Tag: Nicholas Kristof

NYT Room for Debate: the Oregon Medicaid Study & ObamaCare

Today’s New York Times Room for Debate” feature poses the question, “Do the mixed results of an Oregon health care study show that government medical insurance should provide only catastrophic coverage?” From my contribution:

ObamaCare aims to cover 16 million poor uninsured adults through Medicaid, plus 16 million higher-income uninsured Americans through government-subsidized “private” insurance. Supporters portrayed these “reforms” as a matter of life and death, particularly for the poor. Yet a monumental new study finds that “Medicaid coverage generated no significant improvements in measured physical health outcomes” for poor adults. These findings strengthen the case that states should stop implementing ObamaCare, and Congress should swiftly repeal it…

The absence of physical-health improvements indicts the entire enterprise. Supporters have an obligation to show that the $2 trillion in entitlements ObamaCare will launch next year would actually improve enrollees’ health. The Oregon study shows they cannot meet their burden of proof. What part of “no discernible improvement” don’t they understand?

Read the whole thing here. See also the contributions by Drew Altman, Austin Frakt, Robert Reich, and Grace-Marie Turner.

Remember When ‘Liberals’ Were Liberal?

Nick Kristof devotes his NYT column today to wishing that American society were organized like the U.S. military. The armed forces “live by an astonishingly liberal ethos,” he gushes, and closes the column by suggesting that ”as the United States armed forces try to pull Iraqi and Afghan societies into the 21st century, maybe they could do the same for America’s.”

(I swear I’m not making this up.)

Kristof looks at the military and sees the ideal United States:

The military helped lead the way in racial desegregation, and even today it does more to provide equal opportunity to working-class families — especially to blacks — than just about any social program. It has been an escalator of social mobility in American society because it invests in soldiers and gives them skills and opportunities.

The United States armed forces knit together whites, blacks, Asians and Hispanics from diverse backgrounds, invests in their education and training, provides them with excellent health care and child care. And it does all this with minimal income gaps: A senior general earns about 10 times what a private makes, while, by my calculation, C.E.O.’s at major companies earn about 300 times as much as those cleaning their offices. That’s right: the military ethos can sound pretty lefty.

…The military is innately hierarchical, yet it nurtures a camaraderie in part because the military looks after its employees. This is a rare enclave of single-payer universal health care, and it continues with a veterans’ health care system that has much lower costs than the American system as a whole.

How times change. Four decades ago, folks like Kristof were marching on the Pentagon and burning their draft cards. Today they want to enlist.

More seriously: Racial equality, social mobility, and freedom from concerns about health care and child care are laudable goals. (Among the virtues of free markets is that they move society toward such goals.) Also, the U.S. armed services have helped improve many people’s lives, giving them careers, skills, education, and other benefits.

But, granting all that and assuming Kristof’s view of the armed forces isn’t romanticized (I know, but assume), he overlooks two important points:

First, the U.S. military is an all-volunteer force, which means that service members freely choose to take on both the obligations and benefits of military life. Yet lots of people choose not to live that life, for many reasons — including that they’re displeased with the benefits. Kristof gushes about how the military treats its members (again, assume); but what’s the difference between the military offering benefits that its service members like, and the private sector offering different benefits that its workers like? (Remember the lament that public employees receive lower wages than similar private-sector workers.)

It should also be noted that, until the U.S. military became an all-volunteer force, it compensated and treated its service members more like cannon-fodder. But once the services had to compete for labor in a free market, they expanded the benefits that Kristof now hails. Private-sector employers have to compete in that same marketplace.

Second, the U.S. military is the U.S. military. That is, it is financed through taxation, directed by politicians, and operated as a rigid hierarchy. Costs and the individual preferences of its service members are not of high concern. The social changes Kristof favors can be implemented by force in such a world. But that coercion is out of place in a world where costs matter and people have freedom.

Such a world most certainly does not have “an astonishing liberal ethos.”

Hope and Dismay about Haiti’s Future

Nicholas Kristof provides “a useful reminder of the limitations of charity and foreign aid” in his New York Times op-ed about Haiti today. “Nearly a year after the earthquake in Haiti,” he notes, “more than one million people are still living in tents and reconstruction has barely begun.”

He emphasizes the importance of “trade, not aid” and of the role of business: “It’s hard to think of a charitable project that will be as beneficial as the Coca-Cola Company’s decision to build up the mango juice industry in Haiti, supporting 25,000 farmers.”

He also cites a seemingly successful microfinance aid project that lends money to poor women in Haiti to begin and expand business ventures by, for example, investing in livestock or growing fruit for sale. It is impossible to evaluate the record of that organization based on the anecdotes Kristof provides, but, while microcredit may for a time alleviate the conditions under which poor recipients live (and be successful at pulling some recipients out of poverty), there is little evidence from its overall record that microcredit effectively reduces poverty. It is certainly not a way to reduce poverty on a widespread or sustainable basis. David Roodman of the Center for Global Development notes, for example, that “microfinance institutions in Haiti only reach perhaps 250,000 people, about 2.5% of the population.” (For a critique of some of the claims of microcredit proponents see Thomas Dichter’s Cato study.)

In line with Kristof’s main argument and with decades of evidence of successful countries around the world, the most effective way to reduce poverty in economically repressed Haiti is by opening its markets and increasing economic freedom. Unfortunately, Haiti’s reconstruction and long-term development plan, according to which the United States and international donors have pledged more than $15 billion, reads like a relic of central planning with virtually no mention of policies that promote economic freedom. Two sentences in the document mention the importance of clarifying land titles. One page mentions the role of the private sector, but it is in regards to its cooperation with the government’s “development centers” that will operate throughout the country to stimulate predetermined industries using government funds and guarantees and for “better redistribution of [the] population.”

We’ve been down this road before. If the Haitian government wishes to avoid disappointment and free itself from dependence on international aid, it needs to rethink its approach to development.

Prop. 19 Roundup

Here’s some recent commentary on California’s Prop. 19 ballot initiative:

  • Today, New York Times columnist Nicholas Kristof makes the case against the war on cannabis.  Although there is no mention of Cato, Kristoff mentions the work of our senior fellow, Jeff Miron, and links to our report on the Budgetary Impact of Ending Drug Prohibition.  Kristoff also mentions Portugal’s drug decriminalization policies and links to a Time Magazine article that highlights the Cato report on that subject by Glenn Greenwald.
  • Nick Gillespie and Matt Welch make the case that Prop. 19 is the most important item before the voters in this election cycle.  Even more important than whether Barbara Boxer can continue her work in the Senate?  Yes, read the whole thing.  Dan Mitchell has additional thoughts here.
  • George Soros is in the news for helping the Prop. 19 effort with a one million dollar contribution.  He explained his reasons for supporting Prop. 19 in a Wall Street Journal op-ed.

For additional Cato scholarship on drug policy, go here.