Senin, 31 Agustus 2015

Two options to help you manage your accounts receivable


I recently created an online course called “Show me the Money,” which ties in perfectly to today’s article. As you may have figured out, my online course is all about accounts receivable. Managing your accounts receivable takes into account many factors, including the new patient phone call, treatment planning, follow up, and collection letters. One thing you can do to manage your accounts receivable is to create the appropriate payment plan when needed. There are two different types of payment plans in Dentrix that can help you with the management of your accounts receivable.

The Payment Agreement is one type of payment plan in Dentrix. Use this if patients have already completed their treatment and have an existing balance you want to extend for a period of time. Entering in the payment agreements into Dentrix will help you manage your accounts in three huge ways.

  1. If you have read my articles about patient collections, you know that I use the Collection Manager Report for managing accounts receivable. This report allows you to enter columns of information that will show you Payment Agreement Balance, Payment Agreement Amount Due, and # of missed payments. Having this information at your fingertips can be extremely helpful on this report because you don’t have to do any research about the account balance. You can see that the patient is on a payment plan and if he or she is current with payments. Read More . . . on the Collection Manager Report.
  2. When you create a Payment Agreement, it will light up the Payment Agreement Summary section on the Ledger so anyone who opens the ledger will see that the account is on a payment plan as well as the status of the payments. If there are missed payments, this will show up in red in the Past Due section. This will be extremely helpful if the financial coordinator is on vacation and relying on other team members to collect money at the time of service or field phone calls.
  3. When you send billing statements, if you have entered in the Payment Agreement, it will accurately reflect the amount due from the family. The billing statement will show the total account balance and, in the PLEASE PAY THIS AMOUNT box, it will show the agreed payment amount. Also, if the patient has missed a payment, the billing statement will show a past due amount at the top of the statement to draw attention to this missed payment. If you are not using this feature, you might be writing on the statement … and that takes more time out of your schedule.

The second option for setting up a payment plan is using the Future Due Payment Plan feature. Use this when the patient is going to incur charges over a period of time in the future, such as orthodontic treatment. The Future Due Payment Plan helps you manage your accounts receivable in three ways as well.
  1. In a similar manner as discussed above, you can filter your Collection Manager Report to search for patients with a FDPP so you can focus on those accounts and see if any of these accounts have missed a payment.
  2. When you create a FDPP, it will remove the balance out of your accounts receivable and bill it out at increments you decide on. For example, if a patient is going to schedule a $5,000 12-month ortho treatment and put $1,500 down, then you can set up the payment plan to “hide” the $3,500 and bill out $291.66 each month automatically. Additionally, you can set it up so it will automatically create an insurance claim to go out to the insurance company as well.
  3. Finally, you can print out a coupon book if the patient would like a reminder for their payments.

If you would like more information on my online course titled “Show me the Money” . . . CLICK HERE.

Whither inflation?

(Note: This post uses mathjax to display equations and has several graphs. I've noticed that the blog gets picked up here and there and mangled along the way. If you can't read it or see the graphs, come back to the original .)

The news reports from Jackson Hole are very interesting. Fed officials are grappling with a tough question: what will happen to inflation? Why is there so little inflation now? How will a rate rise affect inflation? How can we trust models of the latter that are so wrong on the former?

Well, why don't we turn to the most utterly standard model for the answers to this question -- the sticky-price intertemporal substitution model. (It's often called "new-Keynesian" but I'm trying to avoid that word since its operation and predictions turn out to be diametrically opposed to anything "Keyneisan," as we'll see.)

Here is the model's answer:

Response of inflation (red) and output (black) to a permanent rise in interest rates (blue). 

The blue line supposes a step function rise in nominal interest rates. The red line plots the response of inflation and the black line plots output.  The solid lines plot the answer to the standard question, what if the Fed suddenly and unexpectedly raises rates? But the Fed is not suddenly and unexpectedly doing anything, so the dashed lines plot answers to the much more relevant question: what if the Fed tells us long in advance that the rate rise is coming?

According to this standard model, the answer is clear: Inflation rises throughout the episode, smoothly joining the higher nominal interest rate. Output declines.

The model: \begin{equation} x_{t} =E_{t}x_{t+1}-\sigma(i_{t}-E_{t}\pi_{t+1}) \label{one} \end{equation} \begin{equation} \pi_{t} =\beta E_{t}\pi_{t+1}+\kappa x_{t} \label{two} \end{equation} where \(x\) denotes the output gap, \(i\) is the nominal interest rate, and \(\pi\) is inflation. The solution  is \begin{equation} \pi_{t+1}=\frac{\kappa\sigma}{\lambda_{1}-\lambda_{2}}E_{t+1}\left[ i_{t}+\sum _{j=1}^{\infty}\lambda_{1}^{-j}i_{t-j}+\sum_{j=1}^{\infty}\lambda_{2} ^{j}E_{t+1}i_{t+j}\right] \label{three} \end{equation} \begin{equation*} x_{t+1}=\frac{\sigma}{\lambda_{1}-\lambda_{2}}E_{t+1}\left[ (1-\beta\lambda_1^{-1}) \sum _{j=0}^{\infty}\lambda_{1}^{-j}i_{t-j}+(1-\beta \lambda_2^{-1}) \sum_{j=1}^{\infty}\lambda_{2}^{j}E_{t+1}i_{t+j}\right] \end{equation*} where \[ \lambda_{1} =\frac{1}{2} \left( 1+\beta+\kappa\sigma +\sqrt{\left( 1+\beta+\kappa\sigma\right)^{2}-4\beta}\right) > 1 \] \[ \lambda_{2} =\frac{1}{2}\left( 1+\beta+\kappa\sigma -\sqrt{\left( 1+\beta+\kappa\sigma\right)^{2}-4\beta}\right) < 1. \] I use \(\beta = 0.97, \ \kappa = 0.2, \ \sigma = 0.3 \) to make the plot. As you see from \((\ref{three}\)), inflation is a two-sided geometrically-weighted moving average of the nominal interest rate, with positive weights. So the basic picture is not sensitive to parameter values.

The expected and unexpected lines are the same once the announcement is made. This standard model embodies exactly zero of the rational expectations idea that unexpected policy moves matter more than expected policy moves. (That's not an endorsement, it's a fact about the model.)

The Neo-Fisherian hypothesis and sticky prices

A bit of context. In some earlier blog posts (start here) I explored the "neo-Fisherian" idea that perhaps raising interest rates raises inflation. The idea is simple. The nominal interest rate is the real rate plus expected inflation, \[ i_t = r_t + E_t \pi_{t+1} \] In the long run, real rates are independent of monetary policy. This "Fisher relation" is a steady state of any model -- higher interest rates correspond to higher inflation.

However, is it a stable steady state, or unstable? If the nominal interest rate is stuck, say, at zero, do tiny bits of inflation spiral away from the Fisher equation? Or do blips in inflation melt away and converge steadily towards the interest rate? I'll call the latter the "long-run" Fisherian view. Even if that is true, perhaps an interest rate rise temporarily lowers inflation, and then inflation catches up in the long run. That's the "short-run" Fisherian question.

One might suspect that the new-Fisherian idea is true for flexible prices, but that sticky prices lead to a failure of either the short-run or long-run neo-Fisherian hypothesis. The graph shows that this supposition is absolutely false. The most utterly standard modern model of sticky prices generates a short-run and long-run neo-Fisherian response. And reduces output along the way.

Multiple equilibria and other issues 

Obviously, it's not that easy. There are about a hundred objections. The most obvious: this model with a fixed interest rate target has multiple equilibria. On the date of the announcement of the policy change, inflation and output can jump.

Inflation response to an interest rate rise: multiple equilibria

The picture shows some of the possibilities when people learn rates will rise three periods ahead of the actual rise. The solid red line is the response I showed above. The dashed red lines show what happens if there is an additional "sunspot" jump in inflation, which can happen in these models.

Math: You can add an arbitrary \(\lambda_{1}^{-t}\delta_\tau \) to the impulse-response function given by (\(\ref{three}\)), where \(\tau\) is the time of the announcement (\(\tau=-3\) in the graph), and it still obeys equations \( ( \ref{one})-(\ref{two})\). These are impulse response functions and sunspots must be unexepected. So the only issue is the jump on announcement. Response functions are thereafter unique.

A huge amount of academic effort is expended on pruning these equilibria (me too), which I won't talk about here. The bottom two lines show that it is possible to get a temporarily lower inflation response out of the model, if you can get a negative "sunspot" to coincide with the policy announcement.

But I think the plot says we're mostly wasting our time on this issue. The alternative equilibria have the biggest effect on inflation when the policy is announced, not when the policy actually happens. But we do not see big changes in inflation when the Fed makes announcements.  The Fed is not at all worried about inflation past that is slowly cooling as the day of the rise approaches, as these equilibria show. It's worried about inflation or deflation future in response to the actual rate rise.

The graph suggests to me that most of the "sensible" equilibria are pretty near the solid line.

The graph also shows that all the multiple equilibria are stable, and thus neo-Fisherian. At best we can have a short-run discussion. In the long run, a rate rise raises inflation in any equilibrium of this model.

Yeah, there's lots more here -- what about Taylor rules, stochastic exits from the zero bound, off-equilibrium threats, QE, better Phillips curves with lagged inflation terms, habits in the IS curve, credit constraints, investment and capital, learning dynamics, fiscal policy, and so on and so on. This is a blog post, so we'll stop here. The paper to follow will deal with some of this.

And the point is made. The basic simplest model makes a sharp and surprising prediction. Maybe that prediction is wrong because one or another epicycle matters. But I don't think much current discussion recognizes that this is the starting point, and you need patches to recover the opposite sign, not the other way around.

Data and models

I started with the observation that it would be nice if the model we use to analyze the rate rise gave a vaguely plausible description of recent reality.



The graph shows the Federal Funds rate (green), the 10 year bond rate (red) and core CPI inflation (blue).

The conventional way of reading this graph is that inflation is unstable, and so needs the Fed to actively adjust rates. Inflation is like a broom held upside down, with inflation on the top and the funds rate on the bottom. When inflation declines a bit, the Fed drives the funds rate down to push inflation back up, just as you would follow a falling broom. When inflation rises a bit, the Fed similarly quickly raises the funds rate.

That view represents the conventional doctrine, that an interest rate peg is unstable, and will lead quickly to either hyperinflation (Milton Friedman's famous 1968 analysis) or to a deflationary "spiral" or "vortex."

And this instability view predicts what will happen should the Fed deliberately raise rates. Raising rates is like deliberately moving the bottom of the broom. The top moves the other way, lowering inflation. When inflation is low enough, the Fed then quickly lowers rates to stop the broom from tipping off.

But in 2008, interest rates hit zero. The broom handle could not move. The conventional view predicted that the broom will topple. Traditional Keynesians warned that a deflationary "spiral" or "vortex" would break out. Traditional monetarists looked at QE, and warned hyperinflation would break out.

(I added the 10 year rate as an indicator of expected inflation, and to emphasize how little effect QE had. $3 trillion dollars of bond purchases later, good luck seeing anything but a steady downward trend in 10 year rates.)

The amazing thing about the last 7 years in the US and Europe -- and 20 in Japan -- is that nothing happened! After the recession ended, inflation continued its gently downward trend.

This is monetary economics Michelson–Morley moment. We set off what were supposed to be atomic bombs -- reserves rose from $50 billion to $3,000 billion, the crucial stabilizer of interest rate movements was stuck, and nothing happened.  

Oh sure, you can try to patch it up. Maybe we discover after the fact that wages are eternally sticky, even for 7 to 20 years while half the population changes jobs, so, sorry, that deflation vortex we predicted can't happen after all. Maybe the Fed is so wise it neatly steered the economy between the Great Deflationary Vortex on one side with just enough of the Hyperinflationary Quantitative Easing on the other to produce quiet. Maybe the great Fiscal Stimulus really did have a multipler of 6 or so (needed to be self-financing, as some claimed) and just offset the Deflationary Vortex.

But when the seas are so quiet, and the tiller has been locked at 0 for seven years, it's awfully hard to take seriously the Captain's stories of great typhoons, vortices, and hyperwhales narrowly avoided by great skill and daring.

Occam's razor says, let us take the facts seriously: An interest peg is stable after all.  The classic theories that predict instability of an interest rate peg -- and consequently that higher rates will lead to lower inflation -- are just wrong, at least in our circumstances (important qualifier follows).

But if those classic theories failed dramatically, what can take their place? Fortunately, I started this post with just one such theory. The utterly standard sticky-price model, sitting in Mike Woodford's and Jordi Gali's textbooks, predicts exactly what happened: inflation is stable under a peg, and thus raising interest rates to a new peg will raise inflation.

The difference between traditional Keynesian or Monetarist models and this modern sticky-price model is deep and essential. In this model, people are forward-looking. In the standard unstable traditional-Keynesian or Monetarist model, people look backward. When written in equations, the traditional "IS" curve (\(\ref{one}\)) does not have \(E_t x_{t+1} \) or \(E_t\pi_{t+1}\) in it, and the "Phillips curve" (\(\ref{two}\)) has past inflation in it,
not expected future inflation.

Forward looking people generates stability, and backward looking people generates instability. If you drove a car by looking in the rear-view mirror, the car may indeed regularly veer off the road, unless the Fed sitting next to you yells about things to come and stabilizes the car. But when people drive looking through the front windshield, cars are quite stable, reverting to the middle of the road when the wind buffets them to one side or the other.

The response function is also consistent with the experience of a few countries such as Sweden which did raise rates and swiftly abandoned the effort. Those rises didn't do much either way to inflation, but they did lower output. Just as the graph says.

What to do? A robust approach

I will not follow the standard economists' approach -- here's my bright new idea, the government should follow my advice tomorrow. Is this right? Maybe. Maybe not. I'm working on it, and hoping by that and this blog post to encourage others to do so as well.

But if you're running the Fed, you don't have the luxury of waiting for research. You have to face an uncomfortable fact, which the news out of Jackson hole says they're facing: They don't really know what will happen or how the economy works. Nor does anyone else. They know that their own forecasts and models have been wrong 7 years in a row -- as has everyone elses', except a few bloggers with remarkably spotty memories -- so pinpoint structural forecasts of what will happen by raising rates made by those same models and logic are darn suspect.

A robust policy decision should integrate over possibilities. So as far as I'll go is that this is a decent possibility, and should add to the caution over raising rates. Raising rates if there is a fire -- actual inflation -- might be sensible. Raising rates because of inflation forecasts from models that have been wrong seven years in a row seems a bit diceyer.

Of course, there is a bit of divergence in goals as well. The Fed wants more inflation, so might take this model as more reason to tighten. And if this model is right, the Fed will produce the inflation which it desires and can then congratulate itself for foreseeing!

I like zero.  Zero rates are pretty darn good. Zero inflation is pretty darn good too. We get the Friedman-optimal quantity of money. And more. Financial stability: With no interest cost, people and businesses hold a lot of money, and don’t conjure complex but fragile cash-management schemes. Three trillion dollars of reserves are three trillion dollars of narrow banking. Taxes: You don’t pay taxes on inflationary gains and taxes erode less of the return on investments.  We don't suffer sticky-price distortions from the economy.  Yeah, growth is too slow, but monetary policy has nothing to do with long-run growth.

So, face it, the outcomes we desire from monetary policy are just about perfect. We don't really know how this happened, but we should savor it while it lasts.

This last point might be the main one. The model I showed above is utterly standard, as is the main result. "New-Keynesian" papers about the "zero bound" have been analyzing this state for nearly 20 years. The result that inflation is stable around the steady state is at least 20 years old.  All the effort, however, has been about how to escape the zero bound. But why? If a very low interest peg is stable, and achieves the optimum quantity of money, why not leave it alone? OK, there's this multiple equilibrium technicality, but that hardly seems reason to go back to "normal."

The only real concern is that some hidden force might be building up to upend this delightful state of affairs. That's behind most calls for raising rates. But clearly, nobody knows with any certainty what that force might be or how to adjust policy levers to head it off.

One warning. In the above model, the interest rate peg is stable only so long as fiscal policy is solvent. Technically, I assume that fiscal surpluses are enough to pay off government debt at whatever inflation or deflation occurs.  Historically, pegs have fallen apart many times, and always when the government did not have the fiscal resources or fiscal desire to support them. The statement "an interest rate peg is stable" needs this huge asterisk.




Selasa, 25 Agustus 2015

It's time to replace your paper Rolodex


Do you remember when you had that big Rolodex sitting on your desk? With this vital office supply, you could easily find the number to the local Walgreens pharmacy to phone in a prescription for a patient or locate the janitor’s number to let him know the office would be closed on Monday for a holiday? Oh, you still have one on your desk? How is that working out for you? Did one of your team members “borrow” one of the cards and accidently re-file it back in the wrong order?

What if Dentrix G6 could organize your Rolodex for you so you never lost anything and your entire team could have access to it? That would be pretty awesome, right? Also, what if Dentrix G6 could pull all your labs, referring sources, employers, insurance carriers, and providers/staff into an electronic Rolodex for you so you could organize them by color and filter them by category? Would that just blow your mind? Let’s just step it up one more notch and let you add your own categories like pharmacies, contractors, family members, etc., so you can keep all your contacts right at your fingertips.

Let me introduce you to eDex. eDex has been launched in Dentrix G6 and is one of my favorite new features. eDex will completely replace that paper Rolodex sitting on your desk and your entire team will have access to it because it is inside your Dentrix software. Now you have room for that dual monitor you have been asking for J.

Senin, 24 Agustus 2015

Phillips art

The Wall Street Journal gets a prize for Art in Economics for their Phillips curve article. Abstract expressionist division, not contemporary realism, alas.

Source: Wall Street Journal
(For the uninitiated: There is supposed to be a stable negatively sloped curve here by which higher inflation comes with lower unemployment. Beyond that correlation, most policy economists read it as cause and effect, higher unemployment begets lower inflation and vice versa. The point of the article is how little reality conforms to that bedrock belief.)

Too much debt, part II

"China to flood economy with cash" reads today's WSJ headline. When you read the article, however, you find it's not quite true. China to flood economy with debt is more accurate.
The expected move to free up more funds for lending—by reducing the deposits banks must hold in reserve—is directly aimed at countering the effects of a weaker currency,

The People’s Bank of China’s latest planned move, which could come before the end of this month or early next month, would involve a half-percentage-point reduction in banks’ reserve-requirement ratio, potentially releasing 678 billion yuan ($106.2 billion) in funds for banks to make loans.
I had hoped the world learned this lesson in the financial crisis. Equity is great. When things go bad, shareholders lose value by prices falling, but they cannot run and the firm cannot fail if it does not pay equity holders.

Financial crises are always and everywhere about debt, especially short term debt. Lending more, encouraging more bank leverage, reducing reserves and margin requirements, means that when the downturn comes a needless wave of runs and defaults follows.

Inevitably, it seems, another downturn will come, another set of books will have been found to have been cooked, and then we will find out who lent too much money to whom. US investment banks, 2008, strike one. Greece, 2010, strike 2. China, 2015, strike 3? Do we no longer bother closing the barn doors even after the horse leaves?

This story should also give one pause about the wisdom of "macro-prudential" policy, by which wise central bankers are supposed to presciently open and close the spigots of leverage to manage asset prices.

Rabu, 19 Agustus 2015

Are you an organizational freak?


I am an organization freak. If you walk into my closet, you will find my clothes arranged not only by style but also by color. Everything has a place. The same thing applies for organizing your patient’s chart. I go into offices that use color-coded forms in their paper chart or stickers to designate certain things.

When you are organizing your patient chart in Dentrix, you can organize certain things to make it work better for you and more efficient for your team. If you are using the clinical note templates, you will notice that there are about 17 categories listed. What I find in every office I work with is that they probably use about six of those categories. For example, a general dentist might have templates in Hygiene, Restorative, Fixed Prosthetics, Periodontics, and Endodontics, where as a pediatric dentist might only use Hygiene, Exams, and Restorative.

My point is that when you have 17 categories listed and you are only using four to six of them get rid of the ones you are not using. You have the flexibility here to combine, eliminate, and add your own categories. Make the list work for you.

First, go in and delete any clinical note templates you will never use then delete the category. For example, if you are a periodontist then delete the endo templates and the endo category. Next, rearrange the categories so that the most frequently used categories are on the top. Finally, create categories that are not listed but you would use in your office. I have worked with some offices where we have created categories for Products, TMJ, Sleep Apnea, etc. If your practice has multiple doctors, you can create categories specific for their templates. For example, Dr. John’s templates, Dr. Joe’s templates, Susie’s templates, etc.

Keeping things organized helps your team become more efficient and productive. Take advantage of all the customization that your Dentrix software has to offer and you will become a super-user.

Check out other blog posts on the topic of customization and efficiency in your patient chart:

Europa hat die Banken missbraucht

An editorial in Süddeutche Zeitung, on Greece, banks and the Euro, summarizing some recent blog posts.

I don't speak German, so I don't know how the translation went, but it sounds great to me:


Die jüngste Griechenland-Krise rückt das größte Strukturproblem des Euro in den Vordergrund: Unter dem Dach einer gemeinsamen Währung müssen Staaten genauso wie Firmen pleitegehen können. Banken müssen international offen sein, sie dürfen nicht vollgepackt sein mit den Schuldtiteln lokaler Regierungen. So war der Euro ursprünglich konzipiert. Leider haben Europas Politiker die erste Prämisse vergessen und sind zur zweiten gar nicht erst vorgedrungen. Jetzt ist es Zeit, beides in Angriff zu nehmen.... 
The English version:

Greek Lessons for a Healthy Euro

The most recent Greek crisis brings to the foreground the main structural problem of the euro: Under a common currency sovereigns must default just like corporations default. And banks must be open internationally, not stuffed with local governments’ debts.

This is how the euro was initially conceived. Alas, europe’s leaders forgot about the first and never got around to the second. It’s time to fix both.



If Volkswagen defaults on its debts and goes bankrupt, nobody dreams that it therefore has to leave the euro zone and start paying its workers in Volkswagen marks. In a currency union, governments cannot print their way out of trouble, so they are just like companies.

When Greece got in to trouble, the first bailout went to the German and French banks who had bought lots of Greek debt. Those debts were all transferred to official holders, meaning, indirectly the German taxpayer.

Why, with the 2008 financial crisis already in the rear view mirror, were European banks — too big to fail, apparently — allowed to load up on Greek debt, to the point that they had to be bailed out? Why did europe’s bank regulators let banks hold sovereign debt as a risk free asset?

The problem has only gotten worse. Greek banks are stuffed with Greek government debt. That’s why there was a run. Greeks, knowing their banks will fail if the government defaults, rush to get money out. They have stopped paying their mortgages, as they have stopped paying taxes, and stopped paying each other. The economy is plummeting. Even with the banks now supposedly open, capital controls remain in place so Greeks cannot pay for imports. And savvy Greeks know there is still a chance of Grexit, deal failure, depositor “bail-ins,” and tightened capital controls. They would be fools to put money back in banks.

A modern economy cannot function without banks. Greece will not restart its economy, restart its tax collections, and restart any hope of paying its debts without completely open and trustworthy banks.

Banking across Europe should be open, and divorced from local government debt. A Greek should be able to put his or her euros in a pan-european bank, whose assets are diversified across Europe and will not even hiccup if Greece’s government defaults. A Greek business should be able to borrow from the same bank, whose deposits come from all over Europe. If a Greek bank fails, any European bank should be able to come in and operate it the next morning. And the Greek government should have no right to grab deposits, force banks to buy its debts, or change the currency of those deposits.

If this had been the case, there would have been no run. The Greek economy would not have collapsed. And then Europe could have been a lot tougher with the Greek government about repayment.

This is how the United States works. When states and cities in the U.S. default — such as Detroit, Puerto Rico, or, possibly Illinois — there is no run on the banks, and banks do not fail or close. Why? Because nobody dreams that defaulting states or cities must secede from the dollar zone and invent a new currency.  State and city governments cannot force state banks to lend them money, and cannot grab or redenominate deposits. Americans can easily put money in Federally chartered, nationally diversified banks that are immune from state  and local government defaults.

As a result, when one of our state governments gets in fiscal trouble, nobody thinks they need to rush to their bank to get their money out, there is no “contagion,” and much less pressure for bailouts.

This was how the euro was supposed to be set up. Many economists have been warning about it for years. But governments like to use their banks as piggy banks, and it never happened.

Greece is not the end. Italian and Spanish banks are just as loaded up with their governments’ debts, and just as prone to a run. There is time to de-fuse this bomb slowly, but that time will run out.

Sovereign default without exit and open banking are the key requirements for the european currency union. A currency union does not need “fiscal union.” The US did not bail out the city of Detroit, or states when they failed. A currency union does not require similar economies. Panama uses the US dollar. A currency union does not need countries to have similar cultures, values, economic development, or productivity. A currency union does not need political union.  Europe used gold as the common currency for centuries, centuries when Kings defaulted frequently.

Many people say that small countries need their own currencies, so they can artfully devalue. But a century’s worth of devaluations and inflations did not produce a Greek growth miracle. There is no exchange rate at which Greece’s government workers will start exporting Porsches to Stuttgart.  Rather, it was binding themselves to the euro that produced a boom, only sadly wasted.

Greece off the euro will be a disaster. Drachmas will surely not be convertible, so Greece will end up like Cuba or Venezuela, with government workers and pensioners paid in worthless local currency, and everyone who can get paper euros operating on a cash basis.  No efficient large businesses can work in such an economy.  Greece’s only hope is to liberalize its economy, open to Europe, grow strongly, and pay back its debts.

The euro is a great and worthy project, and a necessary precursor to healthy open economies in small countries of a globalized world. It’s time to finish building it as originally conceived, not turn it into a bailout union.

Mr. Cochrane is a Senior Fellow of the Hoover Institution at Stanford University.

Greenspan for Capital

Alan Greenspan joins the high-capital banking club, in an intriguing FT editorial
If average bank capital in 2008 had been, say, 20 or even 30 per cent of assets (instead of the recent levels of 10 to 11 per cent), serial debt default contagion would arguably never have been triggered. Had Bear Stearns and Lehman Brothers continued as capital-conscious partnerships, a paradigm under which both thrived, they would probably still be in business. The objection to a capital requirement of 20 per cent or more, even when phased in over a series of years, is that it will suppress bank earnings and lending. History, however, suggests otherwise.
20 to 30 percent used to be the sort of thing one could not say in public without being branded some sort of nut.

Alan also echoes the main point. Banks need lots of regulators micromanaging their investment decisions, because taxpayers pick up the bag for their too-high debts. Banks with lots of capital do not need asset micro-regulation:
...An important collateral pay-off for higher equity in the years ahead could be a significant reduction in bank supervision and regulation.

Lawmakers and regulators, given elevated capital buffers, need to be far less concerned about the quality of the banks’ loan and securities portfolios since any losses would be absorbed by shareholders, not taxpayers. This would enable the Dodd-Frank Act on financial regulation of 2010 to be shelved, ending its potential to distort the markets — a potential seen in the recent decline in market liquidity and flexibility.
A double bravo.

However, to be honest, I have to nitpick a bit on what seems like the right answer for some of the wrong reasons.


Alan seems to argue that the rate of return to equity is independent of leverage:
Banks compete for equity capital against all other businesses....

In the wake of banking crises over the decades, rates of return on bank equity dipped but soon returned to their narrow range. ...

What makes the stability of banks’ rate of return since 1870 especially striking is the fact that the ratio of equity capital to assets was undergoing a significant contraction followed by a modest recovery. Bank equity as a percentage of assets, for example, declined from 36 per cent in 1870 to 7 per cent in 1950..Since then, the ratio has drifted up to today’s 11 per cent. 
So if history is any guide, a gradual rise in regulatory capital requirements as a percentage of assets (in the context of a continued stable rate of return on equity capital) will not suppress phased-in earnings..
There is an exam question in here: what seems wrong? Answer: Competition for equity capital should drive the risk adjusted rate of return for bank equity to be the same as for other businesses. If banks issue more capital, the raw rate of return to equity should decline. So should the variability (beta, risk) of that return. (Other things held constant, which may well be why the historical record is muddy.)

In fact, Alan seems precisely to be making the banks' argument. They claim that the return on equity capital is independent of leverage. They have to pay (say) 10% to shareholders, but only 1% to debt holders, so debt is a cheaper source of financing. Banks claim that forcing them to issue more expensive capital will force them to raise loan rates and strangle lending. Which, curiously, Alan seems to be endorsing. Though he starts with
The objection to a capital requirement of 20 per cent or more, even when phased in over a series of years, is that it will suppress bank earnings and lending. History, however, suggests otherwise.
He follows up with
...bank net income as a percentage of assets will be competitively pressed higher, as it has been in the past, just enough to offset the costs of higher equity requirements. Loan-to-deposit interest rate spreads will widen and/or non-interest earnings will increase.
Ok, so earnings may not be affected, but a rise in loan-to-deposit spreads is exactly what the banks are warning of, and it's hard to see how that would not "suppress bank lending."

All this only happens if investors demand the same return to equity no matter what leverage, and competition then forces banks to deliver that return. This proposition is precisely what advocates (such as myself) or more capital deny. Investors are not that dumb, they demand a competitive risk adjusted rate of return. More capitalized banks will deliver lower rates of return -- and equally lower risk. Bank "stock" will look very much like long term bonds and become the cornerstone of safe portfolios. So we get all of Greenspan's benefits and none of the downside.

Of course, this is just an editorial. He may have meant "risk adjusted" return, and was trying to simplify language.

Selasa, 18 Agustus 2015

The decline in long-term interest rates

Source: Council of Economic Advisers
Long term interest rates are trending down around the world. And it's not just since the great recession and financial crisis. The same trend has been going on for decades.

The Council of Economic Advisers just issued an excellent report surveying our understanding of this question. A blog post summary by Maury Obstfeld and Linda Tesar.

(Many other interesting CEA reports here. Occupational licensing is next on my in box.)

The report is really well done, for explaining the economic issues in clear simple terms, but without hesitating to use a model and an equation when necessary. If you're wondering how to keep your undergraduate or MBA class (heck, your PhD class) busy this week, this report will do the trick.

There is some grumbling in economics circles about the CEA and what role it should play, between Sunday morning talk show cheerleader for the Administration's policies vs. providing dispassionate  economic analysis to the Administration and country. This kind of report is the kind of CEA I cheer for.

I won't summarize the whole thing. Maury and Linda's blog post blog post does a great job of that, and you should just go read it. A few comments however.



1. Surprise surprise, the trend is a surprise. Hence, beware our current forecasts. This is not a criticism, it's just a fact. The best forecasts have been wrong in the past. They may well be wrong in the future.

2. Said: "The long-term interest rate is a central variable in the macroeconomy. A change in the long-term interest rate affects the value of accumulated savings, the cost of borrowing, the valuation of
investment projects, and the sustainability of fiscal deficits."

Unsaid: The surprise decline in long-term interest rates has been a boon to financing deficits. Current deficit forecasts use the current forecast of a return to higher interest rates. If this forecast is wrong once again, and real interest rates on government debt continue at rock-bottom levels, this will be a boon to "fiscal sustainability." Of course, the opposite is also true: If a trend nobody expected and everyone expects to reverse does reverse, then countries with big debts are in trouble.



3. The long term graph makes nicely a point that's been on the back of my mind lately. People typically assume that long term bonds should pay more then short term bonds, because they are riskier. But that's actually a puzzle: most bond investors hold their money for long periods of time, for which long term real bonds are less risky. It's hard, in fact, to get most term structure models to produce an upward-sloping yield curve.

It was not always so. In the 19th century, short term yields were consistently above long term yields.

The difference, of course, is inflation. In the 19th century we were on the gold standard, as noted in the graph. So long term bonds did not have inflation risk.  So, if inflation continues to die, or if our central banks go on a price level target, we might expect the same pattern to hold again. Which would be great for financial stability too. Short term debt causes runs and crises. If long term debt were cheaper, the inducement to finance short would be less.

4. Uncertainty. A message you read loudly between the lines is, that we have very good theoretical understanding of the various mechanisms that can move the trend in interest rates up or down, we (meaning "economic science") have really very little idea of the quantitative force of various mechanisms. By masterfully explaining each mechanism, and then patiently reviewing the vast literature that comes up with hugely different numbers for each mechanism, the point is made clearly, though between the lines.

They might go further. For example, the section on term premiums (the long rate is the average of expected future short rates plus a term premium) cites the latest studies and plots a line, but no standard error or other uncertainty band around that line. As this is an area I've written papers on, I know where the bodies are buried. Term premium estimates come down to forecasting regressions of future bond returns on current variables. Such regressions have huge bands of uncertainty. All forecasts and decompositions should have error bars. The only problem is artistic, as honest error bars would dwarf the forecasts. Well,  knowing what you don't know is real knowledge.

5. Forecasts. On p. 26, after this implicit devastating critique of the state of knowledge, "To illustrate our analyses, we illustrate different approaches to forecasting the long-term nominal interest rate, as is typically done twice a year in the CEA/OMB/Treasury Budget forecast and midsession review." A process for coming up with a number follows. Clearly, the message of the previous 25 pages is that conditioning decisions on a forecast, cranked out to two decimal places, is a bad idea. Economic policy should embrace uncertainty!

This is really a big deal. Much of the illusion of technocratic competence driving our regulatory state is reflected in absurdly accurate forecasts. The joke goes, we know economists have a sense of humor, because economists use decimal points. I'd love to see a Federal Forecast Accuracy Act: All forecasts made by every administrative agency shall include measures of forecast uncertainty. The CBO will evaluate all forecasts after the fact, and agencies shall be penalized when reality exceeds the stated uncertainty bounds more than half of the time.

6. The CEA ain't buying "secular stagnation," in its perpetual "lack of demand" interpretation.  (As a fact, it's undeniable. The question is the diagnosis and treatment.)  See p. 38.

7. In a report whose summary sections are  Fiscal, Monetary, and Foreign-Exchange Policies, Inflation Risk and the Term Premium, Private-sector Deleveraging, Lower Global Long-run Output and Productivity Growth, Shifting Demographics, The Global “Saving Glut”, Safe Asset Shortage, Secular Stagnation?, and Tail Risks and Fundamental Uncertainty, it is perhaps a bit petulant to complain of left-out factors but I will mention one.

The "supply side" part of the analysis is limited to productivity growth. Higher productivity growth leads to higher real interest rates in equilibrium, and (these days) vice versa. But it takes time and transition dynamics to accumulate capital.

One hypothesis that I learned from Larry Summers is that today's production function needs a lot less physical capital to produce the same productivity. A 1930s steel mill is a lot of accumulated savings. Facebook has nothing but a basketball court sized building full of 20-somethings coding while wearing headphones, and a really cool food court. The company is worth billions but it took comparatively little accumulated savings to start it up. If technology moves so that human, rather than physical capital is the heart of the K in F(K,L), productivity growth may determine interest rates in the long run, but there are lower interest rates on the transition path. Larry:
Ponder that the leading technological companies of this age—I think, for example, of Apple and Google— find themselves swimming in cash and facing the challenge of what to do with a very large cash hoard. Ponder the fact that WhatsApp has a greater market value than Sony, with next to no capital investment required to achieve it. Ponder the fact that it used to require tens of millions of dollars to start a significant new venture, and significant new ventures today are seeded with hundreds of thousands of dollars. All of this means reduced demand for investment, with consequences for equilibrium levels of interest rates.
(This is an update, thanks to email correspondent who found the quote.)

Update: Steve Williamson reminds us all that there is no "the" interest rate, and that the rate of return on capital is both stable and much higher than government bond yields. There is a risk premium, and it's big, and it varies over time. Practically all macro and growth theory forgets this fact. Since I've spent most of my career emphasizing the size and volatility of the risk premium, I should remember this reminder in every blog post. Thanks for pointing it out Steve!

Senin, 17 Agustus 2015

Low Hanging Fruit Guarded By Dragons

A nice essay by Brink Lindsey at Cato, analyzing some regulations that are strangling economic growth, with an explicitly bipartisan (multipartisan) appeal.

It's nice because of the unusual focus, not just health, banking, environment, and labor regulation but regulation we don't hear about often enough,
(a) excessive monopoly privileges granted under copyright and patent law; (b) protection of incumbent service providers under occupational licensing; (c) restrictions on high-skilled immigration; and (d) artificial scarcity created by land-use regulation
It takes a while to get going, so skip to p. 7 where the real analysis starts.

I liked especially the analysis of zoning laws, which are the central force behind rising housing prices. They are also curiously damaging to the environment, by forcing people to live far from where they work, and regressive. I say curiously, because tight zoning is so beloved by supposedly green and liberal places, such as Palo Alto.

Sabtu, 15 Agustus 2015

The wrong austerity

Bailout deal brings wave of tax hikes - Ekathimerini.com
A barrage of new tax measures are contained in the new bill presented to Greece’s Parliament
...diesel fuel tax for farmers going from 66 euros per 1,000 liters to 200 euros/1,000 liters from October 1, 2015, and to 330 euros by October 1, 2016. Farmers’ income tax to be paid in advance will rise from 27.5 percent to 55 percent. Income tax for farmers is set to rise from 13 to 20 percent for 2016 and to 26 percent for 2017.
Freelancers will be subject to a gradual increase from 55 to 75 percent in advanced tax payments for income earned in 2015, increasing to 100 percent in 2016. The 2 percent tax break for single payments on income tax is also being abolished from January 1, 2015.
Private education, previously untaxed, will be taxed at 23 percent, including the tutoring schools (frontistiria) that most Greeks send their children to but excluding preschools.
Greece’s vital shipping industry will also be subject to new tax rises. Among other measures, tonnage tax is to increase by 4 percent annually between 2016 and 2020. A special contribution by foreign cargo carriers will remain in place until 2019.
"Austerity" has been a contentious and vague word, descending to an all-purpose insult from the pen of Krugman et al.

But on one point I think we can agree. Steep tax increases, especially steep increases in marginal tax rates on people likely to work, save, invest, start new businesses, and hire others, are an especially bad idea right now. The only hope to pay back debt is growth, and this sort of thing just kills growth. Part of growth is also keeping smart young Greeks in the country, which they are leaving in droves.


Sure, I look at the margins,  incentives, and "supply," while Keynesians look at taxes as just "money in pockets" that drives consumer spending and "demand."  But looked at either way, this is really counterproductive.

In practical terms, there is a Laffer curve, whether of supply side incentives or demand side multipliers. And for paying back debts, the long-run Laffer curve matters:  the effect of taxes on business formation, expansion and growth; on people moving to and from a country. The contentious short-run Laffer curve is on the question whether people with jobs work fewer hours at high taxes. Maybe yes, maybe no, but that's not the issue for Greece or for her creditors.

I think the Europeans think they can just raise tax rates and produce more interest payments. Alas, you have to let a garden grow before you harvest the fruit.

Jumat, 14 Agustus 2015

For better or worse?

Three recent news items and blog posts make a provocative contrast:

Paul Krugman, New York Times,  "The MIT Gang"
It’s actually surprising how little media attention has been given to the dominance of M.I.T.-trained economists in policy positions and policy discourse.... 
James Bartholomew, The Spectator, "British economics graduates have left a trail of misery around the world"
"... the trendy doctrines of our universities have much to answer for" 
(A list that in terms of needless human suffering, is pretty astounding)

Yannis Palaiologos, Politico, Beware of American econ professors!  
World-famous economists — men of Nobel prizes and stellar academic accomplishment — have provided intellectual cover to radicals who appeared at best to be willing to take a stupendously reckless gamble with Greece’s financial, political and geopolitical future, 
To belabor the obvious: Be careful what you wish for.

It is indeed surprising that  little media attention has been given to the dominance of economists trained at MIT in the 1970s in policy positions in US and international organizations.  If a similar dominance from, say, Chicago, or skull and bones, were noticed under a Republican administration and center-right european politics, the media would likely be full of a vast nepotistic right-wing conspiracy.

And given just how much popular opinion thinks of current economic management, it is surprising that Krugman wants more attention to that fact. If the media were to give proper attention, it's not clear they wouldn't write stories like spectator and politico!

Just because politicians find your advice useful, temporarily, doesn't mean you're right. The Spectator article offers chilling counterexamples.


Summers and the nature of policy advice

Larry Summers has a fascinating editorial in the Financial Times titled "Corporate long-termism is no panacea — but it is a start" You really should read the whole thing and come back for commentary.

The three paragraphs in the heart of the editorial are a tour de force:
Businesses will raise wages to a point where the cost is just balanced by the reduced bill for recruiting and motivating workers. At that point, a further increase in wages does not appreciably change their total costs but higher wages certainly makes their workers better off. So there is a strong case for robust minimum wages.
Never mind centuries of supply and demand, centuries of experience with minimum wages and other price controls, or even the current controversies. Never mind that who works for what business and how many do so is a little bit endogenous. Larry has a new and very clever theory about monopsonistic wage setting in the presence of recruitment and motivation costs.  (One that apparently only holds at the lower end of the wage scale where minimum wages bite?)

There is also a strong reason for regulating aspects of pay. Usually competition drives desirable economic arrangements. But not always — especially when there is a risk of a race to the bottom. A company that tries to stand out by offering especially attractive family leave benefits, or job security, or egalitarian wage structures faces the prospect of attracting a disproportionately risk-averse work force. So there is an argument for using mandates to level the playing field.
Once again, bravo. Larry has a new and very clever theory about companies attracting a too-risk-averse pool of workers when they offer benefits instead of pay. (Why are they offering benefits instead of pay? How does this paragraph, in which workers move from job to job, fit with the last one, about bilateral bargaining between fixed workers and firms? ) And an optimal pay mandate can just offset this distortion and give firms the proper pool of risk aversion in its workforce. (Why are excessively risk averse employees a problem? Where do the risk neutral go to work? Why does this not just lead to a different profile of pay vs. benefits to clear the market by risk aversion? )
Profit sharing, too, is an area where there are demonstrable benefits in terms of increased productivity — but an individual company that stands out by offering it may encounter difficulties in recruitment because workers are too risk averse. So there is a strong case for tax incentives to spur profit sharing.
Ditto. "may encounter" is a "strong case" for "tax incentives?"

Ignore my whining, though, and admire the prose. One, two, three, policies enshrined as economic fallacies in Econ 101 classes, are stunningly overturned by clever new theories in three short paragraphs.

My thought: is this really a good way for economists to help to advance public policy?

Larry is the Smartest Guy In The Room.  I mean that, and I mean it as a compliment. I've seen him in action at conferences and other meetings, and his performances are breathtaking. You can see that bravura here. If you have a policy in mind, Larry can come up with three theories to justify it in half an hour, all novel, all clever, all plausible.

But is this at all a service? We all know the elephant (or perhaps I should say donkey) in the room: these are all proposals Mrs. Clinton is making on the campaign trail. For totally different reasons, of course.

Does it really do lots of good to reverse-engineer clever new theories to justify old policies that happen to be politically hot at the moment? And to ignore all the old arguments over those old policies?

Larry's column is great advice for Harvard graduate students. Here are three great thesis topics. Work them out, see if the theory actually holds together (my questions need answering), see if there is a hope of support in the data. You'll have a great thesis.

But is this reverse-engineering great advice for the country?  Shouldn't economics act a little more like science, and keep our clever new ideas as clever new ideas until they have at least some certified theoretical coherence and empirical support?

***

I was also a bit annoyed by the classic missing subject and passive voice that pervades economic policy writing. Just who is going to do all these great things and how?

In this case it's more striking because the prose denies the obvious implicit subject -- the Federal Government. No, it's all going to happen
...not through government actions but through mandates or incentives to change business decision-making." 
And later,
So the idea of achieving reform through altered business behaviour, rather than government programmes, is appealing....
That's important, because of the obvious objection: If these clever new market failures exist, do government bureaucrats have any hope of measuring the distortions well enough to craft a policy? If pay mandates are not about giving one group with political access more pay than others, but to carefully offset an incentive to attract too many high-risk-aversion employees, does the current Department of Labor have a hope of getting it just right?

No, obviously. So it would help a lot if this were not a plea for a hopeless dirigisme. And by using the passive voice with no subject, and explicitly denying this is about government, Larry is trying to overcome that obvious hole in these ideas.

But just who other than the government is going to mandate  mandates, incentivize incentives, alter behaviors, impose "robust minimum wages," enact the "tax incentives to spur profit sharing" do the "regulating aspects of pay" and so on? Is Mrs. Clinton no longer running to be head of a government, but some sort of improve-business do-good website?

The last paragraph attempts an answer
The real need is for a cadre of trusted, tough-minded investors in any given company who can credibly commit to support strong management teams and to provide assurances to a broader investment community so that productive investments are made. Accomplishing that, while maintaining market discipline, is the crucial challenge.
Where is this cadre (!) of investors going to come from? How are they going to take over capital markets? How are these Wise People going to impose the long list of things Larry recommends that only governments can do, including minimum wages, tax incentives, and pay regulation? Just who if not the government is this "crucial challenge" for?

Surely this isn't a pean to the wonders of private equity (Bain capital), who can take companies off the short-termist stock market? Neither Harvard's nor Chicago's endowment managers did a great job of being "long-term" investors, both selling madly in 2008, to say nothing of taking little stance on minimum wages, tax incentives, pay regulation, and so forth. This is not a Summers criticism: university presidents do not direct endowment policy. But if university endowments are not the cadre of wise investors, who are? If (explicitly) not a plea for government intervention, is it a plea for alien invasion or divine intervention?

This part is just inconsistent in a very uncharacteristic way. There is a political discourse that wants to pretend there is a "government lite," that will just nudge us here and there. Unwittingly, perhaps, Larry has set forth quite clearly how empty that promise is.  But why he wants to make this obviously weak argument  I do not understand.

Similarly, the first paragraph is
There are not many wholly new areas to open up in economic policy. But in recent months there has been a wave of innovative proposals directed at improving economic performance in general, and middle-class incomes in particular...
Larry himself provides the counterexample to the idea that corporate short-termism is a "wholly new area"
A generation ago, the Japanese keiretsu system of cross ownership of corporate shares — which insulated corporate managements from share price pressure — was seen as a strength.
What's new, of course, is that the Clinton campaign has taken on these very old ideas.

Why go to such lengths to hide the subject of all these policy entreaties -- very much regulation by the Federal Government -- and pretend the final conclusion is to document a need for a new cadre of investors to parachute in from Mars and take over markets? Why ignore the elephant and donkey in the room when analyzing policy proposals by candidates?

Selasa, 11 Agustus 2015

How can you prepare for the ICD-10 deadline?


The countdown to October 1, 2015 continues as we all wait to see if the implementation of ICD-10 really happens or not. Many of you have been using the ICD-9 code sets when billing medical insurance for procedures like TMJ, sleep apnea, and trauma. However, we are now seeing the use of diagnostic coding in the adoption of EHR and practices that are billing Medicaid. After October 1, we are going to see many more requirements for diagnostic coding. So how can you prepare?
  • Find out if your practice management software will be ready for ICD-10 by October 1. This is critical if you have already been including diagnostic codes on your claims because the insurance providers will start denying claims without ICD-10 after October 1. I reached out to the Dentrix product manager and Dentrix G6.1 will be ready for ICD-10 … but you will still be responsible for adding the codes into the system.
  • Make sure you are using the ADA 2012 claim form because it has been upgraded to accommodate diagnostic coding. Within Dentrix, you can use the DX2012 or the DX2012F claim form to add diagnostic codes. Email me directly at dayna@raedentalmanagement.comif you would like an instructional PDF from the ADA on how to fill out the claim form.
  • Check your state Medicaid requirements to find out what diagnostic codes will be required. If you are already billing Medicaid, you are already familiar with the ICD-9 coding and hopefully you have already been informed about the looming October 1 deadline. Email me directly if you need more information about Medicaid requirements.
  • Start asking the insurance payers if they will pay for additional services if you are submitting the proper diagnosis codes. Many dental plans are now paying for additional preventative cleanings because of the direct relationship between periodontal disease and diabetes and heart disease.

As I get more information about his topic, I will keep you informed as much as possible. However, you can do your own research by clicking on the links below. Also, email me if you would like any of the information I discussed in this blog.

CLICK HERE for ICD and CDT Coding Examples, you must be an ADA member to use this service.

CLICK HERE for free reference tools on the ICD-10 codes

CLICK HERE for the definition and final release from the CDC

 

 

Kamis, 06 Agustus 2015

Your hygiene department is the lifeblood of your practice


Do you sometimes feel a little out of touch with your recare patients? Do you think sometimes there are patients you haven’t seen for a while and you wonder where they are? Are you ready to take your hygiene department to the next level?

Your hygiene department is the lifeblood of the practice. If you don’t have a reliable system for managing when your patients are due for their regular checkups, then your office could be spinning its wheels when it comes to working from accurate lists. If set up properly, the Dentrix Continuing Care system will run like a well-oiled machine. Let’s look at the features that will help you generate accurate lists, give you some custom filter options, and streamline the process.

First, decide what continuing care types you want to track and make sure they are linked to the correct procedure code. Remember, you can only have one continuing care type per procedure code. Some examples might be:
  • PROPHY linked to D1110 and D1120
  • PERIO linked to D4910 and D4341
  • RECARE linked to D4910, D1110, and D1120

CLICK HERE for more information on linking up your continuing care types to procedure codes.

The next piece you want to think about is how you might filter your lists and what kind of customization you can do within the Dentrix Continuing Care system. You are dealing with different biological systems and personalities, so Sally might need to come in every 3 months for her prophy and want to be scheduled only with HYG1 and Michael might need to come in every 6 months for his prophy but want to see HYG4. How do you keep track of all these personalized settings? Its super easy!


On the Family File, double click on the Continuing Care box > highlight the Prophy and click edit. This will open a new window. Here you can edit the patient interval and select a specific hygienist of choice.

After you have customized the patient’s Continuing Care screen, you and your team can now generate customized lists with the push of a button. You can create a list for HYG1 patients and a different list for HGY4 patients. This can help your hygienists and front office team fill openings faster and feel confident your lists are accurate and up to date. CLICK HEREfor more information on keeping your hygiene schedule full (make sure to read all three articles).

Rabu, 05 Agustus 2015

Greece and Banking

Source: Wall Street Journal; Getty Images
A Wall Street Journal Oped with Andy Atkeson, summarizing many points already made on this blog.
Greece suffered a run on its banks, closing them on June 29. Payments froze and the economy was paralyzed. Greek banks reopened on July 20 with the help of the European Central Bank. But many restrictions, including those on cash withdrawals and international money transfers, remain. The crash in the Greek stock market when it reopened Aug. 3 reminds us that Greece’s economy and financial system are still in awful shape. 
Greece’s banking crisis revealed the main structural problem of the eurozone: A currency union must isolate banks from sovereign debt. To fix this central structural problem, Europe must open its nation-based banking system, recognize that sovereign debt is risky and stop letting countries use national banks to fund national deficits.
If Detroit, Puerto Rico or even Illinois defaults on its debts, there is no run on the banks. Why? Because nobody dreams that defaulting U.S. states or cities must secede from the dollar zone and invent a new currency. Also, U.S. state and city governments cannot force state or local banks to lend them money, and cannot grab or redenominate deposits. Americans can easily put money in federally chartered, nationally diversified banks that are immune from state and local government defaults.
Depositors in the eurozone don’t share this privilege....
For the rest, you have to go to WSJ, Hoover (ungated) or wait 30 days until I'm allowed to post it here.

Lucrezia Reichlin and Luis Garicano have an excellent Project Syndicate piece on the same topic.

Writing contest: This is our first paragraph. The Journal's editors thought it was better with latest news first. Which works better?

Sabtu, 01 Agustus 2015

Rule of Law in the Regulatory State

About a month ago, I participated in a conference at Hoover, inspired by the 800th anniversary of the Magna Carta. There were lots of interesting papers.

I participated in a panel on "The Future of Freedom, Democracy, and Prosperity" with Arnold Kling and Lee Ohanian, with Russ Roberts moderating, which Russ has posted as an econtalk podcast.

The podcast gained a bit of traction, most recently with nice coverage in a Holman Jenkins Editorial in the Wall Street Journal.

All of which has finally motivated me to a neglected project, which is to polish up the essay I wrote in preparation for the panel. It's longish for a blog post, and you might prefer the formatting of the pdf version here.


The Rule of Law in the Regulatory State

1. Introduction

The United States’ regulatory bureaucracy has vast power. Regulators can ruin your life, and your business, very quickly, and you have very little recourse. That this power is damaging the economy is a commonplace complaint. Less recognized, but perhaps even more important, the burgeoning regulatory state poses a new threat to our political freedom.

What banker dares to speak out against the Fed, or trader against the SEC? What hospital or health insurer dares to speak out against HHS or Obamacare? What business needing environmental approval for a project dares to speak out against the EPA? What drug company dares to challenge the FDA? Our problems are not just national. What real estate developer needing zoning approval dares to speak out against the local zoning board?


The agencies demand political support for themselves first of all. They are like barons in monarchies, and the King’s problems are secondary. But they can now demand broader support for their political agendas. And the larger partisan political system is discovering how the newly enhanced power of the regulatory state is ideal for enforcing its own political support.

The big story of the last 800 years of United States and British history, is the slow and painful emergence of our political institutions, broadly summarized as “rule of law,” which constrain government power and guarantee our political liberty. The U.S. had rule of law for two centuries before we had democracy, and our democracy sprang from it not the other way around.

This rule of law always has been in danger. But today, the danger is not the tyranny of kings, which motivated the Magna Carta. It is not the tyranny of the majority, which motivated the bill of rights. The threat to freedom and rule of law today comes from the regulatory state. The power of the regulatory state has grown tremendously, and without many of the checks and balances of actual law. We can await ever greater expansion of its political misuse, or we recognize the danger ahead of time and build those checks and balances now.

Yes, part of our current problem is law itself, big vague laws, and politicized and arbitrary prosecutions. But most of “law” is now written and administered by regulatory agencies, not by Congress.

Use of law and regulation to reward supporters and punish enemies is nothing new, of course. Franklin Roosevelt understood that New Deal jobs and contracts were a great way to demand political support. His “war on capital” [see Amity Shlaes' "Forgtten Man"] hounded political opponents. The New Deal may not have been an economic success [an example], and likely prolonged the Great Depression. But it was above all a dramatic political success, enshrining Democratic power for a generation. Richard Nixon tried to get the IRS to audit his “enemies list.” But the tool is now so much stronger.

A label?

I haven’t yet found a really good word to describe this emerging threat of large discretionary regulation, used as tool of political control.

Many people call it “socialism.” But socialism means government ownership of the means of production. In our brave new world private businesses exist, but they are tightly controlled. Obamacare is a vast bureaucracy controlling a large cartelized private business, which does the governments political and economic bidding. Obamacare is not the Veteran’s Administration, or the British National Health Service. Socialism doesn’t produce nearly as much money.

It’s not “capture.” George Stigler described the process by which regulated businesses “capture” their regulators, using regulations to keep competition out. Stigler’s regulated businesses certainly support their regulators politically. But Stigler’s regulators and business golf together and drink together, and the balance power is strongly in the hands of the businesses. “Capture” doesn't see billion-dollar criminal cases and settlements. And “capture” does not describe how national political forces use regulatory power to extract political support.

It’s not really “crony capitalism.” That term has a bit more of the needed political flavor than “capture.” Yes, there is a revolving door, connections by which businesses get regulators to do them favors. But what’s missing in both “capture” and “cronyism” is the opposite flow of power, the Devil’s bargain aspect of it from the point of view of the regulated business or individual, the silencing of political opposition by threat of regulation.

We’re headed for an economic system in which many industries have a handful of large, cartelized businesses— think 6 big banks, 5 big health insurance companies, 4 big energy companies, and so on. Sure, they are protected from competition. But the price of protection is that the businesses support the regulator and administration politically, and does their bidding. If the government wants them to hire, or build factory in unprofitable place, they do it. The benefit of cooperation is a good living and a quiet life. The cost of stepping out of line is personal and business ruin, meted out frequently. That’s neither capture nor cronyism.

“Bureaucratic tyranny,” a phrase that George Nash quotes Herbert Hoover as using is a contender.

Charles Murray, writing recently on the status of the regulatory state notes many of these issues. He totals 4,450 distinct federal crimes— just the law, not including regulations with criminal penalties, or the vastly greater number with civil penalties. He adds up the 175,000 pages of the Code of Federal Regulations, and the vagueness of the enabling legislation — Congress only decrees that rules are “generally fair and equitable,” “just and reasonable,” prohibits “unfair methods of competition” or “excessive profits.” He notes the absence of judicial rights in administrative courts. He notes the wide scope of regulation and the comparatively tiny — but ruinous to those charged — enforcement:
the “Occupational Safety and Health Administration has authority over more than eight million workplaces. But it can call upon only one inspector for about every 3,700 of those workplaces. The Environmental Protection Agency has authority … over every piece of property in the nation. It conducted about 18,000 inspections in 2013—a tiny number in proportion to its mandate.
Murray advocates civil disobedience with insurance for the few zebras who get caught by the regulators.

But by and large Murray deplores merely the silliness of and economic inefficiency of the regulatory state. This misses, I think, the greatest danger, that to our political freedom. Just who gets that visit from the EPA can have a powerful silencing effect.

And it also misses, I think, an explanation for how we got here. Regulators and politicians aren’t nitwits. The libertarian argument that regulation is so dumb — which it surely is — misses the point that it is enacted by really smart people. The fact that the regulatory state is an ideal tool for the entrenchment of political power was surely not missed by its architects.

Likewise, Alex Tabarrok and Tyler Cowen make a good case that most of the economic rationale for regulation has disappeared along with information. Uber stars are far more effective than the Taxi Commission. But the demand for protection and the desire to trade economic protection for political support will remain unchanged. “Protect the consumer” is as much a distracting argument in the Uber vs. Taxi debate as it was when the medieval guilds advanced it.

Rule of Law: the Devil in the Details

“Rule of law” and “regulation” are dangerous Big Vague Words. The rule of law is so morally powerful that the worst tyrants go through the motions. Stalin bothered with show trials. Putin put Pussy Riot on trial, and then they were “legally” convicted of and jailed for the crime of ”hooliganism.” Even Henry the Eighth had trials before chopping heads. Is this not rule of law?

No, of course, but it’s worth reminding ourselves why not as we think about bureaucracies.

“Rule of law” ultimately is a set of restrictions to keep the state from using its awesome power of coercion to force your political support. If you oppose Castro, you go to prison. If you opposed Herbert Hoover, could you still run a business? Sure. If you oppose President Obama, or the future President Hilary Clinton can you do so? If you oppose the polices of one of their regulatory agencies, now powers unto themselves, or speak out against the leaders of those agencies, can you do so? If you support candidates with unpopular positions, can you still get the regulatory approvals you need? It’s not so clear. That is our danger.

“Rule of law” is not just about the existence of written laws, and the superficial mechanics of trials, judges, lawyers, ad sentences. Rule of law lies deep in the details of how those institutions work. Do you have the right to counsel, the right to question witnesses, the right to discovery, the right to appeal, and so forth. Like laws, what matters about regulation, both in its economic efficiency and in its insulation from politics, is not its presence but its character and operation.

Regulators write rules too. They fine you, close down your business, send you to jail, or merely harass you with endless requests, based on apparently written rules. We need criteria to think about whether “rule of law” applies to this regulatory process. Here are some suggestions.
  • Rule vs. Discretion?
  • Simple/precise or vague/complex? 
  • Knowable rules vs. ex-post prosecutions? 
  • Permission or rule book? 
  • Plain text or fixers? 
  • Enforced commonly or arbitrarily? 
  • Right to discovery and challenge decisions. 
  • Right to appeal. 
  • Insulation from political process. 
  • Speed vs. delay. 
  • Consultation, consent of the governed.
One by one:
  • Rule vs. Discretion?
This is really a central distinction. Does the regulation, in operation, function as a clear rule? Or is it simply an excuse for the regulator to impose his or her will on the regulated firm or person? Sometimes discretion is explicit. Sometimes discretion comes in the application of a rule book thousands of pages long with multiple contradictory and vague rules.
  • Simple/precise or vague/complex?
Regulations can be simple and precise — even if silly. “Any structure must be set back six feet from the property line” is simple and precise. Or the regulation can be long, vague and complex. “The firm shall not engage in abusive practices.”

Many regulations go on for hundreds of pages. Long, vague, and complex is a central ingredient which gives the appearance of rules but amounts to discretion.
  • Knowable rules vs. ex-post prosecutions?
Is the rule book knowable ex ante? Or is it, in application, simply a device for ex-post prosecutions. Insider trading rules are, at present, a good example of the latter. The definition of “insider” varies over time, and there is really little hope for a firm to read a coherent rule book to know what is and is not allowed. Much better to stay on good terms with the regulator.
  • Permission or rule book?
In one kind of regulation, there is a rule book. If you follow the rule book, you’re ok. You go ahead and do what you want to do. In much regulation, however, you have to ask for permission from the regulator, and that permission includes a lot of discretion. Environmental review is a good example.
  • Plain text or fixers?
Can a normal person read the plain text of the rule, and understand what action is allowed or not? Or is the rule so complex that specialists are required to understand the rule, and the regulatory agency’s current interpretation of the rule? In particular, are specialists with internal agency contacts necessary, or specialists who used to work at the agency?

As a private pilot, I often bristle at the FAA’s mindless bureaucracy and the plain silliness of much of their regulation. But to their credit, there is a strong culture that the plain text of the rule counts, and each pilot should read the rules and know what they mean. That is a system much harder to misuse. Financial, banking, environmental, health care, and housing regulation stand on the opposite end of the spectrum.
  • Enforced commonly or arbitrarily?
Regulations that are seldom enforced, but then used occasionally to impose enormous penalties are clearly more open to political abuse. If Americans commit three felonies a day in “conspiracy,” internet use, endangered species, wetlands, or employment and immigration regulations (just to start), but one in a hundred thousand is ever prosecuted, just who gets prosecuted is obviously ripe for abuse.
  • Right to discovery, see evidence, and challenge decisions.
Do you have the right to know how a regulatory agency decided your case? Step by step, what assumptions, calculations, or interpretations did it use? Often not, and even in high profile cases.

For example, the Wall Street Journal’s coverage of Met Life’s “systemic” designation reports
The feds ..still refuse to say exactly which [threats] make MetLife a systemic risk or what specific changes the company could make to avoid presenting such a risk.
and continues
…MetLife says that..the government’s decision is based on mere speculation and “undisclosed evidentiary material.”
Since the case is still being decided, the point here is not the correctness or not of these charges. But the charges are a clear example of the kind of regulation that can go wrong

(In fact, the miracle of the MetLife case is that the company had the chutzpah to sue. They are taking a big bet that FSOC doesn’t believe in revenge.)
  • Right to appeal.
And not just to the same agency that makes the decision! In law, the right to appeal is central. In regulation, the right to appeal is often only to appeal to the same agency that made the decision. The Chevron doctrine severely limits your ability to appeal regulatory decisions (and the regulations themselves) to any outside entity. As an example, continuing the above MetLife coverage,
The … stability council “lacks any separation in its legislative, investigative, prosecutorial, and adjudicative functions.” That combined with MetLife’s inability to see the full record on which the decision was based made it “impossible” to get a fair hearing.
As in law, secret evidence, secret decisions, secret testimony; and legislature, prosecutor, judge, jury, and executioner all rolled in to one are classic ingredients for subverting rule of law. And, eventually, for using the machinery of law to silence political opposition.
  • Insulation from political process.
There are many structures in place to try to ensure the “independence” of independent agencies. There is also a tension that we live in a democracy, so independent agencies can’t be too independent if they have great discretionary power.

These important structures try to limit explicit party politics’ use of the regulatory state. They are less successful at limiting the bureaucracy’s use of its regulatory power to prop up its own separate fiefdom. They are also less successful at limiting unwitting political cooperation. When vast majorities of the bureaucracy belong to one political party, when government employee unions funnel unwitting contributions to candidates of that party, and when strong ideological currents link decisions across agencies, explicit cooperation is less necessary.

And, though it was ever thus, the enormous expansion of the size, power, and discretion of the regulatory state makes the insulation structures more important, just as they are falling apart.
  • Speed vs. delay.
The regulatory process can take years, and a canny regulator need not explicitly rule against a political foe. Delay is enough. Lois Lerner herself didn’t deny applications. She just endlessly delayed them. The FDA similarly sits on applications, sometimes for decades.

A central element of a new Magna Carta for regulatory agencies should be a right to speedy decision. If a decision is not rendered in, say, 6 months,  it is approved.
  • Consultation, consent of the governed.
The process by which rules are written needs to be reformed. Congress writes empowering legislation, usually vague and expansive. The agencies undertake their own process for rule writing. They usually invite comment from interested parties, but are typically free to ignore it when they wish. We are as supplicants before the King, asking for his benevolent treatment.

And that was before the current transformation. As exemplified by the EPA’s decision to brand carbon dioxide a pollutant (coverage here), to extend the definition of “navigable waters” to pretty much every puddle, HHS’ many reinterpretations of the ACA, and the Education Department’s “Dear Colleague” letters, even the barely-constrained rule-making process now proceeds beyond its previous mild legal and consultative constraints.

A structure with more formal representation, and more formal rights to draft the rules that govern us, is more in keeping with the parliamentary lessons of the Rule of Law tradition.

2. A Tour

Do we really have reason to be afraid? Let’s take a tour.

These cases are drawn mostly from media coverage, which allows me a quick and current high-level tour. Each case, and many more that are unreported, and a serious investigation to the structure of our massive regulatory state, could easily be drawn out to book length.

My point is not so much a current scandal. My case is that the structure that has emerged is ripe for the Faustian political bargain to emerge, that the trend of using regulation to quash political freedom is in place and will only increase.

As we tour our current regulatory state of affairs, then, think of how well the current regime represents “rule of law,” how well it respects your freedom to speak, your freedom to object, your freedom to oppose the regulator and regulatory regime. Think how insulated it is against the strong temptations of our increasingly polarized, winner-take-all, partisan political system to use regulatory power as a means of enshrining political power.

Banks

Start with finance. Finance is, of course, where the money is.

The Dodd-Frank act is 2,300 pages of legislation, in which “systemic” is never defined, making a “systemic” designation nearly impossible to fight. The act has given rise to tens of thousands of pages of subsidiary regulation, much still to be written. The Volker rule alone — do not fund proprietary trading with insured deposits — runs now to nearly 1,000 pages. To call this Talmudic is to insult the clarity and concision of the Talmud. (Recent critiques here and here.)

The result is immense discretion, both by accident and by design. There is no way one can just read the regulations and know which activities are allowed. Each big bank now has dozens to hundreds of regulators permanently embedded at that bank. The regulators must give their ok on every major decision of the banks.

The “stress tests” are a good case in point. Seeing, I suspect, the futility of much Dodd-Frank regulation, and with the apparent success of the Spring 2009 stress tests in the rear view mirror, such tests have become a cornerstone of the Federal Reserve’s regulatory efforts. But what worked once does not necessarily work again if carved in stone.

In “stress tests,” Federal Reserve staff make up various scenarios, and apply their own computer models and the banks’ computer models to see how the banks fare. However, the Fed does not announce a set scenario ahead of time. They Fed staffers make up new scenarios each time. They understand that if banks know ahead of time what the scenario is and the standards are, then the clever MBAs at the banks will make sure the banks all pass. And billions of dollars hang on the results of this game.

Now, the Fed staffers playing this game, at least those that I have talked to, are honest and a-political. For now. But how long can that last? How long can the Fed resist the temptation to punish banks who have stepped out of line with a stress test designed to exploit their weakness? Is it any wonder that few big banks are speaking out against the whole regime? They understand that being an “enemy” is not the way to win approvals.

And the stress-test staff are getting handsome offers already to come work for the banks, to help the banks to pass the Fed’s stress tests. Ben Bernanke himself is now working for Citadel.

If this sounds like the cozy world of “capture,” however, remember the litany of criminal prosecutions and multibillion-dollar settlements. These are instigated by the Attorney General and Department of Justice, with much closer ties to the Administration, but they revolve around violations of securities regulations. Is it a coincidence that S&P, who embarrassed the Administration by downgrading U.S. debt, faced a $1.4 billion dollar settlement for ratings shenanigans, while Moody’s, which gave the same ratings, did not? Pay up, shut up, and stay out of trouble is the order of the day.

The Wall Street Journal nicely characterized today’s Wall Street, quoting John J. Mack, Morgan Stanley's ex-chairman “Your No.1 client is the government,” which embeds “About 50 full-time government regulators.”

CFPB

Another example: The Consumer Financial Protection Bureau and Department of Justice charged Ally Bank with discrimination in auto lending, and extracted a nearly $100 million settlement. (Coverage here, here, here, here.)  Ally provides money to auto lenders. Lenders negotiate interest rates. Nobody is allowed to collect data on borrowers’ race. So Justice ran statistical analysis on last names and zip codes — Bayesian Improved Surname Geocoding — to decide that minorities are being charge more than they should, essentially encoding ethnic jokes into law.

Why did Ally pay? Sure, they might survive in court. But nobody wants to be branded a racist. And DOJ and CFPB have many more cards up their sleeves. CFPB now can disapprove any retail financial arrangement it deems “abusive,” and put Ally out of business.
Note in this case, there was no charge or evidence of discriminatory practice or intent. The case was purely that DOJ and CFPB didn’t like the statistics of the outcome.

More importantly, was this a knowable regulation, or a bill of attainder? Did CFPB and Justice make available the Bayesian Improved Surname Geocoding program on their website, and tell financial institutions “please download the BISG program, make sure you run loans through it, and that they come out with the right statistics?” Obviously not. This was an unknowable regulation. Ally had no way to make sure it was lending to the right last names.

Ominously, in Wall Street Journal coverage,
Larger settlements may be on the horizon. J.P. Morgan.. warned in a recent filing that it is discussing the issue of possible “statistical disparities” in auto lending with Justice. With more than $50 billion in auto loans on Morgan’s balance sheet at the end of last year, real or imaginary disparities wouldn’t have to be that large to generate a fat settlement.
While the Obamacare (King v. Burwell) and gay marriage decisions soaked up the airtime in the summer of 2015, the Court’s upholding of statistical discrimination and disparate impact stands as the greatest affront to liberty. Without even alleging discriminatory intent, without following any established procedure, the Justice Department can chew numbers as it feels, and based on statistical analysis brand you a racist and drag you to court.

SEC

The SEC’s regulation of insider trading is a fine example of discretion run amok. There is no legal definition of insider trading. Other than corporate insiders (who have legal fiduciary responsibilities not to trade on information) there is little economic rationale for this witch hunt. The game is characterized by big suits with big settlements and novel theories.

And thus, big discretion. The SEC can ruin anyone it wants to. If you’re running a hedge fund and the SEC accuses you of insider trading, it grabs your computers and shuts down your business. Sure, 5 years from now you might win in court, but your customers left and the fund shut down the day they took the computers away. And appeal is only to the SEC itself.

Robosigning

During the financial crisis, many banks didn’t fill out all the forms correctly when foreclosing on houses. The charge was entirely about process — there was no charge that anyone was evicted who was paying his or her mortgages. From the Federal Reserve’s own press releases (here, here; previous post)  we learn that the Fed found them guilty of “unsafe and unsound processes and practices.” The Fed was
acting in conjunction with a comprehensive settlement agreed in principle between the five banking organizations, the state Attorneys General, and the Department of Justice … The Settlement Agreement requires these organizations to provide $25 billion in payments and other designated types of monetary assistance and remediation to residential mortgage borrowers.
The Fed, a supposedly non-political independent agency devoted to bank safety and monetary policy, acted with the Administration, to transfer $25 billion dollars from bank shareholders to mortgage borrowers (not the victims of robosigning, other borrowers) and “nonprofit housing counseling organizations.”

It’s a small example, but a concrete one.

Regulation in general is transitioning from widespread application of rules to sporadic but very large enforcement actions, frequently involving threat of criminal prosecution and ending in large settlements. Documenting this trend, the Wall Street Journal noted the spread of Department of Justice Attorneys to regulatory agencies. For example, the EPA “described a strategy of pursuing larger, more complicated enforcement cases, albeit fewer in number.” Similarly,
Larry Parkinson, another former federal prosecutor who runs FERC’s [Federal Energy Regulatory Commission] investigations, described it as an outgrowth of shifting resources to more serious matters—like market manipulation—and away from more traditional violations. In 2008, for example, a majority of the agency’s penalties were against firms that violated requirements that natural-gas shippers maintain title to the gas. 
“Market Manipulation” is of course a lot more nebulous and discretionary than natural-gas title checks.

The ACA, AKA Obamacare

The ACA is 2,700 pages, and the subsidiary regulation is so convoluted that there is an active debate on the page count of its actual regulations. Justice Scalia invoked the eighth amendment against cruel and unusual punishment as protection against actually reading it.

The Heritage foundation counted 1,327 waivers. Clearly, someone needing a discretionary waiver shouldn’t be a big critic of HHS or the law.

The cartelization of health insurance and health care under the ACA is almost a textbook case of corporatism. The big hospitals doctors, and insurers get a protected small cartel. In return for political support for the ACA, HHS, state exchanges, and so on. And, the ACA itself being an intensely partisan question, that support already leaks into major party politics.

Writing on the consolidation of health insurance into two or three big companies, the Wall Street Journal quotes Aetna CEO Mark Bertolini that the federal regulators “happen to be, for most of us now, our largest customer,” adding
“So there is a relationship you need to figure out there if you’re going to have a sustained positive relationship with your biggest customer. And we can all take our own political point of view of whether it’s right or wrong, but in the end-analysis, they’re paying us a lot of money and they have a right to give us some insight into how they think we should run our business.”
The Journal opined that “such domestication is part of ObamaCare’s goal of political control,” echoing my fear.

United Health wanted to join the California exchange Covered California. Many areas of California have only one or two insurers now, so competition and choice are clearly needed. But participation in the exchange needs prior regulatory approval, and United Health was denied. Why? The LA Times wrote
Peter Lee, executive director of Covered California, said established insurers shouldn't be free to come in right away. Those insurers, he said, should not be allowed to undercut rivals who stepped up at the start and made significant investments to sign up 1.2 million Californians during the first open enrollment.
and quoting Lee further,
We think the health plans that helped make California a national model should not be in essence undercut by plans that sat on the sidelines.
You can’t ask for a clearer example of a regulator, using discretionary power to cartelize his industry, protect incumbent profits, and punish a business for failure to support political objectives. He said nothing about United Health’s ability to serve California customers, or to abide by any regulation.

Again in California, reported by the Wall Street Journal, the Daughters of Charity Health system wanted to sell six insolvent hospitals to Prime, which agreed to take on their debt and and a $300 million pension liabilities. Under state law, Attorney General Kamala Harris must approve nonprofit hospital sales or acquisitions, with only a vague guideline that such transactions must be “in the public interest.” But only four of Prime’s 15 California hospitals are unionized, so the Service Employees International Union was against the merger. Ms. Harris torpedoed the merger, despite a positive report form her own staff.

Was the event a political cave to unions, as represented by the Journal? Perhaps; perhaps not. What matters here is that it certainly could be, as the Attorney General has enormous discretionary power to approve or disapprove hospital mergers. Hospitals are well advised to stay on her good side.

FDA

Henry Miller at Hoover tells the sad tale of the Aquadvantage salmon, submitted for review in 1996 and still under review:
…Consider what they [FDA] have inflicted on a genetically engineered Atlantic salmon, which differs from its wild cohorts only by reaching maturity about 40 percent faster, as the result of the addition to its genome of a growth hormone gene from the Chinook salmon…
It took FDA more than a decade just to decide how they would regulate the AquAdvantage salmon. Characteristically, they decided on the most onerous pathway, regulating the new construct in genetically engineered animals as though it were a veterinary drug, similar to a flea medicine or pain reliever. After several years of deliberation, regulators concluded as early as 2012 that the AquAdvantage Atlantic salmon has no detectable differences and that it “is as safe as food from conventional Atlantic salmon.” …
When the FDA completed its Environmental Assessment in April 2012 and was ready to publish it—the last necessary hurdle before approving the salmon for marketing—the White House mysteriously intervened. The review process vanished from sight until December of that year, when the FDA was finally permitted to publish the EA (the unsurprising verdict: “no significant impact”), which should then have gone out for a brief period of public comment prior to approval.
The reason for the delay in the FDA’s publishing the needed Environmental Assessment was exposed by science writer Jon Entine. He related that the White House interference “came after discussions [in the spring of 2012] between Health and Human Services Secretary Kathleen Sebelius’ office and officials linked to Valerie Jarrett at the Executive Office [of the President], who were debating the political implications of approving the [genetically modified] salmon. Genetically modified plants and animals are controversial among the president’s political base, which was thought critical to his reelection efforts during a low point in the president’s popularity.”
Needless to say, 20 years of delay makes a project pretty unprofitable.

This is a good example, because the FDA regulations prescribe a precise science-based process for evaluating a food. There are time limits for rendering decisions, which the FDA ignores. But strong political forces don’t like GM foods, science be damned.

EPA

A clean environment is important. Pollution is a clear externality. We can also regard it as a Nash equilibrium. Each competitor in an industry is happy to pay the extra money to produce cleanly if all his or her competitors do so.

But the modern EPA violates just about every one of my suggested bullet points for preserving rule of law in the regulatory bureaucracy, and is ripe for political misuse. Discretion vs. rules, the potential for endless delay, the need for ex-ante permission, and a politicized and partisan bureaucracy are just the beginning.

In the Pebble Mine controversy (here and here), EPA issued a preemptive veto of a project before a request for review was submitted, and was found colluding with mining opponents. Note, I’m not opining on whether the mine was a good or bad idea. Merely that the process in view is clearly one that could be misused for political purposes, and that mine owners already must know not to speak ill of the EPA or administration with such sway over the EPA.

The Keystone pipeline stands as the example par excellence of regulatory delay and politicization. Perhaps next to the EPA’s decision to take on carbon as a pollutant.

Already, anyone opposed to a project for other reasons — like, it will block my view — can use environmental review to stop it. Delay is as good as denial in any commercial project.

The small story of Al Armendariz, head of EPA region 6 who proposed “crucifying” some oil companies as an example to the others is instructive. He was caught on tape saying:
The Romans used to conquer little villages in the Mediterranean. They’d go into a little Turkish town somewhere, they’d find the first five guys they saw and they would crucify them. And then you know that town was really easy to manage for the next few years.
…we do have some pretty effective enforcement tools. Compliance can get very high, very, very quickly.
According to the story, Armendariz shut down Range Resources, one of the first fracking companies. Range fought back and eventually a Federal Judge found in its favor. But an agency that operates by “crucifying” a few exemplars, explicitly to impose compliance costs,  is ripe to choose just which exemplars will be crucified on political bases.

Internet

The Internet is the central disruptive technology of our time. So far it has been “permissionless” — unlike just about every other activity in the contemporary United States, you do not need prior approval of a regulator to put up a website.

Pressure grew under the reasonable-sounding banner of “net neutrality,” though what was at stake was the right of some businesses to pay extra for faster delivery. “Net neutrality” meant outlawing business class. The FCC, a supposedly independent agency, studied the issue and found no reason to regulate the internet.

One fine day in November 2014, FCC commissioner Tom Wheeler must have found horse head in bed. Well, more specifically a surprise public announcement from President Obama that “blindsided officials at the FCC” per WSJ coverage.

The result is not just “net neutrality” but to apply full telecommunications regulation circa 1935. In particular, this includes Title II rate regulation, in which the FCC has full power to determine what rates are “reasonable.” The FCC announces it will “forbear” to use that power. Along with its right, under the regulation, to impose content restrictions — yes, to tell you what to put on your website — and the “fairness doctrine.” But forebearance is discretionary. So, a company thinking of investing money in fiber-optic lines had better invest in good relations with the FCC and the Administration that apparently drives its decisions.

The “independence” of regulatory agencies is one of the key structures impeding widespread use of regulatory power to induce political support. The WSJ coverage of the politics behind the decision describes well how specific businesses’ access to the White House drove the result. On the commission, the 3-2 vote with 2 republicans issuing withering dissents speaks of the partisan nature of this regulation.

Alas, the internet is all moving to Washington. Uber hired, straight from the Administration, well known tech wizard, David Pflouffe. Given Uber’s troubles with labor law — a California court recently ruling that its contractors are employees — and taxi regulation throughout the U.S., investing in politics is good business for Uber.

Campaign finance

Campaign finance law and regulation is all about restricting freedom of speech and altering who wins elections. So one should not be surprised about its political use to restrict freedom of speech and alter who wins elections.

Still, the recent trend is more troubling than usual.

Lois Lerner, director of the IRS Exempt Organizations Unit, famously derailed applications for nonprofit status from conservative groups, ahead of the 2012 Presidential election. Her main tactic was endless delay. All you need is for the election to pass.

Governor Scott Walker’s troubles are similarly renown. Milwaukee District Attorney John Chisolm filed “John Doe” probes against conservative issue advocacy groups, “blanketed conservatives with subpoenas, raided their homes and put the targets under a gag order” that they could not even reveal the fact of the investigation. It came to light, and is now in the courts, but not until well after the election. Walker won anyway, but might not have.

The Administration has been pushing since 2010 to force nonprofits to disclose all donors, as campaigns must disclose contributors. It sounds innocuous: “Disclosures?” Who can be against that? Shouldn’t “big money” contributing to politics be public information?

Not when the vast power of the regulatory state can come down on whomever it wants to. Tyrannies always start by making lists. Nixon at least had to compile his own enemies list.

Snowden

The Snowden affair taught us some important lessons about our government. The NSA collected phone call “metadata.” Well, it’s just who called who and not the content of phone calls (unless you call abroad), you may say.

But even metadata is revealing. Suppose you called three cancer doctors, alcoholics anonymous, and two divorce lawyers. And you want to run for the senate. That kind of information is political dynamite.

The NSA has the content, not just metadata, of any emails that go abroad. The NSA likely has many Hilary Clinton’s missing emails. And Jeb Bushes’. Unless neither has ever written an email that rises to the embarrassment level of Mitt Romney’s 47% remark, the information to sink either campaign is likely sitting on NSA computers.

That information would never leak out, you say? Snowden proves the opposite. Any piece of information on a government computer is one Snowden, one Lois Lerner, or one Chinese hacker away from a twitter feed.

John Oliver’s hilarious Snowden interview contained an interesting revelation. The internet is an amazing thing. What do Americans do with it? They send around pictures of their private parts. And NSA employees regularly pass the pictures around to great hilarity.

E-Verify

As part of most immigration deals we are likely to see strong enforcement of the right of employees to work via e-verify. Every single human being who wishes to work in the United States must ask for the ex-ante permission the Federal Government.

Leave aside here the obvious question how the same government that runs the Obamacare website, and, as I write, has had all visa applications to the U.S. shut down for two weeks due to hardware failures, will manage this. Let’s focus on the political implications.

This power will naturally expand. First, people without proper immigration documents. But once in place, why only enforce immigration laws? Already there are a long list of laws governing who can work and when and where. People must have the right licenses, the right background checks, union memberships and so on. Are you guilty in the latest SEC which hunt? E-verify can really make sure you never work in finance again, not so much as a bank teller. Or that a conviction for violating the endangered species act keeps you out of the work force.

Every tyranny controls its citizens by controlling their right to work. Do we really want every American who wants employment to have to ask for the ex-ante permission of the Federal Government of Edward Snowden and Lois Lerner?

Transactions

We have lost the right to transact privately in the terror and drug wars. The right to political dissent requires the ability to speak freely and privately; the right to earn a living despite political opposition; and the right to transact in private. All three are vanishing.

You may have reveled in the ending of Stephen King’s Shawshank Redemption, in which the hero takes cash out of banks and heads to Mexico. Under today’s banking laws, that could no longer happen.

As a recent political example, Dennis Hastert was recently indicted for violating the spirit of the $10,000 limit on bank withdrawals, by withdrawing amounts just shy of the limit. Hastert wanted the money, apparently, to pay blackmail to someone with an embarrassing personal secret.

Hastert is retired. But should aspiring politicians really have no privacy in their personal transactions?

Education

As Daniel Henninger put it:
…historians of the new system will cite the Education Department’s Office for Civil Rights’ 2011 “Dear Colleague” letter on sexual harassment as the watershed event.
This letter—not even a formal regulation—forced creation of quasi-judicial systems of sexual-abuse surveillance on every campus in America. The universities complied for fear of lawsuits from enforcers at the Departments of Education and Justice.
The Justice Department’s Special Litigation Section and Housing and Civil Enforcement Section have forced numerous settlements from police departments, school districts, jails and housing agencies. Whatever the merits, the locals know the price of resisting Justice is too high.
National Review’s coverage of Laura Kipinis’ travails is a good example of the political use of this regulation. Professor Kipinis “wrote a column in the Chronicle of Higher Education arguing that college campuses are in a state of ‘sexual paranoia.’” She quickly became the subject of a “Title IX inquisition,” documented in her essay by that name. Though eventually cleared, the point is the use of regulatory power to silence speech.

3. A Magna Carta for the Regulatory State
The power of the regulatory state has increased steadily. And it lacks many of the checks and balances that give us some “rule of law” in the legal system. (A system which has its own troubles.) The clear danger we face is the use of regulation for political control. Each industry gets carved up into a few compliant oligopolies. And the threat of severe penalties, with little of the standard rule-of-law recourse, keeps people and businesses in line and supporting the political organization or party that controls the agencies.

We’re not there yet. The Koch Brothers are not on the EPA “crucifixion” list, an investigation of every plant they own, or probes by the DOJ, NLRB, EEOC, OSHA, and so on and so on. They could be. The Hoover institution retains its tax-exempt status despite writings such as this one. A free media still exists, and I can read all my horror stories in the morning Wall Street Journal, and the free (for now) internet.

But we are getting there. What stops it from happening? A tree ripe for picking will be picked.

The easy answers are too easy. “Get rid of regulations” is true, but simplistic like “get rid of laws.” What we learned in the 800 years since Magna Carta is that the character of law, and the detailed structures of its operation that matter. Law is good, as it protects citizens from arbitrary power.

It is time for a Magna Carta for the regulatory state. Regulations need to be made in a way that obeys my earlier bullet list. People need the rights to challenge regulators — to see the evidence against them, to challenge decisions, to appeal decisions. Yes, this means in court. Everyone hates lawyers, except when they need one.

People need a right to speedy decision. A “habeas corpus” for regulation would work — if any decision has not been rendered in 6 months, it is automatically in your favor.

A return to economic growth depends on reforming the regulatory state. But the deeper and perhaps more important preservation of our political freedom depends on it even more.