Broken Incentives in Medical Innovation

I recently listened to Mark Zuckerberg interviewing Tyler Cowen and Patrick Collison concerning their thesis that the process of using scientific research to advance major development goals (e.g. extending the average human lifespan) has stagnated. It is a fascinating discussion that fundamentally questions the practice of scientific research as it is currently completed.

Their conversation also made me consider more deeply the incentives in my industry, medical R&D, that have shaped the practices that Cowen and Collison find so problematic. While there are many reasons for the difficulties in maintaining a breakneck pace of technological progress (“all the easy ideas are already done,” “the American education system fails badly on STEM,” etc), I think that there are structural causes that are major contributors to the great slowdown in medical progress. See my full discussion here!

Public libertarian intellectuals

Consider the post-Hayek/Rothbard/Friedman era of libertarianism.

Who has stepped up to fill their shoes? It’s hard to say, but 4 academics who stand out are Tyler CowenMike MungerRobert Higgs, and Bryan Caplan. Their scholarly output is comparable to our own Jacques Delacroix, and their influence within the libertarian quadrant is – or was at some point in time – much greater than Jacques’.

All four of these scholars cut their teeth blogging. The blog is how they teach. The blog is how they vent. The blog is how they share news and knowledge. The blog is how they went from well-respected to essential. All four write opinion pieces for professional outlets, but that’s not how they became essential to libertarians across the globe. Sharing their day-to-day thoughts about the world, to the world (and not just their walled-off social media accounts), is how they were able to step up and usher libertarianism into the next generation.

As the new year approaches, I encourage you to think about what liberty means to you. (Is it best left in the hands of professional Libertarians? You know the incentives they face. You know the choices they’ve made.) I also encourage you to be bold in your goofiness. Be strange! Be strong. Be artsy. Be rude (but never cruel). The professional outlets will always be there, waiting patiently to edit out your voice from The Message. Make 2020 the year a new generation of libertarians stepped up and took on the burden of responsible citizen-scholarship.

The public intellectuals we don’t deserve

Joakim’s latest post is so good that I can’t help but add my own thoughts. I disagree with nearly all of Joakim’s picks (though Jared Diamond and Niall Ferguson are good choices), but I can’t put my finger on why this is. So, in the hopes that maybe you can figure out why my list is so different than Joakim’s, here are my six public intellectuals, and the fields they write about, that everybody should know (aside from my fellow Notewriters, of course):

Evolution: Joe Henrich, an anthropologist at Harvard and author of 2016’s The Secret of Our Success, a book that has done better than any other at explaining cultural evolution and its relationship to biology and genetics. Dr Henrich is the guy doing all of that excellent work on WEIRD (Western, educated, industrialized, rich, democratic) people, too. Here is a pdf to a recent article of his on the Roman Catholic Church.

History: With apologies to Kevin, Charles C. Mann is the author whose work on history should be more popular. Mann’s 1491 (2005) is not only what revisionary work should look like, but it’s also a great primer on the history of science. 1493 (2012) was not as groundbreaking as 1491 but it’s still the best work of popular history out there that explains the world we live in today. Mann’s focus on history as a global phenomenon and on the history of science is what sets him apart from all of the others. His The Wizard and The Prophet came out earlier this year.

Exchange: The science of exchange has gone through a bit of a down spell lately, and for good reason: many in the profession have long claimed to be prophets. Tyler Cowen is not one of those economists. His public conversations and blogging and have done wonders for those who follow along, and his books are breezy, informative, and entertaining. My favorite Cowen book is 2009’s Create Your Own Economy, and his newest, Big Business: A Love Letter to an American Anti-Hero, came out earlier this year. His popular work strives to balance a moderate attitude towards all ideas while still leaning strongly on the counter-intuitive ideas that have helped make economics stand out among its peers in the social sciences.

Ethics: Yes, ethics is still important, and John Lachs is the philosopher we don’t deserve. Lachs, a Vanderbilt professor, authored 2014’s Meddling: On the Virtue of Leaving Other People Alone, which is a great, easy-to-read book on an idea that should be much more popular.

Literature: Nnedi Okorafor. Okorafor’s voice has the potential to revitalize conversations on literature throughout the world. Okorafor dabs mostly in the realm of science fiction and fantasy, but she also writes for Marvel Films and Dark Horse Comics. Start with her Binti trilogy. Literature needs a big change in order for people to start talking about books again, and Okorafor has the potential and the swagger to make that happen.

Inequality: The left is almost entirely unreadable on the most important topic in the world today, with the notable exception of Branko Milanovic (his 2018 2016 book Global Inequality is wonderful, and I’ve heard nothing but good things about his newest book: Capitalism, Alone), and conservatives, led by Ross Douthat, have retreated inward and focused on their well-worn hobbyhorses: church attendance, community, and familiarity (Yoram Hazony’s The Virtue of Nationalism is perhaps the hottest book from this sector of the political quadrant). Unfortunately, inequality has always been best dealt with by libertarians, and nobody from the libertarian camp has felt quite comfortable enough, or been good enough, to step up and write the book that needs to be written. Oh wait, that can’t be right. Deirdre McCloskey exists. I’m tempted to put Bourgeois Equality on the list, but a 700+ page book just doesn’t count as popular. Will Why Liberalism Works, her newest book (2019), finally catapult her into the broader consciousness of the West? Let us hope so, but we don’t deserve her.


  1. Making immigration great again John Fonte, Claremont Review of Books
  2. The post-Brexit paradox of ‘Global Britain’ Sophia Gaston, the Atlantic
  3. Tyler Cowen interview on mostly geopolitics Assaf Uni, Globes
  4. The many faces of Muhammad Tom Holland, Spectator


  1. At home with the homeless Johannes Lenhard, Aeon
  2. Naguib Mahfouz’s Cairo Ursula Lindsey, the Nation
  3. Tyler Cowen on geopolitics marginalrevolution
  4. Collected. Bought. Looted? Friedel & von Gliszczynski, Africa is a Country


  1. Losing the House may actually help Trump more than it hurts him James Rogers, Law & Liberty
  2. Tyler Cowen on the elections Marginal Revolution
  3. Clifford Geertz, radical objectivity, and elections Timothy Taylor, Conversable Economist
  4. Not wearing a poppy Chris Dillow, Stumbling & Mumbling

Law on the market: a debate

I’ve been reading through a great debate of sorts, first encountered in a C4SS anthology. I’m sharing it here, as it’s not everyday that one encounters a semi-live issue getting hashed out by giants in the field.

It starts with Robert Nozick. (Precious little starts with Nozick — we have Randians, Hayekians, Rothbardians, but no Nozickians, and no Nozickian tradition. Although he energized libertarianism as a respectable political philosophy for academics, his narrow scope and silent response to critics seem to have killed his staying power.)

Nozick famously claimed in Anarchy, State and Utopia (1974) that “Individuals have rights, and there are things no person or group may do to them (without violating their rights).” A first reading of Anarchy in the context of institutionalized philosophy makes it seem like a defense of libertarianism from big government, socialistic ideology. But, when Nozick’s connection to the Austro-libertarian anarchists is uncovered, the first part of Anarchy looks much more like a defense of small government from the anarchists.

Nozick tries to deal with the problem of law and police on the marketplace. In Chapter 2 of Anarchy, State and Utopia, he envisions a market model of competing rights-enforcement agencies. Eventually, in the service of their customers, two or more protection agencies will clash. They will fight. This results in the destruction of one (to the immediate monopoly of the other) or the relocation of the customers of each (to the territorial monopoly of each in different jurisdictions). If they choose not to fight because of the high expense, even arbitration can’t prevent a legal monopoly: consolidating to the top through voluntary contracts, government emerges anyway above the agencies. Thus, concludes Nozick, a purely free-market society will evolve into a state through an invisible hand process.

Collected in Free Markets & Capitalism?, published by C4SS, Roderick Long makes an argument against Nozick’s conclusion on the basis of different models of a post-state society (“The Return of Leviathan: Can We Prevent It?” (2013)).

Long points to another argument, this one from Tyler Cowen, that there is no way to save anarchy from collusion leading to monopoly (“Law as a Public Good: The Economics of Anarchy” (1992)).

David Friedman responded to Cowen’s argument the year afterward (“Law as a Private Good: A Response to Tyler Cowen on the Economics of Anarchy“), and Cowen responded back (“Rejoinder to David Friedman on the Economics of Anarchy“). Bryan Caplan, in an unpublished manuscript, critiqued Cowen’s position as well (“Outline of a Critique of Tyler Cowen’s ‘Law as a Public Good’“).

This is a showdown between Nozick and Tyler Cowen on the one hand, and Roderick Long, David Friedman and Bryan Caplan on the other. The whole extended debate is fascinating, but I’m not sure it has a conclusion. Was Nozick correct about the natural emergence of a state? Maybe it will take a NOL writer to finish it off…