Gawande on the structure of medicine

The New Yorker's website contains a commencement address by Atul Gawande, he of the two-counties-in-Texas fame. And yes, you'll still feel like a communist when you read what he writes. In a Mayo Clinic kind of way, mind you!

A change in the VA's PTSD compensation rules

Last week the Times reported new VA rules governing eligibility for disability benefit based on post-traumatic stress disorder (PTSD). And a Room-for-Debate blog covered some discussion of the issues.

One of the challenges in understanding compensation programs for veterans is that data are harder to come by than they are for the entire civilian population. There's a vibrant literature on the effects of Social Security's Disability Insurance, by John Bound and others for example. But veteran subsamples in surveys tend to be small, and relatively few questions about VA compensation or utilization are asked.

Cheating, technology, and behavior

Yesterday the Times reported on cheating practices, prevalence, and technology in the Internet age. On its second page, the article reviewed a recent NBER working paper on cheating, in which the authors conducted an experiment using a Blackboard-based tutorial on plagiarism as the intervention.

Their results revealed that plagiarism, as detected by the ubiquitous TurnItIn database, was more prevalent among students with lower SAT scores. The authors also found that the intervention worked to reduce plagiarism, implying that students may lack knowledge regarding academic integrity.

Update: a Times Room-for-Debate forum on this topic.

Update 2, another Times article.

Update 3, a post by Stanley Fish on (the lack of?) a cogent moral argument against plagiarism.

Update 4, Stanley Fish again on metaphysics.

Glaeser on life expectancy in New York

Ed Glaeser writes about trends in life expectancy in New York City (all of it) versus those for the nation over the last century or so. He cites a New York penalty that declined and reversed by 1940, then increased again to 1990, and then reversed. New Yorkers now enjoy 1.5 more years in period life expectancy at birth than do Americans as a whole. The causes remain rather mysterious; Glaeser reports that mortality rates above age 55 are consistently lower in NYC than elsewhere, but while cancer deaths are less prevalent among New Yorkers, heart disease deaths are not.

Times Smackdown on student evals

Stanley Fish, a professor of humanities and law at FIU, argues against student evaluations here and here, and Alan Jacobs seconds him. Ross Douthat sees more rationality and consistency, but also acknowledges the case against that. A few weeks ago, I had blogged about the latter, a new JPE article by Carrell and West.

The main difference of opinion seems to be over whether "good teaching" can be appreciated by students while engaged in learning, or whether students typically can't appreciate it until later, perhaps once learning has either been achieved or operationalized elsewhere.

A passage from today's column by David Brooks is coincidentally related: "Much of what we do in public policy is to try to get people to behave in their own long-term interests — to finish school, get married, avoid gangs, lose weight, save money. Because the soul is so complicated, much of what we do fails." At least in high school and college, the primary objective of education seems to be imparting long-term gains. Brooks argues that trying to do so is difficult because of the complexities of human behavior and motivations.

Rajan on the financial crisis

Yesterday the Freakonomics blog posted an interview with Raghuram Rajan, who pillories the federal government for a second-rate redistribution policy via extending (housing) credit, and Greenspan's Fed for remaining on the sidelines during the growth of the asset bubble.

I think Rajan could take his analysis about housing credit one step further, but it may not be a direction he'd want to take. During the 1990s, fiscal policy was relatively tight, resulting in monotonic reductions in deficits from 1992 and surpluses in 1998 through 2001. Politically, the balance of power produced PAYGO budget caps, welfare reform, and an environment where small, compartmentalized fiscal policies like the lifetime learning tax credit and other carve-outs were the only ones feasible. It seems to me that one could characterize Fannie and Freddie's expansion of credit to low-income home buyers as the same.

It would appear that some of these policies were more harmless than others. But stepping back, would it be right to blame this circuitous path to income redistribution, as called correctly by Rajan, on the overall program of fiscal austerity?

Incentivizing healthy behaviors

Yesterday's Room for Debate blog included a discussion of financial incentives for individuals to engage in healthy behaviors, like lose weight, quit smoking, and exercise. Kevin Pho cites two studies, one in JAMA and one in NEJM, but his critique is that the NEJM study on smoking cessation includes a racially homogeneous sample. The other sample is smaller but more diverse.

Arthur Caplan writes about the asymmetries; fast-food providers are completely free to peddle unhealthy food, leaving it to individuals to get it right or wrong on their own. Another option that might place a greater burden on suppliers of unhealthy products would be to tax them rather than subsidize healthy behaviors. We already do this with alcohol and cigarette taxes, of course, but we do not tax fast food.

One of the questions is what kind of behavioral response to expect from taxes or subsidies. One might imagine that people engage in unhealthy behaviors because they are addictive, and their demand for them might be relatively inelastic. Only a very high tax would produce behavioral change. Subsidizing healthy behaviors might be more effective in eliciting a behavioral response because demand might be much more elastic.