Results for “caste system” 37 found
Amish arbitrage fact of the day
Eight percent of one sample (n = 112) of Lancaster county Amish have sought medical care in Mexico.
That is from Donald B. Kraybill, Karen M. Johnson-Weiner, and Steven M. Nolt, The Amish, which is an excellent social scientific look at what we outsiders know about Amish communities.
I also learned that the Amish strongly frown on home schooling of children and consider it possible grounds for excommunication. The requirement to use the internet has pushed many Amish out of public school systems, and the Amish are experts at making apprenticeship systems work. Inequality of wealth seems to be rising among the Amish.
Assorted links
The quest for microfoundations
There has been recent debate in the blogosphere about what we learn from demanding microfoundations for macro results. I am a firm believer in microfoundations, while recognizing the abuses to which the concept has been put.
Via Mark Thoma, enter Robert Hall and his latest paper (pdf), here is the abstract:
The financial crisis of late 2008 shifted household expenditure downward, as financial institutions tightened lending standards and required repayment of outstanding consumer loans. The crisis also raised financial frictions by depleting the equity capital of financial institutions. The result was a severe reduction in business and residential investment expenditure. The zero bound on the interest rate worsened the adverse effects of these developments by limiting the corrective response of monetary policy. In a straightforward and comprehensible macro model, I measure the two financial driving forces by matching the actual and forecasted movements of two key variables, the unemployment rate and the investment/GDP ratio. I then use the model to describe a counterfactual economy over the period 2009 through 2020 in which the same increase in financial frictions occurred but no household deleveraging took place. The comparison of the counterfactual and actual economies reveals the separate effects of the two financial driving forces. Deleveraging had an important but transitory role immediately after the crisis, while high financial frictions account for the long period of high unemployment, depressed GDP, and subnormal investment.
Maybe you don’t agree with Hall (I am of mixed mind), but he gives us a systematic framework for analyzing the depth and length of the recent recession, noting that it is microfoundations but not strict DSGE because he wishes to create more space for changes in basic structural parameters.
I have three observations: a) such a paper would not have been possible without a microfoundations approach, b) Hall finds a strong role for intermediation, which is a favorite topic of the microfoundations advocates and a feature lacking in IS-LM models, and c) his methods suggest some weaknesses in the recent stress on deleveraging as the continuing plague, again noting this is a framework for discussion rather than the final answer.
The microfoundations approach proves its value virtually every day.
Philip Tetlock requests your help
He is one of the most important social scientists working today, and he requests that I post this appeal:
Prediction markets can harness the “wisdom of crowds” to solve problems, develop products, and make forecasts. These systems typically treat collective intelligence as a commodity to be mined, not a resource that can be grown and improved. That’s about to change.
Starting in mid-2011, five teams will compete in a U.S.-government-sponsored forecasting tournament. Each team will develop its own tools for harnessing and improving collective intelligence and will be judged on how well its forecasters predict major trends and events around the world over the next four years.
The Good Judgment Team, based in the University of Pennsylvania and the University of California Berkeley, will be one of the five teams competing – and we’d like you to consider joining our team as a forecaster. If you’re willing to experiment with ways to improve your forecasting ability and if being part of cutting-edge scientific research appeals to you, then we want your help.
We can promise you the chance to: (1) learn about yourself (your skill in predicting – and your skill in becoming more accurate over time as you learn from feedback and/or special training exercises); (2) contribute to cutting-edge scientific work on both individual-level factors that promote or inhibit accuracy and group- or team-level factors that contribute to accuracy; and (3) help us distinguish better from worse approaches to generating forecasts of importance to national security, global affairs, and economics.
There is more at the link and they even offer a small honorarium.
Why isn’t your cell phone service better?
Matt Yglesias offers part of the answer:
One major impediment to better wireless service — be it for cell phones or broadband internet — is that right now we have television broadcasters squatting on two different swathes of the radio spectrum. One is used for digital television broadcasts and one for analog broadcasts. This came about as part of an ill-advised congressional giveaway in the mid-1990s. The good news is that half of that spectrum is scheduled to revert back to the federal government which will then auction some of it off and let the rest operate as "unlicensed" spectrum, like the spectrum block that current WiFi application sit on.
The bad news is that if you do that, the approximately 13 percent of households that currently rely on over-the-air (OTA) analog television suddenly can’t get any channels. That’s not going to sit well with the voters. So there’s an impulse in congress to push the transition date backwards and hope more people switch to cable, satellite, or HDTV by then. The problem here is that the spectrum in question would be really, really useful to wireless providers and would let them build various cool and awesome things for people to buy. Even better, the spectrum is so useful that the government will be able to get a lot of money auctioning it off. Way more than enough money, in fact, to give OTA households free conversion boxes to ensure that their TVs still work and still have money left over for something else. For reasons that aren’t clear to me, however, congressional Republicans don’t seem to like this idea and are therefore delaying the advent of better wireless.
As long as we are complaining, most other countries are on a compatible (GSM) system for international cell phones but the U.S. is not (addendum: Many of you have written to note that Cingular is one exception to this claim). I can buy a cell phone and sim card in Dubai and use it in Australia or New Zealand but not in Peoria.
Rx for OTC
I went to the doctor yesterday. I told him that to avoid altitude sickness in Peru I wanted a prescription for Diamox. He used to be surprised when I self-diagnosed but he knows me now. He wrote the prescription and I was done in less than four minutes. I like my doctor but this visit took an hour of my time and probably cost the insurance company at least $100, my deductible was $25. No big deal for me but a non-trivial expense for someone without insurance.
Why aren’t more pharmaceuticals available over the counter? In other words, why must we pay the priestly caste known as physicians for the right to treat ourselves? "Safety," we are told (second only to "for the children" as an excuse for giving up liberty). But, as Sam Peltzman pointed out long ago, safety runs both ways. Not getting a pharmaceutical because it’s too expensive and time consuming to go through a doctor has adverse safety consequences and there is no evidence that the costs of potential mistreatment outweigh the costs of undertreatment. (In anycase, politics not safety is often the reason for restrictions on OTC drugs e.g. the morning after pill.)
In fact, there are many countries where prescriptions are not required for legal medicines and they appear to do just fine. Writing in Reason, Kerry Howley points out (online version, the print version is longer and I am quoted) that in this respect if no other Myanmar is a bastion of rationality and liberty compared to the United States.
Last year, while living in the Southeast Asian nation of Myanmar,
my phones were tapped, my journals were read, my work was censored, and
for the first time in my life, I was given the authority to care for my
own body.There is no prescription drug system in Myanmar, but there are plenty of illnesses waiting to befall an effete Western immune system. My expatriate colleagues and I were free to treat our ailments as we saw fit.
We staved off food poisoning and bouts of malaria with frequent trips to
the local pharmacy, consulting doctors when necessary, but ultimately
responsible for our own medical decisions. We formed doctor-patient
relationships that were partnerships rather than paternalistic
hierarchies, and each of us lived to tell the story.Coming back to the States in the midst of hand-wringing about direct-to-consumer advertising, the restriction of life-saving cholesterol drugs, a wrenching process to make the morning-after-pill readily available, and now a push to put Sudafed behind the counter, it’s increasingly hard to understand why Americans cede crucial health decisions to the bureaucratic dithering of the FDA. In an age of empowerment through information, it is mind-boggling that patients are still willing to be silent spectators while their doctors call the shots.
Why is private health insurance such a disaster?
Why does private health insurance perform so badly in holding down costs? (Here is one story.) I can think of a few hypotheses:
1. Medical ideology portrays doctors as a priestly caste, accountable to no one.
2. The observed cost increases are driven primarily by government reimbursements and purchases.
3. The tax-free nature of employer-supplied insurance benefits encourages wantonness. (TC: Why? You can subsidize the purchase of apples, that doesn’t mean apples will be produced inefficiently or at “excess cost” for that level of apple output.)
4. The tax system discourages insurance policies with higher copayments. (TC: But if copayments are so great, companies today could offer higher-valued benefits along other dimensions, while increasing the copayment rate.)
5. Malpractice suits. This one is true for sure, but put it aside since the problem goes much further.
The most plausible answer is:
6. It is hard to contract in advance for which services should be covered. If you let everything be covered, costs skyrocket. If you allow for “outs,” insurance companies will use these loopholes to cut off high cost patients, thereby eliminating the benefits of insurance.
But why should this be such an insurmountable problem? Why can’t impartial third-party arbitrators arrive at a coverage solution that is reasonably efficient? After all arbitrators settle millions of legal disputes, issues where conflicts of interest could not be more pronounced. Or imagine third-parties that evaluates whether an insurance company covers reasonable expenses or instead screws over its customers?
Yes this does mean a cost-monitoring bureaucracy. But surely under all health care systems someone must decide which treatments are worthwhile or not. Why cannot markets allocate this function to the least cost decider? Why does the usual solution — intermediation — appear to be working so badly?
Inquiring minds wish to know. And simply citing the very large role for government in the American system does not do the trick. Here is one Cato account, you can agree with many of the points but it doesn’t answer my question. Here are some broader market-oriented links.
And this is why I find it so hard to come up with a good plan for health care reform. If we don’t understand why private health insurance functions so badly in our mixed system, we won’t understand how to fix things.