When Uwe “It’s the Prices, Stupid” Reinhardt opened his New York Times op-ed with this question:

Here’s a question I like to put on the final examination in my first-year economics course:

“Are undergraduate medical education in medical schools and subsequent residency training in teaching hospitals (called graduate medical education or GME) public goods that therefore should be publicly funded or at least receive substantial government subsidies?”

I was in the position of Arnold Horshack in the old TV show, Welcome Back, Kotter: I knew the answer and had my hand up in the air. But it’s a trick question. “Public good” is a term of art in economics and public policy theory. A good that is non-rivalrous and non-excludable is a private good. “Non-rivalrous” means that my usage of the good does not preclude your usage of the same good at the same time. An example of a non-rivalrous good, for example, is national defense. We may not benefit by it equally but we both benefit by it at the same time. “Non-excludable” means there’s no way to prevent my using the good without preventing your using it, too. National defense fits that qualification, too, which means that it is, by definition, a public good.

Medical education is obviously a private good and as Dr. Reinhardt notes:

Medical education and training represents human capital that is fully owned by the trainees. They can deploy it as they wish — on patient care, or even in the financial markets, where quite a few physicians now work. In principle, therefore, the owners of that valuable, purely private human capital should pay themselves for its production. That physicians serve society can be acknowledged, but so do many other professions whose education is not publicly funded. Just because privately owned human capital serves the public does not make it a public good.

The more subtle and interesting question is whether an educated medical profession is a public good? I think it is and that’s why regulation of the practice of medicine by local, state, and federal governments is a good idea.

Although physicians these days seem to regard the $80,000 or so per medical resident paid from the Medicare Trust Fund for each and every resident as a law of nature, it isn’t. It’s basically the bribe that was paid to the medical profession to secure its acquiescence to Medicaid in 1965. It’s a bit ironic that such bribery should have been needed since the medical profession has benefited so handsomely from Medicare. Since the passage of the program the wages of physicians have outstripped those of lawyers, accountants, architects, and engineers by far, to the point where the average physician earns a multiple of what the average lawyer earns rather than 10% plus or minus that they earned forty-five years ago.

The reality is that the subsidy has not increased the number of medical residents (that’s been capped) but rather has increased the wages of medical educators.

The smallest reform in our subsidization of medical education that we should implement is that we should limit the subsidy to the education of physicians who will mostly be providing primary care. Other specialties can more than pay their own way.

As to what I think should really be done, my views in the area of healthcare reform are so draconian I don’t even bother airing them.

James Taranto muses over why the anti-war Left is so silent about our bombings in Iraq:

Is it different because this time the president is a Democrat and a reluctant warrior? The Post’s Aaron Blake notes that the poll found support for the strikes strongest among Republicans (61%), especially conservative Republicans (63%), while Democrats were right at the national average of 54%. Only a 49% plurality of independents back the intervention.

One imagines Democratic support would be lower, and Republican support perhaps higher, if a Republican were in the White House. But hard-left antiwar groups like the Answer Coalition (an acronym for Act Now to Stop War and End Racism), which organized that 2001 protest, are not loyal Democrats. They’ve protested, among other things, Obama’s use of drones to kill terrorists and his failure to empty Guantanamo Bay of al Qaeda detainees.

A look at the Answer homepage turns up nothing about the current Iraq intervention. Atop the page are two posters, one a law-enforcement parody–“WANTED: Officer Darren Wilson for the Murder of Mike Brown”–and one an ad for an Aug. 31 “National March in Detroit” to “END the SIEGE of GAZA NOW!”

Hence our hypothesis: The reason no one is protesting against the intervention in Iraq is because the usual suspects are distracted by agitations against Israel and the Ferguson, Mo., police.

I think it’s because there is no “anti-war Left” in the United States to speak of, at least not an organized one. Organization takes more than a few committed individuals. You’ve got to have institutions and with the exception of a few religious institutions there is very little institutional opposition to war here in the United States.

A propos of “do or not do”, the editors of the Washington Post are critical of the president’s plans with respect to Afghanistan:

“People have said, ‘Doesn’t this show that you should never take the troops out of Afghanistan?’ ” a White House official said this week, according to the New York Times. Mr. Obama’s response, according to this official: “He said, ‘No, it actually points to the imperative of having political accommodation. There’s a limit to what we can achieve absent a political process.’ ”

That’s true, of course. But what is the best way to promote political accommodation? Since Mr. Obama announced that he would pull all troops out of Afghanistan by the end of his second term, it’s not surprising that Afghan factions have begun looking for ways to hedge their bets and ensure their survival if order begins to break down. Two presidential candidates have each laid claim to the office, and Secretary of State John F. Kerry’s effort to broker a compromise is in danger. As The Post’s Pamela Constable reported Wednesday, “fears are growing that Afghanistan’s fragile transition process could collapse into violence.”

In the interests of clear thinking, I believe this would be a very good time for the president to re-articulate the reasons he believed that we should put more troops into Afghanistan in 2008 as well as his assessment of whether the goals he wanted to achieve have been accomplished there. Isn’t that how you determine what your policy should be? Figure out what you want to do and the means necessary for accomplishing that?

Anne Applebaum wants the members of NATO to start pulling their weight:

Certainly it is long past time for NATO to become more rigorous about its membership. Some Europeans don’t want to pay for their defense? Maybe those who want to be covered by Article 5, the alliance’s security guarantee, should now be obligated to pay. Perhaps those who contribute less than 1 percent of their national budget should be told that the guarantee no longer applies to them. Certainly there don’t need to be any NATO bases in countries that refuse to contribute. And a much higher percentage of their military spending should go toward funding the NATO budget, so that NATO, as an alliance, can afford to pay for important operations.

NATO also needs to become a lot clearer about its goals. Europe has two immediate security issues: the threat from Russia in the east and the threat from Islamic fundamentalism to the south. NATO therefore needs two command centers, each of which would take care of planning and intelligence for defense against those threats. The basing of troops and equipment needs to be rethought completely: If we were starting from scratch, nobody would put them where they are now. NATO needs to shut down unnecessary commands and legacy bases, and move on.

Something to keep in mind about NATO: the target military expenditure for NATO members is 2% of GDP. Among NATO members only the United States, the United Kingdom, France, and Turkey spend that much and, not coincidentally, those countries are the only NATO members able to project power beyond their own borders.

I don’t believe there’s any hope for Slovakia or Estonia’s spending more on their militaries. Why should they? They know we’ll defend them no matter what.

My own view is that we should be much more reluctant to intervene on behalf of other countries, particularly countries who won’t defend themselves, than we are and consider what purpose NATO actually serves these days. We may have our opportunity sooner than we might like. Despite our responsibility for the situation in Iraq, the “Pottery Barn rule”, etc. our European allies probably have more at stake than we do in what’s going on there. Given the issue, Security Council resolutions, and the stakes, this really seems like the right time to start putting together a joint effort for which NATO might serve as a starting point.

Just to reiterate my point of view for the umpteenth time, I don’t think our interests in Iraq warrant much intervention there but any intervention should be an intervention that achieves its objectives. Why put in any effort just for its own sake? Do or not do. There is no try.

I have a certain amount of sympathy with the president for the amount of flak he’s getting over his vacations and golf-playing. He’s not the fist president to be the subject of criticism for the amount of golf he’s playing. Ike received almost identical complaints. And the president’s vacation time isn’t out of step with the amount of vacation time logged by recent presidents. George W. Bush actually had taken more vacation by this point in his presidency and received criticism for it.

However, I think that even the president’s most ardent supporters need to acknowledge that the president’s statement on the murder of journalist James Foley by ISIL/ISIS terrorists to the effect of “we deeply symmpathize with the members of the Foley family over this heinous…etc.—now where’s that 5-iron?” was tone-deaf. There were probably better alternatives.

My own preference would be refusing to grant access to reporters until after he’d completed his golf game but, then, he’d’ve been criticized for that, too. You just can’t win when you’re president which explains why I’ve never in my wildest most callow imagination dreamed of such a thing. President Obama must certainly be wondering why he pursued the job with such vigor right about now.

Today I learned that the difference in user experience between accessing a touch screen with your finger and with a stylus is roughly equivalent to the difference between shaving with an old, rusty razor blade and a brand-new one.

Joe Klein calls for addressing race relations in a “thoughtful, provocative way”:

You can’t convict a terrified, undertrained cop of murder for trying to defend himself, if that’s what the facts show–but all too often in the past, we’ve exonerated racist thugs who were clearly guilty. We can’t ignore the barbarity that got us here: lynching was a fact, too, not a metaphor. Oddly, the election of Barack Obama–poor guy–has blunted the conversation about race relations, at least on the white side. We elected a black man with a Muslim name to be President. What other country would do that? The conversation has also been blunted, honorably, by the President himself in the face of some of the most tawdry race-baiting since Selma. And it has been blunted by leaders of the black community, who don’t want to harm Obama’s presidency by criticizing him. In a recent New Republic article, Jason Zengerle makes a strong case that hatred of Obama mobilized Alabama conservatives to take over the state legislature in 2010 and strip black officials of the power they had gained since the 1960s.

How’s this for provocative? We don’t have a problem with race relations. Our problem is the bungling of the aftermath of the American Civil War. We have never, here’s that word, integrated the sons and daughters of former slaves into the fabric of American society.

As long as we treat the problem as one of race relations rather than the problems we’ve imposed upon some black people we will continue to proffer solutions that benefit people who do not belong to the group of black people experiencing the problems and haven’t experienced those problems. e.g. Barack Obama, Eric Holder, and Colin Powell (the son of Jamaican immigrants).

As Faulkner put it, the past is never dead. It isn’t even past.

In reaction to the murder of James Foley by ISIS terrorist and the president’s subsequent remarks, the editors of the Wall Street Journal call for the president to take a stand:

The question now—what the world wants to know now, Mr. President—is what are you going to do about it?

Six years into this Presidency, we know Barack Obama can do empathy. We know he can channel a family’s grief for a murdered son and express a nation’s outrage. What we don’t know is if he can muster the will and fortitude to defeat an enemy that is growing in strength and danger on his watch. This is what America and the world need from a President when killers are on the march.

The War of Jenkins Ear was a war between Great Britain and Spain whose precipitating event was the maiming of Robert Jenkins, a British merchant ship captain. Capt. Jenkins’s ear was actually displayed before Parliament to drum up enthusiasm for the war which ultimately lasted nine years, inflicting terrible damage on people and property in the New World colonies, largely because both sides employed privateers.

None of the alternative strategies before us is particularly attractive. Should we declare that journalists who put themselves in harm’s way have themselves to blame it won’t drown out incitements to respond and the political pressure will mount as the atrocities continue. There are no moderate insurgents to support. That is a fiction.

Taking steps which are unlikely to result in a resolution of the problems won’t resolve the problems as should be obvious enough. This cycle will repeat again and again. And, finally, Americans don’t have the stomach for the loss of American life and property and the indefinite occupation of a good part of the Middle East accompanied by the severe repression of a good part of the population that would be required to end these problems once and for all.

Playing golf sounds pretty appealing right about now.

Opera superstar of the 1940s Licia Albanese has died:

Felicia Albanese was born in Bari, in southern Italy, on July 23, 1909. She began singing as a girl, becoming a pupil of Giuseppina Baldassarre-Tedeschi, a noted Butterfly in her day.

Miss Albanese made her debut unexpectedly in 1934, at the Teatro Lirico in Milan. At a performance of “Madama Butterfly” at which she was understudying the title role, the soprano became ill during Act I. Miss Albanese was hustled onstage for Act II.

A great success, she went on to appear at La Scala, Covent Garden and other European houses.

She left Italy for New York in 1939 and the next year, on Feb. 9, made her Met debut as Cio-Cio-San. Reviewing her performance in The Times, Olin Downes wrote:

“She sounded the note of tragedy and made it the more poignant by the constant light and shade of her dramatic interpretation. There was a real simplicity and contagious emotion in it, and everything was so thoughtfully proportioned that climaxes had never to be forced or passion torn to tatters to make it carry across the footlights.”
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At the Met, Miss Albanese’s other roles included Susanna in Mozart’s “Marriage of Figaro,” Micaela in Bizet’s “Carmen,” Marguerite in Gounod’s “Faust” and Desdemona in Verdi’s “Otello.” She was also a mainstay at the San Francisco Opera, where she sang for many years.

Miss Albanese, who became a United States citizen in the 1940s, received the National Medal of Arts from President Bill Clinton in 1995.

She debuted in 1934 and, astonishingly, continued performing until 1985 when she appeared in Stephen Sondheim’s Follies.

I never heard her; I only know of her from old recordings from the 1940s. She had a truly remarkable voice particularly in the upper register. She was the dominant operatic soprano in the United States in the 1940s in a way no one is today.

I honestly had no idea she was still alive. 105!