Today’s Washington Post contains an article titled, “FDA Considers Revoking Approval of Avastin for Advanced Breast Cancer.”  An excerpt:

The debate over Avastin, prescribed to about 17,500 women with breast cancer a year, has become entangled in the politically explosive struggle over medical spending and effectiveness that flared during the battle over health-care reform: How should the government balance protecting patients and controlling costs without restricting access to cutting-edge, and often costly, treatments?

A better question is: why should the government be the one to strike that balance?  Why shouldn’t some women be able to sign up for a health plan that covers Avastin, while others are free to make a different choice?

Why Should Politicians and Bureaucrats Decide Whether Breast-Cancer Patients Can Take Avastin? is a post from Cato @ Liberty - Cato Institute Blog

Although public schools are usually the biggest item in state and local budgets, spending figures provided by public school officials and reported in the media often leave out major costs of education, and understate what is actually spent.

In a new study, Cato’s Adam B. Schaeffer reviews district budgets and state records for the nation’s five largest metro areas and the District of Columbia. Schaeffer finds that, on average, per-pupil spending in these areas is 44 percent higher than officially reported.

In this new video, Schaeffer explains the whole thing in under three minutes:

They Spend WHAT? The Real Cost of Public Schools is a post from Cato @ Liberty - Cato Institute Blog

Today’s New York Times reports that President Obama has “ordered the rapid development of technology to capture carbon dioxide emissions from the burning of coal,” as well as mandating the production of more corn-based ethanol and financing farmers to produce “cellulosic” ethanol from waste fiber.

You’ve got to like the president’s moxie.  Faced with his inability to pass health care reform and cap-and-trade, he now chooses to command the impossible and the inefficient.

Most power plants are simply not designed for carbon capture.  There isn’t any infrastructure to transport large amounts of carbon dioxide, and no one has agreed on where to put all of it.  Corn-based ethanol produces more carbon dioxide in its life cycle than it eliminates, and cellulosic ethanol has been “just around the corner” since I’ve been just around the corner.

However, doing what doesn’t make any economic sense makes a lot of political sense in Washington, because inefficient technologies require subsidies–in this case to farmers, ethanol processors, utilities, engineering and construction conglomerates, and a whole host of others.  Has the president forgotten that his unpopular predecessor started the ethanol boondogle (his response to global warming) and drove up the price of corn to the point of worldwide food riots? Hasn’t he read that cellulosic ethanol is outrageously expensive? Has he ever heard of the “not-in-my-backyard” phenomenon when it comes to storing something people don’t especially like?

Yeah, he probably has.  But the political gains certainly are worth the economic costs.  Think about it.  In the case of carbon capture, it’s so wildly inefficient that it can easily double the amount of fuel necessary to produce carbon-based energy.  What’s not to like if you’re a coal company, now required to load twice as many hopper cars?  What’s not to like if you’re a utility, guaranteed a profit and an incentive to build a snazzy, expensive new plant?  And what’s not to like if you’re a farmer, gaining yet another subsidy?

Obama Commands the Impossible is a post from Cato @ Liberty - Cato Institute Blog

HHS has finally released the second installment of its series of studies on the persistence of Head Start effects. Its finding (see page xiv): virtually all academic effects disappear by the end of 1st grade. There is only one positive statistically significant finding out of eleven academic outcomes measured, the size of that effect is minuscule by recognized standards (it’s half way between zero and what most social scientists consider “small”), and the confidence in the finding is low by recognized standards. (Many authors would categorize it as “insignificant” rather than “significant” — it’s only significant at a 90% confidence interval, not the more common 95% confidence interval).

We have spent more than $100 billion on the program to date (ballpark estimate from Table 375 here) and HHS’s own research shows that its results diminish to essentially nothing by the end of the first grade.

There are other government education programs whose effects actually grow substantially over time, and that are comparatively economical. Consider the federal DC voucher program. Just a year or two after switching from public to private schools, the effect of the private schooling was not big enough to rise to the level of statistical significance. But by their third year in private schools, the evidence was clear that voucher-receiving students were reading more than two grade levels above a randomized control group that stayed in public schools.  This program, as I’ve previously documented, costs 1/4 as much per pupil as DC spends on public education: about $6,600 vs. $28,000.

But Congress, and particularly Democrats, have defunded the DC voucher program while raising spending on Head Start. President Obama is at the forefront of this travesty. If you weren’t already jaded and disgusted by education politics and its domination by employee unions opposed to educational choice, start now.

Head Start’s Impact Evanescent — HHS Study is a post from Cato @ Liberty - Cato Institute Blog

That’s the conclusion of economist Glen Whitman and physician Raymond Raad, who write in Forbes:

Unfortunately, the health care bills moving through Congress could curtail medical innovation. Imposing price controls on drugs and treatments–or indirectly forcing their prices down by means of a “public option” or expanded public insurance programs–would reduce the incentive for innovators to develop new treatments.

Proposed reforms could also retard business model innovation–an area where innovation is weak. Congress has already used its control of Medicare to limit the growth of specialty hospitals. A nationally mandated insurance package would severely curtail innovation in payment methods and insurance products, which have the potential to improve the coordination and delivery of health care services.

The health care debate should address more than just covering the uninsured and controlling costs. When the U.S. generates medical innovations, the whole world benefits. That is a virtue of the American system that is not reflected in comparative life expectancy and mortality statistics.

The op-ed is based on the authors’ Cato Institute policy analysis, “Bending the Productivity Curve: Why America Leads the World in Medical Innovation.”

ObamaCare Threatens Innovation is a post from Cato @ Liberty - Cato Institute Blog

In a post at the Enterprise Blog two days ago, economist Mark Perry deftly parodies a typical mainstream media account of trade protectionism by editing the story in redline to contrast its original presentation with its true significance. I recommend reading the whole thing, but here’s the first paragraph:

WASHINGTON POST (Reuters) – A U.S. trade panel gave final approval on Wednesday to duties taxes ranging from 10 to 16 percent on cost-conscious firms in the U.S. who purchase low-priced Chinese-made steel pipe rather than high-price domestic pipe, in the biggest U.S. trade case to date against China American companies (and their shareholders, employees, and customers) who shop globally for their inputs and find the best value in China.

Perry’s point—and I share his frustration—is that the mainstream media typically fail to convey even a sense of the costs of U.S. protectionism to U.S. interests even though Americans (and non-Americans living in the U.S.) bear the greatest burden of that protectionism. When the U.S. government imposes duties on Chinese steel, it is imposing taxes on U.S. consuming industries, their employees, their shareholders, and their customers.

Considering that more than half of the value of all U.S. imports in a typical year is raw materials and intermediate goods (i.e., inputs for producers operating in the United States, who employ people, transact with other businesses, and pay taxes in the United States), the number of U.S. victims of U.S. import taxes is much larger than one can ever glean from a typical media account. Taxes on Chinese-made ”Oil Country Tubular Goods” or OCTG (the subject in the article Perry edits), which are used for oil exploration and transport, will raise costs in the energy industry, which are likely to be passed onto consumers in the form of higher energy prices.

As described in this paper, trade is no longer a competition between “Us and Them.” There is competition between entities that—because of the proliferation of cross-border investment and transnational production and supply chains—often defy any meaningful national identification. But that competition is preceded by collaboration and cooperation between entities in different countries. The factory floor has broken through its walls and now spans borders and oceans—a fact that renders U.S. workers and workers in other countries complementary in more and more cases, and a fact that amplifies the cost of trade barriers.

But media—chained to the false “Us versus Them” paradigm—describe protectionist policies as actions taken by one national monolith against another, and convey the impression that American readers should be cheering for Team America. It is a worldview that conflates the well-being of “our producers” with some homogenized conception of “the national interest.” It is the same misguided scoreboard mentality that colors reporting of the trade account, where exports are deemed “good” and imports “bad.”  And, it is this simplistic, misleading characterization that, in my opinion, is most responsible for withering public opinion about trade and globalization over the past decade.

I look forward to more of Dr. Perry’s editing projects.

Mainstream Media’s Trade Gap is a post from Cato @ Liberty - Cato Institute Blog

National Journal headline: “Obama Signs Spending Bill, Promises Future Restraint.”

Now where have I heard that before?

Promises, Promises is a post from Cato @ Liberty - Cato Institute Blog

Senate Majority Leader Harry Reid (D-NV) has announced that he has reached a super secret compromise on how to deal with the so-called public option for health reform.  While Reid said the agreement was too important to actually tell anyone what is in it, most of the details have been leaked to the press.

Rather than set-up a completely government-run insurance plan to compete with private insurance, Congress would establish a program similar to the Federal Employees Health Benefit Program (FEHBP), which currently covers government workers, including Members of Congress.  The FEHBP offers a variety of private insurance plans under a program managed by the US Office of Personnel Management (OPM).  Each year OPM uses the Federal procurement process to solicit bids from insurance companies to be one of the plans offered.  Premiums can vary, but participating plans operate under stringent rules.   As a model, the FEHBP is apparently acceptable to moderate Democrats because the insurance plans are private rather than government entities, while liberals like it because it is government regulated and managed.

In addition, the compromise plan would expand Medicare, allowing workers ages 55 to 65 to “buy in” to the program, and may also expand Medicaid.

A few reasons to believe this is yet another truly bad idea:

1. In choosing the FEHBP for a model, Democrats have actually chosen an insurance plan whose costs are rising faster than average.   FEHBP premiums are expected to rise 7.9 percent this year and 8.8 percent in 2010.  By comparison, the Congressional Budget Office predicts that on average, premiums will increase by 5.5 to 6.2 percent annually over the next few years.  In fact, FEHBP premiums are rising so fast that nearly 100,000 federal employees have opted out of the program.
2. FEHBP members are also finding their choices cut back.  Next year, 32 insurance plans will either drop out of the program or reduce their participation.  Some 61,000 workers will lose their current coverage.
3. But former OPM director Linda Springer doubts that the agency has the “capacity, the staff, or the mission,” to be able to manage the new program.  Taking on management of the new program could overburden OPM.  “Ultimate, it would break the system.”
4. Medicare is currently $50-100 trillion in debt, depending on which accounting measure you use.  Allowing younger workers to join the program is the equivalent of crowding a few more passengers onto the Titanic.
5. At the same time, Medicare under reimburses physicians, especially in rural areas.  Expanding Medicare enrollment will both threaten the continued viability of rural hospitals and other providers, and also result in increased cost-shifting, driving up premiums for private insurance.
6. Medicaid is equally a budget-buster. The program now costs more than $330 billion per year, a cost that grew at a rate of roughly 10.7 percent annually.  The program spends money by the bushel, yet under-reimburses providers even worse than Medicare.
7. Ultimately this so-called compromise would expand government health care programs and further squeeze private insurance, resulting in increased costs and higher insurance premiums, and provide a lower-quality of care.

No wonder Senator Reid wants to keep it a secret.

FEHBP Plan Is No ‘Moderate Compromise’ is a post from Cato @ Liberty - Cato Institute Blog

House Democrats introduced the first complete draft of President Obama’s health plan on June 19.

Since then, Congress has spent 158 days considering the Obama health plan without ever laying eyes on a complete cost estimate.

The House passed its version without one. And the Senate has begun floor consideration without one.  (Shouldn’t these eight Democratic-caucusing senators be upset about that?)

(Cross-posted at National Journal’s Health Care Experts Blog.)

ObamaCare Cost-Estimate Watch: Day #158 is a post from Cato @ Liberty - Cato Institute Blog