Interview with Janet Currie: Health, Liability, Overtreatment

Jessie Romero interviews Janet Currie on a range of topics in \”Interview: Janet Currie,\” Econ Focus: Federal Reserve Bank of Richmond, First Quarter 2017, pp. 23-36. Here are a few tidbits: 

Socioeconomic Status and Effects of Pollution

\”There is a large environmental justice literature arguing that low-income and minority people are more likely to be exposed to a whole range of pollutants, and that turns out to be remarkably true for almost any pollutant I’ve looked at. A lot of that has to do with housing segregation; areas that have a lot of pollution are not very desirable to live in so they cost less, and people who don’t have a lot of money end up living there. It also seems to be the case, at least some of the time, that low-income people exposed to the same level of pollutants as higher-income people suffer more harm, because higher-income people can take measures to protect themselves. Think about air pollution. If I live in a polluted place but I have a relatively high income, maybe I have better-quality windows so I have less air coming in, or I can afford to have air purifiers, or I can afford to run my air conditioner. It could even be the case that lower-income people are more vulnerable to the effects of pollution in the first place. For example, someone who is malnourished is more likely to absorb lead than someone who is not malnourished. So people who are better nourished may be better able physiologically to protect themselves against the effects of pollutants.\”

Reform of Joint and Several Liability

\”Joint and several liability, or JSL, is essentially the “deep pockets” rule: If multiple parties are found to be liable for the harm caused, the plaintiff can collect damages from one or all of the parties, regardless of how each one contributed to the harm. So people sue the deep pocket. A hospital is a good example. When Bentley MacLeod and I first started reading about tort cases related to malpractice during child delivery, one of the things that struck us as bizarre is that they often talked about the nurse: The nurse was sitting in the nurse’s station, she didn’t come when I called, she didn’t call the doctor. We wondered, why are they spending so much time talking about what the nurse did or didn’t do? Surely the doctor was the prime mover in deciding treatment? What we eventually realized was, the nurse is the employee of the hospital, whereas doctors are generally working as independent contractors; so if you want to blame the hospital — the deep pocket — you have to tie the nurse to the lawsuit. Most of the time, under JSL, the hospital gets sued and the doctor doesn’t. If the hospital pays, legally it can try to recover damages from the doctor, but they hardly ever do that. Essentially, under JSL, the doctors are working in a regime where they’re never going to get sued. JSL reform makes the payment of damages proportional to the contribution to the harm, which makes it more likely the doctor will be sued. And if the doctor is the decisionmaking agent, then in theory that should improve outcomes.\”

The Difference between Overprovision and Misallocation of Medical Care 

\”Many people are concerned about overtreatment and excessive spending, but the problem is more subtle. Bentley, Jessica Van Parys, and I studied heart attack patients admitted to emergency rooms in Florida. We found large differences in how doctors allocated procedures across patients; some doctors were much less likely to use aggressive treatments with older or sicker patients who might have been deemed less appropriate candidates for the treatment. Young, male doctors who trained at a top-20 medical school were the most likely to treat all patients aggressively, regardless of how appropriate the patient seemed to be. In the case of heart attacks, it appears that all patients have better outcomes with more aggressive treatment, so treating only the “high-appropriateness” patients aggressively harms the “low-appropriateness” patients. Similarly, many people are concerned that U.S. doctors perform too many C-sections. But actually, in another paper, Bentley and I found that it looks like too many women with low-risk pregnancies receive C-sections, while not enough women with high-risk pregnancies receive C-sections. So the goal shouldn’t necessarily be to reduce the total number of C-sections but rather to reallocate them from low-risk to high-risk pregnancies.\”

A couple of add-ons here for interested readers:

Facing the Costs of Paid Parental Leave

An AEI-Brookings Working Group on Paid Family Leave has been considering family leave policies during the last year or so, and some results of their deliberations appear in \”Paid Family andMedical Leave: An Issue Whose Time Has Come\” (May 2017). For the fortunate readers out there who don\’t concern themselves with the political leanings of DC think tanks, the American Enterprise Institute tends to leans right, while Brookings tends to lean left. Thus, the report is based on views of knowledgeable experts from a range of political perspectives. (For those who want names, the Codirectors of the report are Aparna Mathur and Isabel V. Sawhill, and the other participants are Heather Boushey, Ben Gitis, Ron Haskins, Doug Holtz-Eakin, Harry J. Holzer, Elisabeth Jacobs, Abby M. McCloskey, Angela Rachidi, Richard V. Reeves, Christopher J. Ruhm, Betsey Stevenson, and Jane Waldfogel.)

Some of the themes in the report, while certainly worth making, are not especially new. For example, \”the United States is the only advanced nation that does not have a paid leave policy at the national level. The federal Family and Medical Leave Act, passed in 1993, offers 12 weeks of job-protected, unpaid leave, but only about 60 percent of the workforce is eligible for its protections. … Polls show overwhelming public support for paid family and medical leave … with almost 71 percent of Republicans and 83 percent of Democrats in favor of a paid parental leave policy.\”

But economists mistrust polls which ask if people would like to receive a pleasant new benefits, but don\’t place equal emphasis on the costs. Thus, for me the most intriguing point in the report is that apparently no one in the Working Group, no matter their political leanings, favored requiring an employer mandate for employers to pay the costs of paid leave. As the report notes:

\”That said, paid leave generates a variety of concerns from a business perspective. Most obviously, there are business costs associated with paid leave if employers are simply mandated to provide it. For this reason, we think it is worth noting that no one in our working group favored an employer mandate. … This approach is popular with the general public. However, we do not favor it for two reasons. First, it would be burdensome on employers, especially small businesses and those employing a disproportionately high share of likely parents. Second, it will likely lead to a reluctance to hire female workers of a certain age. … Instead, most— although not all of us—favored a slight increase in the payroll tax on employees, with a minority in favor of reduced federal spending in other areas to pay for a new benefit. \”

Here\’s some additional detail on their argument. As a starting point, here\’s an international comparison across OECD countries of paid parental leave. On the left, the bars show what percentage of income is replaces for men and for women. On the right, the bars show the length of parental leave. As the figure shows, it\’s fairly common for countries to have paid parental leave with a length of six months to a year, and it\’s common for the payments to replace about half of wages. 

In the US, a few states have enacted paid parental leave rules. Here\’s a table giving some description. 
As the table helps to illustrate, some of these laws are quite recent, and the evidence on their operation is not in yet. The reason why Washington state isn\’t included in the table, as the report notes, is: \”Washington State has not yet implemented its policy because it has not established a funding mechanism.\” In the other states, \”California, Rhode Island, New Jersey, and New York incorporated paid family and medical leave into the states’ existing TDI [Temporary Disability Insurance] programs, financed through payroll contributions. However, these four states finance the paid family and medical leave benefit exclusively through employee payroll contributions, rather than joint employer/employee contributions …\” 
The report is scrupulous in  pointing out concerns with the existing US programs, and I\’ll mention two of them here. One is that the existing programs do relatively little to help lower-income women. Even among those eligible for paid leave in California, the take-up rate of existing benefits has been low. 

\”Many of the bottom 40 percent of households (by income) are ineligible for job-protected unpaid leave under the FMLA [Family and Medical Leave Act] because they are employed in small firms (with fewer than 50 employees) exempt from the law or because they do not meet the eligibility requirements in terms of hours worked with their current employers. In addition, survey data consistently show that workers in low-income households and those with low educational attainment frequently lack access to any form of paid leave. Moreover, those with fewer resources or less income are much less able to take up this leave even if they are eligible. This has led to a system in which the beneficiaries of current leave policies (whether unpaid or paid by an employer) are primarily those with moderate or high incomes, stable jobs, and employment in larger organizations. …\”

\”Ten years after California’s paid family leave policy was implemented in 2004, take-up rates by eligible mothers ranged from 25 to 40 percent. …  A 2011 study found that half of workers eligible for paid leave were unaware of the program, and a third of those who were aware and eligible but who did not apply for family leave reported that the wage-replacement rate was too low. Others cited the lack of job protection or worried that taking leave would make their employer unhappy or hurt their opportunities for advancement.\”

The report details how the members of the working group differed on a number of points, as one might expect given the membership of the group. But they also work to describe at least a loose consensus proposal that most members of the group could support as a minimum proposal. Here are some central  elements for the design of benefits:  

\”Many (but not all) of those in our group think that only those who have consistently worked with their employer for at least a year (or more than 1,000 hours in a year) should be eligible. Businesses will be averse to protecting employees’ jobs during an extended leave of absence if they contributed only a short period of work before taking leave. Some in our group are in favor of even stricter eligibility rules, but all agree that the employee should have contributed significantly to this benefit through continued participation in the workforce (in the case of a payroll tax) and with a specific
employer (for purposes of job protection). …

\”[I]t would keep the benefits relatively targeted and inexpensive by offering a 70 percent
replacement rate up to a cap of $600 per week, for a limited number of weeks (e.g., eight weeks). … [I]t would include job protection. … The plan’s key elements are its budget neutrality, its extension of benefits to the middle and working class and not just the poor, and its establishment of a floor on the number of weeks of leave provided. States and private employers would be free to supplement this leave if they chose to do so.

\”Our working group would support such a plan— not as everyone’s preferred policy but as a reachable compromise in our group—and we put it forward for others to consider.\”

I very much like the honesty and straightforwardness of the plan. It acknowledges costs. It acknowledges that the US is a diverse country in its political and economic dimensions, and thus sees the federal role not as supplying a one-size-fits-all solution, but rather as setting a baseline on which states can build. It focuses on how to provide basic benefits for those who now often have no leave at all, paid or otherwise. As the report notes: \”Overall, about 40 percent of households in the United States with children under the age of 18 are either headed by a single mother or are homes in which the mother is the primary breadwinner, according to data from the Pew Research Center. This share was just 11 percent in 1960.\”
As have explained in other posts, I think the evidence on the benefits of family leave is not as clear-cut as I might prefer; for more discussion, see \”Some Economics of Parental Leave\” (March 3, 2017). For example, one purported set of benefits of parental leave is giving parents a chance to remain home with children, at least for a time, while another set of benefits is that the parents are more likely to return to the paid workforce. The goals of more time with children and more connection to the workforce are tough to reconcile. The factors that determine whether low-wage parents returns to the labor force may have less to do with the availability of paid leave, and more to do with whether their job has been protected for a time and they are easily welcomed back, or how attractive the low-wage job is to them in the first place.  But the time crunch between parenthood and work is particularly rough in the couple of months right after a newborn arrives, and finding ways to ease that time crunch for the high proportion of US mothers who have limited resources seems a worthwhile goal. 

Interview with Timothy Taylor: Quick Hits

My friend Stephen Dupont, a public relations and marketing guy, did an interview with me at his website.  The interview is aimed at a broad audience, with quick hits on a variety of subjects. There\’s much more at the website, but here\’s a sample: 

Stephen Dupont: Do you affiliate yourself with any particular school of economic thought or philosophy? 

Timothy Taylor: The great health care economist Victor Fuchs used to say that he was a “radical moderate.” He argues that moderates need to be radical, too, or else they will be drowned out by noise from radicals who are on the extremes. Of course, the problem with trying to be middle-of-the-road is that you get hit by ideological traffic going both directions.

Stephen Dupont: As the managing editor of the Journal of Economic Perspectives for more than 30 years, you’ve been a keen observer of economic trends, theories and policies. As you look back, is there anything that has surprised you over the past 30 years in the world of economics?

Timothy Taylor: For me, economics is an ongoing parade of surprises. I was surprised when the Berlin Wall came down, and a number of economists turned to the problem of “transition economies.” I am stunned that China has become the largest economy in the world. I was shocked that the countries of Europe—and Germany in particular—actually gave up their traditional currencies for the euro. I thought U.S. health care spending already sky-high back in 1980 at 9% of GDP, and now it’s approaching 18% of GDP. I did not suspect that the U.S. financial system and economy was as fragile as it turned out to be in the Great Recession of 2007-2009. I never would have thought that the Federal Reserve would take its policy interest rate down to near-zero, and hold it there for seven years. I flatter myself that my understanding of the economy is pretty good—except that I only learn to understand what has happened with a time lag of about two years.

Environmental Protection and Africa\’s Cities

Africa\’s cities are growing rapidly, which presents both an environmental problem and a policy opportunity. The problem is that many of these cities already have severe environmental issues. The opportunity is that because these cities are much smaller than they will be in a few decades, there are opportunities now to guide and shape their growth in ways that can be much more cost-effective than trying to clean up the mess after it has already happened. Roland White, Jane Turpie, and Gwyneth Letley explore these issues in a World Bank report, Greening Africa\’s Cities : Enhancing the Relationship between Urbanization, Environmental Assets, and Ecosystem Services (May 2017).

On the patterns of urbanization in Africa, they write:

\”Urbanization in Africa began later than in any other global region and, at a level of about approximately 40%, Africa remains the least urbanized region in the world. However, as indicated in Figure 3, this is rapidly changing: SSA’s cities have grown at an average rate of close to 4.0% per year over the past twenty years, and are projected to grow between 2.5% and 3.5% annually from 2015 to 2055 (Figure 3). By contrast, globally the average annual urban population growth rate is projected to be between 1.44% and 1.84% from 2015 to 2030 (WHO 2015). From an environmental perspective, this has two important implications. On the one hand, most of Africa’s urban space has yet to emerge. Much of the area which will eventually be covered by the built environment has not yet been constructed and populated. Crucial natural assets – and significant biodiversity – thus remain intact in areas to which cities will eventually spread. On the other hand, this is changing quickly: pressures on the natural environment in and around cities are escalating steadily and these assets are increasingly under serious threat.\”

The existing environmental hazards levels in many African cities are often severe. They write: \”For the entire region the proportion of urban residents with access to sanitation was estimated to be only 37% in 2010. Solid waste coverage also remains very limited with collection rates for many African cities at below 50% …\” 

Here\’s a figure showing particulate concentrations in a range of cities. You think some cities in China have problems with air pollution? On this measure, a number of cities in Africa are considerably worse. 
It\’s not a surprise that the health toll from these environmental pollutants is severe. In a number of countries in sub-Saharan Africa, the estimates of total welfare losses due to high air pollution are often in the range of 5% of GDP.  Here\’s a table showing estimates of premature deaths from various risk factors. For unsafe water and sanitation, the estimates of premature deaths are falling. For household and ambient air pollution, estimated deaths are rising.

There\’s no secret about the solutions here, and White, Turpie and Letley lay them out in some detail. Protect aquatic ecosystems like rivers and marshes. Avoid spreading pollution through stormwater runoff. Collect and treat sewage. Limit sources of air pollution. Preserve some greenspace. Don\’t build in places that are going to flood every few years. Such a list of policy steps can easily be expanded. Again, the goal is not to limit or hinder the urbanization of countries in sub-Saharan Africa, but only to guide it in more environmentally friendly directions. But the governance issues are severe. The authors write:

\”Cities need to strengthen the institutions on which effective green urban planning and management rest by addressing structural limitations, accountability and capacity constraints. … It is also important to recognize that the widespread planning failures evident in African cities are, in essence, a symptom of institutional weakness. In a “greening” context, green urban planning fails to emerge because African urban management institutions lack the capacity to generate such plans, and,
whether or not they are environmentally sensitive, the plans that are produced are seldom implemented or enforced. While the strengthening of government institutions is key, it is also perhaps one of the most challenging issues to address. … Finally, the green urban development agenda needs to be better financially resourced. In the context of the limited fiscal devolution characteristic of cities in many African countries, there is a very substantial agenda here.\”

The authors of the report are clear-eyed about these problems, but the report is nonetheless infused with a can-do spirit, and features a number of encouraging stories. I hope I am wrong, but I confess that I am not optimistic that most of Africa\’s cities will rise to meet these environmental challenges.

For those interested, a couple of other recent posts on sub-Saharan Africa are:

Corporate Benefits from White House Visits: A Tidbit of Evidence

Just because corporate executives pay hundreds of visits to the White House doesn\’t prove that their firms are benefiting from White House connections. Perhaps it\’s just a useful way for the White House to gather information and input about economic effects of real-world policies. Perhaps it\’s a useful way for the White House to get a little reflected glory from those who run successful companies. Perhaps it\’s a way of rewarding diehard supporters who would have been supporting you anyway. But Jeffrey R. Brown and Jiekun Huang actually take a look at how corporate stocks perform right around the time of White House visits. Their evidence appears in All the President’s Friends: Political Access and Firm Value,\” which appears as a National Bureau of Economic Working Paper (#23356, April 2017, not freely available on-line, but many academics will have access through library subscriptions.

The Brown/Huang approach is fairly straightforward. They look at the stock market returns of companies in the 10 days before and the 120 days after the visit of a top executive to the White House between 2009 and 2015. According to the White House logs, there were 2,286 visits by top executives to officials at the White House during these seven years, which includes more than 100 visits apiece with Barack Obama, Valerie Jarrett, and Jeffrey Zients. Brown and Huang adjust for how the overall stock market is doing, so they are looking at \”abnormal\” returns that differ from the average for the market as a whole. Here\’s a figure showing the pattern they find.

Within about 30 days of the visit of a top executive to the White House, on average a company sees its stock rise by nearly 1% more than the market as a whole–and then remain near that higher level at least through the 120-day horizon. When the authors break down the statistics by year, they find that the \”cumulative abnormal returns,\” as they refer to these calculations, \”are significantly positive during the election year (2012), the first years post-election (2009 and 2013) as well as 2014, suggesting that access to influential government officials is particularly beneficial during those years.\”

Of course, the pattern shown here doesn\’t prove that companies are benefiting from their White House connections. Perhaps stock market investors mistakenly perceive a White House visit means good news for the company. Perhaps top executives are more likely to get a White House invitation when good news is about to arrive for their company. But it\’s an interesting tidbit of actual evidence.

When Trotsky (Temporarily) Embraced Prices and Markets

The year was 1932. Leon Trotsky had been already been tossed out of the Communist Party and exiled from Stalin\’s Soviet Union. Writing from a distance, he found himself performing a balancing act: on one side, supporting the broad idea of the Revolution and the ultimate victory of socialism; on the other side, criticizing the first five-year economic plan as poorly designed and replete with failures. In his October 1932 essay, \”The Soviet Economy in Danger,\” Trotsky finds himself arguing that Soviet bureaucrats were far too confident about economic central planning, and instead needed to rely more on prices and supply and demand. 

Here are some snippets from Trotsky, which include a number of phrases and sentences that could have been written by a fierce critic of socialism like Friedrich Hayek. Trotsky\’s concerns include: the large costs of mistakes in centralized decision-making, problems in which quality of output is sacrificed in the drive for greater quantity, lack of coordination across production chains in the economy, how bureaucrats lack a \”universal mind\” and thus need to rely on supply and demand and \”commercial relations.\” Of course, for Trotsky, all of this just proves that socialism is working.

\”Even though the first five-year plan took into consideration all possible aspects, by the very nature of things it could not be anything but a first and rough hypothesis, destined beforehand to fundamental reconstruction in the process of the work. It is impossible to create a priori a complete system of economic harmony. The planning hypothesis could not but include old disproportions and the inevitability of the development of new ones. Centralized management implies not only great advantages but also the danger of centralizing mistakes, that is, of elevating them to an excessively high degree. … 

\”The administrative hue and cry for quantity leads to a frightful lowering of quality; low quality undermines at the next stage the struggle for quantity; the ultimate cost of economically irrational “successes” surpasses as a rule many times the value of these same successes. Every advanced worker is acquainted with this dialectic, not through the books of the Communist academy (alas! more inferior goods), but in practice, through experience in their own mines, factories, railroads, fuel stations, etc. … If we were to introduce a corrective coefficient for quality into the official data, then the indices of the fulfilment of the plan would immediately suffer substantial drops. …

\”The problem of the proportionality of the elements of production and the branches of the economy constitutes the very heart of socialist economy. The tortuous roads that lead to the solution of this problem are not charted on any map. To discover them, or more correctly to lay them, is the work of a lengthy and arduous future. All of industry groans from the lack of spare parts. Weavers’ looms remain inactive because a bolt is not to be had. “The assortment of articles produced,” writes EZ, “in the line of commodities of widespread consumption is haphazard and does not correspond to … the demand.” …

\”If a universal mind existed, of the kind that projected itself into the scientific fancy of Laplace – a mind that could register simultaneously all the processes of nature and society, that could measure the dynamics of their motion, that could forecast the results of their inter-reactions – such a mind, of course, could a priori draw up a faultless and exhaustive economic plan, beginning with the number of acres of wheat down to the last button for a vest. The bureaucracy often imagines that just such a mind is at its disposal; that is why it so easily frees itself from the control of the market and of Soviet democracy. But, in reality, the bureaucracy errs frightfully in its estimate of its spiritual resources. In its projections it is necessarily obliged, in actual performance, to depend upon the proportions (and with equal justice one may say the disproportions) it has inherited from capitalist Russia, upon the data of the economic structure of contemporary capitalist nations, and finally upon the experience of successes and mistakes of the Soviet economy itself. But even the most correct combination of all these elements will allow only a most imperfect framework of a plan, not more.

\”The innumerable living participants in the economy, state and private, collective and individual, must serve notice of their needs and of their relative strength not only through the statistical determinations of plan commissions but by the direct pressure of supply and demand. The plan is checked and, to a considerable degree, realized through the market. The regulation of the market itself must depend upon the tendencies that are brought out through its mechanism. The blueprints produced by the departments must demonstrate their economic efficacy through commercial calculation. …

\”Within the scope of this brief pamphlet I have deemed it necessary to present in all their acuteness the contradictions of the Soviet economy, the incompleteness and the precariousness of many of its conquests, the gross errors of the leadership, and the dangers that stand in the path of socialism. … One who accepts the proletarian revolution only when it is accompanied by all conveniences and lifelong guarantees cannot continue on the road with us. We accept the workers’ state as it is and we assert, “This is our state.” Despite its heritage of backwardness, despite starvation and sluggishness, despite the bureaucratic mistakes and even abominations, the workers of the entire world must defend tooth and nail their future socialist fatherland which this state represents. …\”

The Slow-Motion Crisis in Government Pensions

Around the world, life expectancy is rising, birthrates are either falling or stable, and populations are aging. But Mauricio Soto offers some eye-opening calculations about what this means for those relying on government pensions in \”Pension Shock,\” which appears in the June 2017 issue of Finance & Development.

In the chart, the left-hand panel shows government spending on old-age pensions across OECD countries. The level has basically doubled from over 4% in 1970 to roughly 9% at present. But at least given current projections, and after various steps that governments have taken, government spending on pensions as a share of GDP isn\’t scheduled to rise much more in the next few decades.

The difficulty arises because if government keeps spending the same share of GDP on pensions at a time when the share of the population who are elderly keeps rising, then the average government pensions will cover a smaller share of income. Thus, the right-hand panel shows that while the \”economic replacement rate\” for an average individual over the age of 65 has been around one-third of per capita GDP for the last few decades, it\’s projected to fall to about 20% of per capita GDP by 2040 and later.

What\’s are some of the  possible responses here? One set of reactions could happen within the  political system. For example, the elderly could vote for dramatic increases in taxes on the working generation to support higher pensions. Or government pensions could be redesigned to provide only a basic income support, and nothing much higher, even if you paid much more in payroll taxes throughout your life.

Another set of reactions could happen with the actions of individuals. Soto\’s calculations suggest that if people worked about five years longer before retirement, it would offset about half of the predicted decline in the \”economic replacement rate.\” If everyone also saved at least 6 percent of their income during their working life, this would offset the other half of the fall in the \”economic replacement rate.\” Again, these changes are just what is necessary to offset the expected decline in what government pensions are currently scheduled to pay.

The needs and expectations of an aging population are a tectonic shift under our current political and economic understandings, and will cause some earthquakes before it\’s done.

What is Killing US Coal?

US coal output and coal jobs have dropped in recent years. In \”What Is Killing the US Coal Industry?\”, Charles D. Kolstad names and investigates the suspects. The essay is a March 2017 Policy Brief for the Stanford Institute for Economic Policy Research. Here is Kolstad\’s list of suspects:

  • \”Environmental regulations — the primary suspect for some — killed coal. 
  • \”Deregulating railroads in the 1970s allowed cheap Western coal to displace more costly Eastern coal, resulting in major job losses in the labor-intensive Eastern coal industry. 
  • \”The fracking revolution has driven down natural gas prices, making coal less competitive in electricity production. 
  • \”Coal mining jobs are going away because of the same productivity gains that have led to fewer manufacturing jobs across the country — workers can produce more coal per hour, meaning fewer workers are needed to maintain steady coal output. 
  • \”Other reasons include financial markets, which may see the future of coal as risky (for a variety of reasons) and thus a poor investment.\” 
The list of suspects has obvious political implications. For example, if the drop in coal is about high productivity growth among coal miners, or the rise of natural gas production, then there\’s not much the government can (or should) be doing to alter the situation. If the drop in coal is mainly about environmental rules, then we could perhaps have an argument over the costs and benefits of such rules, or whether such rules might be redesigned in a way that reduces a substantial share of the costs but keeps a substantial share of the benefits. 
Kolstead\’s conclusion: \”[E]nvironmental regulations did not kill coal. Progress is the culprit.\” Here\’s some additional detail, starting with the big-picture overview of US coal output and jobs.

Total US coal output rose fairly steadily from 1950 up to about 2010. However, the graph shows that all of the rise was in western coal, like the Powder River Basin in Montana and Wyoming, rather than eastern coal like West Virginia and Pennsylvania. Railroad deregulation in the 1970s made it much more cost-effective for western coal to be shipped around the country.

Employment in the coal industry first fell sharply in the 1950s with the agreement between the United Mineworkers union to pursue automation in the coal industry in exchange for better wages. There is another long decline in coal miner jobs starting around 1980, but it is mostly in eastern mines. Remember, the output of eastern mines wasn\’t changing much during most of this time, which implies that the productivity of coal miners was rising substantially.

More recently, the rise of natural gas production has taken market share from coal: for example, coal has traditionally been the main fuel for generating electricity, even into the early 2000s. However, the share of electricity generated by natural gas now exceeds that from coal.

What about environmental regulations as a reason for decline in the coal industry? Kolsted points out two ironies here.

First, it\’s true that air pollution rules passed back in 1970 to reduce sulfur emissions tended to hurt high-sulfur eastern coal. But then those rules were given exceptions to help offset the harms to eastern coal. The result was that coal-fired power plants in the east ended up holding on to old and inefficient facilities much longer–and in recent years the age of those facilities has caught up with them. Kolsted explains:

\”The easiest way to meet the 1970 sulfur emissions regulations was to burn low-sulfur coal, which set off  a dramatic expansion of low-sulfur coal mining, primarily in Wyoming. The strong demand for low-sulfur coal threatened high-sulfur coal producers, primarily in the East. 

\”In order to save coal-mining jobs in the East, the Clean Air Act was amended in 1977 to require equipment on all new coal-fired power plants to physically remove sulfur from the smokestacks after combustion, reducing the attractiveness of low-sulfur coal (all coal becoming “compliance coal”). This reduced the competitive threat to Eastern mines.

\”Another feature of the 1970 Clean Air Act had more subtle and delayed effects. That is the exemption of existing (as of 1970) power plants from sulfur reduction rules. This “grandfathering” was done for political reasons to facilitate passage of the Act. But it was also viewed as fair and without long-term consequences since those older plants were expected to retire at the end of their 40- or 50-year lives anyway. But as Revesz and Lienke (2016) detail, this exemption provided an incentive to keep old and dirty power plants operating rather than retire, despite the higher operating costs of old plants. To protect health and welfare, this necessitated the EPA’s imposition of more restrictions on old power plants over the years, including the acid rain provisions instituted in 1990 during the Bush administration. Additional rules were put in place during the next three presidential administrations to deal with the problems caused by old plants operating long after their assumed retirement date.

\”Now, nearly 50 years after the 1970 Act, shuttering of old power plants has finally begun. … [T]he coal plants retired in 2015 were quite old (the oldest began operation in 1944, the year the Allies landed in Normandy). … This suggests that the decline in coal-fired electricity generation is largely the result of an aging fleet of power plants, which may well have been retired years ago absent the Clean Air Act’s grandfathering clause.\”

Second, if environmental regulations are loosened for all types of energy production–that is, for natural gas as well as for coal–it\’s quite plausible that natural gas will continue to gain relative to coal.

So yes, environmental rules affected eastern coal production. But the big stories for the fall of coal are productivity growth among coal miners and the rise of natural gas. demand for eastern coal might well be larger today if instead of favoring aging coal-fired electrical power plants through grandfathering rules, those plants had been updated and replaced over the decades.  

Interview with Hilary Hoynes: Anti-Poverty Programs

Douglas Clement offers yet another of his excellent interviews, this one with Hilary Hoynes, in The Region, published by the Federal Reserve Bank of Minneapolis (June 1, 2017).  Here are some tidbits.

Long-Term Returns to Food Stamps

\”Food stamps are a central part of the U.S. social safety net, and it’s a means-tested program—meaning that you have to have low income to participate. And, remarkably, it has remained fairly intact over the past 20, 30, 40 years while other parts of the safety net for low-income families have been restricted and reformed. Also, it’s federal—run out of the USDA—so it doesn’t vary a lot geographically. That’s helpful because it really provides a uniform floor across the United States. In very poor areas, even in states that don’t tend to provide a lot of assistance for the poor, food stamps create a kind of universal minimum across all places. It does, however, create challenges for doing evaluation because it doesn’t vary much across space, and it also hasn’t varied much over time. …

\”Food stamps started under President Kennedy. His first executive action was to start some pilot programs for food stamps. … Those pilot programs eventually led to passage of the Food Stamp Act in 1964. But it wasn’t until 1974, 10 years later, that subsequent legislation compelled all areas to implement food stamps. In that 10-year interim, Congress essentially said to U.S. counties, “We’re going to appropriate these funds for this program. If you’re interested in implementing this program, please apply and we will fund them, subject to our appropriation.” … This resulted in gradual rollout of food stamps across the almost 3,200 U.S. counties. …

\”The “rollout design” is one of the tools in our tool bag for doing evaluation. And, of course, we need to convince ourselves that that rollout was as good as random, that it wasn’t systematic, that certain areas had the rollout earlier than others. In our first paper on this, my co-author Diane Schanzenbach and I really dug into the nature of the rollout and the political economy behind it. At the end of the day, we were convinced that it was as good as random which places got food stamps earlier rather than later. …

\”In the paper in last year’s AER with Douglas Almond and Diane Schanzenbach, we took a long-term evaluation lens to this program. Food stamps rolled out in the ’60s and ’70s, so the cohorts affected, or not, in early or late childhood are in their early 50s today. This presented an opportunity to address a question that no one has ever looked at before in the context of food stamps: What are their long-run benefits? …

\”We couldn’t in our data know precisely which families were on food stamps, so it’s sort of an indirect estimate. But we know whether food stamps were implemented when these individuals were 2 or 4 or 14 or 20 years old. We essentially analyzed the data within that lens: How old were you when food stamps were rolled out in your county?

\”The headline finding was about health. We measured metabolic syndrome, which is essentially a range of conditions including high blood pressure, diabetes, heart disease and obesity. … And we found that the more exposure to food stamps that a person had, the lower their risk of metabolic syndrome in adulthood. In particular, the gains were greatest if the food stamps program was implemented before an individual was 3 or 4 years old. That period between in utero exposure—prebirth—to those first three or four years of life, was the age range where having more exposure to food stamps available led to a more dramatic reduction in the incidence of metabolic syndrome in adulthood. … Then we also looked at effects on human capital outcomes. …  In short, we found that better nutrition in early childhood leads to human capital improvement and better outcomes in adulthood, but that finding was limited to women.\”

On the Earned Income Tax Credit

\”The EITC is the most important anti-poverty program for families with children in America. It removes the most children from poverty, and it’s organized as an in-work benefit rather than an out-of-work benefit. Welfare, for instance, is an out-of-work benefit …  The whole idea of in-work programs like EITC is to respond to that and say, “Well, American voters would rather have a program that redistributes while encouraging work, not discouraging work.” The EITC operates as an earning subsidy on incomes up to about $14,000. For every dollar that you earn, if you’re a single mother with two children or a married couple with two children, for every dollar that you earn up to about $14,000, you get 40 cents added to that dollar through the EITC. It’s a quite powerful increase in your after-tax wage.

\”It still needs to phase out or everybody would get it, so there are some negative work incentives that are faced by higher-income workers at levels where the EITC phases out: between about $15,000 and $40,000—or $18,000 and $45,000, depending on your family size. And it’s phased out at a rate of about 21 cents on the dollar. So, if you earn an additional dollar, your EITC is reduced by 21 cents, a gradual phase-out.

\”Research shows that this program design has a dramatic effect on employment. When the EITC expands, you see more low-skilled workers, particularly single mothers, in the labor market. It has a very powerful effect on transitioning people from out-of-work to in-work. And in so doing, it lowers poverty rates, not just because you’re giving households a tax refund at the end of the year—and of course, if you give someone money, you’re going to reduce poverty—but just as important is the fact that by encouraging work, earnings go up in the household, and that also reduces poverty. It generates a roughly 2-for-1 reduction in poverty for every dollar of federal spending, and that’s every efficient. … It does redistribution within the tax code, rather than a sort of brick-and-mortar social welfare operation that is the model of the state-based social safety net.\”

Head Start Doesn\’t Fade for All Groups 

\”[M]any studies that look at the effects of Head Start (and, to some extent, of programs like Perry Preschool and others) have found that increases in cognitive test scores for children in the years they’re in Head Start seem to fade out once they enter school. … Is it possible that this fadeout is masking the fact that there are gains for some groups that somehow, in the global mean, seem to disappear?

\”It turns out that the story isn’t quite that simple; but we did discover that, yes, Head Start increases cognitive test scores, but those global mean results mask the fact that the gains are very concentrated at the bottom of the skill distribution. The test scores at the bottom of the distribution went up by a lot; whereas, test scores in the middle and the top of the distribution didn’t go up by very much. …

\”Fast forward in this Head Start impact study, and observe kids through grade 1. We found that overall, the fadeout occurs throughout the distribution for the full population. But by looking across groups based on maternal education, race, ethnicity and other characteristics, we uncovered this finding of much larger gains for a specific group: kids who enter Head Start as English language learners—that is, English is not the primarily language at home. And in this experiment, that turned out to mostly be Spanish speakers because of the population in the experiment. These results were contemporaneous when the kids are still in Head Start, but they also persisted through transition to elementary school. Fadeout didn’t occur.\”

Hoynes has written for the Journal of Economic Perspectives, where I work as Managing Editor, a couple of times. For those who would like to sample her work up close, the articles are:

How America Could Save $65 Billion in Mobile Phone Bills

It is a fact of nature that all countries have the same electromagnetic spectrum of radio frequencies. It is a fact of politics that countries have different rules for allocating these frequencies. And it is a fact of economics that people in different countries pay very different rates for their use of spectrum. Mara Faccio and Luigi Zingales ask: \”Why does the price of the same basket of mobile phone services vary around the world from $10.07 to $47.25? Why does the price of a 1GB mobile-broadband internet plan vary from $11.24 to $100.28?\” They investigate the question in a January 2017 working paper \”Political Determinants of Competition in the MobileTelecommunication Industry,\” available from the Stigler Center for the Study of the Economy and the State at the University of Chicago Booth School of Business.  For those who prefer to get their economics via cartoon, the most recent issue of the Chicago Booth Review has you covered with on this topic.

Countries can affect the competitive situation of telecommunications industries in many ways, including the rules that govern entry, the extent of price regulation, whether phone numbers are easily portable when shifting between carriers, whether voice-over-internet calls are permitted, and so on. These rules vary substantially across countries. Faccio and Zingales write: \”[E]very time one crosses a national border in Europe the roaming company of the mobile phone changes. In spite of the European integration process, the mobile communication industry remains segmented at the national level. This is not unique to Europe: throughout the world, the mobile communication industry remains very much segmented by country.\” Another reason to focus on mobile phone and broadband is because the availability and quality of these services can be readily across users in different countries.

Indeed, they have data from the International Telecommunications Union available for 148 countries that includes dozens of variables in They have data on five main categories of variables in each country: regulatory climate; competitive structure; quality of service; spectrum auctions; and broad institutional characteristics (democracy, unions, tax rates and more). Thus, they offer a lot of statistical tables to make their case: \”We show that the way a government designs the rules of the game has an impact on concentration, competition, and prices. Pro-competition regulation reduces prices, but does not hurt quality of services or investments. More democratic governments tend to design more competitive rules, while more politically connected operators are able to distort the rules in their favor, restricting competition.

But beyond the statistics, they offer a comparison between the United States and \”the two EU countries with the level of regulation closest to the Unites States,\” namely Germany and Denmark. They write:

\”The United States exhibits much higher monthly revenues per unique subscriber ($67.6 in 2015:3 vs $23.48 Germany and $31.01 for Denmark), which implies U.S. cellular phone companies have annual revenues per customers $530 higher than their German counterparts, and $439 higher than their Danish counterparts. One reason for the large difference could be that the U.S. carriers tend to subsidize the headsets, while the European carriers do not. The typical subsidy for an iPhone is $500 dollars (they charge $199 for a phone worth $699). Even factoring in this difference, each U.S. customer pays $280 a year more than a German customer and $189 a year more than a Danish one. Given the number of U.S. customers (233.2 million in 2015), this implies that U.S. operators enjoy a transfer of $65.2bn ($44.1bn) vis-à-vis the German (Danish)
benchmark.

\”Not all of this difference is a pure transfer. We do find better quality of service in the
United States, where in 2013 4G connections represented 23.1% of the total and 4G coverage was 95.1%. In Germany, 4G connections represented 2.7% of the total 4G coverage was 64.54%, while for Denmark, 4G connections represented 9.31% of the total and 4G coverage was 92.37%.\”

However, the authors go on to argue that the relatively small differences in quality cannot explain the relatively large differences in prices paid by consumers; indeed, the higher prices paid by consumers help to explain the high stock prices for major US carriers like AT&T, Verizon, T-Mobile, and Sprint. In looking at their overall data set, the authors write: \”We test this hypothesis and we find no evidence that a higher degree of competition leads to lower quality of service or less investments. If anything, the results go in the opposite direction.\”

In the United States, the Federal Communications Commission just completed in March 2017 its first \”incentive\” auction, in which the broadcast TV companies that were allocated huge chunks of spectrum decades ago, but now deliver most of their content via cables, have an chance to sell off that spectrum to mobile services. As the FCC writes: \”In the auction, TV broadcasters could voluntarily give up their current broadcast channel in exchange for a share of the proceeds from an auction of their channel to commercial wireless service providers to provide expanded mobile broadband services.\” This is a step in the right direction. But American consumers have every reason to keep comparing their mobile bills to those in Germany, Denmark, and elsewhere, and to get an answer from their government on why the electromagnetic spectrum that is naturally available everywhere should cost more in the United States.