CEPR - Center for Economic and Policy Research

Multimedia

En Español

Em Português

Other Languages

Home Publications Blogs Beat the Press Robert Samuelson Goes to Bat for Paul Ryan: Strikes Out

Robert Samuelson Goes to Bat for Paul Ryan: Strikes Out

Print
Monday, 13 August 2012 03:50

Governor Romney's decision to select Paul Ryan as his running mate has condemned the country to 90 days of ridiculous news stories and columns about a choice on the size and role of government. The debate is silly because its explicit assumption is that Paul Ryan wants a small role for government. There is no evidence to support this assertion.

The impact of the government on the economy goes far beyond the amount that it taxes and spends. The way in which structures markets has a far more important impact on the economy. For example, government granted patent monpolies for prescription drugs raise the price the country pays for its medicine by close to $270 billion a year (1.8 percent of GDP). This is every bit as much a big government intervention into the economy as if the government raised taxes by this amount. The total cost of all the monopolies that the government grants as "intellectual property" could run as high as $1 trillion year, or roughly a quarter of federal spending.

The government structures the economy in many other ways as well. The implicit "too big to fail" insurance that it gives to the largest banks is a transfer of more than $60 billion a year to their executives and shareholders by some estimates.

The selective protectionism in trade policy, which deliberately puts manufacturing workers in direct competition with low-paid workers in the developing world, while leaving highly paid professionals like doctors and lawyers largely protected, has the effect of redistributing an enormous amount of income upward. And the Federal Reserve Board's policy of raising interest rates to increase unemployment among less-educated workers, and thereby depress their wages, as a way to keep inflation at its 2.0 percent target also has an enormous impact on the distribution of income and the economy.

It is incredibly misleading to restrict a discussion of the government's role in the economy to its tax and spending policies. These policies are at least moderately redistributive, but they don't come close to offsetting the impact of upwardly redistributional policies that the government imposes when it structures the market. (This is the topic of my non-copyright protected book, The End of Loser Liberalism: Making Markets Progressive.)

While Paul Ryan is a vocal opponent of the policies that the government has in place to protect low and middle income people, he has never indicated any opposition to the massive interventions, like patent monopolies for prescription drugs and the Fed's policy of using unemployment to fight inflation, that redistribute income upward. For this reason, it is flatly wrong to describe Mr. Ryan as a supporter of small government. He is more accurately described as an opponent of government interventions that redistribute income downward and a supporter of government policies that redistribute income upward.

Needless to say, Robert Samuelson pushes this line in his column today. The headline of his piece touts the prospects of a "meaningful debate."

Samuelson also gratuitously throws in a couple of false or misleading assertions. He tells readers:

"There would be huge deficits even had there been no Great Recession."

Nope, that ain't true, unless Samuelson has information that he hasn't shared with the Congressional Budget Office (CBO). It's projections in early 2008, before they recognized the downturn coming, showed very modest deficits for the decade ahead. This would have been the case even if the Bush tax cuts had been extended over the whole decade. (It's Table 1-1, read it and you'll know more about the federal budget than anyone at the Washington Post, since they apparently do not have access to CBO projections.)

Samuelson also tells readers:

"It’s impossible to close long-term budget deficits simply by taxing the rich and cutting defense (liberal dogma) or eliminating “waste” and “unneeded” spending (conservative dogma). The “conversation” conducted by Obama and Romney needs to conform to economic and budget realities. If it doesn’t, Americans will discover after the election that they’ve been had."

Of course the reality is that the projected long-term budget problems are a story of a broken health care system. The United States pays more than twice as much per person for its health care as people in other wealthy countries. If its health care costs were remotely comparable to those in Canada, Germany, or any other country with comparable or better health care outcomes we would be looking at long-term surpluses not deficits. To use Samuelson's phrase, the country will be had until the public realizes this simple fact.

Comments (15)Add Comment
Freedom is Not Free: The Paul Ryan Creed
written by Last Mover, August 13, 2012 5:15
Ryan the rent seeker
Keeper of rents

Behind snake oil and rabbit hats
And truths that are bent

Come one, come all
To the Republican Ball

To celebrate markets
Free for all

Free to raise prices
As high as the sky

Free to block entrants
With big gov regs

Free to crush choices
Before they get legs

Free to raise taxes
On thee but not me

Free up the supply side
With monopolies of glee

Choke off big gov
With privatized fees

It's worth it my friend
Freedom is not free

Pay with your life
It's a fair and good price
...
written by liberal, August 13, 2012 7:54
I don't understand why Dean never mentions the largest source of government-granted rents in the economy: land rent.

It's only 10--20% of GDP, after all.
The USA only spends 2.1% of GDP on drugs and medical devices
written by A Greek Bearing Facts, August 13, 2012 8:31
Dean: "... government granted patent monopolies for prescription drugs raise the price the country pays for its medicine by close to $270 billion a year (1.8 percent of GDP)."

That would be a neat trick. According to OECD estimates of health care spending, the USA spent 2.1% of its GDP on pharmaceuticals and medical devices in 2010. Using Dean's estimates, without patent protection the USA would only have spent 0.3% of GDP on these items.

For purposes of comparison, the average large, rich OECD country aside from the USA (I count 20 of them) spent an average of 1.7% of GDP on pharmaceuticals and medical devices. Thus, the USA spends about 0.4% more of its GDP on these items than the average OECD country. That number is quite a bit smaller than Dean's estimate of 1.8% of GDP.

To be sure, all rich OECD countries give patent protection to the inventors of new drugs and medical devices. Perhaps they believe, as the authors of the U.S. Constitution did, that by giving patent protection to inventors we can encourage the creation of useful innovations. The theory may be wrong, as Dean evidently believes it to be, but the USA is not the only country that believes it is true.

For purposes of comparison, the other 20 large, rich member countries of the OECD spent an average of 1.7% of their GDP on drugs and medical devices.
>25% US doctors are from overseas. Not enough to rationalize prices. Some other way to do it? Maybe start with honesty.
written by Rachel, August 13, 2012 8:53
We need to look at other ways to lower the costs of US health care.

Doctors cost too much. In many places, so do nurses. This is the #1 cost issue. But almost no one has enough education and integrity to discuss this. Dean does, but I fear that it costs him.

Unfortunately it is not at all clear that more imported doctors are the answer. We already have a great many. The hospitals like it, but it is not clear that it is a great cost savings to the rest of the country. And there are other ways to bring down these wasteful medical incomes. The big problem is all the tiger-mommies and tiger-daddies (of all races) in the media and academia, who are determined to enrich their wannabe-doctor-progeny. Or to keep their buddies rich. They do no want any hard analysis of the real health cost problems. To them, it's mostly administrative costs.

As for administrative costs, they are substantial. But is a one-size-fits-all policy the only answer? No.
It would benefit the doctors, as would the coercive Medical Homes (or ACOs). So they are the only altenatives the top 2% ever mentions.
Beware of Greeks bearing gift-facts
written by David, August 13, 2012 10:00
@Greek: links to your data would be kind, making your reader work hard can make them cranky and less amenable to your argument. ;-)

Those other countries are also paying for the patents, they just choose to constrain costs. The US system does foster innovation (if you think the number of new drugs created country is a good metric for innovation). But pharmas spend far more on lobbying, advertising, and executive compensation than they do on R&D. There are other means to foster innovation than to use an antiquated system adopted by monarchs, a system appropriate for monarchies not for free-market democracies.
...
written by liberal, August 13, 2012 10:14
A Greek Bearing Facts wrote,
The theory may be wrong, as Dean evidently believes it to be, but the USA is not the only country that believes it is true.


Logical fallacy (Ad Populum) noted.
...
written by liberal, August 13, 2012 10:25
Rachel wrote,

Unfortunately it is not at all clear that more imported doctors are the answer.


The answer is pretty obvious: since medical care (not just medical insurance) is rife with market failures, it should be socialized.

A major component of socialization would be the twin realizations that (a) a lot of medical care is useless and based on little or no evidence, (b) none of us is going to live forever.

Such a system would probably save 30% or more, putting aside administrative savings from socializing health insurance.
@liberal - That's socialism! We need a good market-oriented approach--you know, something like the VA. Take your stinking paws off my Medicare, you damned dirty government!
written by Frankly Curious, August 13, 2012 11:53
@liberal - That's socialism! We need a good market-oriented approach--you know, something like the VA.
financial interest deduction
written by Ben Leet, August 13, 2012 12:14
Representative Schakowsky proposed a budget that eliminated the interest deduction to financial corporations on their interest payments. Mitt Romney and other LBO private equity buy-out artists use this government hand-out regularly. Schakowsky estimated that $70 billion a year would be gained back if it were eliminated, and the brake would be placed on seemingly capricious buy-outs. Simmons mattress was bought out 6 times in 2 decades, "beginning as a healthy company with $164 million in debt in 1991 and ending in bankruptcy in 2009 with $1.3 billioon in debt." (from W. Tabb's book The Restructuring of Capitalism". Also the bank bailouts and quantitative easings, the $ amounts are staggering. Ryan I believe voted for or approved all of them.
Giddy and DA
written by A Greek Bearing Big Ts, August 13, 2012 2:07
A giddy and exubrerant bearing evidence to refute the blog, only find out that he is not the 1%.

In real life, no one should support and present those kinds of DA unless his inv't income is at least 6-digit figures annually and not rely on wages.

People don't know what is actually good 4 them.
A Very Bad Joke
written by Donald Pretari, August 13, 2012 3:54
You can tell if someone has a Basic Understanding Of Political Economy by whether or not they believe the GOP is for Small Govt. If a person answers in the affirmative, you know they don't have a clue about US Political Economy.
which is almost all of it
written by Floccina, August 13, 2012 4:04
For example, government granted patent monpolies for prescription drugs raise the price the country pays for its medicine by close to $270 billion a year (1.8 percent of GDP)


Which is almost all of what is spent on drugs. (Note I agree with ending patent and copyrights.) So since it is only 1.8 of GDP why spend so much time harping on it. IMO excessive licensing is a bigger problem in healthcare and overall.
...
written by skeptonomist, August 13, 2012 4:24
The US ranks below most wealthy nations (and many not-so-wealthy) in number of docs per capita

http://www.globalhealthfacts.org/data/topic/map.aspx?ind=74

despite paying them much more. There are obviously some serious restrictions on the free market in this respect, and it's not just a matter of keeping out foreign docs (I doubt if most docs in Russia for example are foreign). The high cost of health care in the US is a result of several things like this, not just one.
skeptonomist USA doctor count may overstate the number of doctors that keep people healthy
written by John Wright, August 13, 2012 9:05
If one looks at the link referenced by skeptonomist, the count refers to generalists and specialists.

To judge from radio/newspaper ads, the USA has a large and profitable cosmetic medical industry, and associated number of doctors employed in same.

I don't see the cosmetic industry as essential for public health, so perhaps the USA doctors/population count is effectively a lower number if used for public health concerns.

So I would like to see the rankings when these cosmetic specialists are removed from the doctor count, as I suspect there are relatively fewer cosmetic surgery doctors in other countries.

But what is with Japan having even fewer doctors per 10K than the USA 21/10k(Japan) vs 24/10K (USA)?

Japan has the highest life expectancy even though its doctor to 10K population ratio is in 58th place.

What is Japan doing right?



Why harp about the 1.9% spent on pharmaceuticals
written by David, August 14, 2012 12:19
Which is almost all of it
written by Floccina, August 13, 2012 4:04

For example, government granted patent monpolies for prescription drugs raise the price the country pays for its medicine by close to $270 billion a year (1.8 percent of GDP)


Which is almost all of what is spent on drugs. (Note I agree with ending patent and copyrights.) So since it is only 1.8 of GDP why spend so much time harping on it. IMO excessive licensing is a bigger problem in healthcare and overall.


There are several reasons for concern. Not only is it 1.8% of GDP but it continues to grow at a rate in excess of that of other OECD countries. The effect of compounding makes this an issue to keep an eye on.

Not only that, access to drugs is limited by their great expense; only the wealthy can truly afford the new treatments. Many of the 99% have to be devoid of assets before qualifying for government assistance in procuring the drugs.

But most importantly of all: it's not necessary to spend 2 pennies of every dollar so that we can watch erectile dysfunction and allergy commercials with our morning news shows.

Write comment

(Only one link allowed per comment)

This content has been locked. You can no longer post any comments.

busy
 

CEPR.net
Support this blog, donate
Combined Federal Campaign #79613

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.

Archives