NYTimes Book Review Misses Major Points About US Healthcare

Jacob S. Hacker, Yale professor and author of many books and article critiquing the American political system, economy, and the fate of the poor and middle classes, reviewed a new book, AN AMERICAN SICKNESS: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal (NY: Penguin Press, 2017). Most of the review takes up the question of why healthcare is not like other commodities and does not fit into the “let the market solve the problem” ideology of the last 40 years. If you are unpersuaded now, this is useful territory. towards the end of the review Hacker turns to our developed country competitors’ approaches to healthcare.

“The difference between the United States and other countries isn’t the role of insurance; it’s the role of government. More specifically, it’s the way in which those who benefit from America’s dysfunctional market have mobilized to use government to protect their earnings and profits. ….. But in every other rich country, the government not only provides coverage to all citizens; it also provides strong counterpressure to those who seek to use their inherent market power to raise prices or deliver lucrative but unnecessary services — typically in the form of hard limits on how much health care providers can charge.”

This is a great summary statement. Using a variety of tools and institutional arrangements every other government controls prices and healthcare budgets. They do not allow a one-sided market to focus on delivering as many procedures and prescriptions as possible without any systematic focus on health. My criticism is that Hacker should have provided two further data points to put the outrage of American healthcare in its true global setting: US healthcare spending compared to other developed countries and health outcomes relative to other developed countries. As the chart below demonstrates, the US spends more than 25% more than our closest competitor, Switzerland, and twice as much as most including japan, France, Australia and Canada. The health outcomes are woeful. We rank 42 in the world for longevity and 56th for infant mortality.  ((see https://www.cia.gov/library/publications/resources/the-world-factbook/)) These facts need to be front and center in our thinking about healthcare. The developed world is filled with universal healthcare systems with many different structures and approaches, all with several decades of experience at delivering better healthcare at much less expense. The only question is how will poor and middle class people in the united states gain enough political power to end this great rip-off??

https://ourworldindata.org/financing-healthcare/

Building the New American Economy – Not

The title of this short book, only 130 pages, Building the New American Economy: smart, fair, & sustainable by Jeffrey D. Sachs with a foreword by Bernie Sanders (Columbia University Press, 2017) is unfortunately misleading. There is much here about the new economy. The misleading part is that there is very little about its construction, the building of the new economy.

Sachs covers many important issues in a thorough, efficient fashion. If you need a primer or a tune up about the economy this is a good place to start. These include: investment in our society, infrastructure, Federal budget, income inequality, healthcare, energy, military and the empire (not his phrase), and innovation. If you have been reading my postings over the last 5 or so years much of this will seem a bit deja vu. Continue reading

E-Books Flatline; Books (Paper) Return Like Zombies

As the Web was becoming ubiquitous in the early haze of the 21st century the wonders of Google search displaced Altavista and other engines in the search wars. Web wags declared that the age of books, actually all paper-based media, to be over. The Web would quickly provide universal access to all of human knowledge on your computer. This even before the iPhone and Android brought the Internet to our hand and thumbs. Amazon and Apple launched their tablet reading devices, Kindle and iPad. Others followed. The numbers are truly amazing. Over 2 billion tablet computers were sold between 2010 and today. The sale of e-books rose enormously.

On the way to the funeral books proved to be the zombies of the paper media world. Newspapers and magazines have continued to decline. Continue reading

Book Review – The Rise and Fall of American Growth

Rise and Fall of American Growth-bookcoverThe Rise and Fall of American Growth: the US standard of living since the Civil War by Robert J. Gordon1 is a weighty book in every regard. At 762 pages it is a heavy lift – not beach reading or even bed-time either. But I found it almost a page turner. It is very well structured and written. None of the fussiness or obscurantist language one often finds in academic works. The central point of the book is that during the period from 1870 to 1970 the US economy grew at an extraordinary and we will not see a return to that rate for some pretty fundamental reasons. Continue reading

  1. Princeton U. Press. 2016 []

No Place to Hide by Glenn Greenwald – book review

Joe, My friend got back to me. Her contact left the Review five years ago. Sorry.  MarkWe are within days of the anniversary of the first revelations from Edward Snowden’s archive of NSA documents. The drum beat of new stories emerging from this trove continues even to this moment.1 So, Glenn Greenwald’s book, No Place To Hide: Edward Snowden, the NSA, and the US Surveillance State might be greeted with a yawn, what could be new? 

In fact, there is much that is new about how these stories have come to light and a very good overview of what we have learned about what Greenwald calls the US Surveillance State. This is a book in two parts. The first 89 pages read like a cross between a detective thriller and a spy story. There are hand offs of thumb drives at airport boarding gates, virgin computers, cell phones sealed off from the reach of the NSA by removing batteries or stuffed in freezers, meetings with a yet to be identified Snowden by an unsolved Rubik’s cube in hand. Continue reading

  1. NSA Collecting Millions of Faces from Web Images http://www.nytimes.com/2014/06/01/us/nsa-collecting-millions-of-faces-from-web-images.html accessed 06012014 []

Flash Boys Doesn’t Ask the Important Question

Flash Boys cover by Michael Lewis

photo by Patricia Wall/ NYTs

The new book, Flash Boys, by Michael Lewis has reignited the discussion of how our financial markets are rigged by high frequency trading.1 From my 2012 note: 

To turn back to HFTs, why do we need this kind of transaction? How do they contribute to economic growth? These activities are by definition a zero sum game. They are like every other form of gambling a zero sum game. There are winners and losers, but no incremental gain for the economy. Other than enriching the HFTs at cost to others with smaller computers and fewer PhDs on staff what do we get for allowing these activities? Potentially catastrophic destabilization of financial markets? Where is the upside for society as a whole? Isn’t  a primary purpose of any economy to increase the size of the pie, not just to redistribute existing wealth?

We should demand that our financial markets serve their fundamental purposes – connect investors with those who can deploy those resources to create new products and services and enable the flow of these goods and services. To call holding financial instruments whether stocks, bonds, or other assets for mere seconds investments is to beggar the mind. Government needs to step in to penalize economic activity that looks like gambling and certainly does not “grow the pie”. A sliding scale of transaction costs (aka a tax) could bring this to a screeching halt.2 There are sure to be complexities in how to implement such a strategy. But, if at every step we ask how a financial transaction contributes to economic growth at a systemic level, solutions will appear. Right now we have financial markets that are not only rigged but so complex and non-transparent that we are certainly setting ourselves up for future calamities like that which struck us in 2008.

  1. I have written about these issues earlier:  “High Frequency Trading and Deeper Questions about Capitalism” and “Wall St – not about investing but fixing the game” earlier []
  2. We would have to face the international crisis of how to employ all those PhDs currently engaged in the HFT wars []

Book Review – The Whisperers – private life in Stalin’s Russia by Orlando Figes

Whisperes- family life in Stalin's Russia by FigesThis book by Orlando Figes is exciting, terribly depressing, and cautionary. Based on hundreds of in-depth interviews and thousands of letters, diaries, and government documents, Whisperers1 puts real people in place of the faceless numbers that constitute our usual image of the human costs of Stalinist Russia – the 10 million lost during collectivization, the same or larger number disappeared during the various Terrors and the 20 million or more dead during the Great Patriotic War (aka WWII). For those who do not have much background in Russian and Soviet history Figes provides concise sketches of key political and economic developments covering the entire span of Soviet Russia. You will not feel at a loss during the NEP period nor the ensuing collectivization and the round ups of “kulaks”. This allows you to understand the private lives with a reasonable understanding of the context.

But the real contribution of this book is its discussion of the truly radical efforts by the Communist Party to crush the family as a basic unit of society and replace it with other institutions. The goal is to shape the new Soviet man. The coercive intrusion by the state into every aspect of daily life is comprehensive – it adds new depth to understanding the machinery of a totalitarian state.

  1. more here on Figes’ website []

Russia in Private by Richard Yatzeck

Russia in Private by Richard Yatzeck

Russia today seems very far from the country I grew up with as an international ogre on the TV news,  the Soviet Union or USSR. After all, the Wall fell in 1989, already 23 years ago. The Soviet Union 

dissolved in 1991, 21 years ago. It is mostly in the memories of those over 40 years old that crossing behind the Iron Curtain was an exotic, even inexplicable adventure.

In the spring of 1971 I left my high school teaching job several weeks early to join the second Lawrence University Slavic Trip. This three month long camping trip through the Soviet Union, Romania, Bulgaria, Turkey, and Yugoslavia (I left to go to graduate school at Cornell before the trip concluded in Hungary and Czechoslovakia) has stood as a formative event in my life. For the first time I was outside of the US and definitively in foreign cultures.

Now we have Russia in Private (Amazon link) by Richard Yatzeck. Professor Yatzeck suffered through my presence in his Russian literature courses at Lawrence University for four years. More importantly here he also participated in 9 visits between 1961 and 1997. He calculates that cumulatively he has spent three years in the Soviet Union then Russia. 

The structure of the book is loosely chronological from his 1961-62 years of study at Moscow State University (the Harvard of Russia) through camping trips with undergraduates to a final stint at semesters abroad in 1997 in Krasnodar. The central content is really the particular world views of Russians in their public and private lives.

Since there is more continuity in human affairs than not, this book is an excellent introduction to some of the driving elements in the current Russia. It is not a psycho-sociological academic exercise. Whatever didactic goals there might be, the book moves forward with many well told anecdotes and observations of the personal and the private as well as the day-to-day.

George Smalley in Yatzeck's Russia in Private

George Smalley, back cover of Yatzeck’s Russia in Private

One of the treats of Yatzeck’s book for me is the opportunity to revisit George Smalley. George was passionate, sometimes about matters that seemed a bit mysterious to a college-age student. He worked phenomenally hard. He demanded hard work in return and it was difficult not to reciprocate. His language teaching methodology, based in Prague school linguistics (think Russian linguist Nikolay Trubetskoy and the Russian-born American linguist Roman Jakobson), was a miracle of clarity and power. Above all George was a wild and crazy guy.

Who else would invite you in for your private tutorials in Russian with cigarettes burning in both hands, wave you to your seat across from the over flowing ash trays and announce, “You have parachuted into Karaganda. You’ve been arrested and are now being interrogated by the local police.”

Dick Yatzeck’s book inspired a flood of memories and comments from me. The 6,000 word letter I tapped out is available for download here (PDF).

Cod: a biography of the fish that changed the world by Mark Kurlansky

Cod by Mark KurlanskyThis wonderful little book (283 pages including 40 pages of recipes) by Mark Kurlansky is a great introduction to viewing history through a different kind of lens. We are all to used to history as told from the point of view of great men (almost always me) and nation states. Codis about the fish, fishing, processed food, ecology, trade, slavery, rum, fishing technologies, food around the whole of the Atlantic and beyond and more. It is a wonderful example of regional history.

How did the “sacred cod” sculpture end up hanging from the ceiling of the Massachusetts State House? Or, how did salted cod come to be such a prominent part of the cuisines of Spain, Portugal, France and other countries? How did it come that European fishermen competed for access to cod fisheries along the coast of New England and Canada well before the Pilgrims ever arrived? Where did cod fit into the slave trade that brought millions of Africans to the Caribbean, and North and South America?  How did cod come to be almost fished out of existence in the 20th century?

The_Sacred_Cod_of_Massachusetts

The Sacred Cod of Massachusetts - MA State House

This book answers these questions and more.

Title: Cod: a biography of the fish that changed the world
Author: Mark Kurlansky
Publisher: Penguin Books, 1997
Reviewer: Mark Orton

Slavery by Another Name: The Re-Enslavement of Black People in America from the Civil War to World War II

Slavery by Another Name by BlackmonThis book brings to light the extent to which the Jim Crow laws were in fact part of a totalitarian system of government that ruled the South for more than seventy five years. How these laws came to be called Jim Crow by historians instead of  “a system of racist oppression and exploitation” is a mystery. The fact that historians and school textbook writers  adopted this term,which is derogatory in its basis, points to a shameful lack of focus on the facts of life in the South during the period between 1876 and roughly 1965.  Worse it aided the systematic cover up of the actual functions of these laws and their impact on African-Americans. If the word Apartheid had been invented earlier this would also be a useful term.

The research and the writing is compelling. Blackmon has a website devoted to the book and the production of a documentary movie on PBS that will air in 2011.

Slavery by Another Name: The Re-Enslavement of Black People in America from the Civil War to World War II
Author: Douglas A. Blackmon    Publisher: Doubleday, $29.95 (512p) ISBN 978-0-385-50625-0