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June 17th, 2009
Keeping perspective when thinking about Africa
June 17th, 20090
… the proportion of the population of Sub-Saharan Africa affected by famine over the 1990-2005 period averaged less that three tenths of a percent. The proportion who were refugees in 2005 was five tenths of a percent. The number who died in wars 1965-2001 was one one-hundredth of a percent. 14 These figures add up to stories of despair for many millions in Africa –but they remain stories of the small minority. For the rest, progress has been considerable. Take literacy, for example –the percentage of Sub-Saharan Africans who could read and write doubled over the period 1970-1999, from less than one in three to two thirds of the adult population.
This sentiment was echoed by Chris Blattman in response to a recent column by Nicholas Kristof, which offered traveling tips for people going to low-income countries.
Here’s a simple truth: just like home, car accidents not bandits are the bogeyman. Malaria might be the second major risk, for which we have easy solutions. Thieves and rapists are typically a distant danger. This is not to say you shouldn’t take precautions. But personally I try to remember that I have more risk of bandits in New York and New Haven than any of the countries I visit… The essential point: foreign does not equal dangerous. Dwelling on the potential bandit round the next corner will make you miserable, paranoid, and make even a little prejudiced.
The column has some good tips like carrying a fake wallet, but its important to remember the developing world is more than the images we see on the news. Kenny’s book, from what I have read so far, tries to re-focus our measure of development away from economic growth towards other indicators, which for Africa show great progress. I will discuss the merits of this framing as well as other questions brought up by his book in posts to come.
Correlation v Causation and the influence of money
June 16th, 20090
Dr. Arthur L. Klatsky, a cardiologist in Oakland, Calif., wrote a landmark study in the early 1970s finding that members of the Kaiser Permanente health care plan who drank in moderation were less likely to be hospitalized for heart attacks than abstainers.
I probably do not even need to read this paper as its summary indicates Dr. Klatsky does not understand the difference between correlation and causation. Critical studies show moderate drinking is actually an indicator of healthy practices such as eating healthy, working out, and other positive things rather than a cause of good health outcomes.
Moreover, the alcohol industry seems to be funding alcohol studies as well as conferences that coincidentally state that there is a scientific consensus that drinking alcohol in moderation is beneficial to one’s health. So bad science coupled with big money convinced of something totally unfounded. While I may be oversimplifying the debate, the fact remains that no long-term, randomized, clinical trial that meets the ‘gold standard’ of scientific study has ever been done on the issue. There is no way to build a scientific consensus around a connection with lots of holes without such a study.
How to interpret the CBO’s scoring of Kennedy’s healthcare plan
June 16th, 20090
“In an effort to buy some extra time to negotiate with Republicans on the committee, the Democrats on HELP left out some of the more controversial policies in the hopes of reaching a bipartisan agreement sometime this week. The public plan, the employer mandate and the individual mandate were all absent from the proposal the CBO examined. The employer and individual mandates — the first of which pushes employers to offer coverage and the second of which force individuals to purchase coverage — are particularly key to increasing the number of Americans with health insurance.”
One could also go directly to the top for clarification surrounding the CBO’s scoring. CBO Director Doug Elmendorg on his blog states:
These new figures do not represent a formal or complete cost estimate for the draft legislation, for several reasons. The estimates provided do not address the entire bill—only the major provisions related to health insurance coverage. Some details have not been estimated yet, and the draft legislation has not been fully reviewed. Also, because expanded eligibility for the Medicaid program may be added at a later date, those figures are not likely to represent the impact that more comprehensive proposals—which might include a significant expansion of Medicaid or other options for subsidizing coverage for those with income below 150 percent of the federal poverty level—would have both on the federal budget and on the extent of insurance coverage.
So how do we interpret the CBO’s scoring? The scoring was both a miscommunication between HELP and the CBO, check Ezra for details, and a huge political gaff on the part of HELP’s staff. What this scoring tells from a policy perspective is little. The costs will most likely rise along with coverage as more details are scored, which is pretty much what everyone was expecting anyways.