guez, The Disappearance of Josef Mengele, excellent and easy to read in one sitting.
In non-fiction I would give especially high ratings to the following additions:
Andrew Mellor, The Northern Silence: Journeys in Nordic Music & Culture. I will read this one again. It assumes some knowledge of the Nordic countries and also some knowledge of classical music, but it is exactly the kind of book I hope people will write. It explains at a conceptual level how those countries built up such effective networks of musical production and consumption.
Keiron Pim, Endless Flight: The Life of Joseph Roth. Gripping throughout.
Rodric Braithwaite, Russia: Myths and Realities. Perhaps a little simple for some readers, but probably the best place to start on the topic of Russian history.
Allan Kozinn and Adrian Sinclair. The McCartney Legacy: Volume 1: 1969-1973. Having now finished the work, I can’t think of any biography that better integrates the tale of the life and the tale of the creative work. And it changed my views on Paul a good deal, for instance he wrote many of his best solo songs earlier than I had thought.
Here is my earlier non-fiction list for 2022.
The Birx Plan for Early Vaccination of the Nursing Homes
In Covid in the nursing homes: the US experience, Markus Bjoerkheim and I show that the Great Barrington “focused protection” plan was unlikely to have worked. I covered this last week. But there was one strategy which could have saved tens of thousands of lives–early vaccination. If the vaccine trials had been completed just 5 weeks earlier, for example, we could have saved 14 thousand lives in the nursing homes alone. But put aside the possibility of completing the trials earlier. There was another realistic possibility under our noses. We had could have offered nursing home residents the vaccine on a compassionate use basis, i.e. even before all the clinical trials were completed. An early vaccination option was neither unprecedented nor a question of 20-20 hindsight, early vaccination was discussed at the time:
Deborah Birx, the coordinator of the White House Coronavirus Task Force, forcefully advocated that nursing home residents should be given the option of being vaccinated earlier under a compassionate use authorization (Borrell, 2022). Many other treatments, such as convalescent plasma, were authorized under compassionate use procedures and there was more than enough vaccine available to vaccinate all nursing home residents. As a first approximation we find the Birx plan would have prevented in the order of 200,000 nursing home cases and 40,000 nursing home deaths. To put that in perspective, it amounts to reducing overall nursing home Covid deaths by over 26 per cent (using all CMS reported resident nursing home deaths as of 5 December 2021, and estimates of underreported deaths from Shen et al. (2021)).
The lesson is not primarily about the past. It’s about the central importance of vaccines in any plan to protect the vulnerable and about how we should be bolder and braver the next time.
Addendum: See also Tyler’s tremendous post (further below) on focused protection.
Who was really for “focused protection of the vulnerable”?
Yes I do mean during the Covid-19 epidemic. As a follow-up post to Alex’s, and his follow-up, here are some of the effective measures in protecting the vulnerable, or they would have been more effective, had we done them better:
1. Vaccines, including speedy approval of same.
2. Prepping hospitals in January, once it became clear we should be doing so. That also would have limited lockdowns! And yet we did basically nothing.
3. Speeding up and improving the research process for anti-Covid remedies and protections.
4. First Doses First, when that policy was appropriate, among other policy ideas (NYT).
5. Effective and rapid testing equipment, readily available on the market.
If you were out promoting those ideas, you were acting in favor of protecting the vulnerable. If you were not out promoting those ideas, but instead talked about “protecting the vulnerable” in a highly abstract manner, you were not doing much to protect the vulnerable.
And here are three actions that endangered the vulnerable rather than protecting them:
5. Publishing papers suggesting a very, very low Covid-19 mortality rate, and then sticking with those results in media appearances after said results appeared extremely unlikely to be true.
6. Maintaining vague (or in some cases not so vague) affiliations with anti-vax groups.
7. Not having thought through how “herd immunity” doctrines might be modified by ongoing mutations.
Keep all that in mind the next time you hear the phrase “protecting the vulnerable.”
(Dutch) *Pioneers of Capitalism*
The subtitle is The Netherlands 1000-1800, and the authors are Maarten Prak and Jan Luiten van Zanden. An excellent book, here is one excerpt:
…between 1454 and 1500 the Netherlands appears to have printed more than double the European average number of books, with the Hanseatic town of Deventer as the most important center of this new industry. In the sixteenth century, book printing in the Low Countries was originally concentrated in Antwerp, but after 1585 production in the northern Netherlands skyrocketed, reaching an average per capita output that was consistently three to more than four times that of Europe as a whole. During the seventeenth century, Holland became the “bookshop of the world.” Exports of books were important, but the domestic demand for print was equally large.
You can buy it here.
Sunday assorted links
Liberal Democracy Strong
Bravo to Richard Hanania for revisiting some beliefs:
In February, I argued that Russia’s imminent successful invasion of Ukraine was a sign heralding in a new era of multipolarity. By October, I declared every challenge to liberal democracy dead and Fukuyama the prophet of our time. It’s embarrassing to have two contradictory pieces written seven months apart. But it would’ve been more embarrassing to persist in believing false things. If there’s any time to change one’s mind, it’s in the aftermath of large, historical events that went in ways you didn’t expect. Russia’s failure in Ukraine and China’s Zero Covid insanity provided extremely clear and vivid demonstrations of what democratic triumphalists have been saying about the flaws of autocracy. Nothing that the US or Europe have done – from the Iraq War to our own overly hysterical response to the coronavirus – have been in the same ballpark as these Chinese and Russian mistakes. Perhaps the war on terror comes close in terms of total destruction and lives lost, but we could afford to be stupid and it didn’t end up hurting Americans all that much.
In the land of the blind, the one-eyed man is king but still it’s good to see liberal democracy put some points on the scoreboard.
Popular music recommendations for 2022
I said I wasn’t going to give these, because they were too ordinary, but a few of you asked, so here goes, in no particular order:
2. The new Beyonce, Renaissance.
3. Rosalia, Motomami.
4. Bad Bunny, Un Verano Sin Ti.
5. Cecile McLorin Salvant, Ghost Song.
Nothing so unusual or surprising on that list…
Should the United States ban TikTok?
A bipartisan coalition is currently considering such an action and a bill has been introduced to the Senate (FT summary here). I don’t see why we should do this. I am all for keeping TikTok off the smart phones of people in the military and in national intelligence and perhaps a few other roles as well. But beyond that point?
What is the actual evidence that it is serving up slanted, pro-Chinese content, or otherwise swaying public opinion in a negative manner?
On top of that, perhaps many Americans should be more exposed to pro-Chinese views! As part of a broader menu of choice, of course. If only TikTok would teach them the theory of comparative advantage.
If TikTok did turn out to be an insidious and highly effective agent of foreign propaganda, we can always ban it later on. That won’t be hard to do, politically speaking.
You are losing your privacy to the Chinese? The Chinese, for better or worse, already can buy lots of data on you from private data brokers, just as other parties can. Few people seem super worried about that. Nor do we ban trips to China, which often result in a “stripping” of all the available information accessible through that person’s devices (people who matter and who know better often just bring burner phones and laptops, etc.).
What exactly would be the legal basis for such a ban? “I don’t like your company so we are getting rid of it?” We can do better than that.
Saturday assorted links
1. How about sending your *neural nets* to school?
3. “More than half of investors under 35 get investing advice from YouTube” Link here. And more lectures on Rene Girard.
5. Infovores on winners and losers from AI.
6. Center for Election Science, new group for approval voting, here is their FAQs page. And approval voting vs. some alternatives.
7. My Coindesk podcast with Simon Johnson (and two hosts) on the future of crypto after FTX.
The Great Barrington Plan: Would Focused Protection Have Worked?
A key part of The Great Barrington Declaration was the idea of focused protection, “allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk.” This was a reasonable idea and consistent with past practices as recommended by epidemiologists. In a new paper, COVID in the Nursing Homes: The US Experience, my co-author Markus Bjoerkheim and I ask whether focused protection could have worked.
Nursing homes were the epicenter of the pandemic. Even though only about 1.3 million people live in nursing homes at a point in time, the death toll in nursing homes accounted for almost 30 per cent of total Covid-19 deaths in the US during 2020. Thus we asked whether focusing protection on the nursing homes was possible. One way of evaluating focused protection is to see whether any type of nursing homes were better than others. In other words, what can we learn from best practices?
The Centers for Medicaire and Medicaid Services (CMS) has a Five-Star Rating system for nursing homes. The rating system is based on comprehensive data from annual health inspections, staff payrolls, and clinical quality measures from quarterly Minimum Data Set assessments. The rating system has been validated against other measures of quality, such as mortality and hospital readmissions. The ratings are pre-pandemic ratings. Thus, the question to ask is whether higher-quality homes had better Covid-19 outcomes? The answer? No.
The following figure shows predicted deaths by 5-star rating. There is no systematic relationship between nursing homes rating and COVID deaths. (In the figure, we control for factors outside of a nursing homes control, such as case prevalence in the local community. But even if you don’t control for other factors there is little to no relationship. See the paper for more.) Case prevalence in the community not nursing home quality determined death rates.
More generally, we do some exploratory data analysis to see whether there were any “islands of protection” in the sea of COVID and the answer is basically no. Some facilities did more rapid tests and that was good but surprisingly (to us) the numbers of rapid tests needed to scale nationally and make a substantial difference in nursing home deaths was far out of sample and below realistic levels.
Finally, keep in mind that the United States did focused protection. Visits to nursing homes were stopped and residents and staff were tested to a high degree. What the US did was focused protection and lockdowns and masking and we still we had a tremendous death toll in the nursing homes. Focused protection without community controls would have led to more deaths, both in the nursing homes and in the larger community. Whether that would have been a reasonable tradeoff is another question but there is no evidence that we could have lifted community controls and also better protected the nursing homes. Indeed, as I pointed out at the time, lifting community controls would have made it much more difficult to protect the nursing homes.
What Do Think Tanks Think?
From Richard Hanania and Max Abrahms:
Through the use of survey methods, the study presents the first systematic comparison of America-based international relations professors to think tank employees (TTEs) in terms of their preferred conduct of the United States in international affairs. The difference between the two groups in their support for military intervention is stark. TTEs are 0.47 standard deviations more hawkish than professors based on a standard measure of militant internationalism (MI). Controlling for self-described ideology mitigates this effect although it remains statistically significant. Beyond quantifying their relative foreign policy preferences, this study helps to resolve why TTEs tend to assume more hawkish policies. The authors find evidence that hawkishness is associated with proximity to power. Professors who have worked for the federal government score higher on MI, as do TTEs based at institutions located closer to Capitol Hill. In general, the results point to a self-selection mechanism whereby those who favor interventionist policies are more likely to pursue positions to increase their policy influence, perhaps because they know that powerful institutions are more likely to hire hawks. Alternative explanations for differences, such as levels or kinds of foreign policy expertise, have weaker empirical support.
It remains remarkable to me how few people even ask such questions. Both think tanks and foreign policy opinion remain critically understudied, at least in the appropriate serious ways and involving considerations of “public choice” (there is of course a massive dull literature on foreign policy opinion…if you think I am missing some massive literature that you know all about I suspect you do not grok what I actually am asking for).
And here is the Richard Hanania 2022 update.