Sunday, March 4, 2007

The American South

I highly recommend this week's Economist Survey on the American South. It is several articles long but it goes through the great progress that has occurred during the past two generations. For the purposes of the survey, they define the South (as I do) to be the old Confederate states and OK and KY. Here are few bits parsed out from the whole article:
In 1937 southern incomes were only half the American average; today they are 91% of it. If you allow for the lower cost of living in the South, the gap all but vanishes. Since the 1960s, more whites have moved to the South than have left it. Since the 1970s, the same has been true for African-Americans. The South's share of America's population has risen from just over a quarter in 1960 to a third today, making it the most populous American region.

The convergence in living standards must be one of the top stories of past two generations of Southerners. But I still think one of the least known demographic facts of American life is that there has been a rather large re-migration to the South of black Americans pursuing economic opportunities. It says a lot about race relations that more blacks move into the South than away from it each year.
In 1942, 98% of southern whites told pollsters that blacks and whites should attend separate schools, and 96% favoured segregated buses. By 1963, when the civil-rights movement was in full voice, those numbers had fallen to 69% and 48% respectively. Today, open support for segregation is so rare that pollsters no longer bother to ask the question....

Furthermore, in 1958 only 4% of all white Americans approved of inter-racial marriage. As of 2003, 59% of white southerners were telling pollsters that it was “all right for blacks and whites to date”. That is double the 1988 number. Also, black median income in the South is 99% of black median income elsewhere in the country. Finally, "the Pew Research Center found in 2003 that southern blacks were more likely than non-southern ones (by 31% to 20%) to say that “discrimination against blacks today is rare”. In the 1980s southern blacks were no more optimistic on this score than northerners." If the race relations of LA, NYC, Chicago and Washington D.C. are any indication, the problem of racial discrimination may actually be worse outside of the South these days.

The other articles discuss religion, food, culture (branding), and politics. Without recapping all of them, I do highly recommend the politics article (found here) as a helpful primer for non-Southerns who seem to believe that race drives all Southern politics. It discusses the importance of religion and individualism in the shifting from Segregationist Democrats such as George Wallace to modern day Republicanism of the Gov. Sanford (SC) type. Without going into details, the Economist analysis dovetails with my minimal research into the fact that most segregationist Democrats stayed Democratic until they died. The uptick in Republicanism came mostly from their children and internal migration from the North, especially in all non-Presidential politics where Democrats controlled the South until the early 1990s.

All in all, it is a great survey for anyone not to familiar with the modern South. It talks about the good and the bad, but most importantly it helps dispel some of the uglier stereotypes which non-Southerners hoist upon their neighborhoods.

Wednesday, February 28, 2007

The urgency of reforming medical insurance system in the US, why relative poverty matters and why the reform must help the poorest.

It's a sensationalistic story.
It's not a comprehensive study.
It's only the account of one boy.
It's certain there are other reasons why this happened.

But does any of that matter? The fact that it happened at all is bad enough.

Children should not be allowed to die of toothaches because they don't have insurance or money to cover simple dental care. This definitely should not be allowed to happen in the US of A. This is why relative poverty matters. This is why health care in this country needs urgent reform. And this is most definitely why healthcare reform in this country should account for the poorest in this country, even if they are fabulously wealthy by global and historical standards.

Su Dongpo

Monday, February 19, 2007

Re: Poverty in America

Perhaps a redefinition of what constitutes poverty makes sense; but I think anyone engaging in this needs to take into account the fact that relative poverty can have equally damaging effects as absolute poverty.

It turns out that African American living in the US have a lower life expectancy than the more "absolutely" poor lower class in India. (See Amartya Sen, Development as Freedom).

Su Dongpo

Re: Nuclear Proliferation

I'm afraid we may just have to welcome the Ayatollahs to the nuclear club.

First of all, we're way too stretched out and too vulnerable in Iraq and Afghanistan to do anything. Rather than having them surrounded, we've entered their backyard and we have too many enemies there that we haven't defeated.

Second, if we were serious about nuclear non-proliferation we would've waved our big stick at North Korea, not at Iraq. We've lost all credibility in the world of weapons of mass destruction.

I agree with Hamilton's post below, this is a huge tragedy. More for the people of Iran than anything else. The people of Iran have been waging a slow cultural and democratic campaign to attempt to regain their freedom from the Ayatollahs without undoing their own identity. If the Ayatollahs get the bomb, it will most likely solidify that government's position.

Personally, I think a strike on Iran would be unjustified suicide. Iran is one of very few democracy like countries in that area. And they've got us with our pants down, vulnerable in both Iraq and Afghanistan.

But most importantly, we really need to rethink what war is. War is not a tool. It is not a means of diplomacy. It is not a means of meddling with other people's governments and decisions. War is a ghastly human tragedy that should only ever be the utmost last resort of a democratic people. War should never be voluntary. See The End of Iraq by Peter Galbraith.

Su Dongpo

Re: Medical Insurance System

Here is an excellent Paul Krugman article about the inefficiency of our health care system...

Goes to show how good Krugman could be when he isn't ranting about things he knows very little about and instead sticking to economics.

A Proposition for the medical care and insurance crisis in the US

Experimental proposition to be fleshed out:

We should expand the and reshape the two tier form of medical care, coverage and insurance that we currently have in this country into a three tier system that would look something like this:

First tier - strictly market based, completely deregulated tier, especially for the treatment of complex and difficult diseases such as cancer. Allow as much competition as possible by federalizing the regulatory system at this level.

Third tier - a universally covered medical system run by nurse practitioners who have been extensively trained in standard Western triage and diagnosis skills and pain management skills not unlike and perhaps even based in Chinese medicine. This tier should screen and manage all complaints before referral to the second tier. Practitioners at this level would devote substantial amounts of time to each patient and would not earn as much as practitioners at other tiers through the market mechanism, but through a substantial increase in government spending in programs similar to medicare and medicaid, they would still earn good money. In order to accomplish this military spending would have to be cut and lots of money would have to go into recruiting qualified nurses from abroad and subsidizing the training of individuals in the US.

Second tier - the usual medical industry composed of doctors who only see patients from the third tier who have clearly medical pathologies - i.e. bacterial infections, cancers etc but who cannot necessarily afford the more expensive market based systems.

All doctors would participate in all three tiers through some regulation (management of nurses in third tier) but how this would work I'm not entirely sure.

The purpose is to compromise between not impairing what works about the US system - obscure and complicated treatments are readily available for those who can afford them - but fixing what doesn't work - those who can't afford medical treatment tend to suffer disproportionately. The Canadian system errs on that side by allowing everyone the same access but thereby artificially restricts the access of those who can afford better treatment and consequently reduces incentives for improving and experimenting in medical techniques.

This is a very raw idea. This is my proposal, I'm curiously to hear constructive additions and modifications of this proposal. Help me flesh this out.

Su Dongpo

Intellectual Property & Research Incentives for making drugs

In a recent talk, nobel laureate Joseph Stiglitz asserted two very interesting ideas that need substantiation and evidence:

1) First he stated that the patent process is socially inefficient because it awards pharmaceutical companies monopoly power over their particular drugs, thus allowing them to reap large profits off of potentially small contributions but also giving them the incentive to maintain that monopoly power. To bolster this idea he put forth as a fact the idea that pharmaceutical companies spend more on marketing and advertisements than research. The implication being that pharmaceutical companies are using patents to solidify monopoly power rather than to do more research - which is the ostensible social purpose of patents - to give incentives for further research. But the question is, is it true that pharmaceutical companies spend more on marketing and advertising? And if so, where are these figures and what are these figures? Is it a 5 to 1 ratio and who is claiming this? Is this information being spun? And if it is not, shouldn't we be outraged?

2) Stiglitz made a second and similar proposition: he stated that pharmaceuticals spend more on lifestyle drugs - see viagra - then they do on lifesaving drugs. First, is this true? Second, what are the implications of this? I'm guessing my market oriented colleagues will suggest that the market wants what the market wants and that's ok. But as a matter of public policy, especially where lives are at stake, should we be willing to accept this? My answer to that question is an unequivocal no. But then this begs the question of what solution to the problem? Should some lines of research be sponsored wholly by government funding? And if so what implications for the patent process?

Su Dongpo