Economics – Page 209 – artdiamondblog.com

Under Health Care ‘Reform’ the Total Cost of Health Care Will “Go through the Roof!”

“Jonathan Bush, nephew of one former president and cousin of another, built a small medical practice into a national enterprise with nearly 1,200 employees.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. B10) In the world of health care innovation, the founder and chief executive of Athenahealth has an outsize name. In part, that’s because his name is Jonathan Bush, and he is the nephew of one former president and the cousin of another. But it’s also because his company has mastered the intricacies of the doctor-insurer relationship and become a player in the emerging medical records industry.

Based in Watertown, Mass., Athenahealth offers a suite of administrative services for medical practices. It collects payments from insurers and patients, and it manages electronic health records and patient communication systems. All of this is done remotely through the Internet — or “in the cloud,” as Mr. Bush puts it. Doctors don’t have to install or manage software or pay licensing fees; instead, Athenahealth keeps a percentage of the revenue.
. . .
Q. What’s going on in the health care industry to deliver that kind of growth to you?
A. We are a disruptive technology. We are the only cloud-based service in an industry segment full of sclerotic, enormous, personality-free corporations that have been in business making 90 percent margins doing nothing for decades and decades.
Q. What keeps other companies from building cloud-based systems?
A. For software companies, the biggest barrier to entry is that they give up their business model. Those companies would get hammered on Wall Street if they started selling a service that they have to deliver at a loss for five years. In terms of new entrants, there are two things that we’ve done that would take a good decade to replicate. One, we’ve built out the health care Internet. We’ve been building connections into insurance companies and laboratories and hospital medical records for years and years and years.
And the other barrier to entry is that rules engine. Every time a doctor anywhere in the country gets a claim denied, we have analysts ask the Five Whys. When we get to root cause, we write a new rule into Athenanet and from that day on, no other doctor gets that particular denial from that particular insurance company ever again. We now know of 40 million ways that a doctor can have a claim denied in the United States. The average practice has to rework about 35 percent of their claims, and we only have to rework about 5 percent of ours.
Q. What’s the prognosis for bill collecting under health care reform?
A. Well, there’s going to be new connectors and a whole series of new insurance products that will be managed by the states’ health insurance commissioners. And the law provides for every state to do all of these its own way, so they will have their own rules and regulations, and each state will do it differently. That sounds like springtime in Complexity Land.
Q. What do you think will happen to the total cost of health care under reform?
A. Oh, it’s going to go through the roof! It’s widely accepted that this is not a cost-reform bill — it’s an access bill. It’s in fact a cost-expansion bill.

For the full story, see:

ROBB MANDELBAUM. “Views of Health Care Economics From a C.E.O. Named Bush.” The New York Times (Thurs., September 9, 2010): B10.
(Note: ellipsis added.)
(Note: the online version of the article has the date September 8, 2010.)

The Hungry Innovate Because They Have Less to Lose

(p. 124) . . . , the eighteenth-century Swiss mathematician Daniel Bernoulli,” who coined the term “human capital,” explained why innovation has always been a more attractive occupation to have-nots than to haves: not only do small successes seem larger, but they have considerably less to lose.

Source:
Rosen, William. The Most Powerful Idea in the World: A Story of Steam, Industry, and Invention. New York: Random House, 2010.
(Note: ellipsis added.)

Government “Gave People the Crazy Juice”

“Peter J. Boettke of George Mason University is the emerging standardbearer for a revived Austrian school of economics.” Source of caption and photo: online version of the WSJ article quoted and cited below.

(p. B1) Peter J. Boettke, shuffling around in a maroon velour track suit or faux-leather rubber shoes he calls “dress Crocs,” hardly seems like the type to lead a revolution.

But the 50-year-old professor of economics at George Mason University in Virginia is emerging as the intellectual standard-bearer for the Austrian school of economics that opposes government intervention in markets and decries federal spending to prop up demand during times of crisis. Mr. Boettke, whose latest research explores people’s ability to self-regulate, also is minting a new generation of disciples who are spreading the Austrian approach throughout academia, where it had long been left for dead.
To these free-market economists, government intrusion ultimately sows the seeds of the next crisis. It hampers what one famous Austrian, Joseph Schumpeter, called the process of “creative destruction.”
. . .
(p. B3) It wasn’t a lack of government oversight that led to the crisis, as some economists argue, but too much of it, Mr. Boettke says. Specifically, low interest rates and policies that subsidized homeownership “gave people the crazy juice,” he says.

For the full story, see:
KELLY EVANS. “Spreading Hayek, Spurning Keynes; Professor Leads an Austrian Revival.” The Wall Street Journal (Sat., AUGUST 28, 2010): B1 & B3.
(Note: ellipsis added.)

Financial Gain an Important Motive for Invention

(p. 121) In 1930, Joseph Rossman, who had served for decades as an examiner in the U.S. Patent Office, polled more than seven hundred patentees. producing a remarkable picture of the mind of the inventor. Some of the results were predictable; the three biggest motivators were “love of inventing,” “desire to improve.” and “financial gain,” the ranking for each of which was statistically identical. and each at least twice as important as those appearing (p. 122) down the list, such as “desire to achieve,” “prestige,” or “altruism” (and certainly not the old saw, “laziness,” which was named roughly one-thirtieth as frequently as “financial gain”). A century after Rocket, the world of technology had changed immensely: electric power, automobiles, telephones. But the motivations of individual inventors were indistinguishable from those inaugurated by the Industrial Revolution.
. . .
In the same vein, Rossman’s survey revealed that the greatest obstacle perceived by his patentee universe was not lack of knowledge, legal difficulties, lack of time, or even prejudice against the innovation under consideration. Overwhelmingly, the largest obstacle faced by early twentieth-century inventors (and, almost certainly, their ancestors in the eighteenth century) was “lack of capital.” Inventors need investors.

Source:
Rosen, William. The Most Powerful Idea in the World: A Story of Steam, Industry, and Invention. New York: Random House, 2010.
(Note: ellipsis added.)

“We Need to Know What Works”

(p. A12) WASHINGTON–World Bank President Robert Zoellick challenged economists to take on tougher challenges in development economics and to consult a wider range of professionals in developing countries, opening a debate about how effectively economists have attacked problems in global poverty.

“Too often research economists seem not to start with the key knowledge gaps facing development practitioners, but rather search for questions they can answer with the industry’s currently favorite tools,” Mr. Zoellick said at Georgetown University.
. . .
“We need to know what works: we need a research agenda that focuses on results,” he said.
Nobel Prize-winning economist Michael Spence, who led a commission on economic growth, said Mr. Zoellick’s comments are “generally not only in the right direction, but very useful.” Harvard economist Dani Rodrik, who favors a stronger government hand in development, also praised the World Bank president. “The speech hits all the right notes: the need for economists to demonstrate humility, eschew blueprints…and focus on evaluation but not at the expense of the big questions,” Mr. Rodrik said.

For the full story, see:
BOB DAVIS. “World Bank Chief Ignites a Debate.” The Wall Street Journal (Thurs., SEPTEMBER 30, 2010): A12.
(Note: first two ellipses added; ellipsis in last quoted paragraph is in original.)

“Pumping Your Own Gas Is Illegal in New Jersey” and Oregon

“Will Corcoran pumps gas at Tim’s Westview in Ridgefield Park. Pumping your own gas has been illegal in New Jersey for 61 years.” Source of caption and photo: online version of the WSJ article quoted and cited below.

(p. A1) RIDGEFIELD PARK, N.J.–People in New Jersey pick their own strawberries. They chop down their own Christmas trees. They check themselves in at airports and check themselves out at supermarkets. Lately, a few New Jerseyans have been wondering whether it isn’t about time they were allowed to pump their own gas.

Pumping your own gas is illegal in New Jersey. It has been for 61 years. It’s also illegal in Oregon, and in the New York town of Huntington, on Long Island. Just about everywhere else, self-serving Americans do it themselves. As paying at the pump gets easier, the gas station attendant is fast going the way of the elevator operator.
Don’t tell Will Corcoran. When you pull into Tim’s Westview, a Gulf station across from the train tracks in this north Jersey town, you’ll sit in your car while he fills your tank.
Under a cold rain one weekday, he stood at the driver’s window of a Chevy, bent over, yakking. He wore blue. His cap had Gulf Oil’s orange disk on it. After his customer signed the credit slip (Tim’s pumps don’t process cards), Mr. Corcoran, 42 years old, shook hands and saluted like a gas jockey in an old commercial.

For the full story, see:

BARRY NEWMAN. “Self-Service Nation Ends at Garden State Gas Pumps; Changing Law May or May Not Lower Prices; ‘New Jersey Is Heaven!’.” The Wall Street Journal (Sat., NOVEMBER 27, 2010): A1 & A14.

Measuring Inflation by Internet Prices

Source of graphs: online version of the WSJ article quoted and cited below.

(p. A5) Economists Roberto Rigobon and Alberto Cavallo at the Massachusetts Institute of Technology’s Sloan School of Management have come up with a method to scour the Internet for online prices on millions of items and then use them to calculate inflation statistics for a dozen countries on a daily basis. The two have been collecting data for the project for more than three years, but only made their results public this week.
. . .
In countries where the apparatus for collecting prices is limited, or where officials have manipulated inflation data, the economists’ indexes might give a clearer view. In Argentina, for example, the government has been widely accused of massaging price figures to let it pay less interest to holders of inflation-indexed bonds. President Cristina Fernández has defended the government data. For September, the government’s measure of prices rose 11.1% from a year earlier. The economists’ measure in that period: up 19.7%.

For the full story, see:
JUSTIN LAHART. “A Way, Day by Day, of Gauging Prices.” The Wall Street Journal (Thurs., NOVEMBER 11, 2010): A5.
(Note: ellipsis added.)
(Note: the online version of the article is dated NOVEMBER 10, 2010.)

Harvard Economists Find that Spending Cuts Lead to Expansions and Tax Increases Lead to Recessions

(p. A19) Economic history shows that even large adjustments in fiscal policy, if based on well-targeted spending cuts, have often led to expansions, not recessions. Fiscal adjustments based on higher taxes, on the other hand, have generally been recessionary.

My colleague Silvia Ardagna and I recently co-authored a paper examining this pattern, as have many studies over the past 20 years. Our paper looks at the 107 large fiscal adjustments–defined as a cyclically adjusted deficit reduction of at least 1.5% in one year–that took place in 21 Organization for Economic Cooperation and Development (OECD) countries between 1970 and 2007.
. . .
Our results were striking: Over nearly 40 years, expansionary adjustments were based mostly on spending cuts, while recessionary adjustments were based mostly on tax increases. And these results would have been even stronger had our definition of an expansionary period been more lenient (extending, for example, to the top 50% of the OECD). In addition, adjustments based on spending cuts were accompanied by longer-lasting reductions in ratios of debt to GDP.
. . .
The evidence from the last 40 years suggests that spending increases meant to stimulate the economy and tax increases meant to reduce deficits are unlikely to achieve their goals. The opposite combination might.

For the full commentary, see:
ALBERTO ALESINA. “Tax Cuts vs. ‘Stimulus’: The Evidence Is In; A review of over 200 fiscal adjustments in 21 countries shows that spending discipline and tax cuts are the best ways to spur economic growth.” The Wall Street Journal (Weds., November 23, 2010): A19.
(Note: ellipses added.)

A version of the Alesina and Ardagna paper that is downloadable online is:

Alesina, Alberto, and Silvia Ardagna. “Large Changes in Fiscal Policy: Taxes Versus Spending.” 2009.

The published version of the Alesina and Ardagna paper is:
Alesina, Alberto, and Silvia Ardagna. “Large Changes in Fiscal Policy: Taxes Versus Spending.” In Tax Policy and the Economy, edited by Jeffrey R. Brown. Chicago: The University of Chicago Press, 2010, pp. 35-68.

If the Feds Want an Effective Stimulus, They Should Spend to Reduce the Patent Backlog

In my seminar on the Economics of Technology on Tuesday night (11/30/10), Gauri presented some interesting information on intellectual property. At one point she summarized that the lag in processing patents is about three years, but it takes, on average, only about 18 hours to process a patent once the processing has begun.
Later in the seminar, we talked about a brief article by Amar Bhidé on whether large economic stimulus programs have worked in the past, and will work in the present. Bhidé was skeptical, and I am too.
But it occurred to me that one modest economic stimulus expenditure might help. Why not make the highest stimulus spending priority to hire and train enough patent examiners to reduce the patent lag from three years to, say, three weeks?

The Bhidé article mentioned above is:
Bhidé, Amar. “Don’t Believe the Stimulus Scaremongers.” Wall Street Journal, (Tues., February 17, 2009): A15.

Whittle “Struggled for Years to Get Funding and Time to Pursue His Idea”

“When Britain Ruled The Skies: A De Havilland Comet under construction in Belfast in 1954.” Source of caption and photo: online version of the WSJ review quoted and cited below.

(p. C8) Frank Whittle, the brilliant British military pilot and engineer who began patenting jet designs in 1930, struggled for years to get funding and time to pursue his idea. Even after World War II, when a competing Nazi design showed what fighter jets could achieve in battle, U.S. airlines were slow to see jets’ potential for passenger travel.

It took another Brit, airplane designer Geoffrey de Havilland, to awaken postwar America’s aviation behemoths. While Lockheed and Douglas were still churning out rumbling, low-flying propeller planes, De Havilland’s jet-powered Comet began breaking records in 1952. Only after seeing Comets scorch the stratosphere at 500 miles an hour did Howard Hughes want jetliners for TWA and Juan Trippe get interested for Pan Am.
Among American plane makers, it was a military contractor that had struggled in the prewar passenger-plane market–Boeing–that first took up the jetliner challenge. In retrospect, the outcome seems obvious. The Boeing 707 inspired the term “jet set.” Boeing’s iconic 747 “Jumbo Jet” opened jet-setting to the masses.
But in 1952, that outcome was far from obvious. Mr. Verhovek zeroes in on the mid-1950s, when Comets first seemed to own the world and then started plunging from the sky in pieces. The Comet’s fatal design flaw–the result of an insufficient appreciation of the danger of metal fatigue–holds resonance today as both Boeing and Airbus struggle to master the next generation of jetliner materials, composites of carbon fiber and plastic.
. . .
Although “Jet Age” inevitably centers on technology, Mr. Verhovek wisely focuses as well on the outsize personalities behind world-changing innovations. There’s Mr. De Havilland, a manic depressive who was so dedicated to aviation that he kept going after two of his three sons died testing his planes. Mr. Whittle, we learn, sniffed Benzedrine to stay awake, popped tranquilizers to sleep and shriveled to just 127 pounds while developing the jet engine. And Boeing chief executive Bill Allen, a meticulous lawyer, bet the company on passenger jets when not a single U.S. airline wanted one.

For the full review, see:
DANIEL MICHAELS. “Shrinking the World; How jetliners commercialized air travel–stewardesses and all.” The Wall Street Journal (Sat., October 9, 2010): C8.
(Note: ellipsis added.)

The book under review is:
Verhovek, Sam Howe. Jet Age: The Comet, the 707, and the Race to Shrink the World. New York: Avery, 2010.

Coke’s Patent Law Motivated by Belief that Creative Craftsmen Were Source of Britain’s Prosperity

William Rosen discusses the genesis and significance of the world’s first patent law:

(p. 52) The Statute became law in 1624. The immediate impact was barely noticeable, like a pebble rolling down a gradual slope at the top of a snow-covered mountain. For decades, fewer than six patents were awarded annually, though still more in Britain than anywhere else. It was seventy-five years after the Statute was first drafted, on Monday, July 25, 1698, before an anonymous clerk in the employ of the Great Seal Patent Office on Southampton Row, three blocks from the present–day site of the British Museum, granted patent number 356: Thomas Savery’s “new Invention for Raiseing of Water and occasioning Motion to all Sorts of Mill Work by the lmpellent Force of Fire.”

Both the case law and the legislation under which the application was granted had been written by Edward Coke. Both were imperfect, as indeed was Savery’s own engine. The law was vague enough (and Savery’s grant wide-ranging enough; it essentially covered all ways for “Raiseing of Water” by fire) that Thomas Newcomen was compelled to form a partnership with a man whose machine scarcely resembled his own. But it is not too much to claim that Coke’s pen had as decisive an impact on the evolution of steam power as any of Newcomen’s tools. Though he spent most of his life as something of a sycophant to Elizabeth and James, Coke’s philosophical and temperamental affinity for ordinary Englishmen, particularly the nation’s artisans, compelled him to act, time and again, in their interests even when, as with his advocacy of the 1628 Petition of Right (an inspiration for the U.S. Bill of Rights) it landed him in the King’s prisons. He became the greatest advocate for England’s craftsmen, secure in the belief that they, not her landed gentry or her merchants, were the nation’s source of prosperity. By understanding that it was England’s duty, and–perhaps even more important–in England’s interest, to promote the creative labors of her creative laborers, he anticipated an economic philosophy far more modern than he probably understood, and if he grew rich in the service of the nation, he also, with his creation of the world’s first durable patent law, returned the favor.

Source:
Rosen, William. The Most Powerful Idea in the World: A Story of Steam, Industry, and Invention. New York: Random House, 2010.
(Note: italics in original.)