He Who Pays the Sociologist Calls the Tune

Sociologists from around the country have gathered for the annual American Sociological Association conference, and apparently they’re running scared. At least, according to an article appearing in Inside Higher Ed, many are running from research described best using such words as “sex” and “incestuous.” Apparently, having such words in the description of one’s research has been known to draw the ire of conservative activists, and has occasionally placed National Institutes of Health funding in jeopardy.

The problem, of course, is that as much as sociologists might love free money, NIH funding ultimately comes from taxpayers, and – surprise! – some taxpayers actually want a say in how their money is used. And, no, just because someone’s a scientist doesn’t give him the right to do whatever he wants with someone else’s hard-earned ducats. Of course, it can be very hard to examine really controversial issues if everyone gets a say in what you’re doing and how you’re doing it.

Which leads to the only logical solution to the problem: If social science work – or any controversial scientific work, for that matter – is going to be done right, it cannot be conducted through the wallets of taxpayers. Just as scientists need the consent of human subjects to conduct experiments on them, they must have the consent of their funders if they want to be left alone. Which leaves sociologists with an important decision to make: Do they want to conduct science free of political interference, or sell out for the promise of abundant government grants? Unfortunately, right now the latter seems to be the more popular choice.

Grover Norquist & Co. Join the Anti-Universal Coverage Club

Here’s an excerpt from the Americans for Tax Reform blog:

Many debates in health care over the last decade (or five) have focused on the best way to universally insure all Americans.

The Left believes in a single-payer health care system where all Americans are covered by a single government health care plan.

The Center-Left believes in some combination of socialized medicine and heavily government-subsidized private sector health care.

The broad Center-Right coalition believes in individual choice and control, in particular via use of health savings accounts (HSAs).

But maybe we’re getting the question wrong.

Siding with Governments over People, Pope Criticizes Tax Havens

It is rather disappointing that so many religious figures think that compassion should be a function of the state and that bigger government is good for the less fortunate. This approach not only undermines personal responsibility, but it also is anti-empirical because of the ever-growing body of evidence showing that high tax rates and excessive spending hinder growth and thus make it harder for poor people to climb the economic ladder.

Notwithstanding this real-world evidence, the UK-based Times reports that the Pope is about to attack tax havens as part of broader call for more redistribution. Not surprisingly, Italy’s Prime Minster is delighted that his nation’s taxpayers are being told to behave like sheep:

In his second encyclical – the most authoritative statement a pope can issue – the pontiff will denounce the use of “tax havens” and offshore bank accounts by wealthy individuals, since this reduces tax revenues for the benefit of society as a whole. …In it the pontiff focused on “those peoples who are striving to escape from hunger, misery, endemic diseases and ignorance and are looking for a wider share in the benefits of civilisation”. He called on the West to promote an equitable world economic system based on social justice rather than profit. …[Italian Prime Minister] Mr Prodi asked, adding: “If memory serves, St Paul exhorted the faithful to obey authority.”

IMF Wants Higher Taxes in Japan

The International Monetary Fund is urging higher taxes in Japan, though this is not exactly newsworthy since the IMF routinely endorses higher taxes in its country reports (Article IV consultations). To be fair, the IMF does say that it would be a good idea to control spending. And the international bureaucracy wants taxes to be raised in a less-destructive manner. Nonetheless, the notion that Japan will be more prosperous with a higher tax burden (which would be used to finance a bigger government) is rather fanciful. Tax-news.com reports:

The International Monetary Fund (IMF) last week published the conclusions reached by its assessment team during the recently completed Article IV consultation with Japan. …The Article IV report continued: “Most Directors considered that given the size of the task at hand, additional revenue measures will be needed, including for base broadening. They indicated that revenue measures could be best identified in the context of a broad reform of the tax system that addresses the challenges posed by Japan’s aging society and globalization. Among possible measures, increasing the consumption tax has the benefit of being less detrimental to growth and equitable across generations. Some Directors, however, viewed the authorities’ focus on expenditure adjustments as broadly appropriate at this juncture.”

This story, which is so similar to hundreds of other reports on IMF-endorsed tax hikes, raises an interesting question: Does anybody know if the IMF has ever recommended that a country reduce its tax burden?

Bush: The Biggest Taxer in World History

The Treasury Department reported Friday that federal revenues reached $2.12 trillion ($2,120,000,000,0000) for the first ten months of fiscal year 2007. In both current and inflation-adjusted dollars, that puts the federal government on course for the most revenue it’s ever collected in a year. Indeed, it’s the most revenue any government in the history of the world has ever collected. And yet it’s not enough to satisfy the voracious appetites of the spenders in Congress and the administration. Spending was $2.27 trillion for the same ten months.

It seems that the deficit problem in Washington is not a result of insufficient tax revenue but rather the inexorable growth of spending on everything from earmarks to entitlements to war.

To be sure, the U.S. economy is the largest national economy in history, and that’s the main reason for record tax levels. And tax revenues are not at their peak in terms of percentage of GDP–though they’re getting close. Earlier in the year OMB estimated that revenues as a percentage of GDP would reach 18.5 percent in 2007. But as of a month ago that figure had reached 18.8 percent, approaching the levels that typically produce popular demand for relief. But as spending interests become stronger and more widespread in Washington, popular demand for lower taxes faces more resistance. It seems safe to conclude that George W. Bush will go down in history as the biggest taxer and the biggest spender ever.

P4P: I Disagree with Arnold Kling and Dr. Bob

Arnold Kling agrees with Dr. Bob regarding existing efforts to pay physicians for quality – known as pay-for-performance, or P4P – rather than for the volume and intensity of the services they deliver.  Dr. Bob argues:

  1. “High quality — while not invariably more expensive — is often so.”
  2. “[B]y and large,” the guidelines that physicians are supposed to follow “don’t exist — except in a few relatively straightforward areas of medicine.”

I agree with those statements, but I disagree with their conclusions. 

Though the first statement is true, it is also true that a lot of the expensive stuff that doctors deliver is not high quality.  For 30 years, researchers at Dartmouth Medical School have found it very easy to demonstrate that some doctors do a lot more expensive stuff than other doctors do (e.g., specialist consultations, hospital stays, etc.).  But they have found it very, very hard to find any evidence that that extra stuff makes patients any healthier or happier.  Thus, a lot of the expensive stuff that doctors do isn’t high-quality care.

Though the second statement is true, it is also true that where evidence-based guidelines do exist, patients still don’t get the “high-quality” care that the guidelines recommend.  According to Elizabeth McGlynn and her colleagues, patients receive such recommended care only about 55 percent of the time.  (I put “high-quality” in quotes because not every patient should receive what the experts recommend.  But it would be a stretch to say that 45 percent of patients are outliers.)  Even when evidence-based guidelines exist, doctors don’t follow them.

Quality suffers both because physicians don’t do enough of what they should, and do too much of what they shouldn’t.

Physicians generally support P4P incentives that pay them more to do more of the former. But they really hate P4P incentives that penalize them for doing too much of the latter.  (The American Medical Association supports only two types of P4P incentives: those that increase the incomes of some physicians, and those that increase the incomes of all physicians.)

I think third-party P4P, where insurers reward providers for high-quality care, is a fine idea – provided the patient gets to choose her insurer.  For a good overview of the quality problems in the U.S. health care sector, the difficulties in implementing third-party P4P, and why the federal government should stay out of the P4P business, read my law journal article.

What Are You, Some Kind of Communist?

I never sprung for their six(!)-volume history of Whitewater, but I used to love the Wall Street Journal’s Clinton-bashing during the ’90s. Sure, writers for the WSJ could get a little, uh, exuberant with some of their charges, but even if they couldn’t prove that our 42nd president was a drug-running rapist, you could usually count on finding some good dirt on Bill and Hill on the editorial and op-ed pages. 

Well, boy, do I feel like a useful idiot now. It turns out that by savaging our president throughout the ’90s, the Journal was “taking a page from the old Soviet playbook.” Say it ain’t so, Paul Gigot!

Anyway, that’s what I got out of ”Propaganda Redux,” the op-ed by Ion Mihai Pacepa that ran in Tuesday’s Wall Street Journal, even though the author’s main focus, predictably, is on Bush-bashing. Pacepa is “the highest-ranking intelligence official ever to have defected from the Soviet bloc,” so he knows something about anti-American commie tactics, like spreading doubts about the president. You see:

Sowing the seeds of anti-Americanism by discrediting the American president was one of the main tasks of the Soviet-bloc intelligence community during the years I worked at its top levels. This same strategy is at work today, but it is regarded as bad manners to point out the Soviet parallels. For communists, only the leader counted, no matter the country, friend or foe.

As Pacepa recounts, Soviet bloc spies would stop at nothing in their disinformation campaign, portraying “Nixon as a petty tyrant, Ford as a dimwitted football player and Jimmy Carter as a bumbling peanut farmer.” When you think how close Americans came to believing some of that stuff, it really gives you a chill. We might well have lost the Cold War. 

Yet even today, over a decade and a half after the collapse of the Soviet Union, the ominous parallels remain. As Pacepa notes, “At the 2004 Democratic National Convention, for example, Bush critics continued our mud-slinging at America’s commander in chief.” This will not do, for, as Pacepa explains in the last paragraph:

[T]he communists got it right. It is America’s leader that counts.

And there you have it. Right in the pages of the Wall Street Journal. The second Clinton presidency sure is going to be interesting.