What Uber could teach Medicare: New Year’s Eve price is 6.25 times the normal price.
Pennsylvania will be the first state to have a work requirement for Medicaid.
Is diabetes a global epidemic?
Drug discovery is one of the most wasteful research activities on the planet (which explains why they charge $84,000 for a drug that stops Hepatitis C).
Economists have known about this trend for a while, and they typically provide two main reasons why. First, workers have an increased incentive to show up to work during a bad economy to avoid losing their jobs and falling into a bad job market. Second, a good economy’s workforce might be less healthy since less healthy people can more easily find work during good times.
Now, a new study poses another explanation: better economies increase workloads. Those increased workloads encourage workers to go to work even when they’re sick, and those sick employees then get their coworkers sick. Swiss economist Stefan Pichler developed a model to prove this idea, and his findings suggest that employers should encourage workers to stay home when they’re sick.
At the state level, the exchanges are actually less competitive than the individual markets prior to ObamaCare. Comparing the number of insurers participating in the exchange with the number of carriers that previously offered individual coverage in each state, Edmund Haislmaier, my colleague at Heritage, found that nationally there is now 29 percent less insurer competition in the exchanges relative to the prior individual market. Only five exchanges feature more carriers offering individual coverage than in the pre-ObamaCare era.
Thus, there is even less insurer competition at the county level. In one of every six counties in America (17 percent), the state exchange offers only one insurer — a monopoly. For another 35 percent of counties, only two insurers offer coverage. In another 25 percent, only three insurers are selling coverage. To recap, consumers in more than half of the nation’s counties can “pick” from only one or two insurers on an ObamaCare exchange. In more than three of every four counties, competition is limited to three or fewer insurers.
In Ayn Rand’s novel The Fountainhead, Dominque Francon and Ellsworth Toohey are in a high rise apartment, looking out at the evening lights of New York City. Toohey speaks:
Look at it. A sublime achievement, isn’t it? A heroic achievement. Think of the thousands who worked to create it and of the millions who profit by it. And it is said that but for the spirit of a dozen men, here and there down the ages, but for a dozen men — less, perhaps — none of this would have been possible. And that might be true. If so, there are — again — two possible attitudes to take. We can say that these twelve were great benefactors, that we are all fed by the overflow of the magnificent wealth of their spirit, and that we are glad to accept it in gratitude and brotherhood. Or, we can say that by the splendour of their achievement which we can neither equal nor keep, these twelve have shown us what we are, that we do not want the free gifts of their grandeur, that a cave by an oozing swamp and a fire of sticks rubbed together are preferable to skyscrapers and neon lights — if the cave and the sticks are the limit of our own creative capacities. Of the two attitudes, Dominique, which would you call the truly humanitarian one? Because, you see, I’m a humanitarian.
Until recently, I thought that the latter attitude had become completely disreputable. The idea that we should tear down the good just because they are good or the successful just because they are successful is bad economics, bad ethics and an embarrassingly childish form of envy.
But it has recently re-emerged in large part because of Thomas Piketty’s new book, Capital in the Twenty First Century. Piketty argues that we have been experiencing and will continue to experience growing inequality of income and wealth. To prevent this he argues for punitive taxes on high incomes and a worldwide tax on wealth.
Piketty’s book has created near ecstasy on the political left, where it is taken as an unquestioned article of faith that inequality of income and wealth is bad. See gushing praise from Paul Krugman here and gloating over the right’s ineffectual response to the book here. Among other economists, Robert Solo praises the book in The New Republic (“Piketty is Right”), but Greg Mankiw has a more measured response.
What is more interesting than the book itself is that the left now seems free to say things they previously would have been embarrassed to say.
One doctor reports:
I can freeze a couple of warts in less than a minute and send a bill to a patient’s commercial insurance for much more money than for a fifteen minute visit to change their blood pressure medication.
I can see a Medicaid or Medicare patient for five minutes or forty-five, and up until now, because I work for a Federally Qualified Health Center, the payment we actually receive is the same.
I can chat briefly with a patient who comes in for a dressing change done by my nurse, quickly make sure the wound and the dressing look okay and charge for an office visit. But I cannot bill anything for spending a half hour on the phone with a distraught patient who just developed terrible side effects from his new medication and whose X-ray results suggest he needs more testing…
Most people are aware these days that procedures are reimbursed at a higher rate than “cognitive work”, but many patients are shocked to hear that doctors essentially cannot bill for any work that isn’t done face to face with a patient. This fact, not technophobia, is probably the biggest reason why doctors and patients aren’t emailing, for example.
My research shows that there are indeed substantial net benefits from acting now rather than waiting fifty years. A look at Table 5-1 in my study A Question of Balance (2008) shows that the cost of waiting fifty years to begin reducing CO2 emissions is $2.3 trillion in 2005 prices. If we bring that number to today’s economy and prices, the loss from waiting is $4.1 trillion. Wars have been started over smaller sums.
David Freidman responds:
What he does not mention is that his $4.1 trillion is a cost summed over the entire globe and the rest of the century. Put in annual terms, that comes to about $48 billion a year, a less impressive number. Current world GNP is about $85 trillion/year. So the annual net cost of waiting, on Nordhaus’s own numbers, is about one twentieth of one percent of world GNP. Not precisely a catastrophe.
In the 1960s, the Stanford University psychologist Walter Mischel turned marshmallows into a research tool. He’d present a child with one. “You can eat it now,” he’d say, just before leaving the room, “but if you wait until I get back, you can have two.”
Two marshmallows can tell you almost as much about the developing brain as a zillion-dollar imaging machine can. The length kids can hold out and the strategies they use to do so reveal tons about the functioning of the frontal cortex…
Dr. Mischel and researchers following him showed that the snapshot of frontal development taken with the marshmallow test predicts things like SAT scores, educational attainment and body-mass index in adulthood. This isn’t all that surprising — who you are at age 6 says something about who you’ll be at 60, including how you’ll have navigated the lifelong challenges of doing the harder thing when it is the right thing to do.
