Latest Blog Posts & Articles

Mind-Boggling Partisan Dysfunction

I have done some research on political partisanship, as well as some writing. I think political dysfunction in this country threatens our future. So it was nice to read this opening paragraph, in a relatively recent and wonderfully written article in Time magazine:

Here’s a rainy-season parable about cooperation in American politics: In July 2012, Republicans and Democrats came together during a bitter campaign season to enact sweeping reforms to the National Flood Insurance Program, phasing out subsidies for hundreds of thousands of property owners in flood-prone areas, dragging a debt-ridden program toward fiscal and ecological sustainability. The reforms attracted a genuine bipartisan coalition with groups like the Heritage Foundation on the right and the Nature Conservancy on the left joining forces with Realtors, bankers and insurers. The simple notion that insurance rates should reflect risk was so compelling that the usually polarized House passed the reforms by a 406-to-22 vote. “Everyone was like, Wow,” says David Conrad, a consultant for the Association of State Floodplain Managers. “We had been talking about reform for 15 years, and rationality finally caught up to Congress.”

Then the article continued with the following much shorter paragraph:

It was a rare moment of unity, and in March 2014, the two parties came together for another festival of bipartisanship. This time, they gutted the reforms they had passed less than two years before.

Check out the magazine article, if you want to find out why this all happened. But the article showed me that our political problems run much deeper than partisanship. Even when Congress agrees on something, it often responds to special interests that don’t have the broader interests of the American public in mind. Very disturbing!

Posted in Political Psychology | Tagged ,

Could Pay-For-Performance Lead To Overuse Of Antibiotics?

Not long ago, the Joint Commission (a healthcare quality organization) established that patients with pneumonia should receive antibiotics within four hours of diagnosis. Timely diagnosis and treatment can be the difference between life and death in patients with this illness. In fact, some people believe this kind of quality measure should play a large role in how we pay for medical care. After all, doctors should not be paid solely on the basis of how much care they provide, but also based on the quality of that care. All else equal, a physician who treats pneumonia efficiently should be rewarded more handsomely than one who takes a fortnight to make a diagnosis.

Only one problem with this seemingly sensible view. Experts believe this four-hours-to-treat requirement leads to an over diagnosis of pneumonia and, consequently, to an overuse of antibiotics. How we measure healthcare quality, and how we factor such measures into physician reimbursement, can have surprising effects on how physicians diagnose and treat patients.

Consider another life-threatening illness – sepsis, a syndrome of widespread inflammation and, at its most extreme, multi-organ failure caused by infection. Sepsis typically requires not only high power antibiotics but also intensive care from multiple specialists. A recent article in the New England Journal of Medicine suggests we may be experiencing an over diagnosis of this syndrome, because hospitals often receive higher reimbursement for patients with sepsis than for ones with milder infections. In other words, it pays not to miss sepsis diagnoses. (Visit Forbes to read more and leave comments.)

Posted in Health & Well-being, Health Policy, Medical Decision Making | Tagged , ,

Carbs = Bad!

A recent study published in the Annals of Internal Medicine showed that that old advice – to avoid fat and cholesterol in your diet lest you become a fat person with high cholesterol – is wrong. Instead, it is carbohydrates we should be more wary of. Consider their picture, comparing people with low-carb versus low-fat diets. The low-carb diet wins, hands down:

Carbs Enemy

Now don’t think this study gives us all license to gorge on cheeseburgers to our heart’s content. Instead, just make sure you don’t fill yourself up with carbs thinking its helping you, by curbing your desire for fat.

Carbs are the enemy!

Posted in Health & Well-being

More on Relativity and Happiness

Recently, I wrote about relative wealth and happiness. A new NBER paper, by Stevenson and Wolfers, seems to belie this view. It shows a sharp increase in happiness with increasing income:

Life Satisfaction & IncomeBut these data are consistent with the idea that relative wealth plays an important role in happiness. Americans are much wealthier now than they were, say, before World War II. But there has not been a commensurate increase in happiness. But at any point in time, wealthy people are happier, on average, than less wealthy ones. Relativity still matters.

Posted in Behavioral Economics and Public Policy | Tagged ,

Behavioral Economics and the Relativity Theory of Happiness

Money UnhappyAccording to many traditional economic theories of human nature, higher income should make people happier. That’s because with every additional dollar we make, we can purchase goods that increase our “utility.” Or we can save more money, and reduce anxiety about our financial future.

But of course, once people have enough money to meet the basic necessities, the relationship between additional money and additional happiness gets more complicated. For instance, for many people with high incomes, how happy they are with their earnings depends on the size of their earnings compared to their peers.

Consider a banker who wrote an op-ed in the New York Times a while ago, complaining about his income:

“In my last year on Wall Street my bonus was $3.6 million — and I was angry because it wasn’t big enough.”

The problem of course isn’t the size of the bonus, but the size of his best friend’s bonus, or the size of the bonus he got the previous year.

Traditional economics still provides us with wonderful tools to understand human behavior. We just have to remember to reach into our toolbox for other insights into human nature, to better grasp how people think, decide and behave.

Posted in Behavioral Economics and Public Policy | Tagged ,

Why We Cannot Trust Political Pundits, or Ourselves

Take a look at the image below and decide what you are seeing:

B 13

Some of you might have seen a “B.” Others might have seen the number 13. The image, after all, is ambiguous. For that reason, in fact, it was used by researchers to study  how our hopes influence our perceptions.

The study design was straightforward. One group of participants was told that each time a number flashed up on the screen, they would get to drink a tasty beverage whereas when a letter appeared, they would be forced to drink a noxious health-food smoothie. (I am guessing kale was involved!) The researches then showed people this image for only 400 milliseconds and these folks thought they saw the number 13. In another group of participants, the researchers reversed punishment and reward,  with letters now leading to tasty beverages. In that setting, most people viewing this image saw the letter “B.”

Are you worried that people are lying? (Please visit Forbes to read the article in full.)

Posted in Behavioral Economics and Public Policy, Uncategorized | Tagged , ,

Tobacco is Taking Over the World!

We’ve done a lot of things in the United States over the last few decades to curb tobacco consumption. We’ve warned people cigarettes will kill them, created persuasive ad campaigns to scare people away from cigarettes, and added a hefty tax to the product. As a result, cigarette use in United States is lower than it has been in decades. Which means one thing – to maintain profits, tobacco companies need to get people smoking elsewhere in the world. And their efforts seem to be coming to fruition, based on this picture from the Wall Street Journal, which I learned of through Conrad Hackett, twitter handle @conradhackett, from Pew research.

Tobacco WorldTobacco companies have a legal right to promote and sell their products in most countries. It’s just unfortunate their promotion and sales efforts are so successful.

Posted in Behavioral Economics and Public Policy, Ethics, Health & Well-being, Uncategorized | Tagged ,

Heart-Wrenching Words from Beethoven on Deafness

Beethoven DeafIt is an awful irony that Ludwig van Beethoven, who I consider the greatest composer in the history of the world, experienced deafness from an early age, a disability that did not seem to interfere with his musical productivity one whit. But it certainly cost him a great deal of suffering, as is quite apparent in this quote:

O you men who think or say that I am malevolent, stubborn or misanthropic, how greatly do you wrong me. You do not know the secret cause which makes me seem that way to you…. For 6 [sic] years now I have been hopelessly afflicted, made worse by senseless physicians, from year to year deceived with hopes of improvement, finally compelled to face the prospect of a lasting malady (whose cure will take years or perhaps be impossible). Though born with a fiery, active temperament, even susceptible to the diversions of society, I was soon compelled to withdraw myself, to live life alone…. It was impossible for me to say to people, “Speak louder, shout, for I am deaf.” Ah, how could I possibly admit an infirmity in the one sense which ought to be more perfect in me than in others, a sense which I once possessed in the highest perfection…. For me there can be no relaxation with my fellow-men, no refined conversations, no mutual exchange of ideas. I must live almost alone like one who has been banished.

Painful to read. A man who already had difficulty interacting with other humans, to be further isolated by deafness, an isolation increased by his embarrassment that his affliction involved the main sense relevant to his art and his livelihood.

Posted in Uncategorized | Tagged , ,

Designing a Better Restaurant Menu

My friend and colleague Brian Wansink, from Cornell University, worked with some colleagues to design a preliminary restaurant menu, that maximizes the odds the people will order healthy foods. Trick number one: don’t call them “healthy” foods.

Here is an image of that menu, reproduced in the Atlantic.

Slim By Design Diner

This is a great example of how to use behavioral science to improve the well-being of the general public. Hurrah!

Posted in Behavioral Economics and Public Policy | Tagged ,

What’s Really Scary about Obamacare

This cartoon made the rounds of twitter a few weeks ago, and was first brought to my attention by Timothy McBride (@mcbridetd). But it is such an entertaining cartoon, I thought I would circulate it again:

Scary About OBAMAcareFor all its flaws, Obamacare has done more to increase access to health insurance than any government program since Medicare.

Posted in Health Policy | Tagged , ,