Here's the summary. All figures are per year.
Total healthcare spending: $2.4 trillion.
Cost of malpractice claims: $5.8 billion.
Number of people "severely hurt each year as a result of mistakes at U.S. hospitals": 181,000.
Number of these who file claims: 30,000.
Draw your own conclusions.
Source: Associated Press, July 20, http://www.msnbc.msn.com/id/32011837/ns/health-health_care/
Monday, July 20, 2009
Wednesday, July 8, 2009
pessimistic about the long term
Before the current recession, I used to tell people that I was optimistic about the US economy over the short term, pessimistic medium-term, and optimistic long-term. The short-term optimism was due to immediate economic news being less bad than portrayed. The medium-term pessimism was due to the US trade and federal deficits. The long-term optimism was due to demographics (the young and immigrant US population) and culture (the US tradition of entrepreneurism and strong top universities).
Now, I am pessimistic about the long term. The reason is that there has been a succession of bubbles, each one leading to the next. After each bubble, the authorities have stimulated the next one, because that has seemed easier than dealing in a direct way with the imbalances caused by the previous bubble.
The first bubble was the irrational exuberance of the 1990s that culminated in the dot-com boom. This bubble popped in March of 2000. Greenspan allowed the exuberance to continue too long, and then responded too aggressively. This contributed to a combined housing and banking bubble. The housing bubble started bursting in mid 2005, and the banking bubble in mid 2007. Now, in mid 2009, bubble number three is underway. The administration is propping up consumption by inflating the federal spending bubble. For every two dollars the federal government spends, it collects one dollar in taxes and borrows one dollar.
What all these bubbles have in common is that they have permitted excess US consumption. Essentially, the US buys more stuff than it makes. Americans have felt comfortable doing this because they have felt wealthy: that their tech stocks or houses were worth a lot, or now, that their government has good credit.
The next bubble is coming: it will be inflation. People around the world, including wealthy Americans, are lending massive sums to the US government. The government is spending these in ways that support employment short-term, but are not very productive long-term. The lenders have already started worrying about how the US will repay them. There is only one way the US can make repayments without a huge increase in tax revenue: inflation. This will be the next bubble.
Now, I am pessimistic about the long term. The reason is that there has been a succession of bubbles, each one leading to the next. After each bubble, the authorities have stimulated the next one, because that has seemed easier than dealing in a direct way with the imbalances caused by the previous bubble.
The first bubble was the irrational exuberance of the 1990s that culminated in the dot-com boom. This bubble popped in March of 2000. Greenspan allowed the exuberance to continue too long, and then responded too aggressively. This contributed to a combined housing and banking bubble. The housing bubble started bursting in mid 2005, and the banking bubble in mid 2007. Now, in mid 2009, bubble number three is underway. The administration is propping up consumption by inflating the federal spending bubble. For every two dollars the federal government spends, it collects one dollar in taxes and borrows one dollar.
What all these bubbles have in common is that they have permitted excess US consumption. Essentially, the US buys more stuff than it makes. Americans have felt comfortable doing this because they have felt wealthy: that their tech stocks or houses were worth a lot, or now, that their government has good credit.
The next bubble is coming: it will be inflation. People around the world, including wealthy Americans, are lending massive sums to the US government. The government is spending these in ways that support employment short-term, but are not very productive long-term. The lenders have already started worrying about how the US will repay them. There is only one way the US can make repayments without a huge increase in tax revenue: inflation. This will be the next bubble.
Wednesday, May 13, 2009
About the title of this blog
When I was in school, I remember teachers and family telling me that criticism should be constructive. They meant that I shouldn't just be negative in my comments about something. I should propose positive alternatives.
I didn't agree then and I don't agree now. Sometimes positive alternatives don't exist: you can't get there from here. Sometimes any positive alternatives you can think of immediately are superficial. And sometimes genuine alternatives can only emerge from sustained analysis.
What's more important is that criticism should be correct, or at least insightful and thought-provoking. Good positive suggestions can come later, and separately.
When people claim that criticism is not constructive, what they usually mean is that they don't want to hear it and they don't want to be pushed out of their zone of ignorant comfort. As the slogan says, "If you are not outraged then you are not paying attention."
I didn't agree then and I don't agree now. Sometimes positive alternatives don't exist: you can't get there from here. Sometimes any positive alternatives you can think of immediately are superficial. And sometimes genuine alternatives can only emerge from sustained analysis.
What's more important is that criticism should be correct, or at least insightful and thought-provoking. Good positive suggestions can come later, and separately.
When people claim that criticism is not constructive, what they usually mean is that they don't want to hear it and they don't want to be pushed out of their zone of ignorant comfort. As the slogan says, "If you are not outraged then you are not paying attention."
Tuesday, May 12, 2009
Twisted talk
From the San Diego paper: “People don't appreciate we have been cutting for the past five years,” said Sen. Denise Ducheny, a San Diego Democrat and chairwoman of the Budget Committee.
What's the truth? In 2003/04 the total state budget was $98.9 billion. In 2006/07, the total was $131.4 billion. In 2009/10, $134.8 billion.Sources: http://www.sen.ca.gov/budget/budgethistory.pdf
http://sinet2.sen.ca.gov/budget/2009BudgetAct.pdf
Monday, May 11, 2009
The GM giveaway
Today's newspapers report the likely details of the possible bankruptcy of General Motors. It's interesting to look at the implied valuations of the stakes held by different parties.
The Obama administration wants holders of bonds to swap debt with face value $27 billion for 10 percent of GM's new stock. The UAW would get 39 percent in exchange for $10 billion that GM owes to a trust for healthcare for retired workers. The government would get 50 percent in exchange for its loans, which total $15.4 billion so far and $11.6 billion for the rest of 2009. Existing shareholders will get 1%.
GM's market capitalization today is $0.88 billion. This implies that the company is worth $88 billion after it is recapitalized in bankruptcy. Using this valuation, bondholders will get new stock worth about $9 billion. The UAW will give up its $10 billion claim in exchange for new stock worth $34 billion. The government will get $44 billion of stock in exchange for $27 billion of cash.
The general principle is that shareholders are the residual owners, so it's understandable they should get effectively wiped out. Similarly, the bondholders lent their $27 billion a while ago, so they don't have a senior claim. $9 billion for them, or 33%, seems reasonable. The government lent its money more recently, so it has the senior claim, so it should get over 33%. Why it should get over 100% is not clear.
What is egregious is that the the UAW should get 340%. Their $10 billion is a claim that is several years old. In seniority it should be similar to the bondholders' claim.
Two aspects of the plan make it even worse. First, the UAW will have its cake and eat it too: the new GM will still owe $10 billion cash to the retiree health plan. The UAW will get upside from its stock, and downside protection fom its cash claim. Sweet for them.
Second, the UAW will have 39% voting rights. This will be effective control on all issues where the government is not willing to fight the UAW publicly.
What can one predict for the future? Under union control, you can bet that GM will continue to sink. The government will never be able to cash in its shares for anything close to $44 billion. For a few more years, the union will be able to extract cash from GM, partly as wages and partly as healthcare payments. Perhaps the union will cash in some of its stock, but most likely they will use it just for voting control. In a few years, when the corpse has been sucked dry, the rump will be sold off. The taxpayers will be out $27 billion cash. Most of this money will have been frittered away in payments to unproductive workers.
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