In New York magazine, Steve Hall lays out the good, bad, and the ugly of cancer-drug economics. Warning: it is mostly bad and ugly.
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The pharmacist e-mailed the numbers, and Saltz stared at the figures on his computer screen. Zaltrap, the drug that was extremely similar to Avastin, cost roughly $11,000 a month. (And because that extra 42 days wouldn’t be possible without taking the drug for, say, seven months before—which was roughly what was happening in clinical trials—the price for that six-week life extension could be as high as $75,000.)
“Wow,” he said to himself, “that’s a deal-changer for me.”
That may not seem like a heretical statement, but the unspoken rule in American health care is that doctors should never consider the cost of a medicine that might be beneficial to patients. When the FDA approves a new cancer drug, it analyzes safety and effectiveness only. Medicare is obliged to reimburse payment for the drug, and private insurers in most states must cover the cost. Any doctor who considers cost—or the value of a costly drug—risks being accused of “rationing” health care.
If you want to remind yourself what a really good magazine article can be, check out Willy Staley‘s N.Y. Times Magazine piece “22 Hours in Balthazar.” Balthazar is a SoHo restaurant that’s been around long enough to be an institution but is still good enough to inspire devotion from scene-setters, tourists, and locals alike. How?
That’s the question the article (and photographs) answer, in an elegant and fact-filled manner. For instance:
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For now, everything is quiet at Balthazar. The last guests from the night before left just a few hours ago, and the nighttime porters are still finishing their thorough scrub of the restaurant. But the delivery trucks are starting to arrive all over again, idling on Crosby. Men in lifting belts wheel hand trucks stacked high with food from across the globe: 80 pounds of ground beef, 700 pounds of top butt, 175 shoulder tenders, 1 case of New York strips, all from the Midwest; 5 pounds of chicken livers, 6 cases of chicken bones, 120 chicken breast cutlets; 30 pounds of bacon; 300 littleneck clams, 110 pounds of mussels from Prince Edward Island, another 20 pounds from New Zealand, 50 trout, 25 pounds of U10 shrimp (fewer than 10 pieces per pound), 55 whole dorade, 3 cases of escargot, 360 Little Skookum oysters from Washington State, 3 whole tunas, 45 skates, 18 black sea bass, 2 bags of 100 to 120 whelks, 45 lobster culls. That’s just the fish and meat order.
How do copyright laws affect creativity? Do stronger laws increase profitability — and, therefore, do they increase creativity? If musicians/filmmakers/authors/software designers/etc. etc. etc. don’t have the strong incentive of copyright protection, will they create less or inferior work?
These question are both broad and long; many great minds have wrestled with them, and will continue to do so. Our recurring guest bloggers Kal Raustiala and Chris Sprigman regularly discuss copyright; Levitt touched on it here, and we discussed copyright protection in this podcast.
Now, in a new working paper (abstract; PDF) called “Copyright and the Profitability of Authorship: Evidence from Payments to Writers in the Romantic Period,” Megan MacGarvie and Petra Moser take up the argument:
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Scott Turow, President of the American Authors’ Guild, warned that regimes that weaken copyright, such as digital piracy may cause the “slow death of the American author” (Turow 2013). Empirical analyses of file sharing, however, reveal no significant effects on the quantity or quality of recorded music (Oberholzer-Gee and Strumpf 2009; Waldfogel 2013), which suggests that the importance of copyright protection may be overstated.
(HT: Lots of people — thanks!)
That is the argument made in a new paper (abstract; PDF) by Katherine Coffman, Lucas Coffman, and Keith Marzilli Ericson, entitled “The Size of the LGBT Population and the Magnitude of Anti-Gay Sentiment Are Substantially Underestimated”:
Measuring sexual orientation, behavior, and related opinions is difficult because responses are biased towards socially acceptable answers. We test whether measurements are biased even when responses are private and anonymous and use our results to identify sexuality-related norms and how they vary. We run an experiment on 2,516 U.S. participants. Participants were randomly assigned to either a “best practices method” that was computer-based and provides privacy and anonymity, or to a “veiled elicitation method” that further conceals individual responses. Answers in the veiled method preclude inference about any particular individual, but can be used to accurately estimate statistics about the population. Comparing the two methods shows sexuality-related questions receive biased responses even under current best practices, and, for many questions, the bias is substantial. The veiled method increased self-reports of non-heterosexual identity by 65% (p<0.05) and same-sex sexual experiences by 59% (p<0.01). The veiled method also increased the rates of anti-gay sentiment. Respondents were 67% more likely to express disapproval of an openly gay manager at work (p<0.01) and 71% more likely to say it is okay to discriminate against lesbian, gay, or bisexual individuals (p<0.01). The results show non-heterosexuality and anti-gay sentiment are substantially underestimated in existing surveys, and the privacy afforded by current best practices is not always sufficient to eliminate bias. Finally, our results identify two social norms: it is perceived as socially undesirable both to be open about being gay, and to be unaccepting of gay individuals.
Are You Male, With a Job in Finance or Economics, and Want to Get on a “Wilderness Experience” TV Show?
Then today is your lucky day. Here’s a request we received from friends at a TV production company:
We’re casting the first season of Enter the Wild, an inspiring documentary series for a major cable network. In the show, a diverse group of real people takes an outdoor survival course taught by one of the country’s most acclaimed wilderness experts.
It’s not a competition show. It’s not Survivor. The series will follow participants as they engage in a fully immersive, three-week course. Our hope is that everyone will walk away not only with life-saving skills, but a new perspective on their lives and their relationship with nature.
We’d love to include a the point of view of a male with a work background in financial markets or economics in this wilderness experience. You can apply or get more information at our website.
A “casting treatment” from the company gives further information about the types of characters they are looking for. If I were a young anthropology researcher, I would be all over this thing — for what it says about the people who make, watch, and appear on modern TV. Here are a few of my favorites: Read More »
A Freakonomics Radio listener named Sandra Elsen writes:
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Today, I went to my son’s kindergarten. He attends the local International School (what the Realtor described as the “Hippy-Dippy” school, lol), in a semi-rural area, just outside of the city in a middle-class town.
There, I was asked to help them learn a new game. The concept was simple: a six-sided block had three 1′s and three 2′s marked on each side. They had to trace the number that was rolled on their worksheet. Roll, trace. Once five of one number was achieved, either the firetruck or the firefighter (pictured at the bottom of the sheet) “won.” The teacher indicated it was a “race” to see which picture would win.
1. Wow! Listeners have so far responded way, way, way better than Levitt predicted they would in the podcast — so: 1a) Thanks!; and 1b) Nice job in proving a pretty smart guy very wrong.
2. Some of your comments and e-mails noted that WNYC’s fund-raising site doesn’t allow for contributions via PayPal, text, Flattr, Bitcoin, etc. That is true. Hopefully some of these avenues will be added over time. Some of you also noted that the podcast already has advertising, so why are we also asking for contributions from listeners? Good question. Short answer: WNYC is the funding producer of our podcast, and as such is responsible for paying all our producer and engineer salaries, studio time, field-recording costs, music-licensing costs, bandwidth, and a million other things, like the transcription of interviews (for every minute of talking that ends up in the podcast, we’ve probably got about five minutes of interview tape). We are grateful for the advertisers on our podcast, but that revenue is not nearly enough to produce the podcast. That’s why we came to you, our listeners, for additional support. Read More »