Though I imagine Roderick Long and I disagree on many questions, I am of the view that the heart of the conservative domestic policy message should be this: the basics of a middle class life — a good-sized home not too far from employment opportunities, medical insurance that can protect against big income shocks, and access to high-quality schools — are way, way, way more expensive than they need to be, and the culprit is a combination of a dysfunctional public sector and overregulation. The traditional approach to making the basics of a middle class life more widely available is to increase the resources devoted to dysfunctional public sector institutions, to increase the number of regulations, and perhaps to create new public sector institutions in the hope that they will escape the sclerosis that plagues older ones. This approach hasn’t turned out very well.
Note, however, the trajectory of various other consumption goods: appliances, automobiles, and amenities; personal services in domains that are not burdened by licensing restrictions; the cost and quality of housing in regions that aren’t severely capacity-constrained by zoning restrictions and other regulations.
Somehow libertarians and conservatives need to connect these threads, as Nick Gillespie and Matt Welch try to do in their The Declaration of Independents: the assumptions need to flip so that voters start wondering why the public education system isn’t offering higher quality at lower cost, in marked contrast to, say, fast-casual dining chains or the manufacturers of consumer electronics or the purveyors of coffee.
This will strike many of you as a gross oversimplification. But before I give up completely on disabusing you of that notion, let’s connect a few recent threads:
(1) As Ryan Avent argues in The Gated City and as Edward Glaeser has argued in Triumph of the City and, with Joseph Gyourko, Rethinking Federal Housing Policy, a series of federal (subsidies for mortgage debt) and local (zoning restrictions, rent regulations, etc.) interventions have made affordable, high-quality housing scarce in many of the countries most productive and regions regions. One familiar policy “solution” has been to increase direct housing subsidies rather than to dismantle policies that drive price increases.
(2) The economist David Levinson has made the important point that accessibility is a product of both density and speed, i.e., reducing congestion can increase one’s access to employment opportunities by reducing the time cost of reaching them. Resistance to HOT lanes, private toll roads, etc., exacerbates the accessibility problem by forcing us to rely on slow-moving public bureaucracies that face a number of political imperatives that compel them to, among other things, deploy labor inefficiently, devote resources to projects that aren’t cost-effective, etc.
(3) Allowing for more specialized educational providers and providing parents with flexible K-12 Spending Accounts (KSAs) could help drive down the cost of high-quality instruction. New entrants, including blended learning environments and virtual schools, could offer parents more educational options without forcing them to purchase access to “good school districts” via the purchase or rental of real estate that might stretch household budgets to the breaking point.
(4) By transitioning to competitive pricing in Medicare and catastrophic insurance for all but the sickest and poorest under-65s, we would in theory encourage the emergence of low-cost business models for the provision of medical care, per The Innovator’s Prescription. Controversial ideas like cash-for-care medical indemnities are among the innovations that might, if depoliticized, help reduce systemwide costs.
(5) Per the Chen and Chevalier research, we could take a number of steps to attack the supply constraints on the number of licensed medical providers, e.g., we could make graduate medical training in the U.S. less strenuous and time-consuming, which is to say more comparable to graduate medical training in every other advanced country. More aggressively, we could further empower nurse practitioners and physician assistants to undertake work that is currently the province of physicians.
(6) Reform of the FDA could drive down the cost of developing new drug therapies, making them more accessible.
(7) And I imagine that patent reform would have a salutary impact on middle class living standards in all kinds of unpredictable ways.
If we attack cost increases at the source, we could effectively raise real incomes, thus addressing the anxiety associated with lackluster male wage growth. If the goal is more middle class economic security, getting there by making economic security much cheaper is at least as good as getting there by increasing the tax burden without limit to redistribute income, most of which will wind up in the hands of the medical cartels (medical providers extracting rents, claiming it’s for the sick), the school cartels (teachers and administrators extracting rents from state and local governments, claiming it’s for the children), and the housing cartels (landlords extracting rents, claiming that overbuilding would destroy the landscape).
Arnold Kling and Nick Schulz are thinking along these lines, as evidenced by their excellent National Affairs essay on “The New Commanding Heights.” All we need is for someone to find a catchy and accessible way of talking about this broad agenda.
I should note that this approach doesn’t necessarily mean just eliminating regulations. It might involve creating new regulations, to, for example, help structure new education markets or to promote the use of pay-as-you-drive auto insurance. But the bias should be towards creating more room for entrepreneurial experimentation, not towards restricting it.
re:5 -- why not let people study medicine as undergraduates, as most other OECD countries do?
Reply to this commentLinkReport Abuse"Somehow libertarians and conservatives need to connect these threads..."
As a liberal, there are things I agree with here. For example, urbanists who want and would benefit from denser construction are mostly going to be liberals. So why limit your coalition from the outset?
Reply to this commentLinkReport Abuse"Somehow libertarians and conservatives need to connect these threads..."
As a liberal, there are several components of this agenda I would actively support, and I don't think I am alone. For example, urbanists who want and would benefit from denser construction in cities are likely to be liberals. Why limit your coalition from the outset?
Reply to this commentLinkReport AbuseMr. Salam is under the illusion that he is a conservative.
Reply to this commentLinkReport Abuse"This will strike many of you as a gross oversimplification."
YES!
Let me say it again. YES!
First of all Mr. Salam, you need to disabuse yourself of this notion that you are a conservative. Or, more specifically, that if conservatives won political power, anything LIKE the sort of policies you advocate would ever come about.
Now that I have started with a compliment, here is the criticism:
"the culprit is a combination of a dysfunctional public sector and overregulation"
Give me a break. You are clearly capable of more intelligent thinking than this. I imagine that talking about "overregulation" makes you feel good, like you are part of team Republican, but this is nothing more than, in your words, a "gross oversimplification." Plenty of culprits exist in the private sector as well.
One should not measure regulations by their quantity, but rather by their quality.
As far I am concerned, as a liberal, I would be perfectly happy to see unnecessary words cut out of our Code of Federal Regulations. But that is more a matter of good writing than anything else. Why say in a more complex way what can be said more simply, assuming, of course, that nothing vitally important is lost.
Quit with the tired point about how you can't go about fixing broken regulations with more regulation. That is exactly what should happen. Of course regulation, like any other human endeavor, is a work in progress. You can't expect mere humans to get it exactly right the first time. Of course, old regulation that isn't working exactly as intended should be continually fixed with new regulation. Also without the illusion that it will ever be perfect.
If the regulatory process itself has sclerosis, what can you do to fix that? Why not actually think about that? It is easy enough to point your fingers at problems. It is much harder to actually have anything constructive to say about fixing them. Let's not forget that much of the sclerosis that infects the regulatory process was put their by Republicans who were trying to jam the gears for its own sake. This makes it more difficult to correct bad regulation.
The bottom-line is this. If you want to actually "talk" to liberals and actually be listened to, you have to think with two parts of your brain. One part of your brain is, well, maybe we can reduce some regulation here, or streamline some regulation there. The other part of your brain is that well, there seems to be some loopholes here that need more regulation to fill, or acknowledging that some areas may be under-regulated is a problem sometimes as well. At the end of the day, what matters is quality, not quantity. Quantity is only part of what concerns quality.
Countless books have been written and ink spilled on the topic of so-called "overregulation." Fine. I am not saying it never happens. But it just strikes me as a gross oversimplification to act like that is the whole story. I for one have no idea why you would want to waste your intellectual talents increasing the size of this bloated literature. I actually think you are smart enough that you might make a real contribution instead of wasting time with ideological hackery.
I simply don't trust the policy analysis of people who have seemingly lobotomized themselves. You may convince me that a particular idea is a good one (i.e. a particular approach to public policy that integrates the private sector to solve a particular problem). But you are never going to convince me to perform a lobotomy just because you have chosen to victimize yourself in that manner. And you know what, everything you have to say about particular policies carries less weight for me when I know you are lobotomized. That instead of being able to see clearly, the problem for you is always going to be "overregulation" and a "dysfunctional public sector."
I can practically write the script myself. It is so dull and predictable. And a gross oversimplification.
All of that said, let me end on a more positive note. Despite the severe problematic ideological garbage you bring to the table, you have some really good specific ideas. For example, I agree that we should carefully review the regulations we have in place regarding the medical profession and think about how we can address certain anti-competitive constraints on supply. :)
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