Whose Body Is It Anyway?

When I taught benefit‐​cost analysis at the Naval Postgraduate School, one of the first principles I explained was that, to do a good analysis, you need to consider the costs and benefits to the various people affected rather than taking as gospel the desires of policymakers. We studied both good and bad examples of benefit‐​cost analyses. In the bad ones, a common error was to leave out the gains to consumers when they consumed items that policymakers did not want them to. A typical case was alcoholic beverages; policymakers kept overlooking the enjoyment that consumers receive from a drink.

In his book The Rediscovery of Tobacco: Smoking, Vaping, and the Creative Destruction of the Cigarette, independent journalist (and one‐​time Cato staffer) Jacob Grier avoids that error. Not only does he consider the costs of cigarettes and other forms of tobacco to their users and to nonsmokers, but he also considers the benefits to users. In doing so, he makes a case for people’s freedom to smoke or inhale what they want when it does not inflict harm on non‐​users. Along the way, he details how the antismoking movement has shown its disregard for the interests of smokers. He also shows that the damage from secondhand and “thirdhand” smoke is often overstated and that the harm from e‐​cigarettes is overstated and the benefits understated. Although I am a dyed‐​in‐​the‐​wool nonsmoker and non‐​vaper and Grier did not persuade me to try these substances (nor did he attempt to change readers’ minds), I learned a lot from this book. You could say that I “rediscovered tobacco.”

This is from David R. Henderson, “Whose Body Is It Anyway?” Regulation, Spring 2021.

Another highlight:

Grier notes an interesting difference in research methodologies between studies of the health effects on smokers in the 1940s and 1950s and the later studies of researchers on secondhand smoke. The earlier researchers had noticed a huge increase in deaths from lung cancer in the first half of the 20th century and wanted to figure out why. They established a clear relationship between smoking cigarettes and lung cancer. But, notes Grier, research on secondhand smoke “reversed that approach.” He writes, “Scientists started out with a hypothesis — that secondhand smoke was causing lung cancer in nonsmokers — and took on the task of finding the bodies.”

My one criticism:

Antismoking activists, he notes, didn’t stop with secondhand smoke. They raised the ante by stirring up concern about “thirdhand smoke.” What’s that? Grier quotes a definition the New York Times posited in 2009: “the invisible yet toxic brew of gases and particles clinging to smokers’ hair and clothing, not to mention cushions and carpeting, that lingers long after secondhand smoke has cleared the room.” Grier comments that he does not know “if studies will ever successfully demonstrate that thirdhand smoke increases the risk of any particular disease, and, crucially neither do the researchers who have been promoting these fears to the public for more than a decade.” This is awkward wording. He seems to be saying that the researchers have no evidence, but I wish he had stated his point more clearly.

Read the whole thing. To do so, you need to go to the link and then download the pdf.

 

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Brookings’ Cliff Winston on Infrastructure

President Joe Biden is planning a multi-trillion-dollar infrastructure and jobs package to spur transformative change to the economy. Unfortunately, the infrastructure component of his plan will fail to significantly improve the nation’s roads, bridges, and the like because it ignores the vast inefficiencies in current transportation policy that greatly reduce benefits from infrastructure spending.

Let me take you on the journey of a dollar of government spending intended to improve, for example, travel conditions on a highway. This dollar will have a long, perilous trip and encounter many dangers enroute that will divert it from its correct destination and take large, wasteful chunks out of it. By the time it reaches the wrong destination, it will fund much less than a dollar’s worth of highway improvements. The dangers it encounters include inefficient road pricing and investment policy, inflated input and project costs, misallocation of highway revenues, and the slow adoption of technological innovations.

This is from Clifford Winston, “How Federal Infrastructure Dollars Get Nickeled and Dimed,” Barron’s, March 24, 2021.

I highly recommend the whole piece. Actually, everything I’ve ever read by Cliff has been at least good and usually great.

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The case against COVID lockdowns, well argued.

On the website of the Center for Study of Partisanship and Ideology, a newly formed (2020) organization which I’ll make a point of following closely, there is a very good article by Philippe Lemoine (a Ph.D. candidate in philosophy at Cornell University). Lemoine is making the case against lockdowns. I am biased in favor of such a position, so I may be easily persuaded, but I think Lemoine argues it very well, in a tone which is sensible and takes into account the- understandable- worries of pro-lockdown people, and so may persuade others who have a different view. His reasoning is nuanced; he points out that policy decisions aren’t the only thing that affect the way the pandemic is progressing. He tries to do something which should be obvious but has so far been unthinkable: discuss costs and benefits of different non-pharmaceutical measures, instead of interpreting measures as a proxy of a broader political worldview.

There are many insights in this piece but let me just single out one:

if you look at the data without preconceived notions instead of picking the examples that suit you and ignoring all the others, you will notice 3 things:

• In places that locked down, incidence often began to fall before the lockdown was in place or immediately after, which given the reporting delay and the incubation period means that the lockdown can’t be responsible for the fall of incidence or at least that incidence would have fallen even in the absence of a lockdown.
• Conversely, it’s often the case that it takes several days or even weeks after the start of a lockdown for incidence to start falling, which means that locking down was not sufficient to push R below 1 and that other factors had to do the job.
• Finally, there are plenty of places that did not lockdown, but where the epidemic nevertheless receded long before the herd immunity threshold was reached even though incidence was increasing quasi-exponentially, meaning that even in the absence of a lockdown other factors can and often do cause incidence to fall long before saturation.

Read the whole thing. HT Don Boudreaux and CafeHayek.

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Fear Me Not! I Got My COVID Vaccine.

Last Monday, I got my COVID vaccine; the full effects should be kicking in soon.  How should I change my behavior?  How should anyone?

One popular answer is: Not at all.  Why not?  The top reason I’ve heard is: Because even those of us who have been vaccinated can’t be absolutely sure we won’t be infected – or spread infection to others.  Some use the same reasoning to argue that people who have recovered from COVID shouldn’t change their behavior either.  As immunologist Alexander Sette puts it:

Not taking any precautions—including wearing a face mask, practicing social distancing, or getting vaccinated—after an initial coronavirus infection is comparable to “driving a car where you’re 90% sure the car has brakes.”

However, both common sense and economic reasoning virtually the opposite.  If a risk falls by 90%, and there are large gains to accepting the risk, you should not only accept more of the risk; you should probably accept much more risk.  This is what self-interest recommends; and when your risk-taking benefits others, this is what humanitarianism recommends as well.  Remember: Your social distancing doesn’t just harm your quality of life; it harms the quality of life of everyone who doesn’t have the pleasure of your company.

What about the “90% sure the car has brakes” argument?  This posits an lopsided scenario where you have a 10% chance of killing or seriously injuring others for a trivial reason.  You shouldn’t die with 100% probability to see a movie; neither should you die with a 10% probability to see a movie.  Anyone who has ever driven to a movie, however, has accepted a .0000001% chance of dying en route.  And doing so is both prudent and considerate.  Or to tweak the hypothetical, it would be perfectly reasonable to drive regularly even though there is 10% chance that your brakes will go out sometime in the next twenty years of driving.

The better argument against changing your behavior – or at least not changing it much – is that we still don’t know

make you lonely; it makes people who would have interacted with you lonely as well.  make both you and other people lonely.  insofar as your risky activities benefit others, it is also what  accept much more risk.

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Is Amazon a Corporate Mother Teresa?

Amazon is in many ways a fascinating company and deserves to be defended against most of its mainstream critics. However, it would be simplistic to explain its campaign for a $15 federally-imposed minimum wage by identifying it with a corporate Mother Teresa. Its more obvious reasons to preach for minimum wages are not defendable.

I will not repeat all the arguments against the minimum wage, summarized in a good article by Cato Institute’s Ryan Bourne (“The Case Against a $15 Federal Minimum Wage: Q&A”). My co-blogger David Henderson has also defended many of the standard economic arguments. There exist some disagreements among economists about the employment effect of minimum wages, but they mainly relate to the size and victims of the negative effect (see Bourne’s overview).

One thing is sure: Amazon would benefit from forcing higher costs on its small competitors, including mom-and-pop businesses. A higher minimum wage would have exactly this effect while it would have zero effect on Amazon’s costs. As the company already pays a starting wage equal to the proposed $15 minimum, the latter would be non-binding and irrelevant for the retail behemoth.

One reason why Amazon was able to bid up the wage of its entry-level workforce is that its technology and other capital embedded in its warehouses and distribution network increase the productivity of its employees, which justifies the bidding up from a pure profit-maximizing viewpoint. There is nothing wrong with profits, but there is something wrong wtith using state power to bankrupt one’s competitors. This is what is happening. Jonathan Meer, an economist at A&M University observes:

It’s a lot harder for Joe’s Hardware. We should take note that Amazon—the place with no cashiers—is the one calling for a higher minimum wage.

Other large companies—such as Walmart—have come out in favor of an increase in the federal minimum but not up to $15. In their case, indeed, $15 would be binding for some employees. (Cf. Eric Morath and Heather Haddon, “Many Businesses Support a Minimum-Wage Increase—Just Not Biden’s $15-an-Hour Plan,” Wall Street Journal, March 1, 2021)

Amazon has another reason to be politically correct, that is, to signal its virtue under current faddish and unrealistic ideas. The company can hope to cajole DC’s powerful men to spare it from some regulation that would bite. The systemic effects of such behavior point to crony capitalism and groveling toward the state, which are not good for free enterprise and future prosperity.

It is not clear, to say the least, what kind of acceptable ethics could justify Amazon’s current behavior.

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Bioethics: Tuskegee vs. COVID

When bioethicists want to justify their own existence, they routinely point to the infamous Tuskegee Syphilis Study.  It’s a gripping story.  Back in 1932, the U.S. Public Health Service started a study of 399 black men with latent syphilis, plus a control group of 201 black men without syphilis.  Contrary to what I’ve sometimes heard, the researchers never injected anyone with syphilis.  However, they grossly violated the principle of informed consent, with disastrous consequences:

As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS, who never informed subjects of their diagnosis and disguised placebos, ineffective methods, and diagnostic procedures as treatment.

The men were initially told that the “study” was only going to last six months, but it was extended to 40 years. After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic was widely available and had become the standard treatment for syphilis.

Why do bioethicists habitually invoke the Tuskegee experiment?  To justify current Human Subjects Review.  Which is bizarre, because Human Subjects Review applies to a vast range of obviously innocuous activities.  Under current rules, you need approval from Human Subjects merely to conduct a survey – i.e., to talk to a bunch of people and record their answers.

The rationale, presumably, is: “You should only conduct research on human beings if they give you informed consent.  And we shouldn’t let researchers decide for themselves if informed consent has been given.  Only bioethicists (and their well-trained minions) can make that call.”

On reflection, this just pushes the issue back a step.  Researchers aren’t allowed decide if their human experiment requires informed consent.  However, they are allowed to decide if what they’re doing counts as an experiment.   No one submits a formal request to their Human Subjects Review Board before emailing other researchers questions about their work.  No professor submits a formal request to their Human Subjects Review Board before polling his students.  Why not?  Because they don’t classify such activities as “experiments.”  How is a formal survey any more “experimental” than emailing researchers or polling students?  To quote The Prisoner, “Questions are a burden to others; answers, a prison for oneself.”

The safest answer for bioethicists, of course, is simply: “They should give our approval for those activities, too.”  The more territory bioethicists claim for themselves, however, the more you have to wonder, “How good is bioethicists’ moral judgment in the first place?”

To answer this question, let me bring up a bioethical incident thousands of times deadlier than the Tuskegee experiment.  You see, there was a deadly plague called COVID-19.  Researchers quickly came up with promising vaccines.  They could have tested the safety and efficacy of these vaccines in about one month using voluntary paid human experimentation.  How?

Step 1: Vaccinate half the volunteers and give the other half a placebo.

Step 2: Wait a week, then inject all the volunteers with COVID-19.  (Alternately, give half of each subgroup a placebo injection).

Step 3: Compare the COVID infection rates of the vaccinated and unvaccinated 2-4 weeks later.

In the real world, researchers only did Step 1, then waited about six months to compare naturally-occurring infection rates.  During this period, ignorance of the various vaccines’ efficacy continued, almost no one received any COVID vaccine, and over a million people died.  In the end, researchers discovered that the vaccines were highly effective, so this delay really did cause mass death.

How come no country on Earth tried voluntary paid human experimentation?*  As far as I can tell, the most important factor was the formal and informal opposition of bioethicists.  In particular, bioethicists converged on absurdly (or impossibly) high standards for “truly informed consent” to deliberate infection.  Here’s a prime example:

An important principle in human challenge studies is that subjects must give their informed consent in order to take part. That means they should be provided with all the relevant information about the risk they are considering. But that is impossible for such a new disease.

Why can’t you bluntly tell would-be subjects, “This is a very new disease, so there could be all sorts of unforeseen complications.  Do you still consent?”  Because the real point of bioethics isn’t to ensure informed consent, but to veto informed consent to whatever gives bioethicists the willies.

I’m no paternalist, but I understand paternalism.  Paternalists want to stop people from harming themselves.  The goal of bioethicists, however, is far stranger.  Bioethicists want to stop people from helping others! Even if experimental subjects heroically volunteer to be injected for no money at all, bioethicists stand on guard to overrule them.

I’ve said it before and I’ll say it again: Bioethics is to ethics as astrology is to astronomy.  If bioethicists had previously prevented a hundred Tuskegees from happening, COVID would still have turned the existence of their entire profession into a net negative for humanity.  Verily, we would be better off if their field had never existed.

If you find this hard to believe, remember: What the Tuskegee researchers did was already illegal in 1932.  Instead of creating a pile of new rules enforced by a cult of sanctimonious busybodies, the obvious response was to apply the familiar laws of contract and fiduciary duty.  These rules alone would have sent people like the Tuskegee researchers to jail where they belong.  And they would have left forthright practitioners of voluntary paid human experimentation free to do their vital life-saving work.

In a just world, future generations would hear stories of the monstrous effort to impede COVID-19 vaccine research.  Textbooks and documentaries would icily describe bioethicists’ lame rationalizations for allowing over a million people die.  If the Tuskegee experiments laid the groundwork for modern Human Subjects Review, the COVID non-experiments would lay the groundwork for the abolition of these deadly shackles on medical progress.

Which is further proof, in case you needed any, that we don’t live in a just world.

* At least as I’m writing.  Maybe this will have started by the time you read this.

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Revolution is the Hell of It: Algerian Edition

In 1968, Abbie Hoffman famously wrote a book called Revolution for the Hell of It.

In 1973, this negatively inspired David Friedman to write a chapter called “Revolution is the Hell of It.”

Last month, I watched The Battle of Algiers, probably the most famous pro-terrorist (or at least anti-anti-terrorist) movie in history.  If you don’t know the sordid history of the “liberation” of Algeria, you should.  The whole movie is gripping, but this little speech by terrorist Ben M’Hidi stayed with me.  Though the writers probably intended the speech to be an inspiration rather than a warning, it’s a vivid vindication of Friedman over Hoffman.

BEN M’HIDI: Do you know something Ali? Starting a revolution is hard, and it’s even harder to continue it. Winning is hardest of all. But only afterward, when we have won, will the real hardships begin.

Which raises the obvious pacifist question: “Then why start?”  Committing evil deeds when the benefits are large and reliable might be justified.  Committing evil deeds when the benefits are deeply speculative is absurd.

Am I really going to defend colonialism?  No.  As I’ve said before, both colonialism and anti-colonialism are blameworthy expressions of violent nationalism:

But don’t you either have to be pro-colonial or anti-colonial?  No.  You can take the cynical view that foreign and native rule are about equally bad.  You can take the pacifist view that the difference between foreign and native rule isn’t worth a war.  Or, like me, you can merge these positions into cynical pacifism.  On this view, fighting wars to start colonial rule was one monstrous crime – and fighting wars to end colonial rule was another.

In the case of Algeria, however, I should add that native rule turned out to be vastly worse.

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Cost/Benefit Analysis or Rock, Paper, Scissors

President Reagan began regulatory reform with Executive Order 12291, titled simply “Federal Regulation”; President Clinton watered it down with EO 12866; and President Trump beefed it up with EO 13771 (“Reducing Regulation and Controlling Regulatory Costs”) and EO 13777 (“Enforcing the Regulatory Reform Agenda.”) The executive orders required a cost/benefit analysis to assure that the costs of major regulations would be compared with their benefits. But on his first day in office, President Biden revoked those executive orders with his own memorandum titled “Modernizing Regulatory Review.” If you read the memorandum carefully, you’ll see that the word “modernizing” is inapt. Indeed, the memorandum would more accurately be labeled “Replacing Cost/Benefit Analysis with Rock, Paper, Scissors.”

This is from David R. Henderson, “Open Season For New Regulations,” Defining Ideas, February 4, 2021.

Another excerpt:

But even if that weren’t a problem, there are two other major problems. First, notice that the OMB is being put in a position not so much to screen regulations as to propose them. Does this mean the agencies will quit proposing regulations and passively await direction from the OMB? No way. Indeed, the memorandum reads as if President Biden is proposing that OMB be a cheerleader for new regulation. He states that he wants OIRA to “play a more proactive role in partnering with agencies to explore, promote, and undertake regulatory initiatives that are likely to yield significant benefits.” Rah, rah, sis boom bah.

The second major problem is one that anyone with much experience dealing with bureaucracy will probably notice: with so many possible criteria, regulators will have running room to implement regulations they like because those regulations pass some criteria even while they fail others. The regulators might, for example, choose a regulation that promotes public health and safety but at the expense of economic growth. Without cost/benefit analysis as a guide, how will they trade off between these two criteria? Any way they like.

Note also the disappointment I express with Cass Sunstein’s take. He should know better.

Read the whole thing.

 

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Richard Yetter Chappell on Lessons from the Pandemic

It’s generally recognized that our (American) response to the Covid-19 pandemic was disastrous. But I think far fewer appreciate the full scale of the disaster, or the most significant causal levers by which the worst effects could have been avoided. (Yes, Trump was bad.  But his public health disinformation and politicization of masking—while obviously bad—may prove relatively trivial compared to the mammoth failings of our public health institutions and medical establishment.) Much of the pandemic’s harm could have been mitigated had our institutions been properly guided by the most basic norms of cost-benefit analysis.

This is the opening paragraph of Richard Yetter Chappell, “Lessons from the Pandemic,DailyNous, January 19, 2021.

The whole thing is excellent. Chappell is a philosopher but the piece reads like a well-written analysis by a policy economist.

Another excerpt:

In ordinary circumstances, the status quo is relatively safe and so untested medical innovations present asymmetric risks. That is, until they are proven safe and effective, it may be reasonable to assume that the potential risks of an untested product outweigh its potential benefits, and so block public access to such products until they pass stringent testing requirements. (There are arguments to be made that FDA regulations are excessively onerous even in ordinary circumstances, but I remain neutral on that question here. I take it that there is at least a reasonable case to be made in the FDA’s defense ordinarily. No such case for the FDA’s stringency seems possible in a pandemic.)

A pandemic reverses the asymmetry of risk. Now it is the status quo that is immensely dangerous, and a typical sort of medical intervention (an experimental drug or vaccine, say) is comparatively less so. The potential benefits of innovation likely outweigh the potential risks for many individuals, and vastly so on a societal scale, where the value of information is immense. So the FDA’s usual regulations should have been streamlined or suspended for potential pandemic solutions (in the same way that any ethics barriers beyond the minimum baseline of informed consent should have been suspended for pandemic research). This should be the first thing the government does in the face of a new pandemic. By blocking access to experimental vaccines at the start of the pandemicthe FDA should be regarded as causally responsible for every Covid death that is occurring now (and many that occurred previously).

This last sentence is almost correct and similar to what Charley Hooper and I argued last month in “The FDA’s Deadly Caution,” AIER, December 16, 2020. Surely there are some deaths that would be occurring now, even without FDA intervention, due to people not taking the vaccine or due to the vaccines’ not being 100% effective

Yet another excerpt:

Closely related to the above mistake is the implicit assumption that it’s somehow better to do (or allow) nothing than to do (or allow) something imperfect. Letting the perfect be the enemy of the good in a pandemic is disastrous. Blocking quick Covid tests for having lower accuracy than slow ones is an obvious example of this form of stupidity. Deciding in advance that a vaccine must prove at least 50% effective in trials to receive FDA approval is another. (Obviously a 40% effective vaccine would be better than nothing!  Fortunately it didn’t come to that in the end, but this policy introduced extra risk of disastrous outcomes for no gain whatsoever.)

Compare Dr. Ladapo’s argument in the WSJ that “Doctors should follow the evidence for promising therapies. Instead they demand certainty.” (Steve Kirsch expands on the complaint.) Again, this is a very basic form of irrationality that we’re seeing from the medical establishment.

Misguided perfectionism has also damaged the vaccine rollout due to prioritizing complex allocation schemes over ensuring that as many people are vaccinated as quickly as possible. (Some are letting doses spoil rather than “risk” vaccinating anyone “out of turn”!)

More examples are discussed here.

Do read the whole thing.

HT2 Daniel Shapiro.

 

 

 

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Valerie Ramey Has the Same Quandary I Do

On April 12, in “The VSL Quandary,” I wrote:

That $65 trillion is not a typo. Luigi (who blogged briefly on EconLog) is actually advocating that the U.S. government be willing to sacrifice 3 years of GDP to save what he estimates to be 7.2 million U.S. lives.

But here’s a good rule for reasoning about anything: if your model tells you that you should take measures to save 7.2 million people in a way that will likely cost the lives of over 30 million people, and if a large percent of those 7.2 million are in the pool of 30 million, there’s something seriously wrong with your model.

If the government were to shut down the economy in a way that cost 3 years of GDP, who would produce food, who would ship food, who would work at hospitals, who would produce electricity, and who would assure clean potable water? I think 30 million lives lost, just under 10 percent of the U.S. population, is probably a minimum estimate of the lives lost from the shutdown.

It’s nice to see that UC San Diego economist Valerie Ramey confronted the same issue. In an interview with David A. Price of the Federal Reserve Bank of Richmond, Ramey says:

I am working on a couple of things. One is with Garey [Ramey] again. It’s called “The Value of Statistical Life Meets the Aggregate Resource Constraint.” There’s a concept called the value of statistical life that is used by regulatory agencies; researchers estimate how much wage people are willing to give up not to work in a more dangerous occupation. Ten million dollars for the equivalent of a lost life is a typical estimate. And regulatory agencies in government use those numbers to decide how much to spend to prevent death.

People then started using those numbers to think about COVID-19. One thing we wondered was whether you could actually take those numbers and use them for bigger risks of death.

Here’s the kind of stark example we can use for illustration. Suppose that Martians took the 330 million people in the U.S. hostage and said, “If you want them back, you need to pay a ransom of $10 million because we know that’s how much you value a statistical life.” Well, that would add up to $3.3 quadrillion. But the GDP is only $21 trillion. The total value of the wealth in the United States — if you add up all the capital stock, the minerals, and land — is about $125 trillion. This extreme example illustrates the importance of considering the resources available.

By the way, David Price does excellent interviews.

The picture above is of Valerie Ramey.

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