Policy Points

16.12.2009 Policy Points Comments Off on Learning from Agriculture

Learning from Agriculture

In a clever piece in The New Yorker, Atul Gawande argues that America’s current crisis of spiraling health care costs is analogous to the agricultural crisis that roiled the nature at the advent of the last century. And the secret to that success, argues Gawande, was a willingness to experiment continuously with various strategies that eventually grew into a (somewhat) coherent, successful whole. Writes Gawande:

Much like farming, medicine involves hundreds of thousands of local entities across the country—hospitals, clinics, pharmacies, home-health agencies, drug and device suppliers. They provide complex services for the thousands of diseases, conditions, and injuries that afflict us. They want to provide good care, but they also measure their success by the amount of revenue they take in, and, as each pursues its individual interests, the net result has been disastrous. Our fee-for-service system, doling out separate payments for everything and everyone involved in a patient’s care, has all the wrong incentives: it rewards doing more over doing right, it increases paperwork and the duplication of efforts, and it discourages clinicians from working together for the best possible results. Knowledge diffuses too slowly. Our information systems are primitive. The malpractice system is wasteful and counterproductive. And the best way to fix all this is—well, plenty of people have plenty of ideas. It’s just that nobody knows for sure.

The history of American agriculture suggests that you can have transformation without a master plan, without knowing all the answers up front. Government has a crucial role to play here—not running the system but guiding it, by looking for the best strategies and practices and finding ways to get them adopted, county by county. Transforming health care everywhere starts with transforming it somewhere. But how?

15.12.2009 Policy Points Comments Off on Around the Dial – Dec. 15

Around the Dial – Dec. 15

Economic policy reports, blog postings, and media stories of interest:

15.12.2009 In the News, Policy Points Comments Off on The State of the NC Labor Market

The State of the NC Labor Market

Last Sunday, John Quinterno of South by North Strategies was a guest on the public affairs shows News and Views, which airs on the Raleigh-Durham radio station WRAL-FM (101.5).

In this recorded interview Quinterno discussed the state of the jobs market and explained why the strength of the recovery has been greatly exaggerated.

Click here to listen to the entire audio interview, and see below for a video clip from the conversation.


15.12.2009 Policy Points Comments Off on Critiquing the Jobs Proposal

Critiquing the Jobs Proposal

Writing for CBS MoneyWatch.com, economist Mark Thoma raises concerns about the Obama administration’s recent jobs proposal. Says Thoma:

This proposal is not very specific, and if it makes it through the legislative process it will likely change quite a bit. But as it stands there are three problems with it. First, it does not create jobs directly, all job creation occurs indirectly through incentives such as reduced capital gains taxes for small businesses, other measures that make investment cheaper, rebates for home weatherization, etc. The program relies upon people acting upon these incentives, which they may or may not do, and even if the incentives are acted upon job creation is likely to be slow due to its indirect nature. Second, the amount, $70 billion, is too small to make much of a difference given the size of the unemployment problem. Third, it’s disappointing that one of the best job creation/preservation measures the administration could have proposed, more help for state and local governments battered by budget problems arising from the recession, is not part of the proposal.

We need more direct and more immediate job creation than this proposal puts forth, and we need a much larger job stimulus package to make a noticeable dent in the problem. The argument for the package as announced is that this is the most that the administration can possibly get, anything larger or involving direct hiring won’t be politically feasible due to worries over the deficit and worries that direct hiring amounts to wasteful “make-work” (a view I disagree with).

14.12.2009 Policy Points Comments Off on Around the Dial – Dec. 14

Around the Dial – Dec. 14

Economic policy reports, blog postings, and media stories of interest: