Posts Tagged ‘Greg Mankiw’

the tragedy of means tests

Monday, November 16th, 2009

Greg Mankiw is one of a handful of economists who worry about the effect of means tests on the welfare of the poor. Some time ago, he  posted a quote of “Kennedy School economist Jeff Liebman (via Jeff Frankel’s new blog) [who] tells a sad story about the incentive effects of government programs aimed at helping the poor”:

the poverty trap is still very much a reality in the U.S. A woman called me out of the blue last week and told me her self-sufficiency counselor had suggested she get in touch with me. She had moved from a $25,000 a year job to a $35,000 a year job, and suddenly she couldn’t make ends meet any more. I told her I didn’t know what I could do for her, but agreed to meet with her. She showed me all her pay stubs etc. She really did come out behind by several hundred dollars a month. She lost free health insurance and instead had to pay $230 a month for her employer-provided health insurance. Her rent associated with her section 8 voucher went up by 30% of the income gain (which is the rule). She lost the ($280 a month) subsidized child care voucher she had for after-school care for her child. She lost around $1600 a year of the EITC. She paid payroll tax on the additional income. Finally, the new job was in Boston, and she lived in a suburb. So now she has $300 a month of additional gas and parking charges. She asked me if she should go back to earning $25,000.

Greg Mankiw, “The Poverty Trap”, 10 February 2008.

Jeffrey Liebman is now Executive Associate Director of Obama’s Office of Management and Budget (OMB).

More recently, Mankiw linked to work by Boston University economists Kotlikoff and Rapson, who give the tax-transfer system of the US very low marks:

America’s tax-transfer system confronts the vast majority of American households with either high, very high, or astronomically high total effective marginal tax rates on labor supply and saving. It also provides very substantial tax arbitrage opportunities to a subset of households, particularly those with high incomes or advanced ages.

The pattern of net marginal tax rates and arbitrage opportunities with respect to age, marital status, and earnings is quite simply all over the map. But this is what one would expect given the amazing complexity of the fiscal system, the fact that the various components of the system are being developed with little or no thought to their interaction, and that the various governmental bodies responsible for the different elements of our tax-transfer system appear to make little or no attempt to understand the overall work and saving disincentives as well as arbitrage opportunities they are producing.

Laurence J. Kotlikoff and David Rapson, “Does It Pay, at the Margin, to Work and Save? — Measuring Effective Marginal Taxes on Americans’ Labor Supply and Saving”, Boston University, October 2006.

For reasons that I do not fully understand, political conservatives like Mankiw frequently fail to draw the obvious conclusion that universal benefits trump targeted transfers. The unwritten implication is the poor would be better off without transfers, but with their work incentives intact. Where are the ‘compassionate conservatives’?

health insurance and implicit taxes

Sunday, November 1st, 2009

Greg Mankiw today complains, like Tyler Cowen last week, that the proposed US health care reform bill contains income-tested subsidies that implicitly tax the incomes of the poor.

[Under President Obama's] policies, the largest increases in marginal tax rates may well apply not to the rich but to millions of middle-class families. These increases would not show up explicitly in the tax code but, rather, implicitly as part of health care reform. ….A family of four with an income, say, of $54,000 would pay $9,900 for health care. That covers only about half the actual cost. ….Now suppose that the same family earns an additional $12,000. …. In that case, the federal subsidy shrinks, so the family’s cost of health care rises to $12,700.

In other words, $2,800 of the $12,000 of extra income, or 23 percent, would be effectively taxed away by the government’s new health care system.

That implicit marginal tax rate of 23 percent … comes on top of the explicit marginal tax rate the family already faces from income and payroll taxes.

N. Gregory Mankiw, “Economic View: Supply-Side Ideas, Turned Upside Down”, New York Times, 1 November 2009.

On his blog, Mankiw explains that this is one “representative” example. Implicit tax rates are much higher for families with less income, for example 34% for a family of four with an income between $42,000 and $54,000, and higher yet for those with lower incomes.

What are the alternatives to the proposed reform? One option is to do nothing, leaving millions without health insurance. Another option is to fund universal health insurance from general government revenue. Mankiw cautions that this option is costly: “If large health insurance subsidies were offered to all Americans, regardless of income, the program’s cost would be exorbitant, requiring substantial increases in explicit taxes.”

But the cost of basic health insurance, spread over all taxpayers, would surely require less than a 23 percentage-point increase in explicit taxes on income. Another alternative is to finance health care with a national sales or value-added tax. This earmarked tax would have the advantage of taxing consumption, not savings. It is also a tax paid by everyone, rich and poor alike.

Income-tested subsidies – means tests – are implicit taxes on incomes of the working poor, which discourage them from working harder. Mankiw is right to emphasize the work incentives of explicit and implicit taxes. With this in mind, someone ought to take a close look at alternative ways to finance universal health care in the US.

Mankiw on unequal provision of health care

Sunday, September 20th, 2009

Harvard economist Greg Mankiw, in today’s New York Times, offers an interesting thought experiment. “Imagine that someone invented a … Dorian Gray pill …. Every day that you take the Dorian Gray, you will not die, get sick, or even age. Absolutely guaranteed. The catch? A year’s supply costs $150,000.”

So here is the hard question: How should we, as a society, decide who gets the benefits of this medical breakthrough? Are we going to be health care egalitarians and try to prohibit Bill Gates from using his wealth to outlive Joe Sixpack? Or are we going to learn to live (and die) with vast differences in health outcomes? Is there a middle way? ….

The push for universal coverage is based on the appealing premise that everyone should have access to the best health care possible whenever they need it. That soft-hearted aspiration, however, runs into the hardheaded reality that state-of-the-art health care is increasingly expensive. At some point, someone in the system has to say there are some things we will not pay for. The big question is, who? The government? Insurance companies? Or consumers themselves? And should the answer necessarily be the same for everyone?

N. Gregory Mankiw, “Economic View: Why Health Care Will Never Be Equal”, New York Times, 20 September 2009.

Greg Mankiw is correct: health care will never be the same for everyone. But he is wrong to assert that universal coverage means provision of “the best health care possible”. Private insurers and governments alike refuse to pay for some procedures either because they are not cost-effective or because they are cosmetic. Even in countries with universal health coverage, citizens have the option of paying privately for any health care they desire. Ten percent of UK residents, for example, have private health insurance that allows them to go to private clinics rather than the National Health Service. Canada is a glaring exception to this rule, but for most Canadians the US border and private payment is a short drive away.

What universal coverage means is that basic health care is provided to all residents, regardless of income. Each society has to decide what is meant by “basic care”, which determines in turn the amount of public money spent on health care.

A good analogy is schooling. Governments typically provide universal schooling, at least through high school. Parents who want their children to consume a better – or different – type of schooling are free to pay fees in an independent school of their choice. Bill Gates is not forced to send his children to public school. Similarly, no one would force Bill Gates to limit his consumption of health care to that provided by Medicare from age 65 or by a similar universal system for all ages.

The case for universal health care, like the case for universal schooling, is that differences in outcomes can be mitigated–not eliminated, which is an impossible goal.

HT to Greg Mankiw.