Tuesday, April 27, 2010

Four papers i wanna write if I'm ever patient


Local Organizing in a Global World: The Marginalization of Bright-eyed Idealists
(Post-industrialization has largely worked itself through the developed world, this means more and more problems are driven by external forces fundamentally outside the control of communities or would be activists. An organizer in the Rust Belt today might do better to work in New Delhi. But what does this mean for the identity or prospects of the individual who wants to affect positive change?)

The Evolution of Real versus Derived Profits on Wall Street from 1970-2010
(This information is so proprietary- but I imagine the shift from primary to derived assets would be interesting. There is no normative judgment that derived or synthetic profits are bad, but it's a macro analysis I don't know that's been done. Additionally, a larger real asset base only potentially provides a broader base for structured income products. At some point though, productivity necessitates actually making something in the first place.)

Prisoners Just Want Community: Lessons in the Green Prisons Movement
(This idea of hardened criminals wanting to cut the pesticides out of the prison yard, or compost their food or install solar cells is very interesting. What motivates this? Boredom? Manipulation? Atonement? I assert that if prisoners had access to these programs in the first place they might never have committed crimes, as the green movement connects people profoundly not just with a broader purpose, but an entire community. Parole programs could incorporate these services into their programs as both service and therapy.)

Speed of Thought as Speed Bumps for Information Transmital
As the vectors of information delivery expand and accelerate now on a seemingly annual basis, the rate limiting step of our ability to celebrate or appreciate, yet alone digest, information may increasingly be our innate capacity to process such exposure. In 2005, the email checking and AOL searching of 2000 seemed pedestrian, and in 2010, the blogging and i-tuning of 2005 seems pedestrian compared to our tweeting and i-padding, and there's little to suggest it won't be the same in 2015- my guess would be in the direction of integrated devices reaching out to us, rather than passively responding to our requests, based on the many known preferences it has compiled from our routine requests, a sort of Amazon suggested purchases feature for all media across all platforms. Yet I find myself sometimes simply unable to make sense of everything I see before me, the children's book Where the Wild Things Are turned into a major motion picture turned into a digital dowload turned into an instant App on my i-pad, to watch on the side as I work an excel sheet and check my blog-feed. There is more that I want to watch and do, and am now capable of, than I could ever complete. In these moments the brain almost freezes akin to a hardrive. Which one to open? Which to prioritize? In other words, there may be a limit to how useful such devices may be, the rate limiting step being our thoughts patterns themselves.

P.s. - As Goldman Sachs testifies today, I have a hard time understanding the allegations and think the SEC's case is going to have a hard time (it was only voted out by 3-2). Goldman was selling income streams from insurance on mortgage debt (synthetic CDOs) to two global institutions that engaged in this all the time. Any transaction necessitates a buyer and a seller, the idea that these funds would go long by buying in assumes there is a counterparty that would go short. It's immaterial what Goldman thought of the deal, they are the market maker. The funds requested assets of a certain type to buy, Goldman obliged, and in the process consulted with individuals of varying perspectives. For someone to make money on long positions, there has to be another party willing to cover the positive spread if they are proven wrong, which would be the shorts. Our regulatory system is about 30 years behind the curve and needs to be upgraded, but this vilification of the bankers society collectively depends on for basic finance as well as investment finance can at times look like a modern day witch hunt, or the populist version of McCarthyism. I am no deep sympathizer with speculators, particularly in the non-deliverable commodities sector, but last time I checked people are innocent until proven guilty. Also, derivatives need to be regulated, but this can be done through registries, clearinghouses, or exchanges, or some type of self reporting. Why the fixation on exchanges? Most of these contracts don't even involve public entities, they should just report their balance sheet to the SEC/CFTC and be done with it, John Q. Public doesn't need to be able to Google their proprietary deals so we can hear a bunch of mindless quipping and potentially damaging adjustments to market confidence.)

Wednesday, April 7, 2010

Sit back and enjoy the show


There seemed to be at least two over-riding criticisms of the newly passed healthcare reform law:

1) It would not, contrary to official estimates, reduce the deficit, but rather add to it.

2) It would represent something more or less "un-American"- a significant expansion of government at the cost of free market choice and competition and a general ideological move towards socialism.

What I am perhaps most pleased about with this bill is that over the coming years, certainly the next 5-10 years, we can evaluate these claims with real world results and see who is right. We can test these claims, comparing Congressional estimates of cost with those of the Administration and the Wall Street Journal and Rush Limbaugh and the American Enterprise Institute and Brookings- and we can see who was most correct. Afterall, prejudging outcomes and assuming away complexity in favor of one sized fits all answers and ideology is anathema to science. So let's sit back and see the results of this experiment. These arguments will not linger abstractly out in the ether of public debate and controversy forever, with two sides eternally duking it out over fundamentally unproveable philosophical or moral questions (I'm sure more than a few come to mind). We will get hard data about how many more people get healthcare, on the rate of price growth, on the cost of these new mandatory government spending programs on the budget and tax rates, on the success and replicability of the 27 cost control and quality care pilots this bill establishes, on whether we remain a country of elections and predominantly privately produced and procured goods and services, or whether we become the new Venezuela. All of this, and much, much more, time will reveal.

For instance, the intent of these new pilots is to look for best practices, cost control measures, and general innovation in healthcare delivery. The point is to test new things for proof of concept, cutting funds for what doesn't work, and scaling up what does. Evidence based, pragmatic cost control measures are good ideas whether in corporate America or government. Many (potentially) good, cost-saving ideas are in this bill, and the potential savings weren't even priced into the budget estimates. Stuff like bundling payments across hospitals and outpatient services to reduce administrative costs and create greater negotiating leverage, paying hospitals with higher infection and readmission rates less, sending out undercover inspectors to look for waste and abuse, working on payment systems that reward quality of outcome and care over sheer volume (as is currently the case for the fee for service model) and clearly conveying the state of peer reviewed medical literature to practitioners in the field, so there is no ambiguity about the state of scientific knowledge on what works, and what is a waste, both of treatment and money. After all these assertions and claims that have been discussed the last 14 months during the genesis of this law, we will get to concretely see what savings and best practices come out of these 27 seperate case studies. For economists or researchers looking for good data sets and means to test null hypotheses, it's almost overwhelming to think of all the good analysis that could be done. Yet one thing is for sure, we know what healthcare costs today, we know how much waste there is, we know how many errors there are, we know how many people are covered- and now we are about to discover which way this law pushes all these indicators.

One could spend a great portion of her life reading criticisms and attacks of every aspect of this law (and even criticisms of things not in it!) from countless think tanks, research institutes, lobbies, and yes, gasbag bloggers such as myself. But what is so exciting about this historic piece of legislation, in addition to the potential to provide care for millions and root out inhumane abuses in the insurance industry and expand competition and choice- is that we will get to test these assertions very clearly. I just hope we keep score, and in 2020 if everyone takes for granted that kids can't be denied health coverage, or domestic abuse can't be classified as a preexisting condition, or a consumer isn't forced to buy into an oligopoly because the government now forces companies to post their plans side by side online to drive choice and innovation, or that healthcare costs are growing slightly above inflation rather than 250% of it- that we don't shrug this off as just the natural progression of things, as some inevitable outcome or industry innovation. No, like any good science experiment, we have been operating a good control scenario for about the last 50 years, and now we can compare it to the future. If these changes come about, we can make clear scientific arguments of attribution. Whichever side has it right, it will be a triumphant essay they pen in the National Review or Cato blog- an epic example of "told you so!" In other words, after 40 years of debate, it's finally down to the 4th quarter of a close contest, and we're getting closer to seeing who the winner is.

As a caveat, on the first two criticisms- deficit control and socialism- I would point out that this bill cuts $550 billion from Medicare in the next 10 years by eliminating 15 cents on the dollar of Medicare Part D (because it's 15% more expensive than public run plans and gets no better results). CEOs and turnaround private equity guys gets plaudits for this constantly, ruthelessly cutting waste and ineffeciency to force better results and make hard decisions. Oh, and in this case, it will also fulfill a promise the previous administration made to seniors about prescription drug coverage but didn't actually fund. But cutting medicare funding hardly seems like adding to the deficit to me, and curtailing the size of government payouts hardly seems like expanding government. Also, creating competitive transparent online exchanges, for customers to review and scrutinize plans, none of which will be government programs by the way, hardly seems like something that would be expected to increase prices, and hardly something that is socialist, in fact it seems like the essence of market based capitalism.

And from a behavioral economics standpoint, I've decided to take this new system for a spin, test out all my new government benefits by being a little clumsier here and there. JK