Andrew Gelman writes:
Bloggitude: who gets upset by what?: I often read Greg Mankiw's blog because it has lots of interesting little bits. Also, just as it can be fun to read the writings of someone nonideological, because you never know where they'll stand on any given issue, it can also be enjoyable to read more partisan writings--in Mankiw's case, you'll get an educated conservative take on a wide range of economic issues. Sometimes I think Mankiw is misled by his ideology (as in his blogs on his work incentives, recidivism, and Sonia Sotomayor's savings account); other times he makes a good point (as with the Obama team's unemployment forecast and effects of tax cuts). But he's often thought-provoking.
But I was unhappy to see Mankiw's latest blog entry. Here it is, in its entirety:
Three on Health Policy
- John Cochrane
- Robert Samuelson
- Charles Krauthammer
What sort of value is Mankiw adding here? He's across the river from an excellent, excellent department of health care policy. Wouldn't it be more helpful for Mankiw to read some of their papers and give his comments, from the perspective of a conservative economist? What does he gain by linking to newspaper pundits (links 2 and 3 above)?...
[Mankiw] is linking to arguments about economics--but arguments that are being made by people with much less expertise than he has! It would be like me approvingly linking to a Dilbert cartoon that endorses Bayesian statistics.
I guess the real question is why this bothers me.... I'm certainly not saying that Mankiw has any duty to be commenting on the top papers in health care policy research for his blog.... I just don't see what he is offering by linking to newspaper op-eds. I think he'd have much more to offer, even as a blogger, by critiquing the work of academic health-care policy researchers...
I think Andrew is feeling the tug of a set of ideas that I associated with medieval historian Ernst Kantorowicz, perhaps best known as the author of the magnificent The King's Two Bodies: A Study in Medieval Political Theology:
Ernst Kantorowicz: The Fundamental Issue:: I... wish to emphasize the true and fundamental issue at stake: professional and human dignity. There are three professions which are entitled to wear a gown: the judge, the priest, the scholar. This garment stands for its bearer's maturity of mind, his independence of judgment, and his direct responsibility to his conscience and to his God. It signifies... inner sovereignty:... [its wearers] should be the very last to allow themselves to act under duress and yield to pressure. It is a shameful and undignified action, it is an affront and a violation of both human sovereignty and professional dignity that the Regents of this University have dared to bully the bearer of this gown into a situation in which--under the pressure of a bewildering economic coercion-‑he is compelled to give up either his tenure or, together with his freedom of judgment, his human dignity and his responsible sovereignty as a scholar...
When you become a professor, Ernst Kantorowicz says, you take on two obligations:
- To think as hard as you can, and
- To say what you think.
Thus you raise the level of the debate by helping others to think better, and by serving as a positive role model that they, too, ought in their best selves not to yield to peer pressure or ideological blinders or the fear that they won't get invited to the right dinner parties but instead to, in their turn, think as hard as they can and tell people what they think.
Andrew's problem with Greg, I think, is that he sees Greg as linking to people who by and large are trying to lower the level of the debate. Greg links to Robert Samuelson who claims that the Obama administration is not trying to "bend the curve" of Medicare and Medicaid costs at a moment every conversation I have on health care with a senior administration official winds up being at least one third about getting more bang-for-the-buck from Medicare--comparative effectiveness research, MedPAC, et cetera--and then sneers at Obama for not exercising "genuine presidential leadership." Anyone who reads Samuelson winds up knowing less about the health care reform debate aferwards then before.
Greg links to Charles Krauthammer, who misrepresents Doug Elmendorf, writing "researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness..." and not mentioning that Elmendorf's letter states:
because a preventive service adds to total spending does not mean that it is a bad investment... a large fraction of preventive care adds to spending but should be deemed "cost effective"... provides clinical benefits that justify those added costs.... A further consideration affecting the budgetary impact... is that... preventive care may increase longevity... that effect reinforces the desirability of such care, but... add[s] to federal spending in the long run.
Once again, anyone who reads Krauthammer winds up less well-informed than they were before.
John Cochrane's piece suffers, I think, from a different problem. Here at Berkeley--and, indeed, throughout the rest of the sane academic world--we work in the shadow of George Akerlof, Joe Stiglitz, and Michael Spence, and Kenneth Arrow and believe that the individual health insurance market is broken because of a combination of adverse selection by insurers and moral hazard on the part of insurees. Cochrane believes differently--that "the tax deduction for employer-provided group insurance... has nearly destroyed the individual insurance market [and] is a central culprit..." That, I think, makes Cochrane's views on health care confused--and I say this as someone who has learned more about asset prices from John Cochrane than from anybody else alive.