Beat the Press

Beat the press por Dean Baker

Beat the Press is Dean Baker's commentary on economic reporting. He is a Senior Economist at the Center for Economic and Policy Research (CEPR). To never miss a post, subscribe to a weekly email roundup of Beat the Press. Please also consider supporting the blog on Patreon.

I have been harping on the fact that it is very likely China will be mass producing and distributing a vaccine at least a month, and quite possibly several months, before the United States. This should make people very angry.

Even a month’s delay is likely to mean tens of thousands of avoidable deaths and hundreds of thousands of avoidable infections. And, it adds a month to the time period before we can get back to living normal lives. Of course, the delay could end up being many months, since we still have no idea how the clinical trials will turn out for the leading U.S. contenders.

We are in the situation where we can be waiting several months for a vaccine, after one has already been demonstrated to be safe and effective, because the Trump administration opted to pursue a route of patent monopoly research, as opposed to open-source collaborative research. If Trump had gone the latter route, as soon as China, or anyone, had a vaccine, everyone would have a vaccine, or at least everyone would be able to manufacture it.

 

Patent Monopoly Financing Versus Open Source

Since people seem to find the alternative to Trump’s patent monopoly approach confusing, let me outline it simply, so that people can see what is at issue. As it turned out, Trump quite explicitly turned the development of a vaccine into a race. He created “Operation Warp Speed,” to which he committed more than $10 billion of public funds. This effort is supposed to develop both vaccines and treatments for the coronavirus.

The funding takes a variety of forms. Several companies received some upfront funding, but are relying primarily on advance purchase agreements for an effective vaccine. For example, Pfizer signed a contract that commits the government to buying 100 million doses for $1.95 billion ($19.50 per shot), if it has a successful vaccine.

By contrast, Moderna relied largely on upfront funding, getting $483 million for its pre-clinical research and phase 1 and 2 trials, and then another $472 million to cover the cost of its phase 3 trials. Incredibly, after largely picking up Moderna’s development costs, the government is also allowing Moderna to have a patent monopoly on its vaccine. This means it will effectively be paying Moderna twice. First with the direct funding and then a second time by allowing it to charge monopoly prices on its vaccine.

This nationalistic patent monopoly route was the one Trump chose to pursue. It should be mentioned there was little visible opposition from leading Democrats in Congress.

But, we could have taken a different route. We could have looked to pool research, not just nationally, but internationally. This would mean that all research findings would be posted on the web as soon as practical, and that any patents would be placed in the public domain so that everyone could take advantage of them.

We were actually seeing this sort of cooperation in the early days of the pandemic, which allowed scientists to gain an understanding of the virus more quickly than if we had followed the path of patent monopoly supported research. This path of cooperation could have continued, if Operation Warp Speed had been structured differently. Instead of paying for the research costs of a company like Moderna, and then telling them they could get a patent monopoly so that they could charge whatever they want, we could have made the condition of the funding that all its findings would be fully public and patents would be in the public domain.

Since some folks have a hard time understanding what incentive Moderna would have if they weren’t getting a patent monopoly, let me explain: they would be getting paid.

Just as most of us work for money, not patent monopolies, Moderna and other drug companies developing vaccines or treatments would be getting paid directly for their research. Their incentive would be that they presumably want to continue to get paid. If they went two or three months and had nothing to show, then they would not continue to get paid.

This is the idea of working for money. I thought that most economists were familiar with it, but when it comes to financing drug research, they seem to view it as an alien concept.[1]

Anyhow, if we committed $10 billion for open research, presumably we would want comparable commitments (adjusted for size and wealth) from other countries. For example, Germany, which has an economy that is roughly one fifth the size of the U.S. economy, would be expected to commit to paying $2 billion to support open research. China would also be expected to make a commitment that was comparable relative to its GDP, although as a much poorer country (on a per person basis), perhaps the commitment would only be half as large relative to its economy.

If we had leadership in the United States that was committed to pursuing a path of open research, then presumably it would be possible to quickly work out a deal that countries were reasonably satisfied with. It doesn’t matter that a deal may not make everyone perfectly happy. Lots of things are happening in the pandemic and the responses are far from perfectly fair. Such is life.

Anyhow, in this world of open research, if it turned out that China’s vaccines were showing more promise earlier than the ones developed by Pfizer and Moderna and other U.S. companies, we would be able to manufacture and mass distribute their vaccines, as soon as the Food and Drug Administration (FDA) approved them. No one would need permission from China since the research was open, and anyone could manufacture the vaccines who had the capability.

Just to be clear, using a Chinese vaccine does not mean accepting China’s safety standards. The FDA would make its own determination of a vaccine’s safety and effectiveness based on the data from the clinical trials. If it could not be confident that the data supported approval, then it would not be granted, just as is the case with any domestic vaccine or drug.

If we had gone this route, if the Chinese vaccines are shown to be safe and effective before the vaccines developed by U.S. companies, we would not be left waiting. If China, or any other country had a vaccine, we would as well. This system still leaves a problem for developing countries who lack manufacturing capabilities, but at least intellectual property concerns would not be preventing people from getting a vaccine or treatment.

 

Open Research and Inequality

It is hard to understand how, not just mainstream Democrats, but even progressive leaders like Senators Bernie Sanders, Elizabeth Warren, and Representative Alexandra Ocasio-Cortez, were not pushing for an open research response to the pandemic. This almost certainly would have given us a vaccine more quickly.

However, an open research approach to the pandemic also could have been a very important model for biomedical research more generally. If we went a route of financing research upfront and putting all patents in the public domain, it could save us $400 billion a year on prescription drug spending. This comes to more than $3,000 per household. It is more than twice the size of the Trump tax cut. This is real money.

Patent monopolies also have a lot to do with inequality. We are often told that technology is a big part of the story of upward redistribution over the last four decades. While this story is frequently exaggerated, insofar as it is true, it is because we have designed patent and copyright laws so that some people can get very rich at the expense of everyone else. Bill Gates would still be working for a living if the government did not give Microsoft patent and copyright monopolies on its software.

It is more than a bit bizarre that political figures who devote so much effort to combatting inequality look the other way when we design a pandemic health care research plan that both slows research progress and gives more money to those at the top.

It’s fine to have progressive taxes, but it is even better to structure the market so that we don’t have so much inequality in the first place. If the minimum wage had kept pace with productivity since its 1968 peak, it would be $24 an hour today. That would be a hugely different world.

While it would be great if we could raise the minimum wage to $24 an hour, we can’t do that without changing many of the rules that allow so much income to be redistributed upward. The current system of patents and copyrights is a really big part of that story. In the case of the pandemic, it is not just leading to inequality, it is also costing people’s health and their lives. Progressives should be paying attention.    

[1] I discuss in chapter 5 of Rigged how this sort of system can be structured in a more systematic way (it’s free). But in the context of dealing with the pandemic emergency, the arrangements would have to be somewhat ad hoc, as is already the case with Operation Warp Speed.

I have been harping on the fact that it is very likely China will be mass producing and distributing a vaccine at least a month, and quite possibly several months, before the United States. This should make people very angry.

Even a month’s delay is likely to mean tens of thousands of avoidable deaths and hundreds of thousands of avoidable infections. And, it adds a month to the time period before we can get back to living normal lives. Of course, the delay could end up being many months, since we still have no idea how the clinical trials will turn out for the leading U.S. contenders.

We are in the situation where we can be waiting several months for a vaccine, after one has already been demonstrated to be safe and effective, because the Trump administration opted to pursue a route of patent monopoly research, as opposed to open-source collaborative research. If Trump had gone the latter route, as soon as China, or anyone, had a vaccine, everyone would have a vaccine, or at least everyone would be able to manufacture it.

 

Patent Monopoly Financing Versus Open Source

Since people seem to find the alternative to Trump’s patent monopoly approach confusing, let me outline it simply, so that people can see what is at issue. As it turned out, Trump quite explicitly turned the development of a vaccine into a race. He created “Operation Warp Speed,” to which he committed more than $10 billion of public funds. This effort is supposed to develop both vaccines and treatments for the coronavirus.

The funding takes a variety of forms. Several companies received some upfront funding, but are relying primarily on advance purchase agreements for an effective vaccine. For example, Pfizer signed a contract that commits the government to buying 100 million doses for $1.95 billion ($19.50 per shot), if it has a successful vaccine.

By contrast, Moderna relied largely on upfront funding, getting $483 million for its pre-clinical research and phase 1 and 2 trials, and then another $472 million to cover the cost of its phase 3 trials. Incredibly, after largely picking up Moderna’s development costs, the government is also allowing Moderna to have a patent monopoly on its vaccine. This means it will effectively be paying Moderna twice. First with the direct funding and then a second time by allowing it to charge monopoly prices on its vaccine.

This nationalistic patent monopoly route was the one Trump chose to pursue. It should be mentioned there was little visible opposition from leading Democrats in Congress.

But, we could have taken a different route. We could have looked to pool research, not just nationally, but internationally. This would mean that all research findings would be posted on the web as soon as practical, and that any patents would be placed in the public domain so that everyone could take advantage of them.

We were actually seeing this sort of cooperation in the early days of the pandemic, which allowed scientists to gain an understanding of the virus more quickly than if we had followed the path of patent monopoly supported research. This path of cooperation could have continued, if Operation Warp Speed had been structured differently. Instead of paying for the research costs of a company like Moderna, and then telling them they could get a patent monopoly so that they could charge whatever they want, we could have made the condition of the funding that all its findings would be fully public and patents would be in the public domain.

Since some folks have a hard time understanding what incentive Moderna would have if they weren’t getting a patent monopoly, let me explain: they would be getting paid.

Just as most of us work for money, not patent monopolies, Moderna and other drug companies developing vaccines or treatments would be getting paid directly for their research. Their incentive would be that they presumably want to continue to get paid. If they went two or three months and had nothing to show, then they would not continue to get paid.

This is the idea of working for money. I thought that most economists were familiar with it, but when it comes to financing drug research, they seem to view it as an alien concept.[1]

Anyhow, if we committed $10 billion for open research, presumably we would want comparable commitments (adjusted for size and wealth) from other countries. For example, Germany, which has an economy that is roughly one fifth the size of the U.S. economy, would be expected to commit to paying $2 billion to support open research. China would also be expected to make a commitment that was comparable relative to its GDP, although as a much poorer country (on a per person basis), perhaps the commitment would only be half as large relative to its economy.

If we had leadership in the United States that was committed to pursuing a path of open research, then presumably it would be possible to quickly work out a deal that countries were reasonably satisfied with. It doesn’t matter that a deal may not make everyone perfectly happy. Lots of things are happening in the pandemic and the responses are far from perfectly fair. Such is life.

Anyhow, in this world of open research, if it turned out that China’s vaccines were showing more promise earlier than the ones developed by Pfizer and Moderna and other U.S. companies, we would be able to manufacture and mass distribute their vaccines, as soon as the Food and Drug Administration (FDA) approved them. No one would need permission from China since the research was open, and anyone could manufacture the vaccines who had the capability.

Just to be clear, using a Chinese vaccine does not mean accepting China’s safety standards. The FDA would make its own determination of a vaccine’s safety and effectiveness based on the data from the clinical trials. If it could not be confident that the data supported approval, then it would not be granted, just as is the case with any domestic vaccine or drug.

If we had gone this route, if the Chinese vaccines are shown to be safe and effective before the vaccines developed by U.S. companies, we would not be left waiting. If China, or any other country had a vaccine, we would as well. This system still leaves a problem for developing countries who lack manufacturing capabilities, but at least intellectual property concerns would not be preventing people from getting a vaccine or treatment.

 

Open Research and Inequality

It is hard to understand how, not just mainstream Democrats, but even progressive leaders like Senators Bernie Sanders, Elizabeth Warren, and Representative Alexandra Ocasio-Cortez, were not pushing for an open research response to the pandemic. This almost certainly would have given us a vaccine more quickly.

However, an open research approach to the pandemic also could have been a very important model for biomedical research more generally. If we went a route of financing research upfront and putting all patents in the public domain, it could save us $400 billion a year on prescription drug spending. This comes to more than $3,000 per household. It is more than twice the size of the Trump tax cut. This is real money.

Patent monopolies also have a lot to do with inequality. We are often told that technology is a big part of the story of upward redistribution over the last four decades. While this story is frequently exaggerated, insofar as it is true, it is because we have designed patent and copyright laws so that some people can get very rich at the expense of everyone else. Bill Gates would still be working for a living if the government did not give Microsoft patent and copyright monopolies on its software.

It is more than a bit bizarre that political figures who devote so much effort to combatting inequality look the other way when we design a pandemic health care research plan that both slows research progress and gives more money to those at the top.

It’s fine to have progressive taxes, but it is even better to structure the market so that we don’t have so much inequality in the first place. If the minimum wage had kept pace with productivity since its 1968 peak, it would be $24 an hour today. That would be a hugely different world.

While it would be great if we could raise the minimum wage to $24 an hour, we can’t do that without changing many of the rules that allow so much income to be redistributed upward. The current system of patents and copyrights is a really big part of that story. In the case of the pandemic, it is not just leading to inequality, it is also costing people’s health and their lives. Progressives should be paying attention.    

[1] I discuss in chapter 5 of Rigged how this sort of system can be structured in a more systematic way (it’s free). But in the context of dealing with the pandemic emergency, the arrangements would have to be somewhat ad hoc, as is already the case with Operation Warp Speed.

The business press routinely gives us stories of employers complaining about labor shortages. This Reuters piece on struggling auto suppliers is the latest example.

The piece does tell us the suppliers have tried the one proven remedy for labor shortages, higher wages, but the data don’t support the claim. According to the graph in the article, the average hourly wage rose from $26.80 in January of 2019 to $28.20 in August. This amounts to a 5.2 percent increase over one and two-thirds years or a 3.1 percent annual rate. That is almost exactly the economy-wide average for the rate of wage growth in the pre-pandemic period. (It’s lower than the current rate.) In other words, auto suppliers are not raising wages especially rapidly, which is likely the reason they are having trouble getting workers.

The business press routinely gives us stories of employers complaining about labor shortages. This Reuters piece on struggling auto suppliers is the latest example.

The piece does tell us the suppliers have tried the one proven remedy for labor shortages, higher wages, but the data don’t support the claim. According to the graph in the article, the average hourly wage rose from $26.80 in January of 2019 to $28.20 in August. This amounts to a 5.2 percent increase over one and two-thirds years or a 3.1 percent annual rate. That is almost exactly the economy-wide average for the rate of wage growth in the pre-pandemic period. (It’s lower than the current rate.) In other words, auto suppliers are not raising wages especially rapidly, which is likely the reason they are having trouble getting workers.

This recession has been very different from prior recessions. Most prior recessions were caused by the Fed jacking up interest rates to fight inflation, which sinks the housing and auto sectors. The last two recessions were driven by the collapse of bubbles that were driving the economy (stocks and housing). This recession is due to the pandemic, which has whacked personal services that are especially likely to spread the disease, such as restaurants, hotels, and gyms.

This has meant that a very different group of workers is being hit with unemployment. Historically, manufacturing and construction, two relatively high-paid sectors were the hardest hit. (Manufacturing is no longer a relatively high-paying sector.) The sectors now being hard-hit are relatively low-paying. While there is always some skewing in layoffs in a downturn, with the last hired, and lowest paid, generally being the first to go, the skewing in this recession is far more pronounced. We are not only seeing the lower-paid workers in each sector losing their jobs, but we are also seeing large-scale layoffs in the lowest-paid sectors.

This shows up clearly if we look at the trends in the average hourly wage. The chart below shows the trends in the year-over-year change in the average hourly wage in the Great Recession and Pandemic Recession.

Source: Bureau of Labor Statistics.

As can be seen, there is a sharp jump in wage growth reported in April. This was due to the mass layoffs associated with the shutdowns. The year-over-year pace slowed to 4.5 percent in August and September, which is still 1.5 percentage points above the pre-recession pace. (Wage growth had actually slowed slightly before the recession, from 3.5 percent to 3.0 percent, in spite of the extraordinarily low unemployment rate.)

There is no remotely comparable uptick in wage growth in the Great Recession. There was a modest uptick in wage growth when the economy collapsed in the fall of 2008 following the Lehman bankruptcy. Year-over-year wage growth had been around 3.8 percent in the summer of 2008. It peaked at 4.7 percent in January but then settled down to 4.0 percent by April, only slightly above the summer pace.

Before anyone gets the idea that recessions are good for wage growth, it is worth looking at wage growth in 2010 and 2011. It slowed sharply over the course of 2010, ending the year at 1.4 percent. It bottomed out at just 1.0 percent in April of 2011. The slow wage growth in the weak labor market following the Great Recession is most of the story of the redistribution from wages to profits in the last four decades. The wage share had been recovering in the last five years, but we can expect that story to be reversed if the unemployment rate remains high as we recover from the pandemic recession.

This recession has been very different from prior recessions. Most prior recessions were caused by the Fed jacking up interest rates to fight inflation, which sinks the housing and auto sectors. The last two recessions were driven by the collapse of bubbles that were driving the economy (stocks and housing). This recession is due to the pandemic, which has whacked personal services that are especially likely to spread the disease, such as restaurants, hotels, and gyms.

This has meant that a very different group of workers is being hit with unemployment. Historically, manufacturing and construction, two relatively high-paid sectors were the hardest hit. (Manufacturing is no longer a relatively high-paying sector.) The sectors now being hard-hit are relatively low-paying. While there is always some skewing in layoffs in a downturn, with the last hired, and lowest paid, generally being the first to go, the skewing in this recession is far more pronounced. We are not only seeing the lower-paid workers in each sector losing their jobs, but we are also seeing large-scale layoffs in the lowest-paid sectors.

This shows up clearly if we look at the trends in the average hourly wage. The chart below shows the trends in the year-over-year change in the average hourly wage in the Great Recession and Pandemic Recession.

Source: Bureau of Labor Statistics.

As can be seen, there is a sharp jump in wage growth reported in April. This was due to the mass layoffs associated with the shutdowns. The year-over-year pace slowed to 4.5 percent in August and September, which is still 1.5 percentage points above the pre-recession pace. (Wage growth had actually slowed slightly before the recession, from 3.5 percent to 3.0 percent, in spite of the extraordinarily low unemployment rate.)

There is no remotely comparable uptick in wage growth in the Great Recession. There was a modest uptick in wage growth when the economy collapsed in the fall of 2008 following the Lehman bankruptcy. Year-over-year wage growth had been around 3.8 percent in the summer of 2008. It peaked at 4.7 percent in January but then settled down to 4.0 percent by April, only slightly above the summer pace.

Before anyone gets the idea that recessions are good for wage growth, it is worth looking at wage growth in 2010 and 2011. It slowed sharply over the course of 2010, ending the year at 1.4 percent. It bottomed out at just 1.0 percent in April of 2011. The slow wage growth in the weak labor market following the Great Recession is most of the story of the redistribution from wages to profits in the last four decades. The wage share had been recovering in the last five years, but we can expect that story to be reversed if the unemployment rate remains high as we recover from the pandemic recession.

One of the main goals of Obamacare was to make insurance affordable for people with health problems. Insurers are happy to insure healthy people. People in good health have few claims, so essentially they are just sending a check to the insurer every month. It’s a good deal if you can get it.

But it’s a very different story if you have serious health issues. For these people, insurers actually have to cough up the money. In the good old days, before the Affordable Care Act (ACA), insurers would either refuse to insure people with serious health conditions altogether (e.g. cancer survivors, heart disease, diabetes) or add large supplements to their premiums.

The ACA prohibited insurers from discriminating against people based on their health condition. They could charge different premiums by age, but they couldn’t turn anyone down because of their health, and they had to charge everyone the same rate. This means that a 60-year-old with three heart attacks would pay the same premium as a 60-year-old who is a serious marathon runner.

Donald Trump has repeatedly said that he wants to get rid of the ACA and is currently pushing a case before the Supreme Court that would end it if he wins. While he says that he wants to preserve protections for people with pre-existing conditions, he has introduced no legislation that would have this effect or even outlined a plan for protecting people with health problems.

For this reason, it is reasonable to ask how much money people should expect to pay for their insurance if they have a health problem and Trump gets his way and eliminates the ACA. The chart below gives some very ballpark numbers.

Source: Author’s calculations, see text.

The starting point here is the average unsubsidized premium under Obamacare. The average premium cost for the middle tier silver plan is $1,212 a month currently, or 14,544 a year. This is averaged over all age groups, so people in their 20s and 30s would pay less, while people in their 50s  and 60s would pay more. This also refers to the unsubsidized rate. Moderate income people, and even most middle-income people, are eligible for subsidies under the ACA. (Low-income people are eligible for Medicaid, which was substantially expanded by the ACA. This expansion will be reversed if Trump wins his Supreme Court case.)

The question then is how much people with health problems can expect to pay if the ACA’s protections for people with pre-existing conditions are ended. This requires somewhat of a shot in the dark since part of the answer will depend on state regulations. If state regulations don’t prohibit turning down people, insurers are likely to simply refuse to cover people with serious health problems like heart disease or cancer.  They also would look to charge different rates depending on the specific condition. A former athlete with a bad knee would pay more than a person with no health issues, but a person with multiple sclerosis would likely pay more than a person with a bad knee.

One way to get a sense of the additional premiums is to look at the high-risk pools that many states had before the ACA. These pools allowed people with health conditions to get insured, but typically at a substantial cost relative to people in good health. The pools also were typically subsidized by the state. In a 2010 article James Capretta and Tom Miller report that in some states the premiums in the high-risk pools were more than double the average premium outside the pools. We can use this doubling as a rough guess as to what premiums would be for people with health issues without any sort of subsidy. (The base premium would also be somewhat lower if we would exclude people with health issues from the pool. On the other hand, people with very severe health issues would almost certainly face even higher premiums, in the absence of any subsidy.)

Using the doubling scenario, the average premium would be $2,424 a month or $29,088 a year. As with the ACA premiums, we would expect premiums for people with health issues to be somewhat lower for those in their 20s and 30s and higher for people in their 50s and 60s. And, with no new legislation, there would be no federal subsidies for anyone, once Obamacare was ended.

 

One of the main goals of Obamacare was to make insurance affordable for people with health problems. Insurers are happy to insure healthy people. People in good health have few claims, so essentially they are just sending a check to the insurer every month. It’s a good deal if you can get it.

But it’s a very different story if you have serious health issues. For these people, insurers actually have to cough up the money. In the good old days, before the Affordable Care Act (ACA), insurers would either refuse to insure people with serious health conditions altogether (e.g. cancer survivors, heart disease, diabetes) or add large supplements to their premiums.

The ACA prohibited insurers from discriminating against people based on their health condition. They could charge different premiums by age, but they couldn’t turn anyone down because of their health, and they had to charge everyone the same rate. This means that a 60-year-old with three heart attacks would pay the same premium as a 60-year-old who is a serious marathon runner.

Donald Trump has repeatedly said that he wants to get rid of the ACA and is currently pushing a case before the Supreme Court that would end it if he wins. While he says that he wants to preserve protections for people with pre-existing conditions, he has introduced no legislation that would have this effect or even outlined a plan for protecting people with health problems.

For this reason, it is reasonable to ask how much money people should expect to pay for their insurance if they have a health problem and Trump gets his way and eliminates the ACA. The chart below gives some very ballpark numbers.

Source: Author’s calculations, see text.

The starting point here is the average unsubsidized premium under Obamacare. The average premium cost for the middle tier silver plan is $1,212 a month currently, or 14,544 a year. This is averaged over all age groups, so people in their 20s and 30s would pay less, while people in their 50s  and 60s would pay more. This also refers to the unsubsidized rate. Moderate income people, and even most middle-income people, are eligible for subsidies under the ACA. (Low-income people are eligible for Medicaid, which was substantially expanded by the ACA. This expansion will be reversed if Trump wins his Supreme Court case.)

The question then is how much people with health problems can expect to pay if the ACA’s protections for people with pre-existing conditions are ended. This requires somewhat of a shot in the dark since part of the answer will depend on state regulations. If state regulations don’t prohibit turning down people, insurers are likely to simply refuse to cover people with serious health problems like heart disease or cancer.  They also would look to charge different rates depending on the specific condition. A former athlete with a bad knee would pay more than a person with no health issues, but a person with multiple sclerosis would likely pay more than a person with a bad knee.

One way to get a sense of the additional premiums is to look at the high-risk pools that many states had before the ACA. These pools allowed people with health conditions to get insured, but typically at a substantial cost relative to people in good health. The pools also were typically subsidized by the state. In a 2010 article James Capretta and Tom Miller report that in some states the premiums in the high-risk pools were more than double the average premium outside the pools. We can use this doubling as a rough guess as to what premiums would be for people with health issues without any sort of subsidy. (The base premium would also be somewhat lower if we would exclude people with health issues from the pool. On the other hand, people with very severe health issues would almost certainly face even higher premiums, in the absence of any subsidy.)

Using the doubling scenario, the average premium would be $2,424 a month or $29,088 a year. As with the ACA premiums, we would expect premiums for people with health issues to be somewhat lower for those in their 20s and 30s and higher for people in their 50s and 60s. And, with no new legislation, there would be no federal subsidies for anyone, once Obamacare was ended.

 

Economists and economic reporters all know that tariffs can lead to corruption. The idea is that if a government-imposed tariff raises the price of a product by 10-25 percent above the free market price, companies have a large incentive to find ways to avoid the tariff. This can mean reclassifying imports to get around the tariff or trying to curry favor with politicians to get exemptions. The New York Times and ProPublica have run several excellent pieces providing examples of such behavior (e.g. here, here, and here).

The reasonable takeaway from these stories is that tariffs should be applied sparingly and with clear purposes in mind. Indiscriminate use of tariffs is likely to lead to large-scale corruption, as corporations use their political power to gain special treatment.

We should be glad that reporters have actively worked to expose the abuses associated with the tariffs Donald Trump has imposed since coming into the White House. But what about the abuses associated with government-granted patent monopolies for prescription drugs? We literally never see a piece pointing out that patent protection creates an enormous incentive for corruption, in fact, one that is far larger than with the Trump tariffs.

Just to get some basic orientation, depending on the country and the product, Trump’s tariffs were generally between 10 and 25 percent. By contrast, government granted patent monopolies often raise the price of a protected drug by at least a factor of ten and often by a factor of one hundred or more. The impact of this protection is therefore equivalent to tariffs of 1,000 or 10,000 percent.

If we think that a tariff of 25 percent provides incentives for corruption, how can we not think that patent protection that is equivalent to tariffs of 1,000 or 10,000 percent provide grounds for corruption? That makes zero sense. Any numerate person who is concerned about the incentives for corruption created by Trump’s tariffs must be concerned about the incentives for corruption created by patent monopolies for prescription drugs.

And, we don’t have to look far. The immediate inspiration for this post is a NYT article on how Pfizer is playing along with Trump in touting his late October date for a vaccine because they hope it will win them favor in any proposals he puts forward to lower drug prices.

If folks are missing the point here, the article implies that Pfizer might push forward for a vaccine approval, before there is sufficient evidence to establish safety and effectiveness, because it hopes Trump will allow Pfizer to enjoy larger patent monopoly rents. So, given Trump’s control of the FDA, we could be getting a vaccine that is either not safe, or effective, or neither, because of Pfizer’s efforts to maximize patent rents. This is exactly the sort of rent-seeking our Econ 101 textbooks all predict.

And, this situation is far from rare. Although it is literally never reported this way, the opioid crisis is largely a story of abuse of patent monopolies. Purdue Pharma and other major opioid manufacturers have paid billions of dollars to settle suits alleging that they misled doctors about the addictiveness of their new generation of opioid painkillers. These companies had incentive to lie about the addictiveness of their drugs because they had government-granted monopolies. If their drugs were selling as generics, it is unlikely they would have made the same sort of effort to push them.

There are many other instances where drug companies have concealed information on the safety and effectiveness of their drugs. The cost from these lies, in poor health and unnecessary deaths, is enormous. Yet, it is never discussed in policy circles.

The refusal to consider the costs stemming from the abuses of patent monopolies would perhaps be more understandable, if there were no alternative mechanisms for financing the development of new drugs and vaccines. But we know this is not true, we just got some great examples with the pandemic.

Moderna, one of the leading contenders to develop a U.S. vaccine, had its research costs pretty much entirely picked by the government. We paid more than $400 million for the pre-clinical research and early phase clinical testing, and then kicked in another $450 million to cover the cost of its Phase 3 clinical tests. While we are — incredibly — still giving the company a monopoly on its vaccine, the fact is that the government basically picked up the full tab for its development costs.

There is no reason that we cannot do this in other circumstances, but without handing out a patent monopoly. In other words, the government can pick up the tab for developing and testing drugs for treating cancer, diabetes, AIDS, and other diseases. When a drug or vaccine goes through the FDA approval process, it can then be sold as a generic that any manufacturer could produce. (I describe a system for financing research in chapter 5 of Rigged [it’s free].)

This could knock $400 billion (five times the food stamp budget or half the military budget) off our annual bill for prescription drugs. It would also eliminate the incentives for corruption created by patent monopolies.

It would be great if we could one day have a serious debate over whether patent monopolies are the best way to finance the development of new drugs and vaccines. But to do so, we need to have a better informed public and policy audience. That means reporting on the corruption that results from patent monopolies, something that the media refuse to do for some reason.

Economists and economic reporters all know that tariffs can lead to corruption. The idea is that if a government-imposed tariff raises the price of a product by 10-25 percent above the free market price, companies have a large incentive to find ways to avoid the tariff. This can mean reclassifying imports to get around the tariff or trying to curry favor with politicians to get exemptions. The New York Times and ProPublica have run several excellent pieces providing examples of such behavior (e.g. here, here, and here).

The reasonable takeaway from these stories is that tariffs should be applied sparingly and with clear purposes in mind. Indiscriminate use of tariffs is likely to lead to large-scale corruption, as corporations use their political power to gain special treatment.

We should be glad that reporters have actively worked to expose the abuses associated with the tariffs Donald Trump has imposed since coming into the White House. But what about the abuses associated with government-granted patent monopolies for prescription drugs? We literally never see a piece pointing out that patent protection creates an enormous incentive for corruption, in fact, one that is far larger than with the Trump tariffs.

Just to get some basic orientation, depending on the country and the product, Trump’s tariffs were generally between 10 and 25 percent. By contrast, government granted patent monopolies often raise the price of a protected drug by at least a factor of ten and often by a factor of one hundred or more. The impact of this protection is therefore equivalent to tariffs of 1,000 or 10,000 percent.

If we think that a tariff of 25 percent provides incentives for corruption, how can we not think that patent protection that is equivalent to tariffs of 1,000 or 10,000 percent provide grounds for corruption? That makes zero sense. Any numerate person who is concerned about the incentives for corruption created by Trump’s tariffs must be concerned about the incentives for corruption created by patent monopolies for prescription drugs.

And, we don’t have to look far. The immediate inspiration for this post is a NYT article on how Pfizer is playing along with Trump in touting his late October date for a vaccine because they hope it will win them favor in any proposals he puts forward to lower drug prices.

If folks are missing the point here, the article implies that Pfizer might push forward for a vaccine approval, before there is sufficient evidence to establish safety and effectiveness, because it hopes Trump will allow Pfizer to enjoy larger patent monopoly rents. So, given Trump’s control of the FDA, we could be getting a vaccine that is either not safe, or effective, or neither, because of Pfizer’s efforts to maximize patent rents. This is exactly the sort of rent-seeking our Econ 101 textbooks all predict.

And, this situation is far from rare. Although it is literally never reported this way, the opioid crisis is largely a story of abuse of patent monopolies. Purdue Pharma and other major opioid manufacturers have paid billions of dollars to settle suits alleging that they misled doctors about the addictiveness of their new generation of opioid painkillers. These companies had incentive to lie about the addictiveness of their drugs because they had government-granted monopolies. If their drugs were selling as generics, it is unlikely they would have made the same sort of effort to push them.

There are many other instances where drug companies have concealed information on the safety and effectiveness of their drugs. The cost from these lies, in poor health and unnecessary deaths, is enormous. Yet, it is never discussed in policy circles.

The refusal to consider the costs stemming from the abuses of patent monopolies would perhaps be more understandable, if there were no alternative mechanisms for financing the development of new drugs and vaccines. But we know this is not true, we just got some great examples with the pandemic.

Moderna, one of the leading contenders to develop a U.S. vaccine, had its research costs pretty much entirely picked by the government. We paid more than $400 million for the pre-clinical research and early phase clinical testing, and then kicked in another $450 million to cover the cost of its Phase 3 clinical tests. While we are — incredibly — still giving the company a monopoly on its vaccine, the fact is that the government basically picked up the full tab for its development costs.

There is no reason that we cannot do this in other circumstances, but without handing out a patent monopoly. In other words, the government can pick up the tab for developing and testing drugs for treating cancer, diabetes, AIDS, and other diseases. When a drug or vaccine goes through the FDA approval process, it can then be sold as a generic that any manufacturer could produce. (I describe a system for financing research in chapter 5 of Rigged [it’s free].)

This could knock $400 billion (five times the food stamp budget or half the military budget) off our annual bill for prescription drugs. It would also eliminate the incentives for corruption created by patent monopolies.

It would be great if we could one day have a serious debate over whether patent monopolies are the best way to finance the development of new drugs and vaccines. But to do so, we need to have a better informed public and policy audience. That means reporting on the corruption that results from patent monopolies, something that the media refuse to do for some reason.

Donald Trump boasts endlessly about the economic recovery and insists that people are doing great now. The numbers disagree.

We will get the last employment report before the election on Friday. The unemployment rate reported for August was 8.4 percent. We’ll see what happens on Friday, but we are not doing especially well compared to other countries. Here’s the picture.

Source: OECD.

As can be seen, the 8.4 percent August unemployment rate reported for August was well above the 2.9 percent rate reported for Japan, 3.4 percent rate for the United Kingdom, and 4.4 percent rate for Germany. (These are July rates, except for the UK, for which the OECD only has the May rate.) Denmark comes in at 6.0 percent and France at 6.9 percent. The U.S does come in better than Italy, which had a 9.7 percent unemployment rate, and Canada with a 10.2 percent unemployment rate.

In short, the economy has come back a long way from the middle of the shutdown in April, but it still has far to go. And workers in many other countries have done much better.

As Trump might say, numbers have been very bad to him.

Donald Trump boasts endlessly about the economic recovery and insists that people are doing great now. The numbers disagree.

We will get the last employment report before the election on Friday. The unemployment rate reported for August was 8.4 percent. We’ll see what happens on Friday, but we are not doing especially well compared to other countries. Here’s the picture.

Source: OECD.

As can be seen, the 8.4 percent August unemployment rate reported for August was well above the 2.9 percent rate reported for Japan, 3.4 percent rate for the United Kingdom, and 4.4 percent rate for Germany. (These are July rates, except for the UK, for which the OECD only has the May rate.) Denmark comes in at 6.0 percent and France at 6.9 percent. The U.S does come in better than Italy, which had a 9.7 percent unemployment rate, and Canada with a 10.2 percent unemployment rate.

In short, the economy has come back a long way from the middle of the shutdown in April, but it still has far to go. And workers in many other countries have done much better.

As Trump might say, numbers have been very bad to him.

It is a cult among policy types to say that CEOs maximize shareholder returns, as in this NYT piece. This is in spite of the fact that returns to shareholders have not been especially good in the last two decades. And, this is even though returns were boosted by a huge corporate tax cut in 2017 that increased after-tax profits by more than 10 percent, other things equal.

There is considerable evidence that CEOs do not earn their $20 million pay, in the sense of providing $20 million in additional returns to shareholders, compared to the next schmuck down the line. This matters in a big way because CEO pay influences pay structures throughout the economy. If CEOs got paid 20 to 30 times the pay of ordinary workers, like they did in the 1960s or 1970s, or around $2 million to $3 million a year, the next in line execs would likely get around $1.5 million and the third tier corporate execs would get in the high hundreds of thousands. That is a contrast from today when the CFO and other top tier execs might get close to $10 million and the third tier can easily make $2-$3 million. 

In that world, a university president would probably make around $400,000 to $500,000, with corresponding reductions in pay for other top administrators. The same would be true for foundations and other non-profits, as well as government. Perhaps the fact that people’s whose pay is inflated, at least indirectly, by high CEO pay, largely set the terms of debate in this country, explains why the untrue claim that corporations are run to maximize shareholder returns is taken as gospel. 

It is a cult among policy types to say that CEOs maximize shareholder returns, as in this NYT piece. This is in spite of the fact that returns to shareholders have not been especially good in the last two decades. And, this is even though returns were boosted by a huge corporate tax cut in 2017 that increased after-tax profits by more than 10 percent, other things equal.

There is considerable evidence that CEOs do not earn their $20 million pay, in the sense of providing $20 million in additional returns to shareholders, compared to the next schmuck down the line. This matters in a big way because CEO pay influences pay structures throughout the economy. If CEOs got paid 20 to 30 times the pay of ordinary workers, like they did in the 1960s or 1970s, or around $2 million to $3 million a year, the next in line execs would likely get around $1.5 million and the third tier corporate execs would get in the high hundreds of thousands. That is a contrast from today when the CFO and other top tier execs might get close to $10 million and the third tier can easily make $2-$3 million. 

In that world, a university president would probably make around $400,000 to $500,000, with corresponding reductions in pay for other top administrators. The same would be true for foundations and other non-profits, as well as government. Perhaps the fact that people’s whose pay is inflated, at least indirectly, by high CEO pay, largely set the terms of debate in this country, explains why the untrue claim that corporations are run to maximize shareholder returns is taken as gospel. 

Last week an official with China’s Center for Disease Control and Prevention (CDC) said that the country may have a vaccine available for widespread distribution by November or December. This would almost certainly be at least a month or two before a vaccine is available for distribution in the United States, and possibly quite a bit longer.

While we may want to treat statements from Chinese government officials with some skepticism, there is reason to believe that this claim is close to the mark. China has reported giving its vaccines to more than 100,000 people. In addition to giving it to tens of thousands of people enrolled in clinical trials, it also has given them to front line workers, such as medical personal, through an emergency use authorization. 

This may not have been a good policy, since these workers faced the safety risks associated with a vaccine that has only undergone limited testing, but it does mean that a large number of people have now been exposed to China’s leading vaccine candidates. If there were serious side effects, it would be hard for China to bury evidence of large numbers of adverse reactions. If no such evidence surfaces, we can assume that bad reactions to the vaccines were either rare and/or not very serious.

Of course, the evidence to date tells us little about long-term effects. But that would be true even if we had a couple more months of testing. Evidence of long-term effects may not show up for years. Ideally, researchers would have enough understanding of a vaccine so that they would largely be able to rule out problems showing up years down the road, but we know they do sometimes overlook risks. In any case, the possibility of longer-term problems would still be there with a longer initial testing period.

It is possible that the vaccines are not as effective as claimed. Since China has been very successful in controlling the pandemic, even front-line workers would face a limited risk of exposure. However, they have been doing Phase 3 testing in Brazil, Bangladesh, and other countries with much more severe outbreaks. 

On this issue, it is worth noting that the United Arab Emirates (UAE), one of the countries in which China is conducting its phase 3 trials, just granted an emergency use authorization for one of its vaccines to be given to frontline workers there. Presumably, this reflects the positive results of the trial, since it is unlikely that the UAE would grant this authorization simply to please China’s government. 

The companies have not yet shared their data, so it’s possible that the evidence does not support the claim of this Chinese CDC official. But here too, the value of making an obviously false claim would be limited. If the companies either fail to produce their data or the data does not show solid evidence of a vaccine’s effectiveness, the official and China’s government would end up looking rather foolish.

Since they are not just trying to bluff their way through an election, but are rather concerned about China’s longer-term standing to the world, it’s hard to see why they would make a claim that would soon be shown to be false. In short, the promise of a vaccine being distributed in November or December is quite likely true. 

I suppose this will get those hoping that the United States would win the vaccine “race” very angry. But it should get the rest of us asking why we were having a race. 

Why Is Cooperative Research So Hard to Understand?

In the early days of the pandemic, there was a large degree of international cooperation, with scientists around the world quickly sharing new findings. This allowed for our understanding of the virus to advance far more rapidly than would otherwise be the case. 

But we quickly shifted to a path of nationalistic competition. Donald Trump led the way down this path, with his “Operation Warp Speed.” Other countries followed a similar route, even as they maintained some commitment to the World Health Organization’s efforts to promote sharing with developing countries.

But the issue was not just nationalism, it is also the monopolization of research findings. If Moderna, Pfizer, or one of the other U.S. drug companies ends up developing a safe and effective vaccine, they fully intend to sell it at a considerable profit, and they will be sharing the money with their top executives and their shareholders, not the American people. This outcome makes sense if the point of the policy is to maximize drug company profits. It makes no sense if the policy goal is to produce the best health outcomes at the lowest possible cost.

The United States did not have to take the patent monopoly nationalistic route. Suppose that all the money from Operation Warp Speed went to fully open research. This would not just be an accidental outcome, it would be an explicit condition of the funding. If a drug company received money from this program, all its results must be posted on the Internet as quickly as practical, and any findings would be in the public domain.

Since we would not just want to pay for the rest of the world’s research, we could have negotiated commitments from other countries to make payments that are proportionate, given their size and per capita income. Of course, there is no guarantee that they would all go along, especially with Donald Trump as president. But in principle, this would be a mutually beneficial agreement for pretty much everyone. 

They would contribute their share of funding to the research pool and they would then have the right to produce any vaccines or treatments that are developed. If it turned out to be the case that a U.S. drug company was the first to come up with an effective vaccine, any company with the necessary manufacturing facilities would be able to freely produce and distribute the vaccine anywhere in the world. They would not need to negotiate over patent rights.

The same would be true if, as now seems to be the case, China turned out to develop the first effective vaccine. Our manufacturers would be free to start producing the vaccine as soon as it received the necessary approvals from the Food and Drug Administration. There would be no issue of people here going without the vaccine just because the developer was a Chinese company.

It’s not surprising that Donald Trump did not go the route of cooperative development. His first priority is advancing his own political prospects and if he thinks that means having the U.S. win a vaccine race, that is what he is going to do. And, he certainly has no intention of pursuing a course that could limit drug company profits.

But the big question is where were the Democrats? If they were objecting to the path of vaccine nationalism and monopoly, it was not easy to hear their complaints. And, I’m not talking just about centrist Democrats like Biden, Pelosi, and Schumer, I also didn’t hear complaints from the Bernie Sanders or Elizabeth Warren wing of the party. Why were there no objections to the Trump course and advocacy for a cooperative alternative?

Going a cooperative route would not just offer benefits in the context of developing vaccines and treatments for the coronavirus, although these benefits would be incredibly important. It also could have provided a great model of an alternative path for financing the development of prescription drugs. 

We will spend over $500 billion this year on prescription drugs. We would pay less than $100 billion if these drugs were available in a free market without patent monopolies and related protections. The $400 billion in annual savings is more than five times what we spend on food stamps each year. It comes close to $3,000 per household. In other words, it is real money.

Patent and copyright monopolies are also a big part of the upward redistribution of income over the last four decades. If we had alternatives mechanisms for financing innovation and creative work, people like Bill Gates would be much less rich, and the rest of us would have far more money.

Again, it is easy to understand why Donald Trump would have zero interest in promoting world health and reducing inequality. It’s also understandable that politicians who are dependent on campaign contributions from those who have benefitted from upward redistribution, would not want to pursue routes that call into question the mechanisms of upward redistribution. 

But where were the progressive voices? The pandemic gave us an extraordinary opportunity to experiment with an alternative mechanism for financing research that could have enormously benefitted public health, both in the United States and elsewhere. The failure to have a visible alternative will cost both lives and money long into the future.  

Last week an official with China’s Center for Disease Control and Prevention (CDC) said that the country may have a vaccine available for widespread distribution by November or December. This would almost certainly be at least a month or two before a vaccine is available for distribution in the United States, and possibly quite a bit longer.

While we may want to treat statements from Chinese government officials with some skepticism, there is reason to believe that this claim is close to the mark. China has reported giving its vaccines to more than 100,000 people. In addition to giving it to tens of thousands of people enrolled in clinical trials, it also has given them to front line workers, such as medical personal, through an emergency use authorization. 

This may not have been a good policy, since these workers faced the safety risks associated with a vaccine that has only undergone limited testing, but it does mean that a large number of people have now been exposed to China’s leading vaccine candidates. If there were serious side effects, it would be hard for China to bury evidence of large numbers of adverse reactions. If no such evidence surfaces, we can assume that bad reactions to the vaccines were either rare and/or not very serious.

Of course, the evidence to date tells us little about long-term effects. But that would be true even if we had a couple more months of testing. Evidence of long-term effects may not show up for years. Ideally, researchers would have enough understanding of a vaccine so that they would largely be able to rule out problems showing up years down the road, but we know they do sometimes overlook risks. In any case, the possibility of longer-term problems would still be there with a longer initial testing period.

It is possible that the vaccines are not as effective as claimed. Since China has been very successful in controlling the pandemic, even front-line workers would face a limited risk of exposure. However, they have been doing Phase 3 testing in Brazil, Bangladesh, and other countries with much more severe outbreaks. 

On this issue, it is worth noting that the United Arab Emirates (UAE), one of the countries in which China is conducting its phase 3 trials, just granted an emergency use authorization for one of its vaccines to be given to frontline workers there. Presumably, this reflects the positive results of the trial, since it is unlikely that the UAE would grant this authorization simply to please China’s government. 

The companies have not yet shared their data, so it’s possible that the evidence does not support the claim of this Chinese CDC official. But here too, the value of making an obviously false claim would be limited. If the companies either fail to produce their data or the data does not show solid evidence of a vaccine’s effectiveness, the official and China’s government would end up looking rather foolish.

Since they are not just trying to bluff their way through an election, but are rather concerned about China’s longer-term standing to the world, it’s hard to see why they would make a claim that would soon be shown to be false. In short, the promise of a vaccine being distributed in November or December is quite likely true. 

I suppose this will get those hoping that the United States would win the vaccine “race” very angry. But it should get the rest of us asking why we were having a race. 

Why Is Cooperative Research So Hard to Understand?

In the early days of the pandemic, there was a large degree of international cooperation, with scientists around the world quickly sharing new findings. This allowed for our understanding of the virus to advance far more rapidly than would otherwise be the case. 

But we quickly shifted to a path of nationalistic competition. Donald Trump led the way down this path, with his “Operation Warp Speed.” Other countries followed a similar route, even as they maintained some commitment to the World Health Organization’s efforts to promote sharing with developing countries.

But the issue was not just nationalism, it is also the monopolization of research findings. If Moderna, Pfizer, or one of the other U.S. drug companies ends up developing a safe and effective vaccine, they fully intend to sell it at a considerable profit, and they will be sharing the money with their top executives and their shareholders, not the American people. This outcome makes sense if the point of the policy is to maximize drug company profits. It makes no sense if the policy goal is to produce the best health outcomes at the lowest possible cost.

The United States did not have to take the patent monopoly nationalistic route. Suppose that all the money from Operation Warp Speed went to fully open research. This would not just be an accidental outcome, it would be an explicit condition of the funding. If a drug company received money from this program, all its results must be posted on the Internet as quickly as practical, and any findings would be in the public domain.

Since we would not just want to pay for the rest of the world’s research, we could have negotiated commitments from other countries to make payments that are proportionate, given their size and per capita income. Of course, there is no guarantee that they would all go along, especially with Donald Trump as president. But in principle, this would be a mutually beneficial agreement for pretty much everyone. 

They would contribute their share of funding to the research pool and they would then have the right to produce any vaccines or treatments that are developed. If it turned out to be the case that a U.S. drug company was the first to come up with an effective vaccine, any company with the necessary manufacturing facilities would be able to freely produce and distribute the vaccine anywhere in the world. They would not need to negotiate over patent rights.

The same would be true if, as now seems to be the case, China turned out to develop the first effective vaccine. Our manufacturers would be free to start producing the vaccine as soon as it received the necessary approvals from the Food and Drug Administration. There would be no issue of people here going without the vaccine just because the developer was a Chinese company.

It’s not surprising that Donald Trump did not go the route of cooperative development. His first priority is advancing his own political prospects and if he thinks that means having the U.S. win a vaccine race, that is what he is going to do. And, he certainly has no intention of pursuing a course that could limit drug company profits.

But the big question is where were the Democrats? If they were objecting to the path of vaccine nationalism and monopoly, it was not easy to hear their complaints. And, I’m not talking just about centrist Democrats like Biden, Pelosi, and Schumer, I also didn’t hear complaints from the Bernie Sanders or Elizabeth Warren wing of the party. Why were there no objections to the Trump course and advocacy for a cooperative alternative?

Going a cooperative route would not just offer benefits in the context of developing vaccines and treatments for the coronavirus, although these benefits would be incredibly important. It also could have provided a great model of an alternative path for financing the development of prescription drugs. 

We will spend over $500 billion this year on prescription drugs. We would pay less than $100 billion if these drugs were available in a free market without patent monopolies and related protections. The $400 billion in annual savings is more than five times what we spend on food stamps each year. It comes close to $3,000 per household. In other words, it is real money.

Patent and copyright monopolies are also a big part of the upward redistribution of income over the last four decades. If we had alternatives mechanisms for financing innovation and creative work, people like Bill Gates would be much less rich, and the rest of us would have far more money.

Again, it is easy to understand why Donald Trump would have zero interest in promoting world health and reducing inequality. It’s also understandable that politicians who are dependent on campaign contributions from those who have benefitted from upward redistribution, would not want to pursue routes that call into question the mechanisms of upward redistribution. 

But where were the progressive voices? The pandemic gave us an extraordinary opportunity to experiment with an alternative mechanism for financing research that could have enormously benefitted public health, both in the United States and elsewhere. The failure to have a visible alternative will cost both lives and money long into the future.  

This is an incredibly ghoulish question that would be absurd to ask in normal times. But these are not normal times. We know Donald Trump has staffed the top levels of his administration with people who unhesitatingly put Donald Trump’s political prospects above the well-being of the people. It is certainly plausible that Republican governors have similar priorities.

A simple test for the governors is to look at their positive test rates for the coronavirus. Test rates are a good measure of how serious the governors are in trying to bring the pandemic under control. While they can take measures to limit the actual spread, such as longer and stronger lockdowns and mask requirements, many factors determining the spread are outside their control.

For example, New York, New Jersey, and other states in the Northeast were hard hit early because they had a large number of international travelers. More recently, North Dakota has seen a huge spike in infections because Kristi Noem, the governor of neighboring South Dakota, thought it was clever to have a huge week long motorcycle rally in the middle of a pandemic.

However, positive rates are largely under the control of the state. If the governor makes more of an effort to find positive cases, the state will have a lower positive rate. In states with high positive rates, governors have been less concerned about tracking the spread of the pandemic.

This is a matter of life and death for tens of thousands of people, since if a person knows they are infected, they can take steps to protect their co-workers, friends, and family. If they don’t know, they will likely get many of these people infected as well.

It is not hard to imagine that Republican governors would deliberately limit testing so that they find fewer cases. Donald Trump explicitly said at a campaign rally that he told his staff to “slow the testing down.” He subsequently insisted that he was not joking.

In this context, it is perfectly reasonable to ask whether there is evidence that Republican governors have decided to deliberately slow testing, knowing that it will mean that more people in their states get sick and die, just so that Donald Trump will have fewer reported cases.

Here is the story. The chart shows the ten states with the highest positive rates and the ten states with the lowest rates. (The data are seven-day averages, given for September 20th, by the John Hopkins University Coronavirus Resource Center.)    

 

 

 

Eight of the ten states with the highest positive rates have Republican governors. The exceptions are Wisconsin and Kansas. Wisconsin stands out as being the worst state by this measure.  This could be the fault of its Democratic governor, Tony Evers, but the Republican controlled legislature may also be a factor. The legislature has repeatedly taken steps to thwart Evers’ effort to contain the virus, as has the state’s Supreme Court.

We see pretty much the opposite picture when we look at the states with low positive rates, although the relationship is not as strong. Six of the ten states have Democratic leaders. The four exceptions are Phil Scott in Vermont, which has the second lowest rate, Charlie Baker, in Massachusetts, which has the third lowest positive rate, Chris Sununu in New Hampshire, with seventh lowest rate,  and Mike Dunleavy in Alaska, which scrapes in with the tenth lowest positive rate.

The sharp contrast, with blue states having very low positive rates, and red states having very high positive rates, does not prove that Republican governors are deliberately restricting testing. However, it is certainly consistent with this story and should be the basis for some serious questioning of these governors.

(Correction: this post has been corrected to reflect the fact that Kansas has a Democratic governor and Vermont and New Hampshire have Republican governors.)

This is an incredibly ghoulish question that would be absurd to ask in normal times. But these are not normal times. We know Donald Trump has staffed the top levels of his administration with people who unhesitatingly put Donald Trump’s political prospects above the well-being of the people. It is certainly plausible that Republican governors have similar priorities.

A simple test for the governors is to look at their positive test rates for the coronavirus. Test rates are a good measure of how serious the governors are in trying to bring the pandemic under control. While they can take measures to limit the actual spread, such as longer and stronger lockdowns and mask requirements, many factors determining the spread are outside their control.

For example, New York, New Jersey, and other states in the Northeast were hard hit early because they had a large number of international travelers. More recently, North Dakota has seen a huge spike in infections because Kristi Noem, the governor of neighboring South Dakota, thought it was clever to have a huge week long motorcycle rally in the middle of a pandemic.

However, positive rates are largely under the control of the state. If the governor makes more of an effort to find positive cases, the state will have a lower positive rate. In states with high positive rates, governors have been less concerned about tracking the spread of the pandemic.

This is a matter of life and death for tens of thousands of people, since if a person knows they are infected, they can take steps to protect their co-workers, friends, and family. If they don’t know, they will likely get many of these people infected as well.

It is not hard to imagine that Republican governors would deliberately limit testing so that they find fewer cases. Donald Trump explicitly said at a campaign rally that he told his staff to “slow the testing down.” He subsequently insisted that he was not joking.

In this context, it is perfectly reasonable to ask whether there is evidence that Republican governors have decided to deliberately slow testing, knowing that it will mean that more people in their states get sick and die, just so that Donald Trump will have fewer reported cases.

Here is the story. The chart shows the ten states with the highest positive rates and the ten states with the lowest rates. (The data are seven-day averages, given for September 20th, by the John Hopkins University Coronavirus Resource Center.)    

 

 

 

Eight of the ten states with the highest positive rates have Republican governors. The exceptions are Wisconsin and Kansas. Wisconsin stands out as being the worst state by this measure.  This could be the fault of its Democratic governor, Tony Evers, but the Republican controlled legislature may also be a factor. The legislature has repeatedly taken steps to thwart Evers’ effort to contain the virus, as has the state’s Supreme Court.

We see pretty much the opposite picture when we look at the states with low positive rates, although the relationship is not as strong. Six of the ten states have Democratic leaders. The four exceptions are Phil Scott in Vermont, which has the second lowest rate, Charlie Baker, in Massachusetts, which has the third lowest positive rate, Chris Sununu in New Hampshire, with seventh lowest rate,  and Mike Dunleavy in Alaska, which scrapes in with the tenth lowest positive rate.

The sharp contrast, with blue states having very low positive rates, and red states having very high positive rates, does not prove that Republican governors are deliberately restricting testing. However, it is certainly consistent with this story and should be the basis for some serious questioning of these governors.

(Correction: this post has been corrected to reflect the fact that Kansas has a Democratic governor and Vermont and New Hampshire have Republican governors.)

I have long enjoyed reading Matthew Klein’s columns in the Financial Times and elsewhere. They are invariably insightful and I have learned much from them. I am less familiar with Michael Pettis’ work, but I have liked what I have read. Therefore, I expected a lot from their book, Trade Wars are Class Wars, and I was not disappointed.

The basic point is that the major trade imbalances in the world over the last four decades have been driven by the suppression of wage growth, with income being redistributed from labor to capital. This has led to shortfalls in aggregate demand that countries try to offset by having trade surpluses. The main actors in that picture are China and Germany.

In the Klein-Pettis view, the U.S. has also suffered from this upward redistribution, although it has taken a somewhat different form since the country has run persistent trade deficits over this period. While I largely agree with this framing, I have some minor quibbles with the story they layout and one very large one.

In the minor quibble category, Klein and Pettis (KP) criticize Trump adviser Peter Navarro for focusing on the bilateral trade deficits the United States runs with China and other countries. I have no stake in defending Peter Navarro, but at least some of us who are concerned about the trade deficit with China have argued that the U.S. should be pressing China to raise the value of its currency relative to the dollar.

If the renminbi rose against the dollar, it should mean, other things equal, that China would have a lower trade surplus and therefore fewer savings, and the United States would have a smaller trade deficit, and therefore more savings. This isn’t an issue of a policy being thwarted by the inescapable logic of accounting identities, it is a question of the direction of causation in these identities. And, if we don’t think the U.S. economy is at full employment, more net exports will mean higher GDP and more savings.

I should also mention here that KP make the valid point that the direct trade balance between China and the U.S. does not accurately measure the net flows between the two countries, since much of the price of items exported from China is due to inputs from other countries. Therefore, our imports from China overstate the value of goods produced in China and then exported to the United States.

While this is true, it neglects the flip side, that many of the items we buy from Japan, the European Union, and elsewhere, include inputs from China. If we want to pull out the third country value-added from the goods imported from China, to get a better measure of bilateral trade flows, we also have to add in the Chinese value-added in the items imported from third countries. While KP are not guilty of the one-sided adjustment, other economists are. It is one of the items in the Games Economists Play textbook.  

Another point that is at least under-emphasized in KP, is that real wages soared in China in the period since 2000, in spite of the wage repression measures they describe. Real wages have risen at close to double-digit annual rates over this period. While they would have risen even faster if the country had not maintained an undervalued currency, and other measures to suppress wage growth, it has to be easier politically to maintain a policy of repressing wage growth in a context where wages are rising rapidly than when they are stagnating or falling.

KP also hold out the prospect that China is going to run up against some limit as it encourages companies to pursue wasteful investment projects that leave them ever further in debt. It’s not clear why a country that issues its own currency and has massive foreign reserves and a trade surplus, would ever hit a limit. I suppose if somehow excessive debt leads to explosive demand growth, and an inflationary spiral, it would be a serious problem. But it is hard to see how we get from where we are now, with persistent shortfalls in demand as the main issue, to the complete opposite problem.

My last quibble on the surplus country side is the claim that the assets issued or guaranteed by the U.S. government are risk-free. I know this is the standard wisdom, but I have no idea what it is supposed to mean.

I get that the U.S. government is not about to default on its debt. That can be treated as a near certainty. But the dollar can and often does fall in value relative to other currencies. In fact, since the start of 2020, the dollar has fallen by more than 6.0 percent against the euro. I’m not sure why the prospect that the dollar could fall in value relative to other currencies should not be seen as a risk. I don’t think most people would consider an investment that loses 6.0 percent of its value in eight months as risk-free.

On the U.S. side, KP for some reason ignore the wealth effect when discussing the low savings rates in the United States in the 1990s and the 2000s pre-crash. The idea of a wealth effect on consumption is not new, nor to my knowledge especially controversial.

The 1990s stock market bubble created close to $10 billion in bubble wealth. Assuming a wealth effect of 3-4 percent, this implied increased consumption on the order of 3-4 percent of GDP. That fits well with the drop in savings we saw over this period. As a practical matter, this manifested itself in smaller contributions to 401(k)s and also declining employer contributions to defined benefit pensions. The rise in the stock market was effectively making the contribution for employers. Some of us warned about the problem this was creating for pensions at the time, but the irrational exuberance of the day drowned us out.   

There was a similar story with the housing bubble. As KP note, people were happy to borrow against the rapidly growing equity in their homes. With the bubble creating roughly $8 trillion in additional housing equity, and a housing wealth effect of 4-6 cents on the dollar, the run-up in house prices can fully explain the fall in saving rates in the bubble years.

My reason for harping on this issue is that many economists were surprised when consumption plunged in 2008-2010. There was no basis for this surprise. The bubble that had been driving consumption had been deflated. Savings rates returned to roughly their long-term average, and have stayed there even as the debt overhang from the crash dissipated. There is nothing surprising in this story that needs explaining.

Okay, but enough of the quibbles, my big objection is the failure to focus adequately on the structuring of trade. This is a very central part of the wage suppression story, at least in the United States.

First, it is important to make the point that in the United States the upward redistribution was for the most part not from wages to profits, but from the wages of ordinary workers to the wages of highly paid workers like CEOs and other top executives, Wall Street and Silicon Valley types, and highly paid professionals.

KP for some reason see a very different picture of the data than me. They report a 7.0 percentage point drop in the labor share of national income from 2000 to 2007 (p 179). I see a drop of 1.2 percentage points (NIPA Table 1.10, Line 2 divided by the sum of Line 2 and Line 9).

Furthermore, even this drop in labor shares is questionable. Profits were inflated during these years by the profits earned in the financial sector from issuing dubious loans that subsequently went bad. This would be similar to companies reporting profits on non-existent sales. There were not real profits and of course, the banks lost hugely when these loans went bad in 2008—2010.[1]

There was a drop in labor shares in the weak labor market resulting from the Great Recession. This was being reversed with the recovery, but we still had some way to go when the pandemic hit. By my calculations, just over 10 percent of the gap between productivity growth and median wage growth from 1979 to 2019 can be explained by this shift from labor to capital. The rest is due to upward redistribution within the wage structure.  

This gets us to the structure of the trade. Our trade policy was focused on reducing or eliminating barriers to merchandise trade. This has the predicted and actual result of lowering the wages of manufacturing workers, which spilled over to putting downward pressure on the wages of non-college-educated workers more generally. When workers in the United States had to compete with workers in China and elsewhere, earning less than one-tenth of their pay, it was inevitable they would either take large pay cuts or lose their jobs.

However, trade liberalization did not have to focus on manufactured goods or at least exclusively focus on manufactured goods. We could have focused trade policy on reducing barriers that prevent qualified professionals from working in the United States. Doctors and dentists in the United States earn roughly twice as much as their counterparts in other wealthy countries. Trade liberalization in these professions could have brought their pay closer to the OECD average, saving households more than $100 billion annually from their healthcare bill. We didn’t see the liberalization of licensing restrictions (they were actually made tighter in the 1990s) because doctors and dentists have far more political power than autoworkers.

The other part of this story that is almost completely absent from KP is the tightening of rules on patent and copyright monopolies, which have been a key part of every trade deal for the last three decades. These monopolies are forms of protectionism, the polar opposite of free trade. They lead to prices for prescription drugs, medical equipment, software, and other protected items that are often hundreds of times the free market price, the equivalent of tariffs of tens of thousands percent.

They also are associated with enormous upward redistribution, as ordinary workers have to pay much higher prices for the benefit of the people with the skills associated with producing these products. Bill Gates would likely still be working for a living if Microsoft had to sell software without government-granted copyright or patent monopolies.   

This is a huge issue going forward, as the cost of protection for intellectual products is likely to continue to grow as a share of the economy. It is already huge. We will spend over $500 billion this year on prescription drugs alone. If these drugs were sold in a free market, we would almost certainly pay less than $100 billion. The difference of $400 billion is more than $3,000 per family. This $400 billion in potential savings is almost 80 percent of what we will spend on cars and parts in 2020.

In future trade deals, the terms of protection for intellectual products, both foreign and domestic, will swamp the importance of trade in manufactured goods. The loss of good-paying jobs in manufacturing was a huge deal in the 1980s, 1990s, and especially the 2000s, but unfortunately, we don’t stand much to lose anymore.

Manufacturing employment is now less than 9.0 percent of total employment. Furthermore, while manufacturing jobs used to provide relatively good-paying employment for workers without college degrees, this is no longer true. The average wage for production and non-supervisory workers in manufacturing is 6.0 percent less than for production and non-supervisory workers in the private sector as a whole. This gap would be reduced when factoring in benefits, but the idea that a manufacturing job is a good-paying job where a worker could support a family and have health care and a pension is simply no longer true.

The reason for the deterioration in the quality of manufacturing jobs is not a secret. The unionization rate in manufacturing has plummeted, largely due to trade. Until the pandemic hit in March, we had added back more than 1.6 million manufacturing jobs from the Great Recession trough in 2010. Nonetheless, the number of union members in manufacturing had fallen by almost 900,000. In short, as we added back jobs in the sector, they were overwhelmingly lower paying non-union jobs. There is little reason to believe that these workers were much better off than workers in an Amazon distribution center or other service sector jobs.

This points to the fact that manufacturing jobs should not be at the center of the trade agenda for those concerned about reversing the upward redistribution of income. The focus should be on reducing the protectionist barriers that raise the pay of the most highly paid professionals, and on limiting the protections for intellectual property that raise the prices we pay for a wide range of items and hand the money to a relatively small elite in a position to benefit.

As in real war, when it comes to trade, it is important that we not be fighting the last war. We have to go beyond KP to be properly prepared for battle.

[1] The corresponding overstatement on the output side would be treating the issuance of the loan as adding value. In reality, a bad loan is not adding value to the economy.

I have long enjoyed reading Matthew Klein’s columns in the Financial Times and elsewhere. They are invariably insightful and I have learned much from them. I am less familiar with Michael Pettis’ work, but I have liked what I have read. Therefore, I expected a lot from their book, Trade Wars are Class Wars, and I was not disappointed.

The basic point is that the major trade imbalances in the world over the last four decades have been driven by the suppression of wage growth, with income being redistributed from labor to capital. This has led to shortfalls in aggregate demand that countries try to offset by having trade surpluses. The main actors in that picture are China and Germany.

In the Klein-Pettis view, the U.S. has also suffered from this upward redistribution, although it has taken a somewhat different form since the country has run persistent trade deficits over this period. While I largely agree with this framing, I have some minor quibbles with the story they layout and one very large one.

In the minor quibble category, Klein and Pettis (KP) criticize Trump adviser Peter Navarro for focusing on the bilateral trade deficits the United States runs with China and other countries. I have no stake in defending Peter Navarro, but at least some of us who are concerned about the trade deficit with China have argued that the U.S. should be pressing China to raise the value of its currency relative to the dollar.

If the renminbi rose against the dollar, it should mean, other things equal, that China would have a lower trade surplus and therefore fewer savings, and the United States would have a smaller trade deficit, and therefore more savings. This isn’t an issue of a policy being thwarted by the inescapable logic of accounting identities, it is a question of the direction of causation in these identities. And, if we don’t think the U.S. economy is at full employment, more net exports will mean higher GDP and more savings.

I should also mention here that KP make the valid point that the direct trade balance between China and the U.S. does not accurately measure the net flows between the two countries, since much of the price of items exported from China is due to inputs from other countries. Therefore, our imports from China overstate the value of goods produced in China and then exported to the United States.

While this is true, it neglects the flip side, that many of the items we buy from Japan, the European Union, and elsewhere, include inputs from China. If we want to pull out the third country value-added from the goods imported from China, to get a better measure of bilateral trade flows, we also have to add in the Chinese value-added in the items imported from third countries. While KP are not guilty of the one-sided adjustment, other economists are. It is one of the items in the Games Economists Play textbook.  

Another point that is at least under-emphasized in KP, is that real wages soared in China in the period since 2000, in spite of the wage repression measures they describe. Real wages have risen at close to double-digit annual rates over this period. While they would have risen even faster if the country had not maintained an undervalued currency, and other measures to suppress wage growth, it has to be easier politically to maintain a policy of repressing wage growth in a context where wages are rising rapidly than when they are stagnating or falling.

KP also hold out the prospect that China is going to run up against some limit as it encourages companies to pursue wasteful investment projects that leave them ever further in debt. It’s not clear why a country that issues its own currency and has massive foreign reserves and a trade surplus, would ever hit a limit. I suppose if somehow excessive debt leads to explosive demand growth, and an inflationary spiral, it would be a serious problem. But it is hard to see how we get from where we are now, with persistent shortfalls in demand as the main issue, to the complete opposite problem.

My last quibble on the surplus country side is the claim that the assets issued or guaranteed by the U.S. government are risk-free. I know this is the standard wisdom, but I have no idea what it is supposed to mean.

I get that the U.S. government is not about to default on its debt. That can be treated as a near certainty. But the dollar can and often does fall in value relative to other currencies. In fact, since the start of 2020, the dollar has fallen by more than 6.0 percent against the euro. I’m not sure why the prospect that the dollar could fall in value relative to other currencies should not be seen as a risk. I don’t think most people would consider an investment that loses 6.0 percent of its value in eight months as risk-free.

On the U.S. side, KP for some reason ignore the wealth effect when discussing the low savings rates in the United States in the 1990s and the 2000s pre-crash. The idea of a wealth effect on consumption is not new, nor to my knowledge especially controversial.

The 1990s stock market bubble created close to $10 billion in bubble wealth. Assuming a wealth effect of 3-4 percent, this implied increased consumption on the order of 3-4 percent of GDP. That fits well with the drop in savings we saw over this period. As a practical matter, this manifested itself in smaller contributions to 401(k)s and also declining employer contributions to defined benefit pensions. The rise in the stock market was effectively making the contribution for employers. Some of us warned about the problem this was creating for pensions at the time, but the irrational exuberance of the day drowned us out.   

There was a similar story with the housing bubble. As KP note, people were happy to borrow against the rapidly growing equity in their homes. With the bubble creating roughly $8 trillion in additional housing equity, and a housing wealth effect of 4-6 cents on the dollar, the run-up in house prices can fully explain the fall in saving rates in the bubble years.

My reason for harping on this issue is that many economists were surprised when consumption plunged in 2008-2010. There was no basis for this surprise. The bubble that had been driving consumption had been deflated. Savings rates returned to roughly their long-term average, and have stayed there even as the debt overhang from the crash dissipated. There is nothing surprising in this story that needs explaining.

Okay, but enough of the quibbles, my big objection is the failure to focus adequately on the structuring of trade. This is a very central part of the wage suppression story, at least in the United States.

First, it is important to make the point that in the United States the upward redistribution was for the most part not from wages to profits, but from the wages of ordinary workers to the wages of highly paid workers like CEOs and other top executives, Wall Street and Silicon Valley types, and highly paid professionals.

KP for some reason see a very different picture of the data than me. They report a 7.0 percentage point drop in the labor share of national income from 2000 to 2007 (p 179). I see a drop of 1.2 percentage points (NIPA Table 1.10, Line 2 divided by the sum of Line 2 and Line 9).

Furthermore, even this drop in labor shares is questionable. Profits were inflated during these years by the profits earned in the financial sector from issuing dubious loans that subsequently went bad. This would be similar to companies reporting profits on non-existent sales. There were not real profits and of course, the banks lost hugely when these loans went bad in 2008—2010.[1]

There was a drop in labor shares in the weak labor market resulting from the Great Recession. This was being reversed with the recovery, but we still had some way to go when the pandemic hit. By my calculations, just over 10 percent of the gap between productivity growth and median wage growth from 1979 to 2019 can be explained by this shift from labor to capital. The rest is due to upward redistribution within the wage structure.  

This gets us to the structure of the trade. Our trade policy was focused on reducing or eliminating barriers to merchandise trade. This has the predicted and actual result of lowering the wages of manufacturing workers, which spilled over to putting downward pressure on the wages of non-college-educated workers more generally. When workers in the United States had to compete with workers in China and elsewhere, earning less than one-tenth of their pay, it was inevitable they would either take large pay cuts or lose their jobs.

However, trade liberalization did not have to focus on manufactured goods or at least exclusively focus on manufactured goods. We could have focused trade policy on reducing barriers that prevent qualified professionals from working in the United States. Doctors and dentists in the United States earn roughly twice as much as their counterparts in other wealthy countries. Trade liberalization in these professions could have brought their pay closer to the OECD average, saving households more than $100 billion annually from their healthcare bill. We didn’t see the liberalization of licensing restrictions (they were actually made tighter in the 1990s) because doctors and dentists have far more political power than autoworkers.

The other part of this story that is almost completely absent from KP is the tightening of rules on patent and copyright monopolies, which have been a key part of every trade deal for the last three decades. These monopolies are forms of protectionism, the polar opposite of free trade. They lead to prices for prescription drugs, medical equipment, software, and other protected items that are often hundreds of times the free market price, the equivalent of tariffs of tens of thousands percent.

They also are associated with enormous upward redistribution, as ordinary workers have to pay much higher prices for the benefit of the people with the skills associated with producing these products. Bill Gates would likely still be working for a living if Microsoft had to sell software without government-granted copyright or patent monopolies.   

This is a huge issue going forward, as the cost of protection for intellectual products is likely to continue to grow as a share of the economy. It is already huge. We will spend over $500 billion this year on prescription drugs alone. If these drugs were sold in a free market, we would almost certainly pay less than $100 billion. The difference of $400 billion is more than $3,000 per family. This $400 billion in potential savings is almost 80 percent of what we will spend on cars and parts in 2020.

In future trade deals, the terms of protection for intellectual products, both foreign and domestic, will swamp the importance of trade in manufactured goods. The loss of good-paying jobs in manufacturing was a huge deal in the 1980s, 1990s, and especially the 2000s, but unfortunately, we don’t stand much to lose anymore.

Manufacturing employment is now less than 9.0 percent of total employment. Furthermore, while manufacturing jobs used to provide relatively good-paying employment for workers without college degrees, this is no longer true. The average wage for production and non-supervisory workers in manufacturing is 6.0 percent less than for production and non-supervisory workers in the private sector as a whole. This gap would be reduced when factoring in benefits, but the idea that a manufacturing job is a good-paying job where a worker could support a family and have health care and a pension is simply no longer true.

The reason for the deterioration in the quality of manufacturing jobs is not a secret. The unionization rate in manufacturing has plummeted, largely due to trade. Until the pandemic hit in March, we had added back more than 1.6 million manufacturing jobs from the Great Recession trough in 2010. Nonetheless, the number of union members in manufacturing had fallen by almost 900,000. In short, as we added back jobs in the sector, they were overwhelmingly lower paying non-union jobs. There is little reason to believe that these workers were much better off than workers in an Amazon distribution center or other service sector jobs.

This points to the fact that manufacturing jobs should not be at the center of the trade agenda for those concerned about reversing the upward redistribution of income. The focus should be on reducing the protectionist barriers that raise the pay of the most highly paid professionals, and on limiting the protections for intellectual property that raise the prices we pay for a wide range of items and hand the money to a relatively small elite in a position to benefit.

As in real war, when it comes to trade, it is important that we not be fighting the last war. We have to go beyond KP to be properly prepared for battle.

[1] The corresponding overstatement on the output side would be treating the issuance of the loan as adding value. In reality, a bad loan is not adding value to the economy.

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