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Home Publications Blogs Beat the Press Helping Those at the Bottom by Paying Neurosurgeons and Pfizer More

Helping Those at the Bottom by Paying Neurosurgeons and Pfizer More

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Friday, 30 March 2012 04:38

Are you upset about inequality? According to the logic in a Washington Post column by Brookings economist Ron Haskins, we can help remedy the situation by doubling the pay of neurosurgeons to roughly $1 million a year and doubling what we pay to the pharmaceutical industry for drugs each year to $600 billion. 

If you don't understand how increasing the income of rich doctors and highly profitable drug companies helps those at bottom, then you obviously don't understand economics. It's all very simple.

Haskins argues that those of us who are concerned about inequality have ignored the value of government benefits. These include benefits like Medicare and Medicaid, that disproportionately benefit low and middle income people. If we add in the value of these benefits, then Haskins tells us that there has actually been very strong income growth at the middle and bottom of the income ladder over the last three decades.

However the problem in this story is that the value of these benefits is measured by their cost. If, for example, we measured the value of these benefits by imputing the per person costs of health care in Canada, Germany, Denmark or any other wealthy country, then including the value of government benefits would not change the income inequality story at all.

The reason for the difference in health care costs between the U.S. and these other countries is not due to the fact that we get better care. In fact, low and moderate income people get far better care in all of these other countries than in the United States. The reason is simply that we pay providers far more than these other countries do. But, if our measure of the income of the poor includes the payments the government makes to doctors and drug companies on their behalf, the more we pay them, the more rapid the growth of the income of the poor.

So if we want to help the poor, we should just increase Medicare and Medicaid reimbursement rates for doctors and drug companies. Got it?

Haskins also has another neat trick. He tells readers:

"Brookings Institution calculations of census data for 2009, a deep recession year, show that adults who graduated from at least high school, had a job, and were both at least age 21 and married before having children had about a 2 percent chance of living in poverty and a better than 70 percent chance of making the middle class — defined as $65,000 or more in household income. People who did not meet any of these factors had a 77 percent chance of living in poverty and a 4 percent chance of making the middle class (or higher). Unless young Americans begin making better decisions, the nation’s problems with poverty and inequality will continue to grow."

While Haskins sees this as a lesson about good choices and morality, there is a real problem of causation here. Suppose that we discovered that adults with just high school degrees who read at least one book a week had an 80 percent likelihood of being middle class. (I have no idea if this is true.) Would it follow that if we got all high school grads to read at least one book a week that 80 percent would be middle class?

This is likely the story that underlies Haskin's data. Workers with just high school degrees who manage to achieve modest degrees of comfort are likely to adopt middle class norms on marriage and children. It does not follow that if all people from poor and moderate income families adopted these norms that they would be middle class.

Comments (7)Add Comment
You made me laugh.
written by diesel, March 30, 2012 8:25
False cause. Nicely done.
Brilliant!
written by Shawn Kenney, March 30, 2012 8:28
Forget the other "factors". They are basically saying someone who has a job makes more money than someone who doesn't have a job...
I'm going to join the one percent
written by Kat, March 30, 2012 8:29
I'm scheduling some neurosurgery ASAP! Hopefully, there will be many complications and at least a year of rehab to really pad the bill.
...
written by j, March 30, 2012 8:39
Medicare and medicaid is not for the poor or middle class. It's for children, elderly people, and disabled people that cannot fully take care of themselves. Some of them are poor and some of them are middle class. But that does mean that these benefits disproportionately benefit the middle class that work but pay outrageous prices for insurance and healthcare. Assuming the falsehood was true, so what? What is wrong with providing healthcare to people that need it? It's like some of these people rather get an extra $1,000 per year to spend on green fees or renovate their kitchens and have people dying in droves in the streets with the emergency room as their only lifeline.
j, I'm not sure he is taking issue with health care spending
written by Kat, March 30, 2012 9:08
for our most vulnerable. I think his argument is more akin to the to the tone deaf argument that food prices may be going up, but hey! you can now get a much better blu ray dvd player than you could get for the same price 2 years ago so it all evens out. At least that's my take on it.
...
written by JMW, March 30, 2012 9:22
Ah, yes. There's an article in the National Tax Journal (March 2012) by Burkhauser, Larrimore and Simon telling us the same thing: If we include the value of transfers and health insurance in the measure of income, the middle class is doing just fine. They defend using the unadjusted cost of benefits by saying in essence, "costs rise."
"Bad" decisions are more likely to have "Bad" Results
written by jumpinjezebel, March 30, 2012 10:45
I'd assume most would agree that if you are 18 - get married or not and have a child that you are probably condeming your future to a large degree to one of probable low or low/middle class living the rest of your life. Of course there are exceptions to everything - but I bet this is true.

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About Beat the Press

Dean Baker is co-director of the Center for Economic and Policy Research in Washington, D.C. He is the author of several books, his latest being The End of Loser Liberalism: Making Markets Progressive. Read more about Dean.

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