At the American Council on Science and Health Alex Berezow takes note of the differences between our health care system and those of other “rich countries”:

The first peculiarity is the amount of money the U.S. spends on healthcare. On a per capita basis, Americans spend 77% more on healthcare than other high-income countries. As a percentage of GDP, healthcare constitutes 1/6 of the U.S. economy, but it constitutes less than 1/8 of the economies of similar nations.

The second peculiarity is how healthcare costs are covered. In the average high-income country, 63% of healthcare spending is covered by the government, whereas less than 50% is covered by the American government. Additionally, prepaid private spending (e.g., insurance) plays a larger role in covering healthcare costs in the U.S. than in other high-income countries. And though out-of-pocket costs (as a percentage) are roughly the same between the U.S. and other similar nations, Americans pay more out-of-pocket due to the high relative cost of healthcare.

The comparison is highlighted in the table at the top of this post. As a word of caution, I think the table understates the percentage of health care paid for by the U. S. government slightly since it doesn’t include the employer-subsidized plans of government workers in its reckoning of “government-paid”.

I see several other differences worthy of note. The U. S. is by far the most diverse OECD country in terms of religion, race, ethnicity, and economy. The U. S. has a much higher percentage of very rich people as well as a much higher percentage of very poor people—people who are poor by world standards, something almost unheard of in other OECD countries.

Here in the U. S. we trust government less than they do in other OECD countries and our government is much less centralized than in other OECD countries. We are much larger both geographically and in terms of population. And the foundations of all the health care systems of all OECD that include single-payer or full on national health systems were laid when per capita health care spending was much, much lower than it is now.

After many years supporting a single-payer system for the U. S. I arrived at the conclusion that such a system would be ruinous here because we simply don’t have the will to contain spending.

The editors of the Wall Street Journal rise in defense of the president’s tax plan:

The White House rolled out its tax principles on Tuesday, investing new energy in the first serious reform debate in 30 years. While the details are sparse and will have to be filled in by Congress, President Trump’s outline resembles the supply-side principles he campaigned on and is an ambitious and necessary economic course correction that would help restore broad-based U.S. prosperity.

Many voters heard Mr. Trump’s make-America-great-again slogan as a promise to raise their incomes and improve economic opportunities after a long stagnation. Eight years of 2% growth since the recession ended in 2009 is the weakest recovery in the postwar era, and the result has been rising anxiety and diminished expectations for millions of Americans.

Faster growth of 3% a year or more is possible, but it will take better policies, and tax reform is an indispensable lever. Mr. Trump’s modernization would be a huge improvement on the current tax code that would give the economy a big lift, especially on the corporate side. The reform would sharply cut the business income rate to 15% from 35%, while simplifying the code for individuals and cutting some marginal rates.

Others, like the editors of the New York Times, castigate it as “cutting his own taxes”.

A few observations:

• GDP = C + BI + G + (X – I)
• The “BI” above is business investment and it’s been the weak link in GDP growth for nearly 20 years.
• The effects of low investment aren’t felt immediately.
• We will suffer the adverse effects of low business investment for decades into the future.
• Our present business tax rates are out of step with the rest of the OECD.
• They provide incentives for businesses’ moving their operations elsewhere and for keeping their offshore earnings offshore.
• U. S. consumer spending is the highest in the OECD already.
• So much of what we consume is made elsewhere that additional consumer spending doesn’t stimulate the economy as much as it used to.
• Government spending, the “G” in the equation above, has risen in real terms faster than either consumer spending or business investment.
• Government spending is a less efficient way of increasing growth because of deadweight loss.
• Government spending rarely helps the poor. At best we end up paying the rich to help the poor.
• Our economy is too large for us to base economic growth on exports.
• Everything we do to increase our exports immediately provokes a threat of trade war.

That we need to reform our business tax rates should be obvious and non-controversial. Instead it’s highly politicized. Maybe that’s well-intentioned. Maybe not.

Update

The editors of Bloomberg have mixed feelings:

The proposal aims to cut tax rates and greatly simplify the code — worthy goals. The U.S. corporate tax rate is one of the highest in the world and ought to be cut. And no American needs persuading that the personal-tax system is too complicated.

But a plan based on the president’s bullet points would involve a big increase in public borrowing, which would be unwise. In addition, starting from here, the political maneuvering needed to get it passed would cancel out much of the benefit.

What’s the solution? I can see several alternatives:

• Cut spending. If we reduced our military commitments, there’s still room for cutting military spending. Administrative reform could cut a little more. I really can’t believe that in the $500 billion per year net spending in Medicare there isn’t room for any efficiencies.
• Increase taxes. I don’t believe an additional bracket, a “millionaire’s tax”, should be out of the question. I’m skeptical that any cuts in personal income tax marginal rates will have much effect on economic growth.
• Borrow the money. At a 1 or 2% cost of borrowing, a 5% return at the rate of return of private capital investment is a no brainer as Tyler Cowen points out.
• Just extend the credit. Don’t borrow. Just “print” the money. As a percentage of the economy and even more relevant as a percentage of money it’s very small. The M2 money supply is around $13 trillion. Compared to that $240 billion is barely a rounding error. The downside risk is practically nonexistent.

Inspired by the NYT’s reluctance to use the phrase “female genital mutilation” out of cultural sensitivity, Arthur Chrenkoff has a proposed style guide for the Gray Lady:

We couldn’t possibly have “culturally loaded” terms in case they “widen the chasm” between the supporters and opponents of certain practices – or right and wrong, as some unsophisticated commentators would call it. All cultures are, after all, equal, so we shouldn’t be judgmental.

Here are some of his proposed dictions:

Killing old and infirm – extreme palliative care

Torture – alternative investigation aid

Hat tip: Glenn Reynolds

I found this article from the Boston University School of Public Health on the genetic foundations of extreme longevity interesting:

The search for the genetic determinants of extreme longevity has been challenging, with the prevalence of centenarians (people older than 100) just one per 5,000 population in developed nations.

But a recently published study led by a School of Public Health researcher, which combines four studies of extreme longevity, has identified new rare variants in chromosomes 4 and 7 associated with extreme survival and with reduced risks for cardiovascular and Alzheimer’s disease.

I don’t expect to live to be 100. I didn’t expect to live to be 60—I’m already the longest-lived male of my direct line in nearly a century. I appear to take after the Schneiders (maternal grandmother). My mom’s Uncle Ed lived to 96. Basically, antibiotics have been very good to the Schneiders.

I continue to think that those who believe that ordinary human lifespans are likely to be extended past 100 or even past 115 are whistling in the dark. Today people who make it to 115 are anomalies. They were anomalies a century ago.

One hundred years ago if you survived childhood your odds of living past 70 were actually pretty good. That was also true 200 years ago, 1,000 years ago, and, in all likelihood, 10,000 years ago. That’s what antibiotics, sanitation, and other public health measures have done for us. None of those things have done much for raising the odds that, if you made it to 70, you’d live to 115 much.

The most detailed genomic analysis of dog breeds to date has been published in Cell Reports:

There are nearly 400 modern domestic dog breeds with a unique histories and genetic profiles. To track the genetic signatures of breed development, we have assembled the most diverse dataset of dog breeds, reflecting their extensive phenotypic variation and heritage. Combining genetic distance, migration, and genome-wide haplotype sharing analyses, we uncover geographic patterns of development and independent origins of common traits. Our analyses reveal the hybrid history of breeds and elucidate the effects of immigration, revealing for the first time a suggestion of New World dog within some modern breeds. Finally, we used cladistics and haplotype sharing to show that some common traits have arisen more than once in the history of the dog. These analyses characterize the complexities of breed development, resolving longstanding questions regarding individual breed origination, the effect of migration on geographically distinct breeds, and, by inference, transfer of trait and disease alleles among dog breeds.

The infographic above depicts the study’s findings. There are a number of things I found interesting about them.

First, the “primitive” dog breeds, e.g. basenjis, Alaskan malemutes, chow chows, etc., are all closely related. That’s what I would have expected. My own breed, the Samoyed, is slightly more distantly related to those ancestral breeds but closely related, for example, to the Eurasier. That’s completely unsurprising since Samoyeds were reportedly part of the breeding program that created the Eurasier.

Second, it answers some questions I’ve been curious about for some time. The cording trait, present in breeds like the poodle and the komondor, has apparently occurred multiple times. Also, while the various breeds of similar looking white herding and cattle dogs, e.g. kuvasz, Anatolian shepherd, and Great Pyrenees, are related, they’re equally related to various breeds of coursing dogs, e.g. saluki, Afghan hound. My Samoyeds are only distantly related to them which I guess is an illustration of form following function.

Although you are frequently told that the mastiff-type dogs are derived ultimately from the Tibetan mastiff, the relationship between the Asian dogs and the European mastiff-type dogs does not appear to be particularly close.

I honestly don’t understand why anyone in the United States supports a U. S. corporate tax with nearly 40% nominal rates on businesses, the highest in the OECD. It only produces about 11% of federal revenues and has a vast array of undesireable consequences from the deadweight loss of the billions spent by companies in avoiding paying taxes to inversions to, as James Freeman points out at the Wall Street Journal, lower wages for workers to inversions to U. S. companies holding vast amounts of cash earned overseas away from our shores so it doesn’t incur U. S. taxes. It fosters big companies that can afford tax avoidance over small ones. It’s perverse.

Far from being a radical notion proposing that the U. S. nominal business income tax rate be lowered to 15% would just bring the U. S. more closely into line with other OECD countries. We wouldn’t become a tax haven. We’d just be more like the other kids.

Rather than arguing about the merits of lowering the rate (which are obvious), we should be working out ways and means for making up for the loss of revenue. The most obvious way would be simply to issue ourselves the credit. Don’t pay interest on it. Just “print” it. I don’t believe that such a small percentage of GDP would result in a run on the dollar.

If that offends you and you insist on a balanced budget, how about a millionaire’s tax? A surtax on personal incomes of over a million bucks would probably do it and it’s what Warren Buffett, Bill Gates, and Mark Zuckerberg have been demanding. Give the lady what she wants, as the saying goes.

I don’t know whether to laugh or to cry when I read something like Gerald Seib’s column in the Wall Street Journal:

Let’s imagine an alternative opening act to the Trump presidency.

Specifically, let’s imagine a presidency that attempted from the outset to take advantage of the fact that Donald Trump isn’t an ideological conservative or a traditional Republican, but rather a radical centrist who should be able to create unconventional, bipartisan coalitions.

Imagine this new president had given a different kind of inaugural address, one in which he didn’t accuse the capital’s political leaders of flourishing at the expense of its citizens but rather sketched out a vision of a new way of working with those leaders.

There is an old Yiddish proverb which responds to that perfectly: if my grandmother had balls, she’d be my grandfather.

Putting it into Aristotelian terms, divisiveness and polarization aren’t accidents, incidental characteristics, of Donald Trump’s presidency. They’re its essence, what makes it what it is. There couldn’t have been the alternative inaugural address that Mr. Seib imagines because Trump is who he is and Trump’s presidency will be what it will be.

At Bloomberg View Noah Smith considers the factors that have led to a decline in the share of GDP that goes to labor. He discusses four:

Economists are therefore scrambling to explain the change. There are, by my count, now four main potential explanations for the mysterious slide in labor’s share. These are: 1) China, 2) robots, 3) monopolies and 4) landlords.

Read the whole thing.

To those I would add two: open borders and massive subsidies to capital intensive but not labor intensive industries.

The problem doesn’t need to have any single cause. Those factors operate synergistically to create the observed effect. And that synergy will make it darned hard to end.

When was it that Hill Street Blues was in first run on TV? Thirty years ago? I didn’t watch it faithfully but did so occasionally and played a sort of game. The show’s writers were cagey about exactly where it was supposed to take place but it was explicitly supposed to be in a big city on the East Coast or Midwest. The game was to count the number of palm trees, eucalyptus trees, and shots of mountains in the distance. The “media bubble” Jack Schafer and Tucker Dougherty write about in this Politico article isn’t new:

The answer to the press’ myopia lies elsewhere, and nobody has produced a better argument for how the national media missed the Trump story than FiveThirtyEight’s Nate Silver, who pointed out that the ideological clustering in top newsrooms led to groupthink. “As of 2013, only 7 percent of [journalists] identified as Republicans,” Silver wrote in March, chiding the press for its political homogeneity. Just after the election, presidential strategist Steve Bannon savaged the press on the same point but with a heartier vocabulary. “The media bubble is the ultimate symbol of what’s wrong with this country,” Bannon said.

Television news production has been concentrated in New York, Los Angeles, or Washington for what? The last fifty years? That’s why every time it snows in New York it’s big news while blizzards in Cleveland go unnoticed. TV reporters cover what’s easy to cover and what affects them. It seems like a big story so it must be a big story.

Meanwhile, have you noticed how many Americans on television have Canadian “ehs”?