I suspect we’re all getting bored of talking about Sandra Fluke, contraception policy, alternative solutions, and the reaction thereto, but I’ve just had an email from a reporter who’s confused on a point so basic, I thought it might be worth clearing it up for a larger audience.
The reporter writes:
As you might suspect, I disagree with your assertion that “All she said, in effect, was that she and others want contraception and they don’t want to pay for it.” I was wondering if you happened to catch the part of her speech where she talked about wanting women whose doctors have prescribed birth control pills to treat medical disorders like endometriosis to be able to get such drugs without having to pass tests demanded by religious institutions? Is this an unimportant part of the debate?
Here is a slightly edited version of my reply:
Thanks for your email. You might not be surprised to learn that I think you’ve still missed the point.
Individuals and their insurers reach certain agreements about what will and won’t be covered. These agreements reflect the needs and preferences of people on both sides. (Of course individuals usually don’t negotiate directly, but they negotiate indirectly by expressing satisfaction and dissatisfaction to their insurers and employers, etc.)
Those agreements reflect all kinds of compromises among various needs and wants, including the ones Sandra Fluke listed. Some of those needs and wants are based on health, others on religion, others on lord-knows-what. But they are all things that someone somewhere cares about. Compromises are reached, and, as always, each side wishes they’d gotten a better deal.
The key question is: Do third parties (e.g. the government) have any legitimate reason to want to modify or overturn those compromises? Most economists will say: Perhaps, if the compromise affects third parties; no otherwise. (Another exception: If there is reason to believe that the negotiators missed an opportunity to benefit both sides. We believe we’ve got a pretty complete catalogue of exactly when these exceptions occur; Sandra Fluke did not point to anything in that catalogue.)
The mere fact that one side is dissatisfied with the compromise does not count as a reason to overturn it.
If you want to see what an actual reason looks like, please see my post on contraceptive sponges, where I’ve listed a bunch of possible legitimate reasons to overturn the compromise —for example, you might think it affects the birth rate and that third parties have some legitimate interest in that. Some of these reasons are (in my opinion) much better than others, but what they have in common is that they are at least reasons.
Ms Fluke’s position, as I understand it, is not that the compromise reached at her institution affects third parties. It is that she (or other students at her university) don’t like the compromise. That’s the difference between what an economist would recognize as an actual reason for third parties to become involved, versus a mere expression of dissatisfaction, with which we might or might not sympathize, but which doesn’t seem to merit government action.
Had Sandra Fluke offered an actual reason for her position (including any of the ones I proposed on my blog), I might have disagreed with her, but we’d at least have had the basis for a thoughtful discussion. By contrast, it’s quite impossible to have a thoughtful discussion with someone who says only that she doesn’t like the outcome of a negotiation. Of course the students want their health policy to cover pills for endometriosis and unsurprisingly, a Catholic college prefers not to cover them. Neither of those preferences seems any more interesting than my preference for cucumbers over tomatoes. If I argued that supermarkets should stock cucumbers instead of tomatoes solely on the basis of my personal preference, my argument would deserve to be mocked.
I hope that’s clear. Please let me know if it’s not so I can try again.
Sincerely, etc.
Edited to add:
The reporter sent me a followup email containing this question:
Do you think that “reasons” accepted by an economist deserve more weight and respect than “reasons” a medical doctor might have for recommending that birth control be universally covered by medical insurance?
To which I replied:
Yes, absolutely. Here’s why: Economists are trained to look at all the consequences of a decision before passing judgment; doctors tend to focus only on some kinds of consequences (those directly related to health) while ignoring others (for example, the many other effects that flow from raising people’s taxes or insurance premiums).
I do believe that any sensible debate about a public policy ought to try to account for all the effects of that policy, not just selected ones.
Economists have thought long and hard about how to make sure we do that. We don’t always get it right, but at least we’ve got a framework for it. Doctors don’t.
Prof. Landsburg,
If I recall correctly, when a monopolist (or any firm for that matter) can choose the terms of a contract and price, then the monopolist will, will choose efficient terms and use the monopoly price to extract its rents. In other words, it is even in the own interest of the monopolist to offer the best possible terms to the consumer.
It follows that if contraceptives are on net beneficial to consumers then even a monopolist will offer to cover these and charge a higher premium.
The terms are used to make the surplus as large as possible and the price is then used to extract the maximum possible amount of that surplus.
your [assert] that “All she said, in effect, was that she and others want contraception and they don’t want to pay for it.”
I was wondering if you happened to catch the part of her speech where she talked about wanting women whose doctors have prescribed birth control pills to treat medical disorders like endometriosis to be able to get such drugs without having to pass tests demanded by religious institutions?
Do the second sentence do anything to challenge the assertion in the first sentence? The second sentence is a non-sequitur, unrelated to the fact that Fluke really is just demanding someone else pay for her contraception.
5 to 1 odds says that when the reporter finally writes the article it will be hostile to Landsburg. 3 to 1 says that the “Yes, absolutely” will be quoted but nothing that follows it.
Possible conversations this reporter has had:
Person 1: People should buy my clothes for me and this should be mandated by congress.
Person 2: All you’ve asserted is that people should be forced to buy you clothes.
Reporter: I disagree with Person 2 because clothes keep people warm in the winter.
No, Steve, I think you have missed the point.
(1) The health care system in this country is broken.
(2) The Affordable Care Act is an attempt to fix the system and will require birth control coverage.
(3) The (recently rejected) Blunt amendment would have allowed any employer with “moral objections” to opt out of the birth control coverage requirement.
(4) Sandra Fluke testified to the negative impact to women of the Blunt amendment based on real experience with mandated insurance having a birth control exception.
Sandra Fluke’s testimony may not make sense to an economist and might (and did) provide fodder for a misogynist radio talk show host. But her testimony spoke loudly to politicians and to people who care about people.
“The key question is: Do third parties (e.g. the government) have any legitimate reason to want to modify or overturn those compromises? … If there is reason to believe that the negotiators missed an opportunity to benefit both sides. We believe we’ve got a pretty complete catalogue of exactly when these exceptions occur; Sandra Fluke did not point to anything in that catalogue.)”
Actually, I think Fluke DID point to one of these– the school thought it was providing the pill to every student with a medical need besides preventing pregnancy, when in fact students were slipping through the cracks and suffering medical compromises.
Do you think that “reasons” accepted by an economist deserve more weight and respect than “reasons” a medical doctor might have for recommending that birth control be universally covered by medical insurance?
Yes, because the question who should pay for what is an economic, not medical question. Do you think that “reasons” accepted by a medical doctor deserve more weight and respect than “reasons” an economist might have for recommending a particular type of cardiac surgery?
I don’t think Steve and the reporter understand what each other is saying.
Georgetown insurance pays for contraceptive pills if they have a non-contraceptive purpose. Fluke complained that it can be difficult to document that purpose. So her complaint could be partially addressed by relaxing the burden of proof to the insurance company. If Fluke’s friend was entitled to the pills under the policy, then she is just asking for something that was already paid for.
I don’t think this changes the basic economic issue. Fluke still wants contraceptive pills for contraceptive purposes, and Georgetown and/or the insurance company may not want to relax the burden of proof. But the reporter seemed to be asking whether the distinction is important.
My take is it just doesn’t seem
fair to force a private company to offer a product. Why can’t an insurance company offer to cover what it feels like, so long as it is honest and clear ? If you want to argue for a government takeover of health care, then argue that (and that may be worth arguing for) but to me as long as we are allowing private health insurance companies to exist in this country, then why not allow them to enter into private negiotiated contacts with groups or individuals? That may or may not cover certain drugs/procedures?
I “can’t” figure “out” why “the” reporter “put” reasons “in” quotes.
asa1490: “But her testimony spoke loudly to politicians and to people who care about people.” That’s true of a lot of stuff deserving mockery; it’s the very basis of irrational demagoguery. We should condemn it even in its milder forms. I linked to a famous, less mild, example yesterday. I presume you would decry that speaker, yet your description fits his appeal.
Josh: “If you want to argue for a government takeover of health care, then argue that…”
That argument was not the point of the hearings at which Ms. Fluke testified. The issue of universal health care (what you choose to call “government takeover of health care”) was settled by the passage of the Affordable Care Act (unless of course Republicans repeal it in the future or it is declared unconstitutional). Republicans were opposed to such a “government takeover”, so the Affordable Care Act includes the Republican idea of allowing private insurance companies to provide coverage under the act. To keep the coverage from being a sham, however, government will regulate what coverage will be provided. The Obama Administration ruled that contraception will be included. The Blunt amendment to the Affordable Care Act would allow employers to opt out of contraception coverage if they had “moral objections” to such coverage. Ms. Blunt’s testimony was narrowly drawn to the issue of why the Blunt amendment is a bad idea. To me, if you read her testimony in the context of what she was asked to address, it is compelling. All of the sex and economic issues raised by others were not part of what she was addressing.
Josh,
I’ve been in the insurance business for years and I can tell you that having a regulator tell you what you can and can’t cover is routine for us. We don’t necessarily like it, but there are many very good arguments for it.
There are several economic distortions in health care insurance that regulations can improve. One, for example, is high information cost. People don’t have the time or resources to research which drugs or procedures they should buy insurance for. One way to address this is to standardize coverages, allowing us to collectively determine the value of each coverage, and sharing the information cost among us.
I have one point I woulkd like some clarification on. Hopefully someone can help me.
Steve says:
In this case isn’t the compromise between the employer (or university in the case of Georgetown) and the insurance company? If the students and employees can be regarded as the 3d parties doesn’t that allow the govt to intercede? I know one answer to this is that the students and employees know, when they are signing up, what the terms of the compromise are and therefore are in a position to avoid such a sub-optimal compromise. Is this a good enough reason for the government not to intercede?
Am I thinking correctly?
Joe,
Point taken. You say your regulator tells you what you “can and can not cover.” Does it also force you to cover certain procedures/drugs on any given policy?
@Joe: re your latest to Josh. All good points. None establishes that mandates motivated by emotional appeals rather than a careful analysis of the costs, information asymmetries, and effeciencies you cite are a good idea. But that is the key issue here: debate and argument vs emotional appeals (I’d say emotional blackmail, SL would say extortion, some say a human face; I am seeking a neutral characterization). Debate and argument deserve respect; emotional appeals not so much.
Imagine an emotional appeal for some cosmetic procedure such as hair implants, and that the human face of baldness persuaded lawmakers to force insurers to pay for that with no restrictions and no co-pays regardless of what the kind of careful analysis you suggest indicates.
There’s a great Depeche Mode song, Everything counts in large amounts. That’s why we should use reason and argument and evidence to make decisions which affect millions of people. It’s irresponsible not to.
Polevaulter Donkeyman,
You are thinking correctly. We might all answer them differently, but those are the right questions.
Also, I would encourage everyone here to do what Polevaulter Donkeyman did. Critically evaluate Landsburgs post and identify the weaknesses. They are numerous.
Steve: “The key question is: Do third parties (e.g. the government) have any legitimate reason to want to modify or overturn those compromises [of negotiated health insurance contracts]?
The answer is obviously yes. The Affordable Care Act requires universal health care coverage. Government has a legitimate interest in regulating the insurance contracts to ensure they meet minimum standards. Ms. Fluke’s testimony spoke to the issue of whether contraception medication for women should be part of the minimum standards. She did not address the economics of that standard; presumedly you economists would have a better take on that issue. Ms. Fluke did have a take on how denial of contraceptive medication affects women.
Also, I find your choice of terms “modify or overturn”, while no doubt sufficiently pejorative for your purposes, to be inaccurate. In practice, the insurance contracts to be offered under the Affordable Care Act will be regulated prospectively, not “modified or overturned” after the fact.
Thanks to Joe, in the insurance business, for pointing out that government regulation of insurance contracts is not a particularly novel idea and that there are many good arguments for it.
Landsburg and the reporter are clearly talking past each other. Landsburg is approaching this issue using the standards of his usual economic toolkit, wherein he assumes that insurance buyers and sellers negotiate a contract, and the government should only interfere with that contract if there are externalities. People who think like the reporter and Sandra Fluke don’t see it that way. They think the government should interfere whenever the contract is unreasonable (for various vague definitions of unreasonable).
I’m wondering if there’s some way we can reconcile these viewpoints. What assumptions would allow us to map the unreasonableness standard to the economic standard? What implicit assumptions would the reporter and Fluke have to be making about the healthcare market for their approach to begin to make economic sense? (And then, could there be any truth to it?)
Perhaps it has something to do with the assymetric costs of complex contracts. When a seller uses a standardized contract, it has an advantage because it can split the cost of analyzing the contract across thousands of customers, whereas each customer has to bear the entire analysis burden for their side of the deal. Many customers would therefore have to weigh the cost of analyzing the contract against the risks of signing or declining the deal without full knowledge. This sound like it would create inefficiencies, which might be large.
On the other hand, when I buy a burger at McDonalds, there’s no contract or complex negotiation. The deal takes place under the standardized terms of a statutory agreement (the Uniform Commercial Code), and by and large, both sides are happy leaving it that way. We know this because either of us is free to demand other terms, but we rarely do.
So what would have to be true about the healthcare market for it to make more sense to use a statutory agreement (with the ensuing public policy debate) instead of individualized negotiation?
Josh,
I am in property rather than health insurance, but the answer is yes. With few exceptions, every health insurance policy must be approved.
Ken B,
“Debate and argument deserve respect; emotional appeals not so much.” I completely disagree, but that’s not the point. People deserve respect.
Joe: People deserve respect unless they do something to forfeit it. That something can include making demands based on self-serving emotional appeals in the palce of logic. It can include other things too, like yelling ‘slut’ on national radio at your political opponents. I for one do not respect Rush Limbaugh. Is it your contention I should? Do you?
I would have responded to the reporter’s follow-up question like so:
Did the doctor supply an economic justification for insurance coverage, or a medical justification for a specific course of treatment?
If the latter, no economist in their right mind would disagree with a trained medical professional on an individual medical prognosis. If the former, what was the doctor’s stated reason for altering the individual arrangements referred to in my original correspondence?
Mark Draughn,
I think you’re on the right track. My take is that the complex contract is the primary justification for regulation. Just imagine if you had to consider every possible treatment to evaluate an insurance policy. This is one of those cases where reducing choice is welfare enhancing.
@Bob Murphy: another example. Say I drag up an anti-semitic quote along the lines of ‘he is a blood sucking vampire like all jew bankers’ and I riposte, “No, that cannot be true; I saw his reflection in a mirror just this morning.” According to my lights I have used a modicum of wit to pwn the bigot, and make him look a fool. Your argument implies I think it’s ok to call other Jewish bankers blood sucking vampires, and deserve condemnation. I reject that.
Ken B,
I deliberately ignored your false equivalence in
http://www.thebigquestions.com/2012/03/08/aftermath/#comment-43882
and I’ll ignore it in
http://www.thebigquestions.com/2012/03/09/letter-to-a-reporter/#comment-44083
Please pick up your game a little.
Joe: no equivalence is being made. You state a principle; I test it in a particular case. It seems to fail. My guess is you do not demand I resepct RL, and do not respect him yourself. I also guess this is because of RL’s actions. So there are exceptions to your absolute.
@asa1940: “people who care about people” AND recognize that every $ that is used to subsidize law school students is $1 less that could be used for anything else, like feeding or housing the truly poor, find themselves forced to look beyond a false sense of self-righteousness.
Ken B,
I don’t know if you do it on purpose or not, but much (not all) of what you write comes across as sophistry rather than a search for a common understanding. To someone who is accustomed to thoughtful conversation, that gets tiresome quickly.
@ Prof. Landsburg (or others):
Anything question in front of congress is obviously a question of public policy.
It seems to me along with economics, sociology would be a good field to weigh in on public policy.
Can you think of an argument that an economist would make that a sociologist would not find to be a legitimate argument?
Not that they would agree, but that they would find it to be a legitimate argument to make on public policy.
I’ll take my answer off the air.
Professor Landsburg,
Quit avoiding the issue and apologize for condoning Rush Limbaugh’s use of offensive and derogatory language. This is what people are angry about.
@ Joe:
If you read other posts, you will see that Ken B and I often argue on issues. However, I think there is the usual back and forth of points given/points refuted.
Here you made the comment “People deserve respect”. Does everyone deserve respect? Should I respect the people shouting on street corners that everyone is going to hell?
Because I can tell you I don’t respect them. I think they make it more difficult for people to come to faith.
They are private citizens making public statements as is Sandra Fluke.
What do you see as the defend-able position as to where the line for where I have to respect someone?
Again, Ken B is not using misogynistic (thank you spell checker) terms. He is saying he doesn’t respect Ms. Fluke.
So please either defend your position, say you understand Ken B’s point, or move on to another topic.
Will A
I’m going to pull a Ken B and make the observation that your statement implicitly endorses everything Limbaugh said about Fluke.
This is a silly game.
I don’t think the doctor’s or economist’s reasons necessarily deserve more weight than the other. I don’t care who states the reasons.
What I care about is the quality of the reasons themselves and whether they are comprehensive or ignore other key aspects.
Replying to Ben’s comment
Ben, am I right in assuming you are a progressive? If so do you believe in the “freedom of speech”? And I don’t mean “freedom of speech” in the First Amendment sense of freedom from government oppression. In the liberal (classical) tradition “freedom of speech” is taken to be good because more speech leads to a vigorous competition of ideas, from which (hopefully) the best idea will win.
Do you think compelled speech protects “freedom of speech”? Nobody is saying freedom of speech means freedom from the consequences of such speech, but you have other ways of reacting to Steve. Don’t read his blog, don’t disseminate his ideas, ignore him. If you are his friend in meatspace, stop being freinds with him. But don’t you think forcing (or demanding) Steve to apologise tends to totalitarianism? Are you comfortable with that?
Individuals and their insurers reach certain agreements about what will and won’t be covered.
Why yes, just yesterday I suggested to my Blue Cross representative that they it would be mutually advantageous to us that they cover an additional 15% of my prescription costs! The helpful gentleman agreed, generated a new premium price quote for me, and faxed me a contract to sign.
And then I woke up.
Ben,
I think you’ve missed the part where the Professor in the original article notes that RL’s use of language is poor and that Sandra Fluke “deserves the same basic respect we owe to any human being”.
Finally noting “Which is more disrespectful — his harsh language or Sandra Fluke’s attempt to pick your pocket?”
So, in essence, he doesn’t condone the language and specifically looks at the reasons. We have been “told” that it’s an issue of language, but evidently, it’s not, it’s temerity to disagree with the argument.
BRD
Ben —
Landsburg did not condone Rush’s derogatory and personally insulting remarks. Please read more carefully what was written, and report back when you’ve realized that what was actually said was perfectly reasonable (hint: Do NOT read the Rochester student paper’s take on the matter, because it badly butchered the original blog post, quoting two or three words at a time way out of context and completely misrepresenting Landsburg’s entire point).
I wish people would read before jumping to conclusions. It’s amazing how many people are misreading, misrepresenting, and misstating what Landsburg has said on this point. What’s even more amazing is the extent to which they are doing so.
Oh, hey, Ben — since you seem either incapable of, or unwilling to, read Landsburg’s actual commentary on the matter, I went and pulled the *key* paragraph where Landsburg addresses the whole slut comment. If you read this paragraph above, say, a 10th grade level, I can assure you that your anger will quickly subside:
“There’s one place where I part company with Rush, though: He wants to brand Ms. Fluke a “slut” because, he says, she’s demanding to be paid for sex. There are two things wrong here. First, the word “slut” connotes (to me at least) precisely the sort of joyous enthusiasm that would render payment superfluous. A far better word might have been “prostitute” (or a five-letter synonym therefor), but that’s still wrong because Ms. Fluke is not in fact demanding to be paid for sex. (Not that there’s anything wrong with that.) She will, as I understand it, be having sex whether she gets paid or not. Her demand is to be paid. The right word for that is something much closer to “extortionist”. Or better yet, “extortionist with an overweening sense of entitlement”. Is there a single word for that?”
@Joe:
You completely failed to grasp Ken B’s and Will A’s point. In the spirit of your own standard, namely, “a search for a common understanding,” please try again.
Tim C,
“Landsburg did not condone Rush’s derogatory and personally insulting remarks.”
No, he just wrote, “…I just don’t get is why the pro-respect crowd is aiming all its fire at Rush. Which is more disrespectful — his harsh language or Sandra Fluke’s attempt to pick your pocket”
So he is saying either that what Limbaugh said wasn’t so bad, or that Fluke’s testimony was so offensive that she deserved it. He is either minimizing or justifying it.
He does disagree with a single word. He would use “extortionist”, but “prostitute” is closer than “slut”.
Please do not ask us to not be offended by that.
Shameless plug:
I made a point about emotional thinking, and its cousin, emotional appeals.
http://travelingatomist.blogspot.com/2009/12/wonders-and-dangers-of-emotional.html
Agree with everything said by Steve. But, to be fair to the other side:
“Individuals and their insurers reach certain agreements about what will and won’t be covered. These agreements reflect the needs and preferences of people on both sides. (Of course individuals usually don’t negotiate directly, but they negotiate indirectly by expressing satisfaction and dissatisfaction to their insurers and employers, etc.)”
Doesn’t hold that much weight in my humble opinion. An employer deciding what the health care package for its workers is, whether the workers like it or not, is very similar to the government deciding what the healthcare package for its citizens is, whether the citizens like it or not.
Of course, if an individual is unhappy with his employer provided health insurance, he can quit his job, but that’s a very weak and indirect way of expressing dissatisfaction for the healthcare package you’re getting. It’s far from ideal.
Jaems Strong: “Of course, if an individual is unhappy with his employer provided health insurance, he can quit his job, but that’s a very weak and indirect way of expressing dissatisfaction for the healthcare package you’re getting. It’s far from ideal.”
It is very far from ideal. But the govt is in this situation more than you might realize. Most people get health ins from work because employers get a tax break. So the same healthcare costs you more privately than through work. And with the market distortions from the tax break that won’t change. A good reason to do away with this deduction.
Joe —
I’ll repeat, please either make an effort to read what is actually written or, if you are incapable of that, learn how to do so without delay. I did not ask you to not be offended.
In addition, I’ll point out that a mature adult should be able to brush off a personal insult from Rush Limbaugh without much difficulty. It’s not like calling someone a slut is out of the range of behavior we normally expect from him. The whole point of these posts is that bald faced emotional appeals deserve no respect from thinking people. That applies equally to Rush’s personally insulting remarks, which is most likely why Landsburg addressed them by pointing out how logically unsound they were.
Enough playing in the sandbox for me today. You kids have fun wasting time with the bully who calls people names.
asa1940
Sandra Fluke testified to the negative impact to women of the Blunt amendment based on real experience with mandated insurance having a birth control exception...
… and ignored that the mandate negatively impacted. Fools like you seem to think that mandating coverage is somehow free and cost free, but it isn’t the entire point of Steve’s argument against Fluke is that she doesn’t give a shit about those she is negatively impacting and cares only about set of women it will positively impact.
So not only has she completely failed to respect individual liberty by going to congress to force others to pay for her shit, she’s failed utterly and completely to even perform a cost benefit analysis.
Henri Hein,
I get their point entirely. Let me explain mine a little further.
When someone seeking understanding hears me say “people deserve respect” in support of my position, he recognizes it as a generalization. He also recognizes that I believe it to hold at least to the extent that it must in order to sustain my position, and perhaps further, but not necessarily. He keeps the discussion reasonably close to the positions we are considering.
When a sophist hears the same thing, he knows that it is clearly not true in every case. He refutes it by citing extreme examples, such as Rush Limbaugh and George Wallace. The point is not understanding, but obfuscation and filibuster, and if I engage the sophist, he succeeds.
So if you want me to engage them, give me something to engage that is productive and useful, something that has some reasonable proximity to the current issue. If you want to challenge that “people deserve respect”, don’t give me a false equivalence, give me a true one. Tell me what this case is like, not what it isn’t like. Don’t test me with an extreme example.
If you or anyone does that, then I will engage them and I will respect their arguments. I will also give them the benefit of the doubt that their generally stated opinions do not necessarily apply to the most extreme cases.
asa1940
The answer is obviously yes.
It is not “obvious” at all.
The Affordable Care Act requires universal health care coverage.
Here you’re assuming your conclusion by saying “Obama care requires universal coverage, therefore it’s ‘obvious’ that third party interference into health care is necessary”. It’s poor logic.
Thanks to Joe, in the insurance business, for pointing out that government regulation of insurance contracts is not a particularly novel idea and that there are many good arguments for it.
And there are many more arguments against it.
@Ken B:
I won’t argue with that :).
@ Joe:
No pulling a Ken B would be to make a snide comment about whether my faith (part of my post) means that I should love everyone and wouldn’t this mean that I should respect everyone.
You made the comment:
To someone who is accustomed to thoughtful conversation
You may be accustomed to polite conversations with those who share your point of view. However, discussion with those who share your point of view is not always very thoughtful.
How a person responds to those who challenge his/her positions is a sign as to how accustomed she/he is to thoughtful conversation.
Ken:
“It is not ‘obvious’ at all.”
Yes it is.
“It’s poor logic.”
I thought it was rich logic.
“And there are many more arguments against it.”
No, by my count there are more arguments for it than against it.
I hope this clarifies the matter.
asa1940,
Well said. Your absurdity is irrefutable!
@ Joe:
(Another try)
It seems like you are saying that an emotional plea is a valid argument. I’m inclined to agree with you. An emotional plea for one person in front of congress is usually a plea to help everyone in a similar situation.
However, there is a tendency for this to come across as self serving. Maybe Michael J. Fox always wanted to speak out on a health care cause and Parkinson’s disease gave him the chance.
Or perhaps the only reason he wants me to give money for Parkinson’s research is because he has it.
Oprah doesn’t suggest donating money to help girls in Africa because of some friend there. She does this because she was moved by her experience.
Consequently, when Oprah speaks about this she says things like “I research this and found out x”. “Did you know that by helping these girls we can make y difference in the world?”
Because of this, I respect Oprah more than I respect Michael J. Fox. Also, I can personally understand how some would find Sandra Fluke’s comments self service and not respect her for it.
asa1940
“It is not ‘obvious’ at all.”
Yes it is.
Ha!! It’s so obvious that many people here, including the host, does NOT think it’s true, much less “obvious”. But I guess you have to claim something is obvious if it is clearly wrong, but you desperately want it to be true, right? It also relieves you of any need to think clearly and logically about anything, when you can just assert the things you want to be true simply be “obvious”, even when not only what you want isn’t obvious, but wrong.
No, by my count there are more arguments for it than against it.
This is false, but even more importantly the number of arguments for or against is not important. The strength of the arguments are what matters.
You desperately want the government to step in and impose your preferences on everyone else. You want your policy to cover contraception, but don’t want to bear the costs. Having that be covered would make your life easier. Having that be covered would make you feel better about the world. And the list goes on about why you want others to pay for the things you want and you want the government to enforce your preference by force.
The argument against: theft is wrong. Having someone steal from you is wrong. Therefore having the government steal for you is wrong.
Uhm, Ken, you do realize that asa1940 was ridiculing you, right?
Dr. J,
Uhm, Ken, you do realize that asa1940 was ridiculing you, right?
So? Steve’s question was about the legitimacy of third parties interfering in trade. asa1940 claims it’s legitimate because there is a law for it. This doesn’t answer Steve’s question, which had the wider implication of asking whether Obamacare itself is legitimate. If you ask someone if a law is legitimate and they reply “It’s obvious. It is a law.”, then you’ve just witnessed someone who is confused about logic. It’s equivalent to saying “All laws are legitimate. Since Obamacare is a law, it’s legitimate.” when someone asked you if the statement “All laws are legitimate” is a valid assertion. It’s a nice way of sidestepping the issue and purposely being obtuse because you know you have no real arguement.
I called him on this and he made a pathetic attempt at humor to deflect from the serious, and obvious, defect in his argument. Ridicule only works if you demonstrate that you are in fact correct and the other person is wrong. Ridicule is a form of taunting, which is effective if you’ve actually put forth a strong argument, but it’s a display nothing of weakness if you use it to replace an strong argument.
Hey, since we are dealing with “rights” here how about providing satin sheets, a bottle of wine and scented candles too? Remember, insurance money and tax money is nobody’s money (the above is sarcasm)
After a quick google search, I believe the reporter is Erica Bryant, some hack who writes for the Democrat & Chronicle. I tried reading a few of her articles but they were all so boring that after a few sentences, I passed out.
Ken (and, tangentially, Steven Landsburg):
At the risk of casting pearls before swine, I will try one more time.
All proofs, based on logic, begin with certain given propositions, the truth of which is known or assumed. These given propositions are then used, in accordance with the rules of logic, to prove further propositions, the truth of which was not initially apparent. In Ms. Fluke’s testimony, the Affordable Health Care Act is assumed to be true; that is the starting point.
This blog’s subject is the worthiness vel non of Ms. Fluke’s testimony concerning one small aspect of the Affordable Care Act: whether a health insurance policy issued under the Affordable Care Act should cover contraception medication. Under the regulations recently announced by the Obama administration, such coverage would be required; the Blount amendment would allow a loophole. Ms. Blount testified against the Blount amendment. Ms. Fluke did not attempt to address the issue whether the Affordable Care Act should be retained or repealed, or whether it was economic or not, or whether Jupiter is now aligned with Mars. As I pointed out here:
http://www.thebigquestions.com/2012/03/09/letter-to-a-reporter/#comment-43991
and here:
http://www.thebigquestions.com/2012/03/09/letter-to-a-reporter/#comment-44051
and here:
http://www.thebigquestions.com/2012/03/09/letter-to-a-reporter/#comment-44051
to criticize Ms. Fluke for failing to address the issue of whether a third party (the government, in this case) has a legitimate interest in “modifying” (i.e., regulating) insurance policies issued under the Affordable Care Act is like asking her to re-argue the case for universal health care. It is like asking her to debate a given proposition in a mathematical proof that is assumed to be true (at least for purposes of the proof). This is a sophomoric debating trick, frequently used (with unfortunate effectiveness, I might add) by Rush Limbaugh, Neal Boortz and other talk show hosts to mislead listeners.
So, you are right. I did not “answer Steve’s question” of “whether Obamacare itself is legitimate”. I argued that Steve’s “key question”, which kicked off this day’s blog entry, is inappropriate and a sophomoric debating trick. In the context of Ms. Fluke’s testimony, Steve’s question is, frankly, unworthy of a professor in a respected university. If you, Ken, don’t get the point, I am sorry for you. But I expect Steven Landsburg to understand my argument. I look forward to seeing his response, should he have the time.
Thanks, Matthew, for identifying Erica Bryant. Here is her article about this blog:
http://www.democratandchronicle.com/article/20120308/NEWS0215/303080067/Erica-Bryant
I am not sure why you called her a hack. I found her article well-reserached and interesting. It kept me awake, even at 11:30 p.m.
11:30 pm is early !
There is an iron law in political debate. If your opponents can misinterpret your words to their political advantage, they will maliciously do so (with glee). And this is a bipartisan law.
That is what we are seeing being done to Landsburg. Anyone who thinks that they can win this argument with logic, forget it. When Steve made the mistake of coupling his logical argument with a correction of Limbaugh’s use of the English language (a prostitute, not a slut, is the correct word for someone who engages in sex for money), rather than condemning it, he gave the jackals all the ammunition they needed.
I think there are some good logical arguments for and against Steve’s main argument. But they are irrelevant now. The jackals have won.
Tick, tick, tick … 15 minutes of fame are done.
I was almost famous once. Alas it wasn’t real – it was by Fluke.
asa1940, can your position be summarized as follows?
Affordable healthcare mandates, that you must provide money to some (semi-private-)fund that is then used to pay you X, but not Y.
Somebody thinks that Y is important for somebody’s health.
Therefore, you should be forced to provide money to a fund that is used to pay some person Y.
Fluke’s testimony was based on the assertion that if some medicine would make your life better, then it is legitimate to force others to pay you for it; the assertion is based on the fact, that the whole Affordable health-care was argued this way, therfore it’s (obviously?) a correct way to argue for forcing somebody to pay for Y; if we assume this assertion is true, then Sandra’s (and MD’s) opinion is what’s important. Steve is questioning this assertion.
Now what seems to me strange is that the student is wanting the ‘fund’ to pay for contraceptives for *all*, while the reasons provided by her are only for some very small minority of students; even within her framwork is she making an argument “you should pay 99% for ‘sex’ so that you won’t skip the 0.1% who wouldn’t be accidentally covered’? BTW: I am from europe and looking into some medical e-shop I am actually surprised you could buy contraceptives in $3000 a year tag. Local prices are generally 20$ a month here…??
I think many commenters have a point. I would summarize it quite differently:
The government has mandated that students in private universities must provide affordable dormitory as a part of a student plan; the universities do, however they have criteria that basically exclude local students (who are a majority on this school) from the plan (each university have different criteria). As you know, housing can cost $5000 a year; I’ll give you horrible examples of people, who probably shouldn’t be excluded from the “affordable dormitory” plan (end up living under the bridge, in a prostitute area, being infected accidentaly HIV…). Therefore, I think, the universities should be mandated to include housing for all students.
The problem is that she is really making a statement “take money from X and give it to Y for reason Z”; where “reason Z” by itself would be totally insufficient to persuade anybody; however the government is already having some laws that do precisely that. Therefore, ‘obviously’, she doesn’t need to find other arguments…
I never quite bought into ‘we should make this law because it is consistent with the other bad laws out there’, but that’s basically what all these people out there are doing.
“I am not sure why you called [Erica Bryant]a hack. I found her article (http://www.democratandchronicle.com/article/20120308/NEWS0215/303080067/Erica-Bryant) well-reserached and interesting.”
@asa1940,
Thanks for the link, otherwise I probably wouldn’t have bothered to find the article and read it. You must not have done any research of your own to know if Byrant’s research was done well. She did not report it to the readers in a way that one can make that conclusion since she obviously distorted her findings.
Here are the comments I posted in response to her article:
“Ms. Bryant wrote, “I am no Ph.D., but I listened to Fluke’s 10-minute speech, and I think that a fourth-grader who summarized it like Landsburg did would flunk. … In fact, the bulk of her testimony focused on barriers that exist for women who need contraceptive drugs for conditions not related to preventing pregnancy.”
Ms. Bryant, I believe you are purposefully distorting Fluke’s testimony in order to tear down Mr. Landsburg. By my count, Fluke, a past-president and current member of Georgetown Law Students for Reproductive Justice, spent 564 words clearly advocating for contraceptive coverage. She spent only 91 more words citing barriers for women who need the same drugs for non-contraceptive needs. Plus she spent another 409 words speaking generically against the Blunt amendment and for the need for “insurance coverage choice.” Therefore, it is an irrefutable fact that she did NOT spend the bulk of her testimony on barriers as you asserted.
In my opinion, Mr. Landsburg’s summary — “All she said, in effect, was that she and others want contraception and they don’t want to pay for it.” — was absolutely accurate. You don’t have to be a PhD but perhaps more intelligent than a 4th grader to realize that Fluke’s testimony was intended to get “free” contraception. To argue otherwise, as you tried to do, is disingenuous and an insult to the intelligence of your readers.
I should also add that your first 5 paragraphs were filled with childish insults almost on the same level that you condemned of Limbaugh and Landsburg. You characterized Landsburg & his writings as: “whining,” “online ramblings,” “creepy-professor,” and “[like a] fourth-grader.”
That your opinion article is listed on the left side of the web page as “FILED UNDER – News” is astounding. Not only did your article “flunk,” so does this “news”-paper.”
Will A,
I agree with all of that. It seems that now we’ve gone quite far in the other direction. To me, none of the cases you mentioned come even close to the justifying the kind of abuse Fluke got.
When I think of the types of arguments that might justify even a little bit of harshness in response, the types of arguments that come to mind first are things like deliberate dishonesty, using your power to dominate the conversation, deliberately incendiary statements, disrespect to others…
Fluke did none of these things. While we might have less respect for her, it is outrageous to conclude that she has forfeited her right to decent treatment.
Joe: Fluke was at a fake hearing in which she was not under oath and was not cross-examined. The ability to get a fake hearing broadcast on television as if it was a real one implies a certain amount of power (political power in this case)–enough that I’d call it “enough power to dominate the conversation”. She was able to make it entirely one-sided! How much more can you dominate?
Ken Arromdee,
She was speaking in opposition to people who called congressional hearings. The balance of power tilts heavily the other way.
In most circumstances I give people the benefit of the doubt and assume that they believe their arguments. In this case, I will give you the benefit of the doubt and assume that you don’t.
If you do believe it, I just have nothing else for you.
” To me, none of the cases you mentioned come even close to the justifying the kind of abuse Fluke got. ”
Nothing justifies the abuse Fluke got from Limbaugh. She did not that stuff from Landsburg. Don’t demand he apologize for Limbaugh.
@Will A: A minor correction. To ‘pull a Ken B’ on your faith post would be to make a snide remark about turning people away from faith would be a feature not a bug. Otherwise, well said.
“She was speaking in opposition to people who called congressional hearings. The balance of power tilts heavily the other way.”
Interesting. Because she was called, on behalf of the status quo, by the majority party, prepped by the majority party, protected from cross examination by rules controlled by the majority party, and the majority party won that vote. You might want to tone down that ‘heavily’.
If you haven’t read the article by Erica Bryant, I recommend you do. One can’t fully comprehend what the forces of science are up against until you read what this foot soldier of the opposition has written. If Bryant were to tell the story, nothing that Landsburg wrote has any merit, Fluke is a poor defenseless altruist crusading for women’s liberation, and the fact that there is at least one economist (candidate) who disagrees with Landsburg completely discredits him. All of Bryant’s “news” articles contain implicit approvals of all things social engineering.
It is a shame, but one must admit that logic and empiricism fail in the face of emotional appeals and pandering in this society.
George Thomas: In criticizing Erica Bryant’s article, you said “it is an irrefutable fact that she did NOT spend the bulk of her testimony on barriers” that exist for women who need contraceptive drugs for conditions not related to preventing pregnancy.
In support of your “irrefutable fact”, you cite your count of words in three categories, allocating 91 words to the category of the barriers in question.
I hate to stoop to your level of counting words, but when your “irrefutable fact” is so easy to refute, I could’t resist.
In her testimony, Ms. Fluke initially gave her background and said show was going to talk about “financial, emotional, and medical burdens” to women when contraception is excluded from insurance coverage (298 words). She then talked about financial burdens of buying contraception without stating a purpose for the contraception (274 words). Then she talked about medical burdens, when contraceptive drugs are needed for non-contraceptive purposes – to treat, for example, polycystic ovarian syndrome and endometriosis (646 words). Next she covered emotional burdens – the message that women’s reproductive health isn’t a priority (129 words). Finally, she addressed whether is is fair to dismiss these concerns because Georgetown women students voluntarily assumed the risk of these burdens by attending a Catholic school (298).
Thus, over twice as much testimony was devoted to barriers to contraceptive drugs used for medical purposes than was devoted to any other subject, and less than 17% was devoted to the financial burden of using contraception for which the purpose was unspecified. From the outline of her testimony above, I think its fair to say that the bulk of her testimony was spent on barriers that exist for women who need contraceptive drugs for conditions not related to preventing pregnancy.
More to the point, Steven Landsburg’s summary — “All she said, in effect, was that she and others want contraception and they don’t want to pay for it.” — was absolutely inaccurate. After all, Prof. Landsburg said “All (i.e., 100%) she said”, and clearly “All she said” covered a lot more than “she and others want contraception and they don’t want to pay for it”.
But beyond that, Ms. Fluke never said she and her fellow students don’t want to pay for contraception. In fact, she and her fellow students pay for their insurance, which the university mandates they have absent a waiver. As she testified, it is not subsidized by the university. Ms. Fluke is clearly arguing against the Blount amendment so that the Affordable Care Act would require the university to forgo its supposedly moral objection to providing contraception under the student health insurance. It is not clear whether the cost of the insurance would go up if contraception is included, since the insurance already covers pregnancy and child birth, even for single women. (You would think the Catholic church would have a moral objection to condoning out-of-wedlock pregnancy.) But, if the cost did go up, the cost would be borne also by the male students so that the cost would be shared 50-50 between the females and the males. Seems fair to me.
Thus, Prof. Landsburg is dead wrong in his summary. Beyond that, he ridiculed the testimony of Ms. Fluke (which he didn’t seem to understand) in despicable terms. I don’t think Erica Bryant could “tear down” Prof. Landsburg. He did it to himself.
Someday far in the future an encyclopedia will summarze this debate. Making predictions the 23rd century is an iffy business but here’s mine:
And his critics said unto him,
‘Steven E Landsburg, do you renounce the Limbaugh and all his works?’
I give the future encyclopedist credit for getting it exactly right.
Previous post, 4th paragraph, 1st line, read “she” instead of “show”. Sorry.
There are none so convinced as though will not read, but I’ll make a last stab.
Asa1940 writes (my emphasis): “Beyond that, he ridiculed the testimony of Ms. Fluke (which he didn’t seem to understand) in despicable terms.”
I am trying to find those terms. I limit my search to terms Steve actually used. I have found possible candidates: ‘extortionist with an overweening sense of entitlement’ and ‘law student’ seem on the surface the most offensive, and were the only ones he used in the first post. ‘Despicable’ seems too stong a word here, especially for the first. But perhaps asa1490 knows law students better than I do.
Now LIMBAUGH used some vile terms, but SL rejected those. It would be unfair of me to assume asa1490 meant THOSE terms. That would make asa1490 risible.
Just when I thought I was out, Neil at 12:48am dragged me back in with:
There is an iron law in political debate. If your opponents can misinterpret your words to their political advantage, they will maliciously do so (with glee). And this is a bipartisan law.
That is what we are seeing being done to Landsburg. Anyone who thinks that they can win this argument with logic, forget it. When Steve made the mistake of coupling his logical argument with a correction of Limbaugh’s use of the English language (a prostitute, not a slut, is the correct word for someone who engages in sex for money), rather than condemning it, he gave the jackals all the ammunition they needed.
OK Neil I told Steve Landsburg in person once that his _Armchair Economist_ was one of the biggest influences on me as an economist and writer (in this vein). All right, so I’m not a “jackal” out to get Steve. Please take a minute to consider what I am saying here, because if I’m right then you will be relieved to learn that the world isn’t as awful as you currently think.
Rush Limbaugh *on the air and in real-time* corrected his use of the term “slut.” (Or maybe Bo Snerdley, his off-air producer, did; I don’t remember.) Rush realized Fluke’s position didn’t make her a slut, so he updated it to “prostitute.”
Now suppose that Rush had had just one more eureka moment. Suppose he added the following sentence to the progression: “What’s that, Snerdly? You say this Fluke gal probably would have sex either way, since she goes to Georgetown after all and probably spends $10 a day on lattes at Starbucks? You’re right, Snerdly. She’s not a prostitute. She’s an…extortionist, I guess. I know! She’s a contraceptive sponge! Ha ha, brilliant, thanks HR.”
So Neil, Ken B., et al., do you want to tell me if Rush had added the above commentary, then there would have been no furor?
Of course there would have been furor; the “contraceptive sponge” would have made things worse, not better, for Rush.
One last thing: There seems to be outrage among Landsburg’s partisans on the issue of using the term in a derogatory fashion, versus choosing correct terminology tailored to Fluke’s testimony. But that is exactly what Limbaugh was doing. Limbaugh wasn’t calling Fluke that word as a generic insult, the way Dan Akroyd in that famous sketch said, “Jane you ignorant slut.” No, Rush was saying that the logic of Fluke’s position implied that she was a slut. Then, Rush corrected himself and realized the term didn’t fit, and switched it to prostitute.
Again–Rush did exactly what Landsburg said was the appropriate thing to do. The only “mistake” Rush made was in settling on “prostitute” as the right way to label Fluke, given her testimony and the worldview it implied, rather than amending it once again to “contraceptive sponge.”
Oops. I confused 1490 and 1940 in Asa’s name. I apologize. I associate 1940 with the defense of freedom, and 1490 with the Inquisition. I guess that explains the slip.
Ken B – You are correct that SL rejected one of Rush Limbaugh’s vile terms, i.e., “slut”, although not because it was vile. Furthermore, I apologize for lack of clarity: when I said “despicable terms”, I wasn’t focusing on single word choices, but the overall tone of SL’s attack on Ms. Fluke’s testimony.
I thought it was despicable, for example, for SL to be envious of Rush Limbaugh’s “spot-on” analogy concerning sex videos, even if he did try and weasel around Limbaugh’s vileness by being 99% sure about what Limbaugh was actually advocating for. Further, I thought putting Ms. Fluke in the category of “contraceptive sponges” was pretty despicable. And finally, I think the way SL has misstated and mischaracterized Ms. Fluke’s testimony, the details of which I have tried to bring to light here, is pretty despicable. That’s just the way I see it.
Apology about 1490 accepted. 1940 is my birth year, if that helps you distinguish the two numbers.
@Bob Murphy
First a correction. RL corrected his term ON AIR to ’round heels’. So its clear he never, as you try to suggest, disavowed the sexual smears. Let me stipualte (again) I condemn and contemn RL.
I left a comment on your blog and repeated it here with an imagined erwite of SL’s first post, so I won’t do it again. Those interested can find it. I made the point that had Steve inserted a ringing denunciation of Limbaugh and the words just before he dismissed the terms ‘slut’ etc that we would not be having this conversation. We would not.
Now some, you among them, want to argue that Steve somehow endorsed the terms. The only argument you present though is the lack of said ringing denunciation. So let’s review the bidding shall we? WITH denunciation, no problem. WITHOUT denunciation, attacks, accusations. What is the goal of the attacks, the demands? It is not to refute his logic. Grant ad arguendo Steve called Fluke a ‘big smelly slut’. Would that affect the correctness of any of his arguments, the soundness of any of his syllogisms? I give you credit for the answer NO. (Joe, you get no such credit).
So what are the attacks for? I’ll tell you my answer. To drum him out of the conversation as unfit. Top provide a pretext to ignore him. To extract a pound of flesh from an adversary.
This worries when the only evidence you have is Steve’s obdurate refusal to genuflect. All you have is that he didn’t denounce RL loudly enough for your comfort, to ally your doubts. This kind of thing gets us full square into ‘loyalty oaths’: prove you’re fit to debate. It is the mindset that leads to walls of students in classrooms cordoning off the unworthy.
I want to ask you Bob why you didn’t denounce anti-semitic smears against Landsburg before you posted this comment? I think ‘kike’ is never appropriate, don’t you think that? Need I say: “Do you see what I did here?”
You said you don’t actually KNOW if Steve disapproves of ‘slut’ as a pejorative. Neither do I! (I have a guess.) What I object to is your demand he clear that up, absent any use of the term himself. Come to think of it, I don’t know that you think ‘incestuous twat’ is an inappropriate term for his critics to call Landsburg. (Do you see what I did again there?)
I hope Steve thinks as I do about ‘slut’. But I won’t demand he prove it to me until he actually uses the term. I object to the fascist mentality that demands of Steve a genuflection. To me that is the key point. It’s the entire reason I am in this fight. That is why I made this mordant joke:
And his critics said unto him,
‘Steven E Landsburg, do you renounce the Limbaugh and all his works?’
@asa1940:
“You are correct that SL rejected one of Rush Limbaugh’s vile terms, i.e., “slut”, although not because it was vile.” Right. He expressed no opinion on whether it’s a vile word. You demand he do so. You say he is using despicable terms based on terms he has used but on his refusal to decry ones he has not. Like I did for illustrative purposes with Murphy and ‘kike’.
Ken B: SL’s logic is impeccable. The problem, in my view, is that he starts with false premises. I have tried to articulate those false premises in my posts.
Neil:
Speaking as someone who is 1/4 jackal I find this deeply offensive. Murphy not only quoted this this despicable screed he ostentatiously repeated the slur without the slightest hint if disapporoval.
asa1940:”Ken B: SL’s logic is impeccable. ”
Which further strengthens my claim that the furor is just an attempt to shut him down. You could tackle his premises with fussing about ‘despicable’ terms.
Ken B: I am not demanding that SL express any opinion as to whether “slut” is vile or not. I don’t care whether he decries the use of any word.
I think Steven Landburg’s actions are despicable for asserting that Ms. Fluke’s position “deserves only to be ridiculed, mocked and jeered”. This assertion is particularly troubling because SL continually states Ms. Fluke’s position falsely.
Steven Landsburg assertions in this matter are further troubling because he is a university professor who has enjoyed, for all I can tell, considerable success in convincing students he has something worthwhile to say. Maybe he does on other matters. Indeed, I can only hope that his assertions in this matter are not a sample of the intellectual rigor he brings to other matters.
I want to return to Bob Murphy again. (I’m a glutton for his punishment).
“do you want to tell me if Rush had added the above commentary, then there would have been no furor?”
No I don’t. First, as I noted, a disclaimer would not be credible for RL, since he also used the slurs with gleeful abandon. A disclaimer would be pointless. Steve did not use the slurs AT ALL. A disclaimer should not be needed. This is a key point your example misses. Steve didn’t call her a slut and Limbaugh did. You cannot change that and expect to get a sensible result.
Let’s vary things one at a time, looking at the partial derivatives as it were (although I know math is hard for you Austrians).
Consider point (R,L):
First RL with slurs, no disclaimer. RL’s a turd.
Second RL with slurs, disclaimer. No credibility, RL’s a turd.
Conclusion: no-one cares about the disclaimer. RL’s a turd.
Consider point (S,L)
First SL no slurs, no disclaimer. Some want SL’s hide.
Second SL no slurs, disclaimer. None want SL’s hide. (OK, a few, the usual suspects.)
Conclusion: a disclaimer is all some people care about.
Which was my point I believe.
Ken B You have a point. I will drop further “despicable” allegations because it detracts from the points I am trying to make.
I am not trying to shut SL down. At
http://www.thebigquestions.com/2012/03/09/letter-to-a-reporter/#comment-44324
I invited SL to respond to my criticisms of his position, should he have the time.
Fer cryin’ out, again:
The key question is: Do third parties (e.g. the government) have any legitimate reason to want to modify or overturn those compromises? Most economists will say: Perhaps, if the compromise affects third parties; no otherwise…. The mere fact that one side is dissatisfied with the compromise does not count as a reason to overturn it.
Minimum wage laws. Mandatory maternal leave. Workers’ compensation. We understand that the state will intervene to unsettle privately negotiated contracts all the time solely for the reason that one side didn’t get the deal we think they should have gotten. (For that matter, you might want to ask a nearby lawyer or law student whether courts, in the role of the state, really never interfere in contracts in order to rewrite the terms of a bargain.)
I maintain the best explanation for this blog involves the phrase “bizarrely elaborate intellectual hoax.” Real academics simply don’t get this soft-headed.
Bob Murphy
The jackals I refer to are not the people posting on this forum. They are the types that mischaracterize Landsburg’s comments for their political agenda, including the intimidation of Steve Landsburg and the disruption of his work.
PS I do not listen to Limbaugh, so I do not know what he said or didn’t say–only what he reportedly said, and I thought Steve corrected his definition.
The contraceptive sponge was a joke, and not even one that Landsburg thought up.
And what does anything Landsburg says on the freewheeling internet have to do with his job? If he called one of his students a contraceptive sponge in class, or out, I might understand the uproar.
Pat:
Minimum wage laws. Mandatory maternal leave. Workers’ compensation. We understand that the state will intervene to unsettle privately negotiated contracts all the time solely for the reason that one side didn’t get the deal we think they should have gotten. (For that matter, you might want to ask a nearby lawyer or law student whether courts, in the role of the state, really never interfere in contracts in order to rewrite the terms of a bargain.)
Are you suggesting that because these things exist, we shouldn’t question them?
asa1940,
I cited that Fluke said 91 *more* words than 564 talking about the need for contraceptive coverage, not just 91 words.
Fluke started off introducing herself as a reproductive justice activist and goes on for over 560 words about the need for contraception and contraception coverage. Of course, no one should think that all that time she was talking about the needs for contraceptive coverage for reproductive justice. That’s just silly. Of course, we should think it was about unspecified reasons. And it took 560+ for her to mention “barriers” in order for me to understand it the “correct” way. Silly me.
In my first post, since I was commenting on Bryant’s point about barriers being the bulk and not unspecified or other topics and Fluke had spent ~650 out of a total of ~1600. By my math, that isn’t fair to call “bulk” given that she spent the rest of testimony advocating for contraceptive coverage as a member of a group for “reproductive justice.” And, bulk means to me the majority and 40% is less than the majority, ie. 51%.
In any case, all the reasons cited by Fluke are in support of her agenda as a reproductive justice activist and no one but a fool should think differently.
And, BTW, you should know that I used Microsoft Word to count the words so you really haven’t “stooped” to my level after all. I’m sure you’re happy about that.
I think there’s an issue missing here, which is that insurance is called insurance because it guards against risk. It is useless against near-term certainty, which is why car insurance doesn’t cover the cost of license plates, since there’s a 100% certainty that all insured cars will have to purchase plates or tags every year. There’s no point in having a middle man marking up the costs of something that everyone is going to have to buy anyway, in return for no increased convenience or other benefit.
Given what the public has learned about the women of Georgetown Law, the same argument would apply. Georgetown could certainly negotiate with its insurance provider to include the costs of contraception for all its female students, and that cost would be passed directly on to those students, plus overhead. What would be the point? Sandra Fluke and the other girls of Georgetown Law would have to shell out more money for contraception, but they’d write a different name on the check.
As for the mandates in Obama Care, specifically the requirement to engage in a private transaction with a third party because of one’s mere existance, suppose Congress passed the Free Labor Act aimed at helping all people, but especially people of color, find jobs? The act would, like Obama Care, rely on the Interstate Commerce Clause for Constitutional support, and it would require all people of color not otherwise employed to provide agricultural labor to private farmers in return for health coverage, clothing, meals and housing, until such time as Congress decides to abolish or amend the act. Since agricultural products such as tobacco and cotton are a large part of interstate commerce, profoundly affecting both the US economy and government revenues, Congress is within its authority to require such an employment transaction between private parties, and Obama Care establishes the Constitutional precedent for it.
George Turner, you are correct about the nature of insurance, at least in a “classical” (for lack of a better word) sense. Unfortunately, through the incentives provided for by a number of government actions, insurance now functions as a pre-payment plan in lieu of wages. Your identification of this proposal as a zero-sum game is also essentially correct. The women of Georgetown University will be impacted in their premiums, but as Landsburg and others have pointed out, the costs will be shared among non-users as well. So one benefit of such a proposal is subsidized cost birth control for it’s users.
My take on this, especially after watching Fluke’s testimony is that she is concerned about the issue in an odd manner. I really can’t pin it down, but it is akin to the aristocracy of old’s opposition to dirtying their hands by trade. She talks about embarrassment at the counter, and her implication that women should not be sullied by the economics of the issue.
FWIW, Krugman has now basically jumped in and called Landsburg unreasonable in his (Krugman’s) latest blog post…not that that means anything of course, but this dust-up has now been in the Wall Street Journal and New York Times. I think this is important because the mainstream media were not discussing the relevant issues in my opinion, but now with mainstream media linking to this blog, if I were landsburg I figure I would be happy with that outcome.
Josh:
Krugman has now basically jumped in and called Landsburg unreasonable in his (Krugman’s) latest blog
Note, however, that he a) lied about what I said (calling it a defense of Rush’s “slut attack”), b) didn’t bother to mention what I did say, thereby missing a chance to teach an economics lesson (whether or not he agreed with it) and c) didn’t link to my blog, to make it difficult for his readers to see what a lying bastard he is.
(Having said that, I very much hope this thread does not now devolve into Krugman-bashing. Let’s try sticking to something interesting.)
Steve, you’re way over this reporter’s head.
Don’t expect anyone with a journalism degree to understand the difference between elasticity and electricity. They hardly understand that 2 + 2 = 4.
Steve, let’s stipulate that Krugman a) lied about what you said and b) didn’t bother to mention what you did say. This makes him a “lying bastard,” to use your words.
As asa1940 has patiently and repeatedly pointed out, you have a) lied about what Fluke said and b) didn’t bother to mention what Fluke did say.
What does that make you?
In your original post on this topic, you said we had “Rush[ed] to Judgment” of Limbaugh, and that we Limbaugh critics were being “dense and humorless.” This, after Limbaugh had slandered Fluke in vile terms. It’s amusing now to see all the legalistic parsing in your defense.
Incidentally, the article is out.
http://www.campustimes.org/2012/03/08/landsburg-on-limbaugh-incites-dialogue-at-ur/
Ollie – Thank you. I’m glad somebody gets it.
May I continue your analogy? Prof. Landsburg also c) didn’t link to Ms. Fluke’s testimony, making it difficult for his readers to see how he lied about it.
I also find (grim) humor in all the legalistic parsing now going on…
asa1940: Prof. Landsburg also c) didn’t link to Ms. Fluke’s testimony
For the record, I most certainly did link to it. But once again I’m going to ask people to try to stay focused on policy issues.
Ollie: He didn’t lie, he paraphrased what she said. Krugman, the Campus Times, Joel Seligman, et al. claim that he said something which he did not. They claim he agreed or approved of Limbaugh calling her a ‘slut.’ A cursory reading of the original post proves that is not the case.
Prof. Landsburg isn’t against women having sex or using birth control. He’s against them making poor arguments, especially in front of congress in an attempt to gain personal benefits at the expense of someone else. If anyone actually bothered to read the post, they might learn that.
asa1940: Yes, he did link to it. Check the first post
@Bob Murphy, since he’s the only cogent ‘jackal’ here.
Can you frame an argument that Steve used ‘slut’ (or any other such term) as a smear, or indicated approval of such a use, *without* relying in an essential way on his failure (or refusal) to denounce RL?
If the answer is NO, as I believe, then all you have left that I can see is an argument based on MENTION and USE. I don’t believe you will confuse them so all I can see for you is this: some terms are so inflammatory that MENTION becomes USE.
Now I grant you thatis a coherent position. I think it wrong, and deeply unfair. However judgemtns about fairness can be hard to argue logically. If that really is your position I hope you are willing to accept the consequences, because I think that would be corrosive of rational debate.
In any event that is still a demand for genuflection. Before you blame SL or anyone you might consider their refusal to genuflect to be a principled rejection of the deamnd. Quakers will not swear an oath to refrain from child molesting.
[Bob, I don’t really think you are a jackal. I respond to you at length as you are the only ‘jackal’ here trying to articulate a sound argument.]
@Steven
You have effectively lost in your battle to make these threads about the policy issues. The only way to get back there, I’d think, would be to block every comment unrelated to the policy issues (which appears to mean blocking most of them).
I think this should have been an anticipated problem. I do not know if this was your intention or not, but by such inflammatory as a hook for your article, you were bound to make it about the terms, not the issues, unless you began taking strict control over what was allowed on the board and what wasn’t. American political discussions, unfortunately, tend towards avoiding issues through focusing on side issues, such as whether or not you called Sandra Fluke a slut.
“Prof. Landsburg isn’t against women having sex or using birth control. He’s against them making poor arguments, especially in front of congress in an attempt to gain personal benefits at the expense of someone else. If anyone actually bothered to read the post, they might learn that.”
Count me in the asf1940 and Ollie camp that finds grim humor is the legalistic parsing now going on. Limbaugh went way overboard for three days, but we’re told not to “Rush to Judgement.” Landsburg tepidly distanced himself from calling Fluke a ‘slut,’ entertained ‘prostitute,’ and finally arrived at ‘extrotionist’ and/or ‘pick pocket.’ All the while, Landsburg defended Limbaugh’s analogy as “spot on,” specifically meaning that it’s perfectly reasonable to demand Ms. Fluke post sex videos so that Limbaugh and Landsburg can be compensated. Dr. patient confidentiality, and a whole host of other things are subservient to Limbaugh’s creepy online video needs. (I’m really not clear how Landsburg and Limbaugh are paying for Georgetown University student insurance — I am assuming there is a tax dollar in the background somewhere).
Meanwhile, as asf1940 has aptly pointed out, the whole context of Fluke’s testimony was completely distorted. The law is at least temporarily settled, and for now it is the law. In that law there are mandates for what is required. The Church objected to one of them on moral grounds, not economic ones. If it had been an econmic argument, it’s not unreasonable to assume someone else would have testified.
The whole tone of Landsburg’s post was hostile toward women. It was intended to be shocking. That’s Landsburg’s schtick. Don’t know how Landsburg can cry victim on this because people he intended to shock acted like people who were shocked. All of it, ironically, taking place in the private sector, that place so well known for it’s efficiency and creative destruction. The president of a private university spoke out under university letterhead and said basically that Landsburg is hurting the brand. Landsburg is lucky he has tenure (presumbably but I don’t really know), or at least comes from a culture sensitive to the needs of academic freedom, because he would be out of just about any private firm for blogging like he did. That’s what happens in the private sector. Not quite the free panacea that tends to be portrayed in these parts.
Krugman was kind to link the newspaper article and not to the blog. Landsburg comes off better in the newspaper.
Twofer:”Count me in the asf1940 and Ollie camp that finds grim humor is the legalistic parsing now going on. ”
If you insist. But then I must count you in the camp that prefers imputations to citations. Fot that is what the ‘legalistic parsing’ is: showing that SL did not say what certain posters say he said.
Some of us call this fairness and accuracy.
“The law is at least temporarily settled, and for now it is the law.”
If this is your argument then it’s no wonder you’d prefer to yell ‘slut’ in a crowded blog.
“If you insist. But then I must count you in the camp that prefers imputations to citations. Fot that is what the ‘legalistic parsing’ is: showing that SL did not say what certain posters say he said.
Some of us call this fairness and accuracy.”
If you mean that you will count me in the group of people that try to take in all the cues in a conversation, I’m good with that. When my wife says to me: “you can go if you want to,” I’m smart enough to know that means “don’t go.”
““The law is at least temporarily settled, and for now it is the law.”
If this is your argument then it’s no wonder you’d prefer to yell ’slut’ in a crowded blog.”
No clue what you are talking about.
Vald – for me, Steve’s language is offensive irrespective of the “slut” issue.
Ms. Fluke testified about some reasons why women want health insurance to cover contraception, but she did not testify to any justification for this coverage in classical economic terms. For this, Steve, a college professor of economics, says her position “deserves only to be ridiculed, mocked and jeered.” Maybe in his economics class, but not in the forum where Ms. Fluke was testifying.
@asa1940
You think his comments would have been more acceptable in a classroom? If he had done this in a classroom, then I WOULD be calling on the university to revoke his tenure. I agree that his response was inappropriate, but at least in a public forum it is unfortunately to be expected.
Asa1940: “Ms. Fluke testified about some reasons why women want health insurance to cover contraception, but she did not testify to any justification for this coverage in classical economic terms”
Her testimony was not merely about “wanting” insurance companies to cover contraception. She wants to force them or someone to provide contraception, which is certainly an economics issue. So, she probably should have given justification for this in economics terms.
@Pat
Minimum wage laws. Mandatory maternal leave. Workers’ compensation. We understand that the state will intervene to unsettle privately negotiated contracts all the time solely for the reason that one side didn’t get the deal we think they should have gotten. (For that matter, you might want to ask a nearby lawyer or law student whether courts, in the role of the state, really never interfere in contracts in order to rewrite the terms of a bargain.)
All this paragraph establishes is that government has the power to meddle in our affairs. It doesn’t grant that this power is being used appropriately. This whole thread isn’t about whether government has the power to mandate free contraceptives or not. It’s whether they should.
These examples are not strictly beneficial. In particular, the minimum wage laws (and the corresponding “living wage” laws) probably contribute significantly to unemployment in the US particularly among urban minorities and those with a criminal record. These rules often create conflicts of interest between classes of people and provide a means for the politically influential to undermine or warp a contract after the fact.
Josh:
You have the “force” thing backwards. Georgetown forces its students to buy medical insurance, as the Affordable Care Act would do for the population in general. Georgetown does not subsidize the insurance, the students bear the full cost. Ms. Fluke testified that 94% of the students oppose Georgetown’s refusal to include contraception in the insurance they are forced to buy, but Georgetown is not listening. Therefore, Ms. Fluke welcomes the Affordable Care Act requirement to require contraception coverage. That to me is a compelling argument, and economics has nothing to do with it.
I cannot understand why you and Steve Landsburg insist that a third-year law student provide an economics justification when her stated purpose is only to identify some hardships female Georgetown students have encountered because of Georgetown’s policy.
Steve Landsburg has a point when he wants to apply some economic scrutiny to the contraception coverage requirement when applied to the nation as a whole. Fine. He can make his points in his blog or he can go to Washington and testify. But to pick on Ms. Fluke, as he and Rush Limbaugh did, is, in my view, contemptible.
@Josh – “She wants to force them or someone to provide contraception, which is certainly an economics issue. So, she probably should have given justification for this in economics terms.”
Josh, The Church opposed on moral grounds, not econmic ones. This is important. But, here is a link which contains links to a number of studies that show the economic value of the pill to taxpayers.
http://economix.blogs.nytimes.com/2012/03/06/the-economic-impact-of-the-pill/#
Are you convinced now? If not, why not?
Josh:
I am giving Steve credit that he would not openly ridicule, mock or jeer a student in his classroom. My point was that his insistence on an economic justification for nation-wide contraception coverage would be appropriately in his purview in his classroom.
I meant to address my post at 5:11 to Vald (re 3:39 post), not Josh. Sorry.
Steve, in your books you’ve said several times that many arguments and proofs in economics depend on assuming that willingness to pay and willingness to accept are approximately equal. So if the willingness to pay is much less than the willingness to accept, which would presumably be the case if you couldn’t afford birth control, would this be a case of market failure and thus justify government action to make the two roughly equal, e.g. by subsidies?
“I suspect we’re all getting bored of talking about Sandra Fluke, contraception policy, alternative solutions, and the reaction thereto…”
This thread shows that Landsburg is wrong again! Where’s Krugman? 116 posts and counting. Obviously, we are not bored with this issue.
@Keshav
I think Sandra Fluke makes a very, very poor test case for deciding on people’s willingness to pay, since the average graduate of Georgetown Law makes $160,000 their first year out of school. Asking people who are struggling through very tough economic times to subsidize the indulgences of rich, pampered elites is politically a non-starter, which is why some are arguing that if Obama Care was in trouble before, her testimony might’ve killed it dead in the public arena if the media debate shifts just a little bit.
In cruder economic terms (emphasis on crude), what she seems to be railing against is the tragedy of the commons. The sage advice to young women for millenia has been “Don’t be the commons.” Given that we can’t change behavior overnight, the possible solutions to the situation at Georgetown are the same that would apply in other cases, from government subsidies (Sandra’s demand) to regulations on usage, perhaps in the form of chastity belts with keys kept by Jesuits in a locked vault in the basement of HHS, along with an array of private measures ranging from Hoya Saxa tip jars to studying more and partying less.
A more innovative solution would be to apply a tax or user fee to all the Sandra Fluke jokes circulating on the Internet, which could not only cover the costs of contraception but also cosmetic surgery, heart transplants, and chemotherapy.
Keshav: Given a substantial gap between WTP and WTA, you do have to be a lot more careful about what criteria you’re employing. But it seems to me that the onus is still on the proponents of govt action to actually TELL US what criterion they’re employing and why they think it applies.
That’s the theoretical point. The practical point is that for small expenses, WTP and WTA are provably very close.
Ken B,
“…she was called, on behalf of the status quo, by the majority party…”
um…no
As I told Ken Arromdee, if you do believe it, I just have nothing else for you.
@Joe: promises promises.
More seriously as usual you seem to just look for pretexts to dismiss people without argument rather than arguing. If ‘um…no’ then what is wrong in the part you quoted?
Fluke was talking to senators. The dems are the majority in the senate.The dems are indeed a party. She was arguing against a change, that is for the status quo. Anyone who testifies is called, via subpoena or invitation. You can’t just waltz in off the street and testify because you want to. And Fluke is indeed a she. So what’s the error?
Ken B:
So what’s the error?
I believe that her “testimony” was not, in fact, official testimony.
Ken B.
Maybe the Wikipedia entry on Fluke can help.
“Speaking before the House Democratic Steering and Policy Committee in a hearing that was not televised…”
@Steve: That may indeed be Joe’s point, but he objected to
““…she was called, on behalf of the status quo, by the majority party…” ”
which is ‘testimony’-free. Indeed the entire comment from which this is excerpted does not mention ‘testimony’. I still do not see where I misstated anything here.
@Joe:
I did miss that. That means several things.
1. my snarky response was in error. Senate not House Dem Steering committee. Silly error on my part.
2. In fact though the error bolsters my original contention that the dems were in the majority at that hearing. Dem controlled forum. Silly error on your part.
3. My original observation seems to fit ‘um yes’ not ‘um no’
Ken B,
I’m just going to point out that your number 2 applies to everyone who speaks at the CPAC, the Republican Convention, or almost any political event.
Let’s just let this one go.
@Ken B
Your response still merits an “umm no”
Sandra Fluke testified before the House Democratic Steering and Policy Committee only as a means to get her testimony into the Congressional record. Her original intent was to testify before the House Committee on Oversight and Government Reform, a forum where the Democrats were in the vast minority. While the steering committee was technically a democratic majority, there really wasn’t any questioning and it was simply a means of getting her statements into the Congressional Record. The whole reason she was there in the first place, and not before a more significant committee was because the Republicans would not hear her testimony.
@Vald:
So what you’re saying is she was called, on behalf of the status quo, by the majority party, but that it’s wrong to point that out because she wanted more.
I took ‘um no’ to be disputing the accuracy of what I said. Apparently all it disputes is the how congenial you find the observation.
@Joe: Of course it does. That’s my point. Fluke was in a rigged, friendly forum. She was not Daniel in the lion’s den.
I’m sorry, I mistyped. The House Committee on Oversight and Government Reform is a Republican majority, as are all committees in the House of Representatives (23-17)
The Democratic Steering Committee is a means of entering the Congressional Record, it has no authority over anything.
Ken B.
Hey look! We can agree! I will stipulate that Fluke was not Daniel in the lion’s den.
Cheers!
You have the “force” thing backwards. Georgetown forces its students to buy medical insurance, as the Affordable Care Act would do for the population in general. Georgetown does not subsidize the insurance, the students bear the full cost. Ms. Fluke testified that 94% of the students oppose Georgetown’s refusal to include contraception in the insurance they are forced to buy, but Georgetown is not listening. Therefore, Ms. Fluke welcomes the Affordable Care Act requirement to require contraception coverage. That to me is a compelling argument, and economics has nothing to do with it.
There’s a simple solution here. Go to some other school that doesn’t have this condition or buy the contraceptive drugs yourself. No one has explained why US Congress should have any interest in this situation.
asa1940:
“I cannot understand why you and Steve Landsburg insist that a third-year law student provide an economics justification when her stated purpose is only to identify some hardships female Georgetown students have encountered because of Georgetown’s policy.”
Let me try. Fluke’s purpose was not just to identify supposed hardships. She also has specific desiderata about how those should be addressed. Fluke is asking that we restrict the choices people be allowed to make. If insurance MUST pay for viagara then my options for buying insurance are reduced. This is true if I am Fluke, Georgetown University, or me. She is asking that we deprive people of choices. She is also asking that others pay for a benefit for her and for a restricted set of beneficiaries. She is asking that we deprive people of benefits. She did this without considering, or even acknowledging, the burdens her demands would place on others. A fortiori then she did so without presenting a reason why those burdens should be imposed. All she said in favour was, the people who get will stuff for free will like it.
Of course, Georgetown does not force anyone to do anything, as they have neither the ability nor the right to apply violence to coerce behavior. That right is held exclusively by the government.
The goal of the Affordable Care Act with respect to Georgetown is to use that right to coerce to force a Catholic University to act against its teachings. Ms. Fluke may think that the Catholic Church’s views on contraceptives and/or abortion are silly, but that is beside the point. The question here is whether the government has the right to coerce the Church to act against its conscience.
Steve- If you are an academic, why don’t you just ask Fluke what she really meant? She made a presentation, probably with time limits. You have had the much easier task of Monday morning quarterbacking. I would like to believe your students who say that you are a good teacher, so why not act like one? Ask her specific questions to which she can respond. Allow her to give a more detailed response. You have attacked her with the vigor I would expect in response to a 20 page long position paper by a fellow academic, but in this case, it is pretty clear that she did not know the rules you expected her to follow.
As a doctor who teaches students, I may not know, according to you, how to analyze policy, but I do know how to treat students. I try to find out what they really know and understand, not attacking them based upon a single presentation. (I suspect this is partially an internet phenomenon. I would like to think that you would have spoken to Ms Fluke much differently in person.)
Steve Sisson
Steve:
Steve- If you are an academic, why don’t you just ask Fluke what she really meant?
I don’t see any ambiguity that needs resolving.
I don’t understand why people who would ordinarily be opposed to a ‘monopoly’ are the same people that consistently argue for national health care. If the largest insurance company announced that it was buying up all the rest, people would be screaming to high heaven.
Single payer would be a monopoly run by the govt. This would be much worse than any private monopoly. What kind of product do you think Blue Cross would offer if it could outlaw all competition and throw its own customers in prison?
Dom V,
You seem to be saying that we should prefer a private, unregulated, monopoly to a government run monopoly. I don’t think that statement quite stands on its own. It makes sense to me that where we allow monopolies, we generally encourage government involvement in order to protect us from their market power. So we could very well prefer a government solution to a monopoly.
It is always nice if we can use competition to protect us from concentration of market power, but the nature of the health care market doesn’t lend itself to that. The market for health care has a lot of departures from our standard market models that make it very difficult to apply a “competition good, government bad” rule.
“The market for health care has a lot of departures from our standard market models that make it very difficult to apply a “competition good, government bad” rule.
Quite so. No reason though to make it worse.
That’s a general point. In the case at hand we can inject some more market into ‘health care’ by recognizing that routine stuff like the pill can be made OTC. If that level of autonomy for women is too high for your comfort, if the notion of allowing a woman to make her own choices without needing a permission slip from someone affronts you, then only force them to check with a pharmacist or a nurse not a doctor. Cheaper, faster. More details here http://reason.com/blog/2012/03/09/postrel-make-the-pill-cheaper-by-making
I’d want any daughter of mine to check with a doctor. I just don’t think she should be forced to to make statists feel good about themselves.
@Joe: (from a previous post) “It is likely that there are good reasons to require a prescription…which may lead to increased costs and under-utilization.”
My point was that we normally think when prices reflect all *necessary* costs of providing a widget, this leads to an efficient allocation of resources, not under-utilization. Prescriptions in particular seem like a deliberate device to prevent *over*-use. If the price of pesticides increases growers might produce fewer apples but we probably wouldn’t call this “under-investment.”
“I think you are underestimating the complexity of health care.”
The cellphone example was also “just an illustration”, the point being that to me the main issue is not complexity per se but asymmetric information. But even there I think you may underestimate the capacity for markets to devise mitigation strategies e.g. Consumer Reports, Underwriters Laboratories, certified used cars, financial planners, all examples of ‘agents’ who can help us run the numbers and figure stuff out. Not saying this entirely resolves the “burden of trust”, but may help make us less helpless.
“high risk people buy insurance, low risk people go without, and the price goes way up.”
All you’re really saying here is making some people overpay allows us to subsidize others. I believe you said you were in PC (property-casualty, not politically correct) insurance…would you characterize people who do not build homes on the Florida coast as ‘driving up’ the cost of hurricane insurance? “Real” insurance is about some people (voluntarily) subsidizing others in a pool in which they all feel they share *similar* underlying risk factors. Insurance “reform”, IMHO, is about achieving broader redistribution (in a non-transparent way). The honest truth is once someone is already “prohibitively high risk”, we may be talking about an important kind of public moral obligation, but this has little to do with insurance. Things certainly get ‘complicated’ and ‘distorted’ when we try to obscure that underlying reality, but that doesn’t “have to be”.
@iceman:
Joe is confusing two questions. Is it wise to consult a doctor? Should I force you consult a doctor? He will always answer question about the second with remarks about the first, and the observation ‘you are underestimating the complexity of health care.’ Yet I bet he doesn’t think St John’s Wort should require a prescription.
iceman,
Prescriptions are used for several reasons, not just to prevent overuse. I don’t consider the pill to have a high potential for abuse, so I am supposing that in this case the prescription is to prevent misuse. If that is the case then a subsidy might be appropriate.
You quoted one of my sentences, but the next one seems more appropriate. “…people at high risk for pancreatic cancer buy pancreatic cancer insurance, people with a lower risk don’t, and the cost of pancreatic cancer insurance becomes prohibitive.” That to me is problematic.
You write that “The honest truth is…this has little to do with insurance.”, and you’re right. We are not talking about insurance. We are talking about healthcare policy, with which health insurance is inextricably intertwined. The very presence of health insurance distorts the entire healthcare market, making health insurance central to our analysis of healthcare policy. It makes no difference whether we call it insurance or “public moral obligation”.
You might be right that some people want to use insurance reform to achieve broader redistribution. I haven’t met those people, but they are probably out there, and there may even be a lot of them. I would encourage you to set that aside and evaluate policies based on their impact, not on the motivation of their supporters. Their motivation is irrelevant.
So, as a starting point, I would ask you, what should the goal of health care policy be? Only once we’ve agreed on that can we begin to evaluate the policy on common terms.
And don’t answer in terms of markets. Markets aren’t the goal, they are just a means of getting to it.
You know what’s funny, Steve? What’s funny is that there’s a mandate at all, sure. But you know what’s even funnier, Steve? What’s even funnier is that a group of people who’s stated agenda is entirely and exclusively based on forbidding contraception to as many women as possible are being given protective cover by other people who claim it’s all an economic decision.
Quick question about the case at hand, Steve: do you believe there’s any price point at all, including, say, a guarantee of a double-matched private dollar in donations for every dollar spent on contraceptive services coverage where the Catholic men who provide insurance coverage to their employees, or the Catholic men who own and administer hospitals and provide other medical services would agree to cover contraception? If the answer is yes then this issue is inside an economist’s bailiwick. If the answer is no, there’s simply no price point and indeed no feasible economic argument that would change the Bishop’s minds then for all your admirable authority in economics your opinion is exactly as relevant as the barber’s down the street because while economics might be relevant to the demand side, and might even be of interest to the regulatory side, economics are of absolutely no interest to those (admittedly artificially) found on the supply side.
And not to twist the shiv but since the question does at least pertain to matters of patient health, doctors, unlike economists, actually do have some degree of standing in the question.
Sheesh!
figleaf
p.s. Now, do you have the authority to opine credibly about whether employers should be in the business of insuring their employees? Sure! Whether governments should be in the business of mandating that employers who receive tax benefits for providing healthcare be required to provide uniform vs. discriminatory healthcare? That too because those questions fall within the scope of economics. But it’s a fallacy ad verecundiam to claim that credibility in economics gives you authority in a debate involving an exclusively theological position.
Figleaf: I quite disagree with you that a religiously motivated preference somehow has less to do with economics than any other preference.
The preferences dictated by the Catholic church strike me as absolutely loony, as do most of the beliefs of the Catholic church, as do most of the beliefs of nearly all religions. But I do not think that those preferences and beliefs should be ignored just because I happen to find them loony.
In fact, it seems to me that you’re arguing for exactly the opposite of your own conclusion when you say there is no price point at which Georgetown would want to provide contraception coverage. That tells me that this is a preference about which they feel particularly strongly, so we should give it more than the usual amount of weight.
Steve L you are a joy to read. Love every word–even when I disagree with you.
@Joe: Not sure of the distinction between ‘abuse’ and ‘misuse’, or how it changes the point that an efficient allocation of resources reflects all *necessary* costs. Apples could be cheaper if worms didn’t warrant the use of pesticides – should we subsidize? (Please don’t accuse me of analogizing people with worms.)
Also don’t see how applying your ‘high/low risk’ framework to a specific scenario changes anything other than emotionally charging the issue (which was the purpose of Fluke’s anecdotes as well). I agree pre-existing conditions / pre-dispositions are problematic, but also an example of how the underlying policy issues have almost nothing to do with insurance. So you do know at least one person who wants to use insurance reform to achieve broader redistribution, and his name is Joe. (In that case the portability of corporate-based benefits is a real issue, which if anything was further entrenched by the ACA – so motivation has an impact.)
To me “the goal of health care policy” is an honest, transparent conversation about how exactly we want to define our public moral obligation to help those who truly need help, in a sustainable, responsible way. Melding it with insurance, which is just an alternative financing mechanism to taxes, only obscures the issue – I submit because policymakers *want* to obscure the redistribution (maybe because they fear we won’t want to pay the taxes?). So I think it makes a big difference what we call it, because one is a phony paradigm. My question to you: If you believe insurance distorts the market, why run the public obligation segment through that channel?
I think this post is disingenuous in one very narrow sense. It is not only a matter of outsiders butting in. Private health insurance contracts as currently offered by employers are ostensibly still voluntary rather than required by the government; but there is so little competition in the marketplace that there is still an all-or-nothing element. If you want health insurance, you either take one of the few joint-service packages offered by your employer or you turn them all down and decide to self-insure–that is, you do your own saving and paying for health-related concerns. Going individually to an outside health insurer is an option but it is so high-priced that I think it is rarely used.
I would argue that honest people who use the jointly-supplied services of their health insurance might have an obligation to pay full price for some iffy services, and not abuse the system they’ve signed up with. Else it is on their conscience; and it will continue to drive up private health insurance rates.
Specifically: If anyone in Dr. Landsburg’s family uses contraceptive pills for contraception rather than for medical reasons such as endometriosis-related matters, my question is: Do they use the insurance he probably has subscribed to as a university professor when they know it is over the line of what they signed up for? When they have non-insurable claims or claims that are at a questionable edge, do they conscientiously pay full rate and not lay off their costs on the other strangers in the group who signed up on the same insurance plan?
And what about other related abuses of private health care plans, which plans are always jointly-supplied packages? How about the risks of multiple partners in sexual practices, or the risks of travel to unusual places, or genetic family risks about which one may suspect and not want to tell one’s doctor? Should one not have the obligation to not accept the insured price if one knows that the services are outside the realm of what is insured?
Is it not theft to use the services of insurance that is paid for, for other purposes that you might personally know are not what was described but could officially be described in that category?
Health insurance is well-known in the insurance industry as an uninsurable risk. Everyone who signs up for health insurance knows private information that the insurer cannot assess. If you abuse the system, your own hands are not clean enough to hold yourself up as a high horse. Only in a small group with a commensurate culture can it sometimes reach a temporary equilibrium.
iceman,
“If you believe insurance distorts the market, why run the public obligation segment through that channel?”
There really is no choice. To me, it is very important to provide health care to all, regardless of income. To do that, we have to at least partially divorce the usage of health care from the payment for health care. That causes distortions of overuse and inefficiency, whether we use the private insurance industry or the government.
Back to the starting point, you’re saying the goal of health care policy is a conversation.
I’m starting from something more like
1. All Americans should have access to convenient, high quality health care regardless of their ability to pay.
2. People with an extraordinary ability to pay should have access to extraordinary health care options.
3. The health care system should be as efficient and innovative as possible.
4. The health care system as a whole must be affordable.
and probably a few more, recognizing that there is a continuum between 1. and 2., and that there must be compromise between all of these goals. Is this anything like what you’re thinking?
#1 & 2 – I agree (as I expect most people do) that we should provide basic medical care for those who truly needs assistance. To me that has nothing to do with insurance, it’s pure redistribution so the financing mechanism is a separate *choice*. We also need to be willing to make difficult but responsible decisions about what exactly constitutes basic care (not sure if that’s the same as ‘non-extraordinary’.) An honest process (e.g. funded with explicit taxes and charitable contributions) does not imply that private insurers have some obligation to write unprofitable business, or restrict people’s ability to obtain private coverage of basic (or extraordinary) care if they could afford to do so. Why should they be lumped into the pool, other than to obscure the redistribution and the need to make those difficult choices? Why separate the link between usage and payment, and therefore increase the distortions and overuse, any more than necessary?
3. Of course where those goals come into conflict, we do well to remember that today’s innovation is tomorrow’s basic care. We stifle the innovation when we try to pretend we’re automatically entitled to it (what about the next thing that hasn’t even been developed yet?). Sometimes people sound like they think the problem is all these darned innovations.
4. Great, but to me only the public segment of the market can create a “spending problem”, since it alone can print money, run up deficits and therefore make promises it can’t keep. Private individuals cannot outspend their means on healthcare or anything else, rather they are required to make the difficult choices.
iceman,
It sounds like we are close to agreement on the goals then. I agree with you on points 3 and 4.
On #1, would you distinguish between your “basic medical care” and my “high quality care”? I intended it to include some fairly expensive treatments for things like cancer and heart disease and such, similar to what the typical employer provided insurance would cover today. Would your goals stop short of that?
I suspect we would largely agree, but to me phrases like “high quality” or “the care we need” (which one hears sometimes) are a little too vague, “basic” helps to sharpen the focus in a more productive way. Just my opinion, and I don’t have the expertise to get too detailed, but to me conceptually a true public plan for the needy should first pay for (I won’t say “cover”) things everyone “needs” (which just means procedures and treatments that have become assimilated over time into mainstream practice). This could even include things like contraception (it was primarily the spectacle of law school students asking for a handout that was being mocked here; as noted, some people here have come up with interesting rationales for mandating such coverage more broadly, but for reasons most people, perhaps even most proponents, have probably not really considered).
I imagine we would also agree on many kinds of high severity events as well, i.e. the kinds of things for which private insurance is typically intended. However new expensive e.g. experimental treatments for things like cancer may require some difficult conversations about where they fall on the ‘basic / extraordinary’ continuum. (I’d note that other systems often simply exclude such treatments, out of fiscal necessity, and for many more people at that point when they’re all lumped together, which is my point about artificially broadening the pool (in which case those who are still fortunate enough to be able to do so may have to go to a different system altogether to get access, while some, perhaps many, on the margin will surely be priced out altogether as a result.))
If we agree on the other points, the resulting system would probably look quite different from “universal public coverage”, or a “public option for all”, or larding private insurance with mandates, which are the directions many people that support the ACA seem to want to go.
Again, I believe many people would agree with what we’re honing in on here, but the vague, emotionally-charged rhetoric gets in the way. I presume this is because most people are viscerally uncomfortable with the very idea of some people having access to things others don’t, especially where “life or death” decisions are involved. But as has been said here, opportunity costs and costs of capital are what they are, whether we pretend to ignore them = just shift or hide them. Probing more deeply reveals that the only alternative for any system — no matter how wealthy, since demand is potentially infinite particularly in this area – is to restrict access to some things for everyone equally. My biggest concern is that stifling innovation, whether intentionally or not, starts to seem like a way to simplify the problem. To me the human costs of that loom very large for all of us over time.
There is a twist here I do not understand. How is the patient supposed to get treatment for an undiagnosed medical condition?
What I am trying to get at is… if the doctor has diagnosed a patient with endometriosis (or some other disease for which birth control pills are a treatment) why does he not write a prescription? Catholic or not, that is perfectly “kosher”.**
If he has not diagnosed the disease, is the patient diagnosing themselves and then attempting to gain a prescription to treat their disease on the pretense of wanting it for birth control instead? Is that really being endorsed? As someone who is rather libertarian regarding medicine, that doesn’t bother me, but I have a suspicion that self-diagnosis and self-medication would bother some of the people making this case.
Or is the idea that the doctor says, “It _might_ be X; I could run some tests to be sure, but why not skip all those tests, take these birth control pills, and tell me if you feel better.”
In that case, it seems like a rather minor hurdle to be asked jump through that your illness actually be diagnosed before it is treated. For pretty much any illness you can think of insurance companies insist on that anyway.
** I am not sure how clear it is to the reporter, but the Catholic Church does not object to the use of birth control to treat an illness, so long as the effect of infertility is not being sought for its own sake — this is the philosophical principle of double effect. The most clear cut example of this would be uterine cancer. If the uterus had to be removed in order to remove the cancerous cells, that would be enthusiastically endorsed as the right thing to do, even though it caused permanent infertility. The primary intended effect, however, would not be infertility, but excision of the cancer. You can make up a lot of cases and examples of this sort of thing, but that is the basic idea.
Thomas L: These are all excellent reasons why contraceptive pills should be covered. Offsetting those is the fact that Georgetown University really really really doesn’t want to provide that coverage. When we have people who really want something a lot (for what appear to them to be excellent reasons) and other people who want something incompatible (for what appear to them to be excellent reasons) we need to decide between a) letting them sort this out themselves or b) mandating a solution.
If your footnote is correct, then it ought to be pretty easy to accomplish a), so there’s no need for b). If it’s not, then I think what you’re missing is any argument for why this is a case of b) as opposed to a).
@Steve Landsburg
Thanks! But I think you may have misunderstood my question.
I was not asking how people with undiagnosed illnesses could find treatment. I was asking how it is that people with illnesses that have not yet been diagnosed by a doctor are seeking a specific kind of treatment for a specific disease they have not yet been diagnosed with?
If they had been diagnosed with an illness for which birth control was the treatment, that is not–as a rule–objected to by the Catholic Church. Per Pope Paul VI:
“[T]he Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever.”
So, “Where’s the beef?” I thought I detected a hint of it in the reporter’s email with, “[T]o treat medical disorders like endometriosis… without having to pass tests demanded by religious institutions.”
It seemed like the requirement of medical tests were more at issue than the ultimate availability of the medicine.
But for most diseases you really do need a diagnosis of your illness before your insurance company will pay for the prescription medicine to treat it. It is something of an anomaly that for birth control one would not, since it could be prescribed for other reasons without any diagnosed medical need.
However, to keep that in the bounds of Catholic teaching, you do have to have a medical need, and so one would have to diagnose the illness before treating it.
This seems like a really low bar to hop over — exactly the same bar that almost any one with almost any other illness has to get over to get their medicine covered.
ThomasL: You are right. I read too fast and misunderstood your point. Thanks for taking the trouble to clarify and get this through my thick head.
iceman,
I agree with all of that.
So we believe that there is some level of health care to which everyone should have access. To put it in terms of an insurance system, that translates to some kind of minimum required coverage.
Does that sound right to you?
“there is some level of health care to which everyone should have access. To put it in terms of an insurance system, that translates to some kind of minimum required coverage.”
Nope. Access and someone-else-pays are different things, and even someone-else-pays need not imply insurance.
@Joe (if still there): your first sentence – we agree on a moral obligation to those for whom “access” to certain ‘basic / essential’ services requires that “someone else pay”. Where we may differ is that personally I prefer this be funded as much as possible through charitable efforts. If pressed, I support a supplemental public safety net primarily on practical grounds to prevent someone from ‘slipping thru the cracks’. But it’s clear to me that the larger the role of govt the less fiscally responsible and accountable the results i.e. little incentive to make the difficult choices about what constitute those ‘basic’ services.
Your second sentence – I think is attempting to close a perceived semantic loop, but I really believe we’re better served by not describing this in terms of insurance (“coverage”). It’s a pure transfer which we could provide through direct payment for defined services. Anything less transparent seems to lead us into attempts to unnecessarily broaden the “pool” and shift / hide costs in ways that threaten the standards of care for all of us over time.
iceman,
I am going to press you, so I’ll accept your support for a public safety net.
You raised the important issue that the government has “little incentive to make the difficult choices about what constitute those ‘basic’ services”. Do you have some thoughts about who would have the proper incentives to make those difficult choices?
By “In terms of an insurance system” I meant that that’s how we would phrase it if we were going to consider it insurance. You are correct that it could be in the form of a more direct transfer, or even self financed, perhaps subject to one’s ability to pay.
Now I am trying to reconcile our desire that everyone have access to certain services with your desire for more variety and options in health insurance. That is easy to do if you are proposing that the choices available in insurance would only apply beyond those “basic / essential” services. Of course, there are other options too, such as perhaps allowing people with the means to self-insure some of these services. Is what you’re thinking of something like that?
@Joe: By all means, press me. I think both individuals who have the means to purchase coverage privately, and charitable organizations providing access for those who lack the means, face inherent budgetary realities that necessitate responsible choices. (Basically anyone who cannot print money and/or run massive deficits at ‘seignorage’ rates, while strongly incentivized to campaign on promising freebies and hiding/deferring the costs.) Private coverage should include basic services and whatever other bells and whistles people choose to pay for. What’s the purpose of lumping that group into any ‘public option’? I understood you to be merely phrasing such a transfer scheme in insurance terms, but the semantics seem to matter here.
iceman,
I am not sure how to reconcile all of this with our goal #1. We’ve agreed that everyone should have access to basic/essential services regardless of their means. That is kind of meaningless if we don’t have a way to determine what basic/essential means. If you’re just leaving it to the private market and charity, then aren’t you abandoning that goal altogether? I’m trying to see a mechanism in your plan that establishes what is basic/essential, and provides that to people who don’t have the means to pay for it.
Joe,
I wasn’t trying to imply those would be the only entities involved, just responding to your question of who has a better incentive (e.g. binding budget constraint) than the govt to address these issues in a fiscally responsible way. I’ve said I support a public safety net to ‘fill in the gaps’, so for the sake of argument let’s just assume that takes the form of a public option of basic/essential services for the truly needy. (Again, I see no reason why that option need be offered to anyone who doesn’t truly need it.)
I’d just add that I’m detecting a hidden premise here that the only way “we” have a “mechanism” for “establishing what is basic/essential” is when “we” act through a govt program. This seems to be a common phenomenon attributed to public policy that I sometimes think of as “the illusion of objectivity”. What specific services to include or exclude would be very difficult decisions (involving medical knowledge, economics, and for some even moral issues as we’ve seen), and different people would surely reach different conclusions. Individuals purchasing their own coverage, and charitable organizations deciding what to offer, would reflect this underlying “variety and options” in the answers, and I tend to consider that a virtue. Govt generally means a uniform compromise, ultimately determined by people who we may simply assume are smarter or better informed (for no apparent reason), and clearly face other ‘inefficient’ incentives as well.
iceman,
Regarding your illusion of objectivity, the trouble is that what we are looking for is agreement on what everyone is at minimum entitled to. That’s always going to mean some sort of a compromise, and it’s always great to use markets for things like that, but when you don’t have a market for it, you have to figure it out some other way.
So back to your desire to have more choices in health insurance, would you like for people to be able to purchase as little insurance as they want? So that they might not have access to basic/essential care?
I know it’s a lost cause but
“So back to your desire to have more choices in health insurance, would you like for people to be able to purchase as little insurance as they want? So that they might not have access to basic/essential care?”
Insurance and access are not the same thing. Insurance and the ability to pay are not the same thing.