- A new history of Islamic Spain Peter Gordon, Asian Review of Books
- A Palestinian perspective on Labour’s anti-Semitism row Nimer Sultany, Disorder of Things
- The crumbling of French culture Guillaume de Thieulloy, Law & Liberty
- Can Asia and Europe make America’s alliances great again? Tongfi Kim, the Diplomat
Around early August 2018, a research paper from the Mercatus Center at George Mason University by Charles Blahous made both the Wall Street Journal and Fox News within two days. It also attracted attention widely in other media. Later, I thought I heard sighs of satisfaction from conservative callers on talk show radio whenever the paper came up.
One figure from the study came and stayed at the surface and was quoted correctly many times (rare occurrence) in the electronic media. The cost of what Senator Sanders proposed with respect to national health care was:
30 trillion US dollars over ten years (actually, 32.6 over thirteen years).
This enormous number elicited pleasure among conservatives because it seemed to underscore the folly of Senator Bernie Sanders’ call for universal healthcare. It meant implicitly, federal, single-payer, government-organized health care. It might be achieved simply by enrolling everyone in Medicare. I thought I could hear snickers of relief among my conservative friends because of the seeming absurdity of the gigantic figure. I believe that’s premature. Large numbers aren’t always all they appear to be.
Let’s divide equally the total estimate over ten years. That’s three trillion dollars per year. It’s also a little more than $10,000 per American man, woman, child, and others, etc.
For the first year of the plan, Sanders’ universal health care amounts to 17.5% of GDP per capita. GDP per capita is a poor but not so bad, really, measure of production. It’s also used to express average gross income. (I think that those who criticize this use of GDP per capita don’t have a substitute to propose that normal human beings understand, or wish to understand.) So it’s 17.5% of GDP/capita. The person who is exactly in the middle of the distribution of American income would have to spend 17.5% of her income on health care, income before taxes and such. That’s a lot of money.
Or, is it?
Let’s imagine economic growth (GDP growth) of 3% per years. It’s optimistic but it’s what conservatives like me think is a realistic target for sustained performance. From 1950 to 1990, GDP per capita growth reached or exceeded 3% for almost all years. It greatly exceeded 3% for several years. I am too lazy to do the arithmetic but I would be bet that the mean annual GDP growth for that forty-year period was well above 3%. So, it’s realistic and probably even modest.
At this 3% growth rate, in the tenth year, the US GDP per capita will be $76.600. At that point, federal universal health care will cost – unless it improves and thus becomes more costly – 13% of GDP per capita. This sounds downright reasonable, especially in view of the rapid aging of the American population.
Now, American conservative enemies of nationalized health care are quick to find instances of dysfunctions of such healthcare delivery systems in other countries. The UK system was the original example and as such, it accumulated mistakes. More recently, we have delighted in Canadian citizens crossing the border for an urgent heart operation their nationalized system could not produce for months: Arrive on Friday evening in a pleasant American resort. Have a good but reasonable dinner. Check in Sat morning. Get the new valve on Monday; back to Canada on Wednesday. At work on the next Monday morning!
The subtext is that many Canadians die because of a shortage of that great free health care: It nice if you can get it, we think. Of course, ragging on the Canadians is both fair and endlessly pleasant. Their unfailing smugness in such matters is like a hunting permit for mental cruelty!
In fact, though, my fellow conservatives don’t seem to make much of an effort to find national health systems that actually work. Sweden has one, Denmark has one; I think Finland has one; I suspect Germany has one. Closer to home, for me, at least, France has one. Now, those who read my blogging know that I am not especially pro-French or pro-France. But I can testify to a fair extent that the French National Healthcare works well. I have used it several times across the past fifty years. I have observed it closely on the occasion of my mother’s slow death.
The French national health system is friendly, almost leisurely, and prompt in giving you appointments including to specialists. It tends to be very thorough to the point of excessive generosity, perhaps. Yes, but you get what you pay for, I can hear you thinking – just like a chronically pessimistic liberal would. Well, actually, Frenchmen live at least three years longer on the average than do American men. And French women live even longer. (About the same as Canadians, incidentally.)
Now, the underlying reasoning is a bit tricky here. I am not stating that French people live longer than Americans because the French national healthcare delivery system is so superior. I am telling you that whatever may be wrong with the French system that escaped my attention is not so bad that it prevents the French from enjoying superior longevity. I don’t want to get here into esoteric considerations of the French lifestyle. And, no, I don’t believe it’s the red wine. The link between drinking red wine daily and cardiac good health is in the same category as Sasquatch: I dearly hope it exists but I am pretty sure it does not. So, I just wish to let you know that I am not crediting French health care out of turn.
The weak side of the French system is that it remunerates doctors rather poorly, from what I hear. I doubt French pediatricians earn $222,000 on the average. (Figure for American pediatricians according to the Wall Street Journal 8/17/18.) But I believe in market processes. France the country has zero trouble finding qualified candidates for its medical schools. (I sure hope none of my current doctors, whom I like without exception, will read this. The wrong pill can so easily happen!)
By the way, I almost forgot to tell you. Total French health care expenditure per person is only about half as high as the American. Rule of thumb: Everything is cheaper in the US than in other developed countries, except health care.
And then, closer to home, there is a government health program that covers (incompletely) about 55 million Americans. It’s not really “universal” even for the age group it targets because one must have contributed to benefit. (Same in France, by the way, at least in principle.) It’s universal in the sense that everyone over 65 who has contributed qualifies. It’s not a charity endeavor. Medicare often slips the minds of critical American conservatives, I suspect, I am guessing, because there are few complaints about it.
That’s unlike the case for another federal health program, for example the Veterans’, which is scandal-ridden and badly run. It’s also unlike Medicaid, which has the reputation of being rife with financial abuse. It’s unlike the federally run Indian Health Service that is on the verge of being closed for systemic incompetence.
I suspect Medicare works well because of a large number of watchful beneficiaries who belong to the age group in which people vote a great deal. My wife and I are both on Medicare. We wish it would cover us 100%, although we are both conservatives, of course! Other than that, we have no complaints at all.
Sorry for the seeming betrayal, fellow conservatives! Is this a call for universal federal health care in America? It’s not, for two reasons. First, every country with a good national health system also has an excellent national civil service, France, in particular. I have no confidence, less than ever in 2018, that the US can achieve the level of civil service quality required. (Less in 2018 because of impressive evidence of corruption in the FBI and in the Justice Department, after the Internal Revenue Service).
Secondly, when small government conservatives (a redundancy, I know) attempt to promote their ideas for good government primarily on the basis of practical considerations, they almost always fail. Ours is a political and a moral posture. We must first present our preferences accordingly rather than appeal to practicality. We should not adopt a system of health delivery that will, in ten years, attribute the management of 13% of our national income to the federal government because it’s not infinitely trustworthy. We cannot encourage the creation of a huge category of new federal serfs (especially of well-paid serfs) who are likely forever to constitute a pro-government party. We cannot, however indirectly, give the government most removed from us, a right of life and death without due process.
That simple. Arguing this position looks like heavy lifting, I know, but look at the alternative.
PS I like George Mason University, a high ranking institution of higher learning that gives a rare home to conservative American scholars, and I like its Mercatus Center that keeps producing high-level research that is also practical.
- Fear of a Black France Grégory Pierrot, Africa is a Country
- Children of the Rohingyas and their Search for Identity Iffat Nawaz, Coldnoon
- The Invention of Representative Democracy Katlyn Marie Carter, Age of Revolutions
- Is psychedelics research closer to theology than science? Jules Evans, Aeon
In the last post, I gave some historical background on how the Ottoman state, whether in reformist or repressive mode (or some combination of the two), was on a road, at least from the early nineteenth century, that was very likely to end in a nation-state for the Turks of Anatolia and the Balkan region of Thrace, which forms a hinterland in its eastern part for the part of Istanbul on the Balkan side of the Bosphorus. Despite the centuries of the Ottoman dynasty (the founder Othman was born in 1299 and this is usually taken as the starting point of the Ottoman state, though obviously there was no such thing when Othman was born), it was also an increasing possibility that the nation-state would be a republic on the French model.
The obvious alternative being a style of monarchism mixing populism and (rather constructed) tradition, born out of a national movement and accommodating the idea of a popular will represented by the monarch, mixed in varying degrees with constitutional and representative institutions. The clearest example of this style is maybe Serbia, to which can be added Montenegro, Bulgaria, Romania and Greece. The older monarchies of imperial Germany and Russia incorporated elements of populist-national monarchy. The Austro-Hungarian Empire, as the Habsburg empire based in Vienna for many centuries became known in 1867, was the Empire most lacking in a core and not surprisingly suffered the most complete disintegration after World War One (that great killer of Empires).
France was the exception in Europe as a republic, particularly as a unitary republic, and was only continuously a republic from 1870. In 1870, Switzerland was the only other republic, but known as the Swiss Confederation, with strong powers for the constituent cantons. The example of French republicanism was still supremely important because of the transformative nature of the 1789 French Revolution, and the ways its development became central events in European history. Part of that came out of the preceding status of France as the premier European nation and the biggest cultural force of the continent. Educated Ottomans were readers of French, and Ottoman political exiles were often in Paris.
High level education often meant studying in Paris. This had such a big influence on the fine arts, including architecture, that apparently 19th century architecture in Istanbul was more based on French Orientalism than earlier Ottoman architecture. The religious conservatives and neo-Ottomanists in power today, who claim to represent authenticity and escape from western models, in reality promote imitation of these 19th century imports.
Ottoman intellectuals and writers read French and were familiar with the idea of France as intellectual and political leader. There were other influences, including important relations with Imperial Germany, but French influence had a particular status for those aiming for change.
Namık Kemal, the ‘Young Ottoman’ reformer who has some continuing appeal to the moderate political right in Turkey, as demonstrated in the foundation of a Namık Kemal University in Thrace 4 years after the AKP came to power, appearing more moderate conservvative than it does now, translated Montesquieu’s The Spirit of the Laws into Ottoman Turkish (modern Turkish is based on major changes from Ottoman).
The more radical reformers who came to power in 1908 were known as Young Turks, that is Jeunes Turcs, often now written in half-Turkish, half-French style as Jön Türkler. The more radical reformers wanted less role for Islam in public life and at the most radical end even regarded Islam as responsible for backwardness. French laicism was therefore a natural pole of attraction, as were the ways nationalism and republicanism came together in the French revolutionary legacy as an expression of the sovereignty of the people.
The Ottomans studying in France were strong influenced by the sociology of Emile Durkheim, who is usually counted as one of the three founders of the discipline of sociology, along with Karl Marx and Max Weber. Durkheim’s social thought was very influenced by an understanding of Montesquieu and Jean-Jacques Rousseau as precursors of sociology. This partly reflects the social analysis they engaged in, but also their idea of how a society is constituted legally and politically, particularly Rousseau’s theory of the social contract. Durkheim’s social thought is permeated by concerns with what kind of social solidarity there can be in modern societies in ways which build on the long history of republican thinking about a community of citizens. This was very important in the late Ottoman and early republican period.
Max Weber was also a major influence. His ideas about disenchantment (a version of secularisation) and the role of the nation-state were of definite interest to Turkish thinkers inclined towards republicanism, nationalism, and secularism. One of the consequences of this is that criticisms of the Turkish republican tradition, as it passed through Kemal Atatürk (‘Kemalism’), are tied up with criticisms of Weber. Some of this Turkish absorption of Durkheim and Weber can be found in English in the work of Ziya Gökalp (1876-1924) and Niyazi Berkes (1908-1988).
It is also worth finding Atatürk’s Great Speech of 1927 (a book length text read out over several days), which is a political intervention not a discussion of social theory, but does show how ideas connected with social theory enter political discourse in Turkey. It is very widely distributed in Turkey, I’ve even seen it on sale in Turkish supermarkets; and it has been translated into English. Berkes is the social scientist and has a rather more academic way of writing than Gökalp (a famously ambiguous thinker) or Atatürk. His The Development of Secularism in Turkey (published in English 1964, while he was working at McGill University in Montreal) must be the single most influential work of social science by a Turk or about Turkey.
Unfortunately a discussion of republicanism in relation to Durkheim, Weber, or any other major thinkers declined after the 1920s and Berkes is really the last great flowering of this tradition in Turkey. This is part of the story of how Turkish republicanism as a mode of thinking declined into defensive gestures and the repetition of dogmas, so is also the history of how extremely superficial gestures towards liberalism by leaders of the Turkish right had undue influence over the more liberal parts of Turkish thinking.
The weakness of thought about republicanism and the superficial absorption of liberalism was the main thread on the intellectual side leading to the disaster of Erdoğan-AKP rule. The rise of AKP was welcomed by many (I suspect most, but I don’t know any ways in which this has been quantified) Turkish liberals until the suppression of the Gezi movement in 2013 and even in some cases until the wave of repression following the coup attempt of 2016.
To be continued
I grew up in France. I know the French language inside out. I follow the French media. In that country, France, people with a Muslim first name are 5% or maybe, 7% of the population. No one estimates that they are close to 10%. I use this name designation because French government agencies are forbidden to cooperate in the collection of religious (or ethic, or racial) data. Moreover, I don’t want to be in the theological business of deciding who is a “real Muslim.” Yet, common sense leads me to suspect that French people who are born Muslims are mostly religiously indifferent or lukewarm, like their nominally Christian neighbors. I am not so sure though about recent immigrants from rural areas bathed in a jihadist atmosphere, as occur in Algeria, and in Morocco, for example. Continue reading
This is a topic that has been bugging me. Very often, historians will (accurately) point out mortality statistics in the United States, Canada (Quebec) and the Latin America during the colonial era were better than in the comparable Old World (comparing French with French, British with British, Spanish with Spanish). However, they will argue that this is evidence that living standards were higher. This is where I wish to make an important nuance.
Settlement colonies (so, here there is a bigger focus on North America, but it applies to smaller extent to Latin America which I am more tempt to label as extractive – see here) are generally frontier economies. This means that they are small economies because of small populations. This means that labor and capital are scarce relative to land. All outputs that come from the relatively abundant factor will thus tend to be cheaper if there is little international trade for the goods that they are best at producing. The colonial period pretty much fits that bill. The American and Canadian colonies were basically agricultural colonies, but very few of those agricultural outputs actually crossed the Atlantic. As such, agricultural produces were cheap. This is akin to saying that nutrition was cheap.
This, by definition, will give settlement colonies an advantage in terms of biological living standards. As they are not international price takers, wheat is cheaper than in the old world. This is why James Lemon spoke of the New World as the “Best poor man’s country” (I love that expression) : it was easy to earn subsistence. However, beyond that it is very hard to go beyond. For example, in my dissertation (articles still in consideration at Cliometrica and Canadian Journal of Economics) I found that when wages were deflated by a subsistence basket containing very few services and manufactured goods and which relied heavily on untransformed foods, Canada was richer than the richest city of France. Once you shifted to a basket that marginally increased transformed goods and manufactured goods, the advantage was wiped away.
Yet, everything indicates that mortality rates were greater in Paris and France and than in Quebec City and Quebec as a whole (but not by a lot) (see images below). Similar gaps seem to exist for the United States relative to Britain, but the data is not as rich as for Quebec. However, the data that exists for New England suggests that death rates were lower than in England but the “bare bones” real incomes measured by Lindert and Williamson show that New England may have been poorer than Great Britain (not by much though).
I am not saying that demographic and biological data is worthless. Quite the contrary (even I wanted to, I could not since I have a paper on the heights of French-Canadians from 1780 to 1830)! The point is that data matters in context. The world is full of small non-linearities between variables. While “good” demographic outcomes are generally tracking “good” economic outcomes, there are contexts where this may be a weaker relation (curvilinear relations between variables). I think that this is a good example of that point.
A few days ago, one of my articles came online at the Journal of Interdisciplinary History. It is a research note, but as far as notes go this one is (I think) an important step forwards with regards to the High-Wage Hypothesis (henceforth HWE for high-wage economy) of industrialization.
In the past, I explained my outlook on this theory which proposes that high wages relative to energy was a key driver of industrialization. As wages were high while energy was cheap, firms had incentives to innovate and develop labor-saving technologies. I argued that I was not convinced by the proposition because there were missing elements to properly test its validity. In that post I argued that to answer why the industrial revolution was British we had to ask why it was not French (a likely competitor). For the HWE to be a valid proposition, wages had to be higher in England than in France by a substantial margin. This is why I have been interested in living standards in France.
In his work, Robert Allen showed that Paris was the richest city in France (something confirmed by Phil Hoffman in his own work). It was also poorer than London (and other British cities). The other cities of France were far behind. In fact, by the 18th century, Allen’s work suggests that Strasbourg (the other city for which he had data) was one of the poorest in Europe.
In the process of assembling comparisons between Canada and France during the colonial era (from the late 17th to the mid-18th centuries), I went to the original sources that Allen used and found that the level of living standards is understated. First, I found out that the wages were not for Strasbourg per se. They applied to a semi-rural community roughly 70km away from Strasbourg. Urban wages and rural wages tend to differ massively and so they were bound to show lower living standards. Moreover, the prices Allen used for his basket applied to urban settings. This means that the wages used were not comparable to the other cities used. I also found out that the type of work that was reported in the sources may not have belonged to unskilled workers but rather to semi-skilled or even skilled workers and that the wages probably included substantial in-kind payments.
Unfortunately, I could not find a direct solution to correct the series proposed by Allen. However, there were two ways to circumvent the issue. The most convincing of those two methods relies on using the reported wages for agricultural workers. While this breaks with the convention established by Allen (a justifiable convention in my opinion) of using urban wages and prices, it is not a problem if we compare with similar types of wage work. We do have similar data to compare with in the form of Gregory Clark’s farm wages in England. The wage rates computed by Allen placed Strasbourg at 64% of the level of wages for agricultural workers in England between 1702 and 1775. In comparison, the lowest of the agricultural wage rates for the Alsatian region places the ratio at 74%. The other wage rates are much closer to wages in England. The less convincing methods relies on semi-skilled construction workers – which is not ideal. However, when these are compared to English wages, they are also substantially higher.
Overall, my research note attempts a modest contribution: properly measure the extent to which wages were lower in France than in Britain. I am not trying to solve the HWE debate with this. However, it does come one step closer to providing the information to do so. Now that we know that the rest of France was not as poor as believed (something which is confirmed by the recent works of Leonardo Ridolfi and Judy Stephenson), we can more readily assess if the gap was “big enough” to matter. If it was not big enough to matter, then we have to move to one of the other five channels that could confirm the HWE (at least that means I have more papers to write).