According to this recent paper by Ben Sommers, et al, in The New England Journal of Medicine, the answer is yes. Sommers and coauthors examine mortality before and after medicaid expansions in certain states, using the same before-after comparison in neighboring states as a control to account for general trends in mortality that would exist without Medicaid changes. They find expansions "were associated with a significant reduction in adjusted all-cause mortality (by 19.6 deaths per 100,000 adults, for a relative reduction of 6.1%; P=0.001)...Mortality reductions were greatest among older adults, nonwhites, and residents of poorer counties." They also find evidence of better self-reported health and reduced delays to getting care with Medicaid expansions.
This is a well done, timely piece. The recent Supreme Court ruling declared the provisions in the Affordable Care Act (ACA) decreeing mandatory Medicaid expansions to be unconstitutional. This has led some state governors to announce that they will not pursue such expansions. Some of this, of course, is dumb election year posturing: the ACA increases the Federal fund matching rate for Medicaid by a great deal, so governors will most likely buy in to the expansions because of these nice financial incentives. That said, this piece provides another angle to this whole debate, as failure to expand Medicaid may not just mean money left on the table, but people's lives as well.
Showing posts with label politics. Show all posts
Showing posts with label politics. Show all posts
Thursday, July 26, 2012
Wednesday, July 18, 2012
Value Based Puchasing and Safety Net Hospitals
One of the mainstays of our current health care reform dialogue is promoting efficiency. The US health care system gets pretty good outcomes for its clients, but it comes at a great cost and with a lack of equity. Regarding cost, there has been a push to pay providers (doctors, clinics, hospitals, etc) for the quality of the services they render, not just for having rendered the service. Along these lines, with the new health care reform bill, Medicare will start paying hospitals based on performance as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). This is what is referred to as Value Based Purchasing (VBP).
En face, it sounds like a great idea. But are there potential downsides to VBP? An elegant new study by Paula Chatterjee and colleagues suggests that the answer might be yes. Paula, et al, look at how safety net hospitals, a group of providers that disproptionately take care of poor, vulnerable patients have performed on HCAHPS surveys, showing that these hospitals typically have fared work on the patient satisfaction aspect of this index. Strikingly, safety net hospitalis were 60% less likely to be at or above the median on a variety of patient experience measures when compared to other hospitals. Because the median is the key metric upon which the Medicare VBP algorithms are based, safety net hospitals will potentially stand to lose key Medicare dollars. As they are financially constrained as it is, this could potentially lead to a negative feedback loop, where safety net hospitals lack the funds to make the improvements necessary to perform better on VBP, thereby losing more funds, and so on.
This example highlights a few key points that are relevant for health care reform anywhere. First, certain kinds of incentives will create, or exacerbate existing, tradeoffs between making the system more equitable versus more efficient. In this case, the push for efficiency may potentially reduce available care options for the poor, which leads to worsening equity. Note that this could even lead to worsened efficiency, if the lack of immediate care for the poor leads to increased downstream costs (eg, more ED visits, or longer hospitalizations when an earlier, less costly, hospitalization would have done). Second, better designed incentives may actually help move to an equilibrium where this tradeoff is minimized. For example, a VBP system which allows safety net hospitals lead time in figuring out best practices (perhaps via learning from each other, or via some explicit "curriculum" or forum created by Medicare) may help them improve quality -which will certainly be equitable given their population- and stay solvent.
Ultimately, I think key for payment reform, which should be the explicit goal for Medicare and other health programs, is to perform the reachable alchemy of improving both equity and efficiency. I say "reachable" for a reason: everyone is aware that other OECD countries spend less and gain the same or more when it comes to health. At least on a less fundamental level (i.e, payment reform within our mish-mosh private system), we can aim to do the same.
En face, it sounds like a great idea. But are there potential downsides to VBP? An elegant new study by Paula Chatterjee and colleagues suggests that the answer might be yes. Paula, et al, look at how safety net hospitals, a group of providers that disproptionately take care of poor, vulnerable patients have performed on HCAHPS surveys, showing that these hospitals typically have fared work on the patient satisfaction aspect of this index. Strikingly, safety net hospitalis were 60% less likely to be at or above the median on a variety of patient experience measures when compared to other hospitals. Because the median is the key metric upon which the Medicare VBP algorithms are based, safety net hospitals will potentially stand to lose key Medicare dollars. As they are financially constrained as it is, this could potentially lead to a negative feedback loop, where safety net hospitals lack the funds to make the improvements necessary to perform better on VBP, thereby losing more funds, and so on.
This example highlights a few key points that are relevant for health care reform anywhere. First, certain kinds of incentives will create, or exacerbate existing, tradeoffs between making the system more equitable versus more efficient. In this case, the push for efficiency may potentially reduce available care options for the poor, which leads to worsening equity. Note that this could even lead to worsened efficiency, if the lack of immediate care for the poor leads to increased downstream costs (eg, more ED visits, or longer hospitalizations when an earlier, less costly, hospitalization would have done). Second, better designed incentives may actually help move to an equilibrium where this tradeoff is minimized. For example, a VBP system which allows safety net hospitals lead time in figuring out best practices (perhaps via learning from each other, or via some explicit "curriculum" or forum created by Medicare) may help them improve quality -which will certainly be equitable given their population- and stay solvent.
Ultimately, I think key for payment reform, which should be the explicit goal for Medicare and other health programs, is to perform the reachable alchemy of improving both equity and efficiency. I say "reachable" for a reason: everyone is aware that other OECD countries spend less and gain the same or more when it comes to health. At least on a less fundamental level (i.e, payment reform within our mish-mosh private system), we can aim to do the same.
Sunday, March 18, 2012
Thank You, Affordable Care Act!
I've come across quite a few patients now in their early 20s presenting with the first symptoms of what may be a serious chronic illness. Many of these individuals happen to be without health insurance for one reason or another. Thankfully, in Massachusetts, the combination of Mass Health (Medicaid), Commonwealth Care and coverage options for young adults under 26 allows many of these individuals to get much needed care. On the other hand, my patients from neighboring states do not necessarily have access to these luxuries, which is were the Patient Protection Affordable Care Act (PPACA) comes in.
The PPACA has quite a few moving parts, some of which are in place and others not (see here and here). One piece that has gone into effect mandates that health plans that cover children of the enrollee to now cover said children up to the age of 26. For several of my patients, this has allowed them to get access to health care as they bridge to their late 20s and eventually find their own care options. As their doctor, this has been huge: it prevents my patients from deferring care for a serious condition that would most certainly result in large short-term and long-term economic and health consequences.
Interestingly, I'm not sure if too many people know about this aspect of the health care law. I told one self-identified Republican, a young man who would go on to benefit from the extension of parental insurance, about it and he seemed shocked: "For real? You mean, this is President Obama's idea? Wow, he's looking out for us."
I wonder now if much of the resistance to the PPACA has to do with similarly placed ignorance. If that is the case, the Republicans should be credited for obfuscating the national debate around the law in their favor and the Democrats chastised for allowing this to happen.
I'm not saying I'm a PPACA homer or anything. The act certainly has some issues. That said, as a new primary care doctor, I just can't imagine practicing in a time where such options were not available. Really, it's incredible that that time was literally a year or so ago. Imagine holding off treatment for newly diagnosed active and fulminant Crohn's disease because of lack of access: would that happen in a just, advanced society? Thankfully, not anymore.
The PPACA has quite a few moving parts, some of which are in place and others not (see here and here). One piece that has gone into effect mandates that health plans that cover children of the enrollee to now cover said children up to the age of 26. For several of my patients, this has allowed them to get access to health care as they bridge to their late 20s and eventually find their own care options. As their doctor, this has been huge: it prevents my patients from deferring care for a serious condition that would most certainly result in large short-term and long-term economic and health consequences.
Interestingly, I'm not sure if too many people know about this aspect of the health care law. I told one self-identified Republican, a young man who would go on to benefit from the extension of parental insurance, about it and he seemed shocked: "For real? You mean, this is President Obama's idea? Wow, he's looking out for us."
I wonder now if much of the resistance to the PPACA has to do with similarly placed ignorance. If that is the case, the Republicans should be credited for obfuscating the national debate around the law in their favor and the Democrats chastised for allowing this to happen.
I'm not saying I'm a PPACA homer or anything. The act certainly has some issues. That said, as a new primary care doctor, I just can't imagine practicing in a time where such options were not available. Really, it's incredible that that time was literally a year or so ago. Imagine holding off treatment for newly diagnosed active and fulminant Crohn's disease because of lack of access: would that happen in a just, advanced society? Thankfully, not anymore.
Friday, March 2, 2012
Aspirations and Investing in Girls
Two great posts in Development Impact (my favorite economics blog right now) on aspirations, expected returns to investments, and the advancement of women. The first reviews evidence on how increased labor market opportunities available to women lead parents to invest more in the daughter's education. The second looks at how recent quotas decreeing that a randomly chosen 1/3 of village governance seats in India be filled by women have led to increased aspirations among girls and their parents, as well as increased investments in the former. In the study they cite, the gender gap in child education (which favors boys at baseline) was decimated when a village headship was randomly assigned to a woman.
The posts, and the articles cited there in, make two powerful points. First, information on opportunities for girls that may be unknown to families (for whom the cost of obtaining such information is high because of, say, lack of access to "plugged in" social networks, media, etc) can be powerful in combating gender bias. Second, proactively breaking down institutional barriers can play an important role, too, something we saw with the Civil Rights Movement here on our shores.
The posts, and the articles cited there in, make two powerful points. First, information on opportunities for girls that may be unknown to families (for whom the cost of obtaining such information is high because of, say, lack of access to "plugged in" social networks, media, etc) can be powerful in combating gender bias. Second, proactively breaking down institutional barriers can play an important role, too, something we saw with the Civil Rights Movement here on our shores.
Monday, February 6, 2012
Does Discrimination Make You Sick? And How?
Interesting new paper, forthcoming in the Journal of Health Economics, that uses 9/11 as a quasi-experimental source of variation to try and get at the causal effect of discrimination (here, against Muslims in the UK) on health outcomes. It also goes a bit further than this and tries to get at some of the mechanisms. The findings are, sadly, along the lines of what I expected:
The attitudes of the general British population towards Muslims changed post 2001, and this change led to a significant increase in Anti-Muslim discrimination. We use this exogenous attitude change to estimate the causal impact of increased discrimination on a range of objective and subjective health outcomes. The difference-in-differences estimates indicate that discrimination worsens blood pressure, cholesterol, BMI and self-assessed general health. Thus, discrimination is a potentially important determinant of the large racial and ethnic health gaps observed in many countries. We also investigate the pathways through which discrimination impacts upon health, and find that discrimination has a negative effect on employment, perceived social support, and health-producing behaviours. Crucially, our results hold for different control groups and model specifications.
So in addition to the deadweight loss of underutilizing potentially talented men and women, as well as increasing social unrest and the potential political costs that might have, we can now add health to the slew of negative impacts from discrimination.
In a later post, I'll go over a paper that Sonia Bhalotra and I are working on that looks at how discrimination can prevent children who have better childhoods into tapping into that wellspring as adults.
The attitudes of the general British population towards Muslims changed post 2001, and this change led to a significant increase in Anti-Muslim discrimination. We use this exogenous attitude change to estimate the causal impact of increased discrimination on a range of objective and subjective health outcomes. The difference-in-differences estimates indicate that discrimination worsens blood pressure, cholesterol, BMI and self-assessed general health. Thus, discrimination is a potentially important determinant of the large racial and ethnic health gaps observed in many countries. We also investigate the pathways through which discrimination impacts upon health, and find that discrimination has a negative effect on employment, perceived social support, and health-producing behaviours. Crucially, our results hold for different control groups and model specifications.
So in addition to the deadweight loss of underutilizing potentially talented men and women, as well as increasing social unrest and the potential political costs that might have, we can now add health to the slew of negative impacts from discrimination.
In a later post, I'll go over a paper that Sonia Bhalotra and I are working on that looks at how discrimination can prevent children who have better childhoods into tapping into that wellspring as adults.
Friday, January 27, 2012
Partisan Professors and Race
Great new paper in the latest issue of the American Economic Journal: Applied Economics about the political orientation of your professor and the grade you may receive in her/his class:
We study grading outcomes associated with professors in an elite university in the United States who were identified—using voter registration records from the county where the university is located—as either Republicans or Democrats. The evidence suggests that student grades are linked to the political orientation of professors. Relative to their Democratic colleagues, Republican professors are associated with a less egalitarian distribution of grades and with lower grades awarded to black students relative to whites.
The paper is by Bar and Zussman and their models look at variations in grades within the same student taking courses in the same department, so it controls for selection into majors and, to some extent, classes. The most interesting part of this paper is the race angle. One may think that it has something to do with the fact the demographics of Republican professors, not so much their ideological preferences. Not so: even controlling for gender, age and race of the professor doesn't change the results.
So how to interpret this? I'm sure that many would argue that Republican professors harbor some subtle, perhaps subconscious, prejudices against black students (this guy would agree). This is entirely possible, but I think the study needs to be interpreted with some caution. First, the sample size of Republican professors is small (only 5.3% are). Secondly, its unclear where the grade variation is coming from. Do students - black or white - perform worse in Republican-professor taught classes (they don't like the take on the material, they may be too ticked off with partisan politics to focus on assignments, etc)? The study can't distinguish this explanation from the racist-professor one.
We study grading outcomes associated with professors in an elite university in the United States who were identified—using voter registration records from the county where the university is located—as either Republicans or Democrats. The evidence suggests that student grades are linked to the political orientation of professors. Relative to their Democratic colleagues, Republican professors are associated with a less egalitarian distribution of grades and with lower grades awarded to black students relative to whites.
The paper is by Bar and Zussman and their models look at variations in grades within the same student taking courses in the same department, so it controls for selection into majors and, to some extent, classes. The most interesting part of this paper is the race angle. One may think that it has something to do with the fact the demographics of Republican professors, not so much their ideological preferences. Not so: even controlling for gender, age and race of the professor doesn't change the results.
So how to interpret this? I'm sure that many would argue that Republican professors harbor some subtle, perhaps subconscious, prejudices against black students (this guy would agree). This is entirely possible, but I think the study needs to be interpreted with some caution. First, the sample size of Republican professors is small (only 5.3% are). Secondly, its unclear where the grade variation is coming from. Do students - black or white - perform worse in Republican-professor taught classes (they don't like the take on the material, they may be too ticked off with partisan politics to focus on assignments, etc)? The study can't distinguish this explanation from the racist-professor one.
Sunday, July 12, 2009
Links: Problems with American Health Care, Job Loss and Unhealthy Behaviors
1. A really interesting piece in the NYT about inefficiency in American health care. The piece, by David Leonhardt, uses prostate cancer as a lens to highlight the gaps between clinical practice and the existing research evidence (or lack thereof). Pretty eye opening stuff.
2. More on American health care: a great piece from The Economist about the challenges awaiting health care reform.
3. My colleagues at Yale, Padmaja Ayyagari, Bill Gallo, Jason Fletcher and Jody Sindelar, along with Partha Deb from CUNY Hunter, have an interesting new paper looking at how job loss influences subsequent unhealthy behaviors. Aside from the interesting research question, this paper is pretty interesting from a methodological standpoint in that they use plausibly (more) exogenous in job loss by exploiting information on business closings as well as employ finite mixture models to model the underlying heterogeneity in effects and people's propensity for unhealthy behaviors. The latter technique is becoming quite hot in health economics now as there is increasing interest in trying to understand how individuals may differ in their underlying propensities towards different behaviors and disease.
2. More on American health care: a great piece from The Economist about the challenges awaiting health care reform.
3. My colleagues at Yale, Padmaja Ayyagari, Bill Gallo, Jason Fletcher and Jody Sindelar, along with Partha Deb from CUNY Hunter, have an interesting new paper looking at how job loss influences subsequent unhealthy behaviors. Aside from the interesting research question, this paper is pretty interesting from a methodological standpoint in that they use plausibly (more) exogenous in job loss by exploiting information on business closings as well as employ finite mixture models to model the underlying heterogeneity in effects and people's propensity for unhealthy behaviors. The latter technique is becoming quite hot in health economics now as there is increasing interest in trying to understand how individuals may differ in their underlying propensities towards different behaviors and disease.
Friday, June 5, 2009
Politicians and Poverty Reduction
A long line of work in political science centers around the topic of clientelism, also known as vote buying. The idea is that politicians (the patrons) provide goods, services or benefits to the public or to those not in positions of power in exchange for votes. (Such favors, for example, could involve the allocation of a large development project to a swing-locality or district). There are lots of reasons to be displeased with "vote-buying" but a big one concerns the marginal returns to public expenditure: funds that are allocated for political reasons may not be allocated productively from the standpoint of some other societal goal. For example, if we are interested in poverty reduction, public funds should be allocated to those who are actually poor (yes, I am oversimplifying here!). Obviously, there is no guarantee that funds allocated by a political formula will follow this more technocratic logic.
So are we destined to an equilibrium where the incentives of politicians and the public are not well-aligned? Not so, according to two recent studies which examine the political impacts of conditional cash transfer programs (CCTs), which are schemes that provide cash to poor families who meet certain objectives (i.e., attending monthly check-ups, sending their children to school, etc; see here for a beautifully detailed account of CCTs the world over) and have been shown to have had numerous positive benefits on health, schooling and general circumstances faced by the poor. The first, by Yale political scientist Ana de la O, looks at the impact of the Mexican CCT, Progresa. Progresa was initially rolled out to a randomly selected subset of localities before more universal rollout a year and a half later. De la O uses this variation to show that people randomly exposed to Progresa longer are around 5 percentage points more likely to vote for the incumbent.
In the second study, Marco Manacorda, Ted Miguel and Andrea Vigorito use a regression discontinuity approach to identify the political impacts of Uruguayan CCT PANES. Comparing individuals just on either side of a pre-designated eligibility score (based on a composite of household and individual socioeconomic characteristics), they find that cash transfers lead to a whopping 21-28 percentage point increase in the probability of voting for the incumbent!
What I like about these papers, besides the use of program evaluation methods to identify causal impacts on voting behavior, is that it suggests that there is a better equilibrium out there: politicians can get re-elected on the basis of policies that have demonstrated large and positive effects on human development rather than through doling out public funds in potentially unproductive ways. My hope is that this catches on in other parts of the world...
So are we destined to an equilibrium where the incentives of politicians and the public are not well-aligned? Not so, according to two recent studies which examine the political impacts of conditional cash transfer programs (CCTs), which are schemes that provide cash to poor families who meet certain objectives (i.e., attending monthly check-ups, sending their children to school, etc; see here for a beautifully detailed account of CCTs the world over) and have been shown to have had numerous positive benefits on health, schooling and general circumstances faced by the poor. The first, by Yale political scientist Ana de la O, looks at the impact of the Mexican CCT, Progresa. Progresa was initially rolled out to a randomly selected subset of localities before more universal rollout a year and a half later. De la O uses this variation to show that people randomly exposed to Progresa longer are around 5 percentage points more likely to vote for the incumbent.
In the second study, Marco Manacorda, Ted Miguel and Andrea Vigorito use a regression discontinuity approach to identify the political impacts of Uruguayan CCT PANES. Comparing individuals just on either side of a pre-designated eligibility score (based on a composite of household and individual socioeconomic characteristics), they find that cash transfers lead to a whopping 21-28 percentage point increase in the probability of voting for the incumbent!
What I like about these papers, besides the use of program evaluation methods to identify causal impacts on voting behavior, is that it suggests that there is a better equilibrium out there: politicians can get re-elected on the basis of policies that have demonstrated large and positive effects on human development rather than through doling out public funds in potentially unproductive ways. My hope is that this catches on in other parts of the world...
Monday, May 4, 2009
The Cost of Political Opposition
Dissent is an important part of public discourse in any setting. In a truly democratic regime, one would expect dissent to carry little cost (though I expect it might in hard to observe ways). But what about in autocratic regimes? What is the price of opposing the ruling party?
In a recent working paper, Chang-Tai Hsieh, Edward Miguel, Daniel Ortega and Francisco Rodriguez try to address this question in the context of the Hugo Chavez led Venezuela. In their own words:
In 2004, the Chávez regime in Venezuela distributed the list of several million voters whom had attempted to remove him from office throughout the government bureaucracy, allegedly to identify and punish these voters. We match the list of petition signers distributed by the government to household survey respondents to measure the economic effects of being identified as a Chavez political opponent. We find that voters who were identified as Chavez opponents experienced a 5 percent drop in earnings and a 1.5 percentage point drop in employment rates after the voter list was released. A back-of-the-envelope calculation suggests that the loss aggregate TFP from the misallocation of workers across jobs was substantial, on the order of 3 percent of GDP.
That political opposition in an autocratic regime can invite economic retribution is not that surprising, but the 3% of GDP number kind of is. It's just a great illustration of how the incentives of the public and autocratic leaders are not aligned: one would hope that a 3% loss of GDP would have dissuaded Chavez from going after his opposition.
All in all, a really interesting, if not very sad, read.
(Ed: Marginal Revolution has an interesting take on this paper, as well)
In a recent working paper, Chang-Tai Hsieh, Edward Miguel, Daniel Ortega and Francisco Rodriguez try to address this question in the context of the Hugo Chavez led Venezuela. In their own words:
In 2004, the Chávez regime in Venezuela distributed the list of several million voters whom had attempted to remove him from office throughout the government bureaucracy, allegedly to identify and punish these voters. We match the list of petition signers distributed by the government to household survey respondents to measure the economic effects of being identified as a Chavez political opponent. We find that voters who were identified as Chavez opponents experienced a 5 percent drop in earnings and a 1.5 percentage point drop in employment rates after the voter list was released. A back-of-the-envelope calculation suggests that the loss aggregate TFP from the misallocation of workers across jobs was substantial, on the order of 3 percent of GDP.
That political opposition in an autocratic regime can invite economic retribution is not that surprising, but the 3% of GDP number kind of is. It's just a great illustration of how the incentives of the public and autocratic leaders are not aligned: one would hope that a 3% loss of GDP would have dissuaded Chavez from going after his opposition.
All in all, a really interesting, if not very sad, read.
(Ed: Marginal Revolution has an interesting take on this paper, as well)
Friday, November 7, 2008
Obama
Addressing my graduating class, the Dean of the Duke University Chapel gave a stirring speech about how we needed to resist being labeled the 9/11 generation. Though the horrific terrorist attacks happened during our senior year, the Dean urged us to think beyond 9/11 and become the generation that made its mark by decisively and proactively moving society away from that event and towards a better future. Rather than becoming pessimistic and jaded about our world, he wanted us to use our energies, skills and talents to refocus the collective gaze of society on the good and the promising.
Nearly seven years later, I witnessed a slew of my friends taking up the Dean's challenge, inspired the first black man gaining a major party nomination for President, who embodied progress, optimism and youth, speaking of hope and change. Several friends participated directly in the Obama campaign, working long hours in battleground states, making calls and coordinating rallies. Others chose to engage in vociferous discussion with their families and friends about their beliefs and about what they felt was the most important decision our country has had to make in a long time. Still others spent election day calling complete strangers encouraging them to get out to vote. Tuesday night, and for the rest of the week thereafter, these friends and many others across the country walked around with gleaming smiles, radiating a sense of optimism that seems to be a perfectly natural extension of the events of the last few months, but also completely remarkable given the aftermath of 9/11 and the recent financial crisis. As one of my professors gushed on the day after the election: "It is now morning in America."
I think the implicit Reagan comparison is entirely appropriate. If Reagan was the transformational figure of our parents' generation, Obama is most definitely ours. Before Tuesday, though, my views on President-Elect Obama had been more muted. To me, "Hope" and "Change" were empty campaign promises that I'd heard before, made by another inspirational candidate who turned out to be an underwhelming President. If anything, I chose to vote for Obama mainly because I liked his technocratic and pragmatic outlook (and also because the erstwhile Maverick Senator McCain had become much less of one).
Tuesday taught me that these concepts are not, and had never been, just vague and hazy campaign rhetoric. Indeed, the tangible effects of being inspired by a man who has become both a symbol and a (potential) instrument for optimism and progress are substantive and significant and should not be underestimated: millions of people appear ready to make sacrifices and continue to work at a grassroots level for change. Some of the optimism appears a bit unhealthy - after all, Obama does not hold a magic wand - but I think much it can be harnessed and put to use in a way never before seen, certainly not in my lifetime.
Prior to Nov 4, 2008, 9/11 was indeed the defining historical moment of our generation. It clearly changed our views about the world and about our own country. Much of this decade has been colored by this event, from the tangible policies and actions we have taken as well as to our national mood more generally. We now have another defining moment for our generation: the election of Barack Obama to the Presidency, with all its optimism and its possibilities. Now let's put this all our good-will, excitement and sense of purpose to good use and get down in the trenches with our new President.
It's time to get to work.
Nearly seven years later, I witnessed a slew of my friends taking up the Dean's challenge, inspired the first black man gaining a major party nomination for President, who embodied progress, optimism and youth, speaking of hope and change. Several friends participated directly in the Obama campaign, working long hours in battleground states, making calls and coordinating rallies. Others chose to engage in vociferous discussion with their families and friends about their beliefs and about what they felt was the most important decision our country has had to make in a long time. Still others spent election day calling complete strangers encouraging them to get out to vote. Tuesday night, and for the rest of the week thereafter, these friends and many others across the country walked around with gleaming smiles, radiating a sense of optimism that seems to be a perfectly natural extension of the events of the last few months, but also completely remarkable given the aftermath of 9/11 and the recent financial crisis. As one of my professors gushed on the day after the election: "It is now morning in America."
I think the implicit Reagan comparison is entirely appropriate. If Reagan was the transformational figure of our parents' generation, Obama is most definitely ours. Before Tuesday, though, my views on President-Elect Obama had been more muted. To me, "Hope" and "Change" were empty campaign promises that I'd heard before, made by another inspirational candidate who turned out to be an underwhelming President. If anything, I chose to vote for Obama mainly because I liked his technocratic and pragmatic outlook (and also because the erstwhile Maverick Senator McCain had become much less of one).
Tuesday taught me that these concepts are not, and had never been, just vague and hazy campaign rhetoric. Indeed, the tangible effects of being inspired by a man who has become both a symbol and a (potential) instrument for optimism and progress are substantive and significant and should not be underestimated: millions of people appear ready to make sacrifices and continue to work at a grassroots level for change. Some of the optimism appears a bit unhealthy - after all, Obama does not hold a magic wand - but I think much it can be harnessed and put to use in a way never before seen, certainly not in my lifetime.
Prior to Nov 4, 2008, 9/11 was indeed the defining historical moment of our generation. It clearly changed our views about the world and about our own country. Much of this decade has been colored by this event, from the tangible policies and actions we have taken as well as to our national mood more generally. We now have another defining moment for our generation: the election of Barack Obama to the Presidency, with all its optimism and its possibilities. Now let's put this all our good-will, excitement and sense of purpose to good use and get down in the trenches with our new President.
It's time to get to work.
Sunday, May 11, 2008
Bad Timing
My doorbell rang last Friday around 9 PM. I happened to be home and, figuring it was my roommate or some other tenant having forgotten their key to get inside, I decided to head downstairs and answer.
To my surprise, I was greeted by two well-dressed white males in their 20s, one of whom as carrying a clip-board. They explained that they were representing a state-wide environmental lobby and went on to talk about a bill they were trying to get passed and how they needed my $15 dollars to do it.
I normally don't provide money to solicitors who accost me in person or over the phone, so the chances that these two would ever get anything from me was pretty low to begin with. However, in this instance, the probability that I would part with my money was pretty much zero given the bizarre timing of their request.
Who comes to your door on Friday night to collect money for the environment? Hardly anyone, I would think. First off, most people are either not around on Friday or want to enjoy the start of their weekends by winding down with family, friends or with a good movie or book. So to have someone at your door at that time is a bit unexpected and, as such, a little scary. Indeed, at one point I thought these guys were going to overpower me and then clean out my apartment.
Not only that, I wasn't sure how this strategy was a good idea from their standpoint, either. For a solicitor, I'd bet the returns to going around on a Friday night are quite low since people will either not be around or too shocked/annoyed to want to listen to any kind of pitch.
So I asked the two solicitors: "This is a bit strange. Why are you guys doing this on Friday night?"
Their answer: "The environment never rests."
They still didn't get any money from me.
To my surprise, I was greeted by two well-dressed white males in their 20s, one of whom as carrying a clip-board. They explained that they were representing a state-wide environmental lobby and went on to talk about a bill they were trying to get passed and how they needed my $15 dollars to do it.
I normally don't provide money to solicitors who accost me in person or over the phone, so the chances that these two would ever get anything from me was pretty low to begin with. However, in this instance, the probability that I would part with my money was pretty much zero given the bizarre timing of their request.
Who comes to your door on Friday night to collect money for the environment? Hardly anyone, I would think. First off, most people are either not around on Friday or want to enjoy the start of their weekends by winding down with family, friends or with a good movie or book. So to have someone at your door at that time is a bit unexpected and, as such, a little scary. Indeed, at one point I thought these guys were going to overpower me and then clean out my apartment.
Not only that, I wasn't sure how this strategy was a good idea from their standpoint, either. For a solicitor, I'd bet the returns to going around on a Friday night are quite low since people will either not be around or too shocked/annoyed to want to listen to any kind of pitch.
So I asked the two solicitors: "This is a bit strange. Why are you guys doing this on Friday night?"
Their answer: "The environment never rests."
They still didn't get any money from me.
Saturday, April 19, 2008
Why Your Congressman's Children Matter to You
Understanding how legislators, and government officials more broadly, form opinions and make decisions is crucial for understanding the broader political climate and predicting policy change. A recent paper in the American Economic Review by Yale economist and political scientist Ebonya Washington addresses this issue with an interesting angle and some startling results:
Parenting daughters, sociologists have shown, increases feminist sympathies. I test the hypothesis that children, much like neighbors or peers, can influence parental behavior. I demonstrate that conditional on total number of children, each daughter increases a congressperson's propensity to vote liberally, particularly on reproductive rights issues. The results identify an important (and previously omitted) explanatory variable in the literature on congressional decision making. Additionally the paper highlights the relevance of child-to-parent behavioral influence.
The crucial assumption in this paper is that the sex composition of the legislator's children is random or, at the very least, unrelated to other factors that might determine voting behavior. Washington addresses this by noting that 1) the time period covered in the study predated the wide-spread diffusion of fetal sex-determining technologies and 2) legislator's do not appear to follow different stopping rules conditional on the sex of birth's children. To address (2) the author utilizes information on the sex of the legislator's first birth (painstakingly recovered from newspaper announcements) and assess whether the total number of children varies with the first kid's gender (she finds that it does not).
A recent working paper by Dalton Conley and Brian McCabe utilizes Washington's finding to study the link between legislator voting behavior and campaign contributions. Noting that recovering causal estimates of this relationship is difficult, the authors use the sex composition of children to predict voting behavior, and then assess the relationship between predicted voting behavior and campaign contributions. The key assumption is that the gender mix of the kids doesn't have a direct, or indirect (via some unobserved factor), influence on campaign contributions.
Parenting daughters, sociologists have shown, increases feminist sympathies. I test the hypothesis that children, much like neighbors or peers, can influence parental behavior. I demonstrate that conditional on total number of children, each daughter increases a congressperson's propensity to vote liberally, particularly on reproductive rights issues. The results identify an important (and previously omitted) explanatory variable in the literature on congressional decision making. Additionally the paper highlights the relevance of child-to-parent behavioral influence.
The crucial assumption in this paper is that the sex composition of the legislator's children is random or, at the very least, unrelated to other factors that might determine voting behavior. Washington addresses this by noting that 1) the time period covered in the study predated the wide-spread diffusion of fetal sex-determining technologies and 2) legislator's do not appear to follow different stopping rules conditional on the sex of birth's children. To address (2) the author utilizes information on the sex of the legislator's first birth (painstakingly recovered from newspaper announcements) and assess whether the total number of children varies with the first kid's gender (she finds that it does not).
A recent working paper by Dalton Conley and Brian McCabe utilizes Washington's finding to study the link between legislator voting behavior and campaign contributions. Noting that recovering causal estimates of this relationship is difficult, the authors use the sex composition of children to predict voting behavior, and then assess the relationship between predicted voting behavior and campaign contributions. The key assumption is that the gender mix of the kids doesn't have a direct, or indirect (via some unobserved factor), influence on campaign contributions.
Thursday, March 27, 2008
The Sinking Ship?
Some new data to back up my earlier assertion that the Democrats are destroying themselves on their way to the nomination:
"Twenty-eight percent of current Hillary Clinton supporters say they would vote for John McCain over Barack Obama in the general election. Nineteen percent of Obama supporters would vote for McCain over Clinton."
More here. There is some talk that Senator Clinton is using this data to support her contention that she should receive the Democratic nomination over Obama. That's kind of interesting (and a bit perverse) since the Clinton Campaign is probably culpable for most of the acrimony in this race. (After all, Clinton is the one who went around saying that John McCain is a better choice than Senator Obama.)
Whether or not these latest poll results have implications for the general election is an open question. One the one hand, those polled may simply be reacting to the bitter infighting among Democrats, with the questions framed in such a way to induce them to take sides. Once a nominee is decided and the convention completed, rank and file Dems will happily be rank and file Dems. On the other hand, independents and moderates, who have tended to gravitate towards McCain in past years, might be turned off by the infighting and board the straight-talk express for good.
It will certainly be interesting to see how this pans out.
"Twenty-eight percent of current Hillary Clinton supporters say they would vote for John McCain over Barack Obama in the general election. Nineteen percent of Obama supporters would vote for McCain over Clinton."
More here. There is some talk that Senator Clinton is using this data to support her contention that she should receive the Democratic nomination over Obama. That's kind of interesting (and a bit perverse) since the Clinton Campaign is probably culpable for most of the acrimony in this race. (After all, Clinton is the one who went around saying that John McCain is a better choice than Senator Obama.)
Whether or not these latest poll results have implications for the general election is an open question. One the one hand, those polled may simply be reacting to the bitter infighting among Democrats, with the questions framed in such a way to induce them to take sides. Once a nominee is decided and the convention completed, rank and file Dems will happily be rank and file Dems. On the other hand, independents and moderates, who have tended to gravitate towards McCain in past years, might be turned off by the infighting and board the straight-talk express for good.
It will certainly be interesting to see how this pans out.
Wednesday, March 19, 2008
Random Wednesdays
I have a bunch of random things in my head today. Here goes:
1) Is it just me or does the Democratic Party always find innovative ways to lose elections? This year infighting might be their undoing. Indeed, the ongoing Clinton-Obama spat should certainly make John McCain happy.
I've tried to stay away from expressing my political opinions in this space, but I've been so frustrated with the current goings on that I have to get this out: if the Democrats lose the general election, you can blame Hillary Clinton. I find it unbelievable how dirty the Clinton campaign has been in this election. Here's a great illustration: they've somehow made Sen. Obama responsible for other people's incendiary comments. Why should Obama be responsible for each and every view or rant presented by his friends? (By the way, Sen. Obama handled the whole ruckus about his pastor with the usual thoughtfulness and aplomb.)
Check out my aunt's recent post on the subject for more on this troubling race to the nomination.
2) I realized recently that I take way too long to make simple decisions. I guess I'm too deliberate for my own good. As such, I've decided to follow the Blink philosophy and allow my intuition/gut-instincts to inform my opinions and decisions. My plan is to start with minor decisions and, over time, work this approach into more important ones.
My first application of this thinking? TV shows. Every day someone recommends a new show to me. I don't have the time to watch full episodes, so I thought it would be interesting to watch a five minute sample of a show and see if I like it enough to invest more time in it.
While waiting for someone to show up, I decided to start with One Tree Hill (on the totally useless Soap Network). In the five minute span, I witnessed cheerleaders and basketball players fighting during some Midnight Madness Celebration; a creepy guy urinating in his wife's pool before she goes for a swim and, later, announcing his intention to run for mayor; Chad Michael Murray's girlfriend flipping out because he was hanging out with another girl even though she made him do so; some girl named Peyton accusing her newly introduced biological mother of not having cancer, etc.
I'm happy to report that I was able to make a quick, firm decision: I will never watch this show again.
3) I'm not a big fan of going to the dentist, but it turns out there might be some economic benefits to having nice teeth, especially for women. Check out this recent paper by Sherry Glied and Matthew Neidel. Here is the abstract:
Healthy teeth are a vital and visible component of general well-being, but there is little systematic evidence to demonstrate their economic value. In this paper, we examine one element of that value, the effect of oral health on labor market outcomes, by exploiting variation in access to fluoridated water during childhood. The politics surrounding the adoption of water fluoridation by local water districts suggests exposure to fluoride during childhood is exogenous to other factors affecting earnings. We find that women who resided in communities with fluoridated water during childhood earn approximately 4% more than women who did not, but we find no effect of fluoridation for men. Furthermore, the effect is almost exclusively concentrated amongst women from families of low socioeconomic status. We find little evidence to support occupational sorting, statistical discrimination, and productivity as potential channels of these effects, suggesting consumer and employer discrimination are the likely driving factors whereby oral health affects earnings.
1) Is it just me or does the Democratic Party always find innovative ways to lose elections? This year infighting might be their undoing. Indeed, the ongoing Clinton-Obama spat should certainly make John McCain happy.
I've tried to stay away from expressing my political opinions in this space, but I've been so frustrated with the current goings on that I have to get this out: if the Democrats lose the general election, you can blame Hillary Clinton. I find it unbelievable how dirty the Clinton campaign has been in this election. Here's a great illustration: they've somehow made Sen. Obama responsible for other people's incendiary comments. Why should Obama be responsible for each and every view or rant presented by his friends? (By the way, Sen. Obama handled the whole ruckus about his pastor with the usual thoughtfulness and aplomb.)
Check out my aunt's recent post on the subject for more on this troubling race to the nomination.
2) I realized recently that I take way too long to make simple decisions. I guess I'm too deliberate for my own good. As such, I've decided to follow the Blink philosophy and allow my intuition/gut-instincts to inform my opinions and decisions. My plan is to start with minor decisions and, over time, work this approach into more important ones.
My first application of this thinking? TV shows. Every day someone recommends a new show to me. I don't have the time to watch full episodes, so I thought it would be interesting to watch a five minute sample of a show and see if I like it enough to invest more time in it.
While waiting for someone to show up, I decided to start with One Tree Hill (on the totally useless Soap Network). In the five minute span, I witnessed cheerleaders and basketball players fighting during some Midnight Madness Celebration; a creepy guy urinating in his wife's pool before she goes for a swim and, later, announcing his intention to run for mayor; Chad Michael Murray's girlfriend flipping out because he was hanging out with another girl even though she made him do so; some girl named Peyton accusing her newly introduced biological mother of not having cancer, etc.
I'm happy to report that I was able to make a quick, firm decision: I will never watch this show again.
3) I'm not a big fan of going to the dentist, but it turns out there might be some economic benefits to having nice teeth, especially for women. Check out this recent paper by Sherry Glied and Matthew Neidel. Here is the abstract:
Healthy teeth are a vital and visible component of general well-being, but there is little systematic evidence to demonstrate their economic value. In this paper, we examine one element of that value, the effect of oral health on labor market outcomes, by exploiting variation in access to fluoridated water during childhood. The politics surrounding the adoption of water fluoridation by local water districts suggests exposure to fluoride during childhood is exogenous to other factors affecting earnings. We find that women who resided in communities with fluoridated water during childhood earn approximately 4% more than women who did not, but we find no effect of fluoridation for men. Furthermore, the effect is almost exclusively concentrated amongst women from families of low socioeconomic status. We find little evidence to support occupational sorting, statistical discrimination, and productivity as potential channels of these effects, suggesting consumer and employer discrimination are the likely driving factors whereby oral health affects earnings.
Monday, February 4, 2008
Does Contributing to a Political Campaign Make You Irrational?
A few months ago, I blogged about the phenomenon of cognitive dissonance in politics, where individuals may makes changes in their attitudes or actions in order to make the two consistent. The driving force behind this is that individuals do not be inconsistent. Santosh over at Brown Man's Burden talks about cognitive dissonance in the context of basketball.
I had my own experience with cognitive dissonance a few days back. Several weeks ago, I made my first ever campaign contribution, throwing a token or two over to the "Straight Talk Express." A few days back, I watched the Republican Debate. Intellectually, it was quite clear to me that Gov. Romney won the day, with Senator McCain sounding a bit confused, even defensive, on several policy issues.
However, when I spoke to a friend of mine afterwards who made this point, I debated him vociferously, offering excuses for McCain's tactics and performance. I obviously knew my friend was right, but I didn't want to believe it because I wanted my mouth to be where my money was (or vice versa).
Campaign contributions are salient very early in political contests: funds are important both in getting campaigns started and sustaining them through the grueling primary and general election season. Given this, I wonder how much "stickiness" there is in political support among those who donate money to political campaigns. Obviously, if you are willing to part with money, you are likely more invested in your candidate than others are. However, controlling for intensity of support, I wonder if those who donate to a candidate are more likely to stick with that candidate even when less than flattering information is revealed about him/her during the course of the campaign. This question is similar in spirit to, but ultimately distinct from, that explored in the Mullainathan and Washington paper linked in my previous post.
I had my own experience with cognitive dissonance a few days back. Several weeks ago, I made my first ever campaign contribution, throwing a token or two over to the "Straight Talk Express." A few days back, I watched the Republican Debate. Intellectually, it was quite clear to me that Gov. Romney won the day, with Senator McCain sounding a bit confused, even defensive, on several policy issues.
However, when I spoke to a friend of mine afterwards who made this point, I debated him vociferously, offering excuses for McCain's tactics and performance. I obviously knew my friend was right, but I didn't want to believe it because I wanted my mouth to be where my money was (or vice versa).
Campaign contributions are salient very early in political contests: funds are important both in getting campaigns started and sustaining them through the grueling primary and general election season. Given this, I wonder how much "stickiness" there is in political support among those who donate money to political campaigns. Obviously, if you are willing to part with money, you are likely more invested in your candidate than others are. However, controlling for intensity of support, I wonder if those who donate to a candidate are more likely to stick with that candidate even when less than flattering information is revealed about him/her during the course of the campaign. This question is similar in spirit to, but ultimately distinct from, that explored in the Mullainathan and Washington paper linked in my previous post.
Wednesday, November 7, 2007
The U.S. Health Care System: Not So Bad?
I am currently serving as a TA for two courses, a basic undergrad health economics class given through the economics department and a health policy class for MPH students via the School of Public Health. At the beginning of the semester, the professors in each class put forth the following question: "How many of you think that the American health care system gives good value for the dollar?" Surprisingly, about 1/3 of the undergrads answered "yes." Not surprisingly, the public health-ers unanimously answered "no."
I think there are two things to take from this. First, there is a great deal of self-selection on the margin of political leanings in public health. Most MPH students tend to identify with democrats/liberals (or, in one of my more cynical moments, "pink-os"), which probably is what induces them to pursue a service-oriented field like public health in the first place. (I'm not sure if the causality works the other way: does learning about public health shift people's voting preferences to the left?).
Second, and most germane to this post, is that, despite what Michael Moore says, not everyone thinks the U.S. health care system is a complete disaster. Slowly but surely, some recent press and research work suggests that the American system isn't really as bad as it seems when making general comparisons with systems in other OECD countries.
For some insight into this, check out recent New York Times article by Greg Mankiw. It is actually the post that I wanted to write and had already written part of before finding out I was scooped. Given that I was about the say the same thing, I think his commentary is very sensible. Here are the major points (I'm not going to give too much away, so as not to destroy any incentives to read the real thing):
1) Cross-country differences in infant mortality rates and life expectancies are mismeasured and overstated when judging different health systems.
2) The 47 million uninsured statistic that everyone quotes masks a lot of things that actually aren't very worrisome, at all.
3) Rising health care costs may be a sign of progress rather than impending doom. At the very least, putting a value judgment on that 16% of GDP tidbit is misguided.
These points don't just stem from conservative, free-market dogmas. Rather, they should be taken seriously for their attention to measurement issues and economic principles. It isn't the first time that alternate, less pernicious interpretations can be given to stylized facts that initially seem quite alarming. Check out an earlier post for another example of this, which also happens to be drawn from the health care arena.
The obvious bottom line: we need to learn from both sides of the health care debate in order to make reasonable policies.
I think there are two things to take from this. First, there is a great deal of self-selection on the margin of political leanings in public health. Most MPH students tend to identify with democrats/liberals (or, in one of my more cynical moments, "pink-os"), which probably is what induces them to pursue a service-oriented field like public health in the first place. (I'm not sure if the causality works the other way: does learning about public health shift people's voting preferences to the left?).
Second, and most germane to this post, is that, despite what Michael Moore says, not everyone thinks the U.S. health care system is a complete disaster. Slowly but surely, some recent press and research work suggests that the American system isn't really as bad as it seems when making general comparisons with systems in other OECD countries.
For some insight into this, check out recent New York Times article by Greg Mankiw. It is actually the post that I wanted to write and had already written part of before finding out I was scooped. Given that I was about the say the same thing, I think his commentary is very sensible. Here are the major points (I'm not going to give too much away, so as not to destroy any incentives to read the real thing):
1) Cross-country differences in infant mortality rates and life expectancies are mismeasured and overstated when judging different health systems.
2) The 47 million uninsured statistic that everyone quotes masks a lot of things that actually aren't very worrisome, at all.
3) Rising health care costs may be a sign of progress rather than impending doom. At the very least, putting a value judgment on that 16% of GDP tidbit is misguided.
These points don't just stem from conservative, free-market dogmas. Rather, they should be taken seriously for their attention to measurement issues and economic principles. It isn't the first time that alternate, less pernicious interpretations can be given to stylized facts that initially seem quite alarming. Check out an earlier post for another example of this, which also happens to be drawn from the health care arena.
The obvious bottom line: we need to learn from both sides of the health care debate in order to make reasonable policies.
Thursday, September 13, 2007
Protesting Stupidity: AIDS Demonstration in Cape Town
This time, I couldn't help but get riled up.
I've been to protests before, though most of these were of the ultimately trivial "uninformed-college-students-angry-against-the-world" sort. For the most part, I've approached these kind of gatherings with a decidedly positive (in the Milton Friedman sense) approach: go see what people are mad about and find out whether their specific concerns are borne out "in the data".
The protest I attended in Cape Town was completely different from these past experiences. This wasn't the kind of demonstration where both sides of the issue had some credibility. Rather, this was a protest against sheer stupidity on the part of elected officials, all of whom should know better.
In particular, demonstrators were protesting the dubious dismissal of South African Deputy Health Minister Nozizwe Madlala-Routledge. The suspicion surrounding the incident lies in Nozizwe's support of aggressive anti-HIV/AIDS policy, which stands in contrast to her superiors' - which includes South African President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang - essentially anti-science stance (they've gone on record with gems like HIV doesn't cause AIDS, garlic may be as effective as ARVs in treating the disease, etc). You can read about the whole story here, here and here. For a more eloquent account of AIDS politics in South Africa, check out some of the older posts at James Hudspeth's blog. He's a medical student who spent an academic year in South Africa and writes like...well, a real writer. For future reference, you'll find him hanging out under links.
A little bit more about the protest: it was, in a word, electrifying. The atmosphere plus the really obvious cause turned this usually casual observer into an active participant. While it was sad that the whole affair had to come to this, it was uplifting to be able to believe - at least for that one moment - that the protesters would ultimately succeed in their fight against AIDS and all the 'dubborn' (thats dumb+stubborn) people who stand in their way.
The affair was organized by the NGO Treatment Action Campaign, and was filled with singing, dances, and speeches by a variety of different activists (labor union reps, women's rights advocates, and so forth). My favorite speech was by a Quaker gentleman (that's what he introduced himself as), who looked completely out of place up on the dais as he was a good deal older and whiter than his counterparts. He went up on podium and, in a soft, calm voice, clinically annihilated each of the justifications put forth by the government for Nozizwe's dismissal.
The response he received was as loud as he was quiet: completely deafening. "Speak softly and carry a big stick," said Big Teddy R. Indeed.
I'm not good enough a writer to really describe in words how electric the atmosphere was at this protest. Instead, I'm going to let the event speak for itself. Check out this video and soak in the sounds and atmosphere. Even at 0.2 megapixel or whatever, its still pretty moving.
I've been to protests before, though most of these were of the ultimately trivial "uninformed-college-students-angry-against-the-world" sort. For the most part, I've approached these kind of gatherings with a decidedly positive (in the Milton Friedman sense) approach: go see what people are mad about and find out whether their specific concerns are borne out "in the data".
The protest I attended in Cape Town was completely different from these past experiences. This wasn't the kind of demonstration where both sides of the issue had some credibility. Rather, this was a protest against sheer stupidity on the part of elected officials, all of whom should know better.
In particular, demonstrators were protesting the dubious dismissal of South African Deputy Health Minister Nozizwe Madlala-Routledge. The suspicion surrounding the incident lies in Nozizwe's support of aggressive anti-HIV/AIDS policy, which stands in contrast to her superiors' - which includes South African President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang - essentially anti-science stance (they've gone on record with gems like HIV doesn't cause AIDS, garlic may be as effective as ARVs in treating the disease, etc). You can read about the whole story here, here and here. For a more eloquent account of AIDS politics in South Africa, check out some of the older posts at James Hudspeth's blog. He's a medical student who spent an academic year in South Africa and writes like...well, a real writer. For future reference, you'll find him hanging out under links.
A little bit more about the protest: it was, in a word, electrifying. The atmosphere plus the really obvious cause turned this usually casual observer into an active participant. While it was sad that the whole affair had to come to this, it was uplifting to be able to believe - at least for that one moment - that the protesters would ultimately succeed in their fight against AIDS and all the 'dubborn' (thats dumb+stubborn) people who stand in their way.
The affair was organized by the NGO Treatment Action Campaign, and was filled with singing, dances, and speeches by a variety of different activists (labor union reps, women's rights advocates, and so forth). My favorite speech was by a Quaker gentleman (that's what he introduced himself as), who looked completely out of place up on the dais as he was a good deal older and whiter than his counterparts. He went up on podium and, in a soft, calm voice, clinically annihilated each of the justifications put forth by the government for Nozizwe's dismissal.
The response he received was as loud as he was quiet: completely deafening. "Speak softly and carry a big stick," said Big Teddy R. Indeed.
I'm not good enough a writer to really describe in words how electric the atmosphere was at this protest. Instead, I'm going to let the event speak for itself. Check out this video and soak in the sounds and atmosphere. Even at 0.2 megapixel or whatever, its still pretty moving.
Saturday, September 8, 2007
Irrational Voters
It's safe to say that these aren't the best of times for President Bush supporters. Depending on your point of view, every month seems to bring a new problem, a new screw-up, or a new impeachable offense. What is interesting is that, despite talk of him being the worst president ever, some 30% of the public still approves of Bush's job performance. "How is this even possible?" asked one of my relatives in India.
Perhaps part of the answer can be found in this very interesting paper by economists Sendhil Mullainathan and Ebonya Washington. Standard economic models of voting posit that individuals express their preferences through their vote. The authors suggest, however, that it is possible for the act of voting to influence beliefs and preferences. How does this occur? As the authors note:
One explanation for the impact of behaviors on beliefs is cognitive dissonance (Festinger, 1957) which refers to one’s internal need for consistency. If an individual performs an activity that is antithetical to his beliefs, the individual may unconsciously change his beliefs to alleviate the discomfort of having inconsistent attitudes and actions.
In order to test for behavioral effects of voting, the authors use an ingenious "natural experiment." First off, note that if we were to take the general population and run a regression of beliefs on voting, the results would be difficult to interpret: does the causality run from voting to beliefs or beliefs to voting? To get around that problem, Mullainathan and Washington exploit the age discontinuity in voting eligibility (i.e. 17 years olds can't vote, but 19 years olds can) and check the beliefs of these individuals two years later. They find that those who voted (the then 19 now 21 year olds) show more polarizing opinions than comparable individuals who did not (then 17, now 19 year olds). Note that, for this to work, those who voted and those who did not due to age restrictions should look the same as far as their traits and such. The authors go to some difficulty to establish this.
I buy it. In 2000, I put my support behind then Governor G. W. Bush. For the next few years, I felt myself supporting the Bush administration's policies less and less (and less and less), but, at least for a few months, I viscerally experienced some weird feeling (shame?) from having acted in one way and, subsequently, believing another. I'm happy to report that I am no longer upset about this and at peace with my anti-neocon stance, but the experience of being dissonant really did resonate with me.
More on voting: I'm really interested in reading this new book The Myth of the Rational Voter: Why Democracies Choose Bad Policies by Bryan Caplan. Supposedly the book is about why voters act stupidly with respect to their best interests.
Perhaps part of the answer can be found in this very interesting paper by economists Sendhil Mullainathan and Ebonya Washington. Standard economic models of voting posit that individuals express their preferences through their vote. The authors suggest, however, that it is possible for the act of voting to influence beliefs and preferences. How does this occur? As the authors note:
One explanation for the impact of behaviors on beliefs is cognitive dissonance (Festinger, 1957) which refers to one’s internal need for consistency. If an individual performs an activity that is antithetical to his beliefs, the individual may unconsciously change his beliefs to alleviate the discomfort of having inconsistent attitudes and actions.
In order to test for behavioral effects of voting, the authors use an ingenious "natural experiment." First off, note that if we were to take the general population and run a regression of beliefs on voting, the results would be difficult to interpret: does the causality run from voting to beliefs or beliefs to voting? To get around that problem, Mullainathan and Washington exploit the age discontinuity in voting eligibility (i.e. 17 years olds can't vote, but 19 years olds can) and check the beliefs of these individuals two years later. They find that those who voted (the then 19 now 21 year olds) show more polarizing opinions than comparable individuals who did not (then 17, now 19 year olds). Note that, for this to work, those who voted and those who did not due to age restrictions should look the same as far as their traits and such. The authors go to some difficulty to establish this.
I buy it. In 2000, I put my support behind then Governor G. W. Bush. For the next few years, I felt myself supporting the Bush administration's policies less and less (and less and less), but, at least for a few months, I viscerally experienced some weird feeling (shame?) from having acted in one way and, subsequently, believing another. I'm happy to report that I am no longer upset about this and at peace with my anti-neocon stance, but the experience of being dissonant really did resonate with me.
More on voting: I'm really interested in reading this new book The Myth of the Rational Voter: Why Democracies Choose Bad Policies by Bryan Caplan. Supposedly the book is about why voters act stupidly with respect to their best interests.
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