Milton Friedman, a Nobel Prize-winning economist, once said, “One of the great mistakes is to judge policies and programs by their intentions rather than their results.” While Andrew Powers ’15 claimed in a recent Herald opinions column that policy evaluation should be based in ethics (“Powers ’15: Principles of American ethics,” Feb. 13), I side with Friedman in grounding our review in policy outcomes. It disturbs me that such a simple idea is lost both on the national stage and on Brown’s campus.
We judge individuals on the basis of whether or not they support policies, but we view such legislation by its stated goals and not its results. These judgments sound something like this: If you believe in restrictions on who should receive welfare benefits and food stamps, your actions are discriminatory and you lack empathy for hungry, impoverished Americans. If you disagree with the Affordable Care Act, you’re against health care for the less fortunate and sick. If you believe there are benefits and costs to stop-and-frisk worth discussing, you’re not for efficient sampling — rather, you’re an insensitive racist who supports a police state. While it’s easy to decry others whose views don’t align with yours, we might consider taking Friedman’s approach as an alternative to shouting matches and ad hominem slander and as a method of implementing better policy.
The congressional cuts to the Supplemental Nutrition Assistance Program last September serve as an important example. The Farm Bill’s inclusion of a $40 billion reduction to food stamps has liberal pundits foaming at the mouth. A closer look at the bill’s effects reveal that those who proposed it are not the alleged out-of-touch Republicans who do not care about the well-being of the poor. Nearly $20 billion of these “cuts” are actually cost savings from enforcing an existing rule and eliminating waivers from non-participating states. This rule requires able-bodied individuals without dependents to work a minimum of 20 hours a week or be enrolled in a job training program. When analyzing this issue by its results, and not its purported intentions to take away food benefits from vulnerable populations, we gain a clearer picture of the bill’s effects.
The Affordable Care Act is another case of this misrepresentation. I’ve heard guest lecturers, Brown professors, students, politicians and news media personalities alike whittle the issue down to insurance coverage for sick individuals who can’t afford it. In doing so, they completely disregard the economic distortions that result from the medical loss ratio mandate, higher dividend taxes, penalties for employers and individuals and higher capital gains taxes.
Even if we solely focus on health outcomes of those covered under public health insurance programs, the results don’t align with the propaganda. Studies from the University of Virginia, Penn and Johns Hopkins University concluded that Medicaid patients are more likely to die from surgery or cancer than their uninsured counterparts, even when adjusting for income level and age. While definitive explanations weren’t provided, I think the root of the problem is quite apparent. Medicaid historically reimburses doctors at a much lower rate than Medicare and private insurance, so the quality of care these patients receive is much worse even when compared to the uninsured, who obtain care from emergency services and charitable clinics.
The ACA attempts to resolve this by bringing Medicaid reimbursement rates in line with Medicare for the next year or so, even for states not choosing to expand Medicaid. But with uncertainty surrounding the sustainable growth rates that drive Medicare compensation, it’s not clear there are any long-term, sustainable solutions to this problem. Through a results-oriented lens, the outcomes of the Affordable Care Act appear murky at best, despite what the Obama administration, your peers or your professors would have you believe.
On our campus, the clearest demonstration of the results-vs.-intentions dilemma arose from the New York City Police Commissioner Ray Kelly talk, or lack thereof, last semester. Irrespective of the issues of free speech and spirit of inquiry that were discussed thoroughly last fall, the protests and outcry from Brown students didn’t make a great deal of rational sense. Kelly was portrayed to be a racist, one whose stop-and-frisk policies were harmful to minorities. Yet the results and programs Kelly has put into place misalign with this narrative entirely. The New York Police Department took a much more data-driven approach under his watch: opening a Real Time Crime Center, expanding and advancing upon its supercomputers, broadening its databases and data collection and bringing in corporate experts to optimize the use of technology in its daily operations. In fact, the department is working to make stop-and-frisk obsolete through development of technology that can detect solid objects, like a gun or weapon, on a person’s body.
Could it be that Kelly’s policies are geared toward sampling efficiently? The results are undeniable: Crime rates and murder rates among young adults fell significantly during his tenure. While murder rates in the United States increased in 2012 before decreasing in 2013, murder rates in New York fell to a record low in 2012 before further decreasing 20 percent in 2013. While it might be true that more minorities are targeted by aggressive policing mechanisms, this policy isn’t wrong insofar as the means of sampling is statistically driven, not racially driven. It makes sense that under a technology-intensive means of data collection and an attempted shift away from stop-and-frisk, these mechanisms are motivated by numbers and not merely the color of one’s skin. Still, it’s undoubtedly a conversation worth having, especially given Kelly’s 75 percent approval rating in New York last year.
It’s not reasonable for Brown students to abandon their ideologies or for news pundits to rework the way they assess and present different policies. But we should consider retrospectively analyzing the results of legislation to make prospective improvements, rather than judging them strictly based on their intended purpose. The next time people disagree with you, take a second to think about the fact that it may be related more to the information they’re using to judge a policy than to their character or ideology.
Jay Upadhyay ’15 is an economics concentrator. He can be reached at jay_upadhyay@brown.edu.
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