Costs Rise in Single-Payer Health Countries

(p. A25) As Democrats and other policy makers debate the merits of Senator Sanders’s proposal, here are a few important observations about international systems that they ought to consider.
First, a vanishingly small number of countries actually have single-payer systems. . . .
. . .
Some of the highest-rated international systems rely on private health insurers for most health care coverage — Germany’s, for example, is something like Obamacare exchanges for everyone, but significantly simpler and truly universal. The Netherlands and Switzerland have both moved recently to add more competition and flexibility to systems that were already built on the use of private insurers.
Second, single-payer countries have also failed to control rising health care costs. This is important, given that Mr. Sanders’s proposal was released without a cost estimate or financing plan. For historical reasons, many other countries started with lower levels of health care spending than we did. Several analyses have shown that this has almost nothing to do with higher administrative costs or corporate profits in the United States and almost everything to do with the higher cost of health care services and the higher salaries of providers here.
Although they started at a lower base — with, for example, doctors and nurses receiving lower salaries — countries around the world have all struggled with rising costs. From 1990 to 2012, the United States’ rate of health care cost growth was below that of many countries, including Japan and Britain. In 2015, the Organization for Economic Cooperation and Development warned that rising health care costs across all countries were unsustainable.behavior, more hotel rooms are available to individuals and families who need them most.”
Third, it is simply untrue that single-payer systems produce a better quality of care across the board.

For the full commentary, see:
LANHEE J. CHEN and MICAH WEINBERG. “‘Medicare for All’ Is No Miracle Cure.” The New York Times (Tues., Sept. 19, 2017): A25.
(Note: ellipses added.)
(Note: the online version of the commentary has the title “The Sanders Single-Payer Plan Is No Miracle Cure.”)

Regulations Reduce Health Care Quality and Increase Health Care Cost

(p. A15) There are two million home health aides in the U.S. They spend more time with the elderly and disabled than anyone else, and their skills are essential to their clients’ quality of life. Yet these aides are poorly trained, and their national median wage is only a smidgen more than $10 an hour.
The reason? State regulations–in particular, Nurse Practice Acts–require registered nurses to perform even routine home-care tasks like administering eyedrops. That duty might not require a nursing degree, but defenders of the current system say aides lack the proper training. “What if they put in the cat’s eyedrops instead?” a health-care consultant asked me. In another conversation, the CEO of a managed-care insurance company wrote off home-care aides as “minimum wage people.”
But aides could do more. With less regulation and better training, they could become as integral to health-care teams as doctors and nurses. That could improve the quality of care while saving buckets of money for everyone involved.
. . .
. . . the potential cost savings are considerable. There are 2.3 million Medicaid patients receiving long-term care at home. Imagine if even half of them replaced one hourlong nurse’s visit a month with a stop by a trained aide. Assuming the nurse makes $35 an hour and the aide $15, that’s an immediate savings of roughly $275 million a year.

For the full commentary, see:
Paul Osterman. “Why Home Care Costs Too Much; Regulations often require that nurses do simple tasks like administer eyedrops.” The Wall Street Journal (Weds., Sept. 13, 2017): A15.
(Note: ellipses added.)
(Note: the online version of the commentary has the date Sept. 12, 2017.)

The commentary, quoted above, is related to the author’s book:
Osterman, Paul. Who Will Care for Us? Long-Term Care and the Long-Term Workforce. New York: Russell Sage Foundation, 2017.

“We Need an Economy That Is Much More Flexible, Much Faster Moving”

(p. A9) France has stagnated for years under chronically elevated unemployment and slow growth. The country’s strong worker protections and expensive benefits have been blamed by some for being at least partly at the root of the problem.
. . .
Mr. Macron’s chan ges make it easier to hire and fire workers and allow some workplace issues to be negotiated directly at the company level, rather than through industrywide agreements, in hopes of stimulating both growth and job creation. The government focused especially on smaller businesses with fewer than 50 employees — the majority of French businesses — which have complained bitterly about excessive red tape and regulations.
. . .
“We are entering into an economy built on innovation, skills, digitalization,” said Mr. Macron in an interview Thursday with the weekly newsmagazine Le Point.
“To succeed in this world we need an economy that is much more flexible, much faster moving.”
Employees will no longer have jobs that last for a lifetime, but periods of unemployment are more likely to be temporary and go in hand-in-hand with more frequent job changes and retraining, he said.
Among the changes in the decrees published Thursday is license for employers to directly negotiate with their workers over certain workplace issues rather than having to follow industrywide agreements. That will allow a car parts factory in one region to have a different agreement with its workers than a similar company elsewhere.
Small companies especially are being given more leeway to bargain directly with workers or their representatives, without the mediation of unions.

For the full story, see:
ALISSA J. RUBIN. “Economy Idle, France Relaxes Its Labor Law.” The New York Times (Fri., SEPT. 1, 2017): A1 & A9.
(Note: ellipses added.)
(Note: the online version of the story has the date AUG. 31, 2017, and has the title “France Unveils Contentious Labor Overhaul in Big Test for Macron.”)

Tinkerer Won Nobel for Gene Targeting

(p. B15) Oliver Smithies, a British-born biochemist and inveterate tinkerer who shared a Nobel Prize for discovering a powerful tool for identifying the roles of individual genes in health and disease, died on Tuesday [January 10, 2017] in Chapel Hill, N.C. He was 91.
. . .
Dr. Smithies’s discovery, known as gene targeting, allows scientists to disable individual genes in mice to understand what the genes do. The loss of a gene typically brings about changes in the appearance or the behavior of the mice, providing important clues about the gene’s function.
. . .
In addition to gene targeting, Dr. Smithies invented a method of separating proteins with a jelly made from ordinary potato starch, a major advance that was cheaper, easier and more precise than existing technologies. His invention, called gel electrophoresis, is in wide use today.
Behind Dr. Smithies’s breakthroughs were ingenious homemade contraptions cobbled from everyday objects and junk. He thought of himself as an inventor and toolmaker and acknowledged that he could not pass a rubbish bin without pausing to inspect the contents — a trait he said he shared with his paternal grandfather, who used to pick up nails and straighten them for later use.
His tinkering did not go unnoticed. Colleagues at Oxford University, where Dr. Smithies pursued his graduate studies, set aside their discarded equipment for him, labeling it, “NBGBOKFO,” or “No bloody good but O.K. for Oliver.”
. . .
To Dr. Smithies, the process of invention was straightforward. “You use whatever is lying around, and you see something that needs to be done, and you try to do it,” he said. “I think it is making things work, you know, somehow.”

For the full obituary, see:
DENISE GELLENE. “Oliver Smithies, Tinkerer Who Transformed Genetics and Won a Nobel, Dies at 91.” The New York Times (Thurs., JAN. 12, 2017): B15.
(Note: ellipses, and bracketed date, added.)
(Note: the online version of the obituary has the date JAN. 11, 2017.)

Price Gouging Rewards Conservation and Increases Supply

(p. B1) On its face, the very idea of price gouging, especially during a natural disaster, feels outrageous. Indeed, 34 states have anti-gouging laws meant to protect consumers.
However, in a small slice of the world of economists and businesses, there is a fascinating debate about the topic — with many arguing that price gouging is actually a good thing.
. .
(p. B6) “Price caps discourage extraordinary supply efforts that would help bring goods in high demand into the affected area,” Michael Giberson, an instructor with the Center for Energy Commerce in the Rawls College of Business at Texas Tech University, wrote in an opinion piece from several years ago that was widely circulated around parts of Wall Street this weekend. Meanwhile, he suggested, “You discourage conservation of needed goods at exactly the time they are in high demand.”
He added, “In a classic case of unintended consequences, the law harms the very people whom lawmakers intend to help.”
Consider this scenario, as described by Matt Zwolinski, the director of the Center for Ethics, Economics, and Public Policy at the University of San Diego: If a hotel that normally charges $50 per room were allowed to double the price to $100 a night during an emergency, “a family that might have chosen to rent separate rooms for parents and children at $50 per night will be more likely to rent only one room at the higher price, and a family whose home was damaged but in livable condition might choose to tough it out if the cost of a hotel room is $100 rather than $50.”
The result, he contended in a paper titled “The Ethics of Price Gouging,” is that allowing higher prices “increases the available supply — as a result of consumers’ economizing behavior, more hotel rooms are available to individuals and families who need them most.”

For the full commentary, see:
Sorkin, Andrew Ross. “DEALBOOK; Price Gouging Can Aid Victims? Why Some Economists Say Yes.” The New York Times (Tues., Sept. 12, 2017): B1 & B6.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date Sept. 11, 2017, and has the title “Hurricane Price Gouging Is Despicable, Right? Not to Some Economists.”)

The article by Zwolinski, mentioned above, is:
Zwolinski, Matt. “The Ethics of Price Gouging.” Business Ethics Quarterly 18, no. 3 (July 2008): 347-78.

“Hurricane Superstar” Had No Use For Global Warming

(p. 24) William M. Gray, whose pioneering research helped him make hurricane predictions for three decades and allowed the East Coast and the Caribbean to gird for their fury, died on Saturday [April 23, 2016] in Fort Collins, Colo. He was 86.
. . .
Dr. Gray issued his first data-driven seasonal forecast in 1984. He eventually aggregated measures of atmospheric conditions, water current and water temperature to predict the number and intensity of tropical storms, rather than their paths or potential landfalls.
. . .
Dr. Gray was skeptical about the causes of climate change, prompting vitriolic exchanges with other scientists. Judith A. Curry, who was chairwoman of the School of Earth and Atmospheric Sciences at the Georgia Institute of Technology, accused him of “brain fossilization.”
Dr. Gray was less alarmed than many of his colleagues at the rate of climate change and attributed it to natural causes, like the circulation of heat-bearing ocean currents, rather than to the human-made greenhouse effect of heat-trapping gasses from burning fossil fuels like coal and oil.
“After unveiling the first Atlantic seasonal hurricane forecasting system in 1984, he became a hurricane superstar and darling of the media,” Chris Mooney wrote in 2007 in “Storm World: Hurricanes, Politics, and the Battle Over Global Warming.” “But he had absolutely no use for the notion of global warming, much less the idea that it might seriously affect the storms he’d spent a lifetime studying. And he had no problem saying so — loudly and often.”
In an interview with Westword, a Denver online newsletter, in 2006, Dr. Gray said, “When I am pushing up daisies, I am very sure that we will find that humans have warmed the globe slightly, but that it’s nothing like what they’re saying.”

For the full obituary, see:
SAM ROBERTS. “William M. Gray, 86, a Predictor of Hurricanes’ Fury.” The New York Times, First Section (Sun., APRIL 24, 2016): 24.
(Note: ellipses, and bracketed date, added.)
(Note: the online version of the obituary has the date APRIL 20 [sic], 2016, and has the title “William M. Gray, Hurricane Predictor and Climate Change Skeptic, Dies at 86.”)

The book by Mooney, mentioned above, is:
Mooney, Chris. Storm World: Hurricanes, Politics, and the Battle over Global Warming. Orlando, FL: Houghton Mifflin Harcourt, 2007.

For Kiva Funding, Entrepreneurs Must First Convince Friends or Family

(p. B6) Lending platform Kiva.org is scrapping its traditional approach to microfinance in the U.S. and instead is turning to something it calls social underwriting.
Before businesses can gain access to a no-interest crowdfunded loan of up to $10,000, Kiva is asking them to get 10 to 20 friends, family members or others to put up at least $25 each.
Kiva, a non-profit organization better known for providing financing in some of the world’s poorest countries, has found that this new approach improves repayment rates and believes it will provide a much-needed boost to its U.S. operation, where growth has been challenging.
. . .
Kiva said about 30% of entrepreneurs who start the private fundraising process can’t get enough people to vouch for them, while 92% of those who overcome that hurdle raise the money they seek. If the program in the U.S. succeeds, Kiva said it may export the private-fundraising model worldwide.

For the full story, see:
Ruth Simon. “Microfinancing Model With a Personal Twist.” The Wall Street Journal (Thurs., Dec. 17, 2015): B6.
(Note: ellipsis added.)
(Note: the online version of the story has the date Dec. 16, 2015, and has the title “Kiva Sets New Rules for U.S. Borrowers to Get Crowdfunded Loans.”)

Ann Arbor Recovers from Borders Bankruptcy “with Remarkable Speed”

(p. B6) ANN ARBOR, Mich. — A patch of sidewalk on the south side of East Liberty Street, four blocks from the main University of Michigan campus, has returned from the dead with remarkable speed.
At almost any hour of day, and especially at mealtimes, a mix of bargain-seeking undergraduates, white-collar tech workers and middle-class townies weave in and out of the restaurants, coffee shop and bank that now line the corridor.
The foot traffic is almost enough to make many in this city feel lucky that the single previous occupant of this red brick low-rise building on the 600 block went bankrupt five years ago. Almost, that is, because that previous tenant was the flagship Borders store.
“In some ways, the neighborhood is stronger and more interesting and more vibrant than it was when Borders was here,” said Susan Pollay, executive director of the Ann Arbor Downtown Development Authority. “As much as I loved Borders — and I mean, I loved it — in the evolution of this building, it’s better than it was.”
Such talk is probably still sacrilege for some local nostalgics, who remember that the store was started by a pair of brothers and Michigan graduates before it turned into an international book chain, but it is difficult to argue on a dollars-and-cents basis with the transformation.
For more than 70 years, the site in this pivotal city block was occupied by a single-business anchor, first a regional department store, Jacobson’s, and then, for decades, Borders.
The chain’s bankruptcy — which, by 2011, was almost overdue as customers had long since turned en masse to the internet to buy books — created a once-in-a-generation release of a large piece of real estate. Suddenly available: a 50,000-square-foot former bookstore that fronts a full block of busy Liberty Street and a 45,000-square-foot adjacent building that previously housed Borders’ corporate headquarters.
There were many ideas about how to use all that space, but one option was immediately taken off the table: installing another anchor tenant.
“We wanted, on purpose, to have a multipurpose building,” said Ron Hughes of Hughes Properties. “I think it’s better for the city as well.”

For the full story, see:
STEVE FRIESS. “Square Feet; Going Small Energizes a Downtown.” The New York Times (Weds., NOV. 9, 2016): B6.
(Note: the online version of the story has the date NOV. 8, 2016, and has the title “Square Feet; At the Former Home to Borders Books, a Tech Hub Now Sprouts.”)

Churchill’s “Natural Curiosity and General Optimism about Life”

(p. A11) In a newly unearthed essay sent to his publisher on Oct. 16, 1939 — just weeks after Britain entered World War II and Churchill became part of the wartime cabinet — and later revised, he was pondering the likelihood of life on other planets.
. . .
The manuscript was passed on to the National Churchill Museum in Fulton, Mo., the site of famed 1946 Iron Curtain speech, in the 1980s by Wendy Reves, the wife of Churchill’s publisher, Emery Reves. It had been overlooked for years until Timothy Riley, who became the museum’s director last year, stumbled upon it recently. Soon after news of the discovery, two other copies were found in a separate archive in Britain.
. . .
Largely self-educated in the sciences, Churchill had boundless curiosity for practically anything, an attitude he once described as “picking up a few things as I went along.”
. . .
He was the first prime minister to hire a science adviser. Frederick Lindemann, a physicist, became Churchill’s “on tap” expert and once described him as a “scientist who had missed his vocation,” said Andrew Nahum, who organized an exhibition on Churchill and science at the Science Museum in London. He found a separate copy of the essay in the Churchill Archives Center at the University of Cambridge.
. . .
In the interwar period, Churchill wrote numerous scientific articles, including one called “Death Rays” and another titled “Are There Men on the Moon?” In 1924, he published a text asking readers “Shall We All Commit Suicide?” in which he speculated that technological advances could lead to the creation of a small bomb that was powerful enough to destroy an entire town.
Churchill’s recently unearthed article on extraterrestrial life was probably written in the same vein and was probably intended to be published as a popular science piece for a newspaper.
Two other scientific essays — one on cell division in the body and another on evolution — are stored in the museum’s archives in Fulton, Mr. Riley, the museum director, said in an interview.
Churchill had a “natural curiosity and general optimism about life,” Mr. Riley said. He had “a willingness to see technical and scientific advances improve not only his immediate world or his country, but the world.”

For the full story, see:
KIMIKO de FREYTAS-TAMURA. “A Lost Essay from Churchill on Alien Life.” The New York Times (Weds., FEB. 16, 2017): A11.
(Note: ellipses added.)
(Note: the online version of the story has the date FEB. 15, 2017, and has the title “Winston Churchill Wrote of Alien Life in a Lost Essay.”)

Libertarian Lessons from the “Little House”

(p. C25) Nothing about Laura Ingalls’s birth to a modest Wisconsin family on Feb. 7, 1867, suggested she would become one of the most significant voices in the canon of the American frontier. A century and a half later, the contribution Laura Ingalls Wilder made still seems astonishing — a fact not lost on her publisher. As a new anniversary-themed batch of “Little House on the Prairie” books rolled in this fall — with homespun-looking covers and introductions by luminaries including Laura Bush and Patricia MacLachlan (author of the gentle Newbery Medal-winning novel “Sarah, Plain and Tall”) — I found myself plunging back into the “Little House” world I’d loved as a child, with a strange feeling of urgency.
. . .
“Little House in the Big Woods” was published in 1932, when Laura was 65 and Rose, her only child, was long divorced, an accomplished, but increasingly broke journalist and author. Rose Wilder Lane had lost both her own money and money she invested for her parents in the 1929 stock market crash, and they were scrounging by, with Almanzo hauling loads and Laura selling eggs and apples and writing occasional pieces about farm life.
Out of desperation Rose suggested that her mother write down the stories of her pioneer childhood, heavily revised the resulting manuscript and found a publisher. In the rest of the books, as well, she provided substantial editing. Some historians insist that Rose — who later became an outspoken antigovernment polemicist and is called one of the godmothers of the libertarian movement, along with Ayn Rand — should be considered the books’ ghostwriter. Christine Woodside’s recent book, “Libertarians on the Prairie,” makes this case, cataloging libertarian messages Rose embedded in the books. (Some are overt: “The politicians are a-swarming in already,” says one character in “The Long Winter.” “They’ll tax the lining out’n a man’s pockets,” he cries. “I don’t see nary use for a county, nohow.”)

For the full commentary, see:
MARIA RUSSO. “READER’S NOTEBOOK; A ‘Little House’ Tinged with Red and Blue.” The New York Times (Fri., FEB. 10, 2017): C25.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date FEB. 7, 2017, and has the title “READER’S NOTEBOOK; Finding America, Both Red and Blue, in the ‘Little House’ Books.”)

Woodside’s book, mentioned above, is:
Woodside, Christine. Libertarians on the Prairie: Laura Ingalls Wilder, Rose Wilder Lane, and the Making of the Little House Books. New York: Arcade Publishing, 2016.