Conference Part I: "Am I Irrelevant?" and the Baseball Hall of Fame

I'm now here in Copenhagen for the International Health Economics Association's (IHEA) 6th World Congress in Health Economics. Yesterday marked the opening and today the first proceedings of this conference. Just as a bit of background, the IHEA conference typically involves over 2000 health economists in one of the ultimate playgrounds for nerds. There is economics everywhere, both in the form of excellent sessions and presentations as well as horrible jokes about supply-and-demand and marginal utility (seriously). On both counts, I feel right at home.

I have to say though that the opening plenary remarks to kick of the conference were particularly depressing, especially for a grad student. The speaker, a Swedish academic, posed a very simple question: for a policymaker interested in reforming a given health system, what can he/she draw from the health economics literature that can be useful in determining what actions to take?

The answer? Apparently, very little. All the fancy theory and empirical work aside, there isn't much evidence to provide definitive answers to the simple big questions like what is the best way to pay providers or should health systems be vertically integrated or not. Abstracting a bit from the talk, even worse, there may not even be a consensus on what the big questions are!

The point was driven home in a standing room only session on the topic "Health System Economics: What is it?" The speakers were some of the all-stars in the field, and each emphasized something completely different in their definitions. Furthermore, one of the panelists pointed out that health economists need to be humble because they do not have meaningful answers, and may be better off as tourists in foreign countries rather than advisers to its ministries!

So here I am, having chosen to invest several years in my twenties (and hopefully not thirties!) in a field hoping that my work will have policy significance and that my discipline can offer something practical for society at large to use. I guess in one sense, these sessions were comforting because it seems like I will always have a job: if 40 years of modern health economics still offers little to work with, there is a lot to do! At the same time, its mostly depressing: everyone wants their work to matter and its sobering when it just might not. I'm going to wait till the end of the conference to talk about this more.

This existential crisis aside, I've had a fun day here so far. I've already been exposed to a whole bunch of papers, but I'd have to say that my favorite involved a study of life, death and the Baseball Hall of Fame. I know, I know: what a great segue from the big questions of the field to something more trivial.

Actually, its not that trivial at all. The main thrust of the paper (will provide a link when the working version is put up on the web) involves looking at how status and stress influence life expectancy. I'm sure you are aware of the studies looking at Oscar or Nobel Prize winners versus nominees, nothing that the former living longer than the latter, possibly because of the physiological benefits of knowing that you are one of the revered "big dogs" in the field.

This paper was interesting because, unlike others, the researchers (indeed everyone who reads ESPN or SI) had access to data on the number of votes nominated and accepted players received en route to the Hall of Fame. Plus, with the Baseball Hall of Fame, there is a definitive cut off in the percentage of votes (writers or veterans) needed to be received in order to make it in. To make a long story short, the authors find that slam dunk winners have the highest survival rates, while winners and non-winners right around the vote threshold appear to have lower survival rates than those nominees receiving a negligible share of votes. They suggest that, given the salience of the Hall of Fame in the life of an MLB baseball player, being on the cusp of admission confers huge stress on the body and mind. They test this proposition loosely by looking at the rate of deaths due to cardiac events among those right around the threshold. Sure enough, it is these individuals who are most likely to die from a heart attack.

So I guess that Jim Rice needs to be worried about his health in addition to his ongoing Hall of Fame candidacy saga.

I'm presenting tomorrow, so I will let you know what that is all about in my next post.