Tyler Cowen's Blog, page 148

The slowdown in health care cost inflation seems to be global

…when it comes to health care spending, the picture is starting to look more global. After decades when health spending in the United States grew much faster than it did in other Western countries, a new pattern has emerged in the last two decades. And it has become particularly pronounced since the economic crisis. The rate of health cost growth has slowed substantially since 2000 in every high-income country, including the United States, Canada, Britain, France, Germany and Switzerland, according to data from the Organization for Economic Cooperation and Development.

The world’s health-care systems are also converging in important ways. New drugs and medical advances, which were once adopted locally and spread more slowly, are now experiencing international launches. Medical technology companies are increasingly global, and seeing regulatory approval in many markets at once. Strategies that can reduce the need for expensive hospital stays, such as performing surgeries in outpatient clinics, are expanding around the world.

Findings from medical research and the ways that doctors practice are also spreading faster and wider. “We’re learning from other countries, and the best practices take a year or two to diffuse, whereas in the past they might have taken five or 10 years,” said Gerard Anderson, a public health professor at Johns Hopkins. “We’re getting a convergence because of a more rapid diffusion of information.”

Two recent papers highlighted the trend. One in The Journal of the American Medical Association compared the United States with countries in the O.E.C.D. Its author, David Squires of the Commonwealth Fund, a New York health care research group, concluded that the similarities in spending growth suggested that “the factors that stimulated the slowdown in the United States also affected other industrialized countries.”

The other paper, from the O.E.C.D.’s own economists, made a similar point, highlighting that what really differentiates the United States from other countries is the high prices we have long paid for medical care, not big differences in how doctors are treating their patients.

That is all from Margot Sanger-Katz at The Upshot.  I would note that those mechanisms of transmission still seem a little murky to me.

Facts about Latino children

Accepting 60,000 children in a population of 317.2 million — less than two hundred-tenths of 1 percent (.02 percent) of our population — would hardly be straining our resources.

Despite the vast differences in wealth and resources between our country and those of Lebanon, Jordan and even Iran, which currently has one of the world’s largest refugee populations, the end-of-the-world scenarios proffered by some ring of hyperbole.

At a time when we were a more generous, caring nation, we brought 14,000 children into the United States from Cuba under Operation Peter Pan. In 1966, we flew 266,000 Cuban men, women and children into the United States from the Port of Camarioca. At the time, those 266,000 Cubans represented .14 percent of our population, seven times the number of migrants we are talking about today.

That is from Ira Kurzban, via Timothy Ogden.

Will Amazon copy Netflix?

According to Gigaom, the e-commerce giant [Amazon] is working on a subscription ebook service called Kindle Unlimited, which would offer unlimited ebook rentals for $9.99 a month.

There is more here.  According to one estimate it would be for 638k titles or so, of course it will matter a great deal which ones.  I would consider this “developing,” but also “not yet confirmed.”

Addendum: Virginia Postrel offers a good analysis.

Scott Sumner wonders what AD (aggregate demand) is, or should be

I do have a very clear idea as to what I think the profession should mean by AD—nominal GDP. And I’ve seen the AD curve drawn as a rectangular hyperbola in a few textbooks (although the number is gradually diminishing.  But it’s clear that most people don’t agree with me.  So what do they think AD is?

On some occasions people discuss AD as if it’s a real concept.  Changes in the real quantity of goods and services purchased by consumers, investors, governments, and (in net terms) foreigners.  But that can’t be AD, as it would imply that all changes in RGDP were caused by shifts in AD.  After all, all purchases are also sales, so the total aggregate quantity supplied equals the total aggregate quantity demanded.

In the textbooks AD is a downward sloping line in P/Y space, which is not generally assumed to be unit elastic.  That means when AS shifts, NGDP may also change.  But why does NGDP change? What is held constant along a given AD curve?  Presumably a given AD curve is supposed to be holding constant things like monetary and fiscal policy, animal spirits, consumer sentiment, etc.

His longer query is here.  I increasingly think it is a mistake to draw too sharp a distinction between aggregate demand and aggregate supply, at least beyond the very first round of an economic shock.  But what do you all think?  What do you all mean by “aggregate demand”?

Assorted links

1. Do we need a conservative literary movement?

2. Is there a new liberaltarian alliance in Washington?  And Thomas Edsall on what young Democrats believe.

3. Growth across Mexican regions, or what went wrong in Campeche?  And reforming Pemex won’t be that easy.

4. How concentrated is wealth at the very top? (pdf)

5. Caplan vs. Borjas on immigration and the trillion dollar bill.

6. Equine markets in everything, those new service sector jobs.

China sentences to ponder

With credit at 200% of GDP and average financing costs of roughly 7%, Chinese borrowers now need to generate cash-flow growth of 14% to cover their interest payments without eroding their profitability or being forced to borrow yet more.

From Free Exchange blog, there is more here.

The continued bending of the health care cost curve?

Peter Orszag: We have had incredibly good news over the past three to five years. If I’d been told when I was director of either CBO or OMB that we would have a 12-month period when Medicare spending was basically flat in nominal terms — and therefore on an inflation-adjusted, per-beneficiary basis, significantly negative — I would have thought impossible and yet that’s exactly what we’re living through.

If this continues, it’s massive — everything you think you know about the nation’s long-term fiscal gap would be wrong.

That is from Vox, there is more here.  Note that since Medicare spending is slowing down too, this phenomenon probably is not just from slow economic growth.  From Wonkblog (don’t get confused) here is further commentary, arguing the fiscal gap still will be a problem.

For whom are the moochers actually voting?

It is a pretty mixed bag, as illustrated by this newly published paper by Dean Lacy, the abstract is here:

The 2012 election campaign popularized the notion that people who benefit from federal spending vote for Democrats, while people who pay the preponderance of taxes vote Republican. A survey conducted during the election included questions to test this hypothesis and to assess the accuracy of voters’ perceptions of federal spending. Voters’ perceptions of their benefit from federal spending are determined by family income, age, employment status, and number of children, as well as by party identification and race. Voters aged 65 and older who believe they are net beneficiaries of federal spending are more likely to be Democrats and vote for Barack Obama than seniors who believe they are net contributors to the federal government. However, the 77.5 percent of voters under age 65 who believe they are net beneficiaries of federal spending are as likely to vote for Romney as for Obama and as likely to be Republicans as Democrats. Voters who live in states that receive more in federal funds than they pay in federal taxes are less likely to vote for Obama or to be Democrats. For most of the electorate, dependence on federal spending is unrelated to vote choice.

Hat tip goes to Kevin Lewis.  I am not able to find an ungated copy.

Kevin also points us to this interesting paper interpreting the Scandinavian model.  The authors are Erling Barth, Karl O. Moene, and Fredrik Willumsen, and the abstract is this:

The small open economies in Scandinavia have for long periods had high work effort, small wage differentials, high productivity, and a generous welfare state. To understand how this might be an economic and political equilibrium we combine models of collective wage bargaining, creative job destruction, and welfare spending. The two-tier system of wage bargaining provides microeconomic efficiency and wage compression. Combined with a vintage approach to the process of creative destruction we show how wage compression fuels investments, enhances average productivity and increases the mean wage by allocating more of the work force to the most modern activities. Finally, we show how the political support of welfare spending is fueled by both a higher mean wage and a lower wage dispersion.

Again, I cannot find an ungated copy.

Sentences to ponder (toward a public choice of foreign policy)

“The voices in Israel go from, ‘Let’s create some friction with Hamas, to show we’re serious,’ to the idea of taking back the Gaza Strip,” says Ya’akov Amidror, a retired general who was until recently Netanyahu’s national security adviser. “And democratic systems are craziest ones in the international arena, because the leadership has to take into consideration all of these ideas.”

There is more here, mostly on what kind of future Hamas will have if any, interesting throughout.

Assorted links

1. 140 Google interview questions.

2. Jim Manzi on Piketty and executive compensation.

3. OrderStatistic on AD, AS, and Paul Krugman.

4. CIA cafeteria review.

5. Data on white nationalists.

6. The wisdom of the confident crowd?  And top economists do not generally favor monetary policy rules.  And Barry Eichengreen has a new forthcoming book.  It looks like a major work.