Matthew – Page 61 – thinking liberal

The Euro does not need a federal superstate to prosper

The Euro crisis is in one of its quiet phases. But few are foolish enough to think that its future is now secure. It is often said that the currency is destined to fail because of a fundamental economic law which means that you cannot operate a successful currency without the full authority and resources of a state behind it. The Euro needs to the apparatus of a federal superstate to survive, it is said. One Tory MP even suggested that the Euro’s promoters were committing fraud to suggest otherwise. But, for all that many in Brussels want it, establishing such a superstate is not politically feasible. And yet it is possible to see emerging the institutional architecture that will allow the Euro to survive and prosper without it. It’s a hard road, but there are enough benefits for the currency’s members to persist with it.

There are four key elements to the architecture. The first is an obvious one: a powerful European Central Bank (ECB), able to do what it takes to ride out the various crises that financial markets will throw at the system. The current ECB has proved up to the task, albeit by pushing at the boundaries of its formal powers, for example by buying the debt of member governments on the secondary market. Confidence that it can handle future crises is growing, adding to the overall stability of the system. And yet this power has its limits; it cannot transfer taxpayer funds from one country to another (referred to as “fiscal transfers” by economists), in the way a federal government could. The Euro has to find a way of existing without the sort of massive fiscal transfers that you see in the United States, for example.

In its place is the second element: provisions for states to default on their debts. This has been resisted tooth and nail by Euro federalists, but at long last it has been implemented for Greece. Alongside this, a crisis infrastructure is emerging, including crisis funds to support governments that are in the process of restructuring their obligations. This whole process needs to go further: publicly held government debt, e.g. that bought by the ECB, needs to be included, for example. Greece will surely need another restructure. But we are seeing the different nations’ bond prices reflecting the risk of default, and this imposes a discipline on government finances. And no government will want to follow the humiliating path of Greece into default, if they can help it.

There remains the problem of managing the banking system, which is very much run along national lines. While Greece got into trouble because of a profligate government, Ireland, Spain and Cyprus were brought down by banking crises. At first the response to a banking crisis was for governments to underwrite all banks’ creditors in order to restore confidence. Many applauded the Irish government when they did this early in the crisis; but it is a terrible idea, transferring liabilities from various people who should have known better to taxpayers who could ill afford it. Therefore the third element of the new architecture is to force bank creditors to pay, or at least contribute to, bailing out bust banks, referred to as “bailing in”. This solution was put in place for Cyprus, and hopefully will be the pattern in future. Of course it remains possible for financially strong governments, like Germany’s, to stand behind their own banks – but this should be discouraged. It is essential for discipline to be brought back into banking, and the system whereby bankers keep the profits and pass losses on to taxpayers has to be terminated.

But this approach is undeniably destabilising; it adds to the risk of bank runs. The obvious solution to this is to establish a Europe wide deposit insurance scheme, just as America has its federal scheme. Initially European governments seemed to favour this, but as they grew to understand its full implications, possible taxpayer transfers between states and increased central regulation, they have backed off. This has left us with the fourth and final element of the new architecture: emergency capital controls. This has been implemented for Cyprus, where depositors at Cyprus banks are suffering severe limits to their ability to move money out. It is an ugly process, and represents a big step bank from the integrated ideal of the Euro. The third and fourth elements in particular mean that a Euro held in a German bank is worth more than one held in a Portuguese one, say. But this is better than the alternatives, which attempt to wish financial risks away into an anonymous federal centre.

I believe that these four elements can evolve into a system that will give the Euro long lasting stability, and a better distribution of risk than a federal system would. We must remember that systems of human relations are only in a small part dependent of formal laws and powers, and much more based on expectations of how people should and will behave. This is how the management of the Euro is evolving. In the early days those expectations were wholly unrealistic, and ultimately required some kind of federal system to underwrite them. Now that we know this cannot be, new expectations are evolving. This is a bit like the way the British constitution and Common Law develops.

But is it worth it? Is it a loveless marriage between southern economies locked into permanent austerity, and more dynamic northern ones which are constantly being dragged down by their neighbours? (And France which manages to be on both sides of this equation at once!) If so the enterprise will lose political support and die anyway.

This question deserves a post all to itself, but I believe that all this pain has benefits to both sides. For the southern economies, joining the Euro was all about converging with their rich northern neighbours and their higher standard of living. Unfortunately they at first thought this would be easy. Lower interest rates and hot money from the north created a short term boom, but could not do the trick. Endless tax transfers (like between north and south Italy), are not on offer, and probably wouldn’t work either. In order to raise living standards the southern economies will have to undertake a painful series of reforms, rather in the way Britain did in the 1980s, Sweden in the 1990s, and, to a lesser extent, Germany in the 2000s. The process is starting, and the new disciplines of the Euro zone help this.

And for the northern economies of Germany, the Netherlands and Finland? Being in the Euro gives them a more stable economic environment, at a time when the global economy has been destabilised by the rising of China and other emerging markets. With a lower exchange rate than otherwise they have been able to preserves their exporting industries and maintain a degree of social stability. You only have to look at Britain to see what might have happened otherwise. There a short-term boom and appreciating exchange rate led to a flooding in of cheap imports and a hollowing out of export industries. Living standards grew for a while, but it could not last. The country is still struggling to escape the bust of 2008/09, with exports remaining weak.

The first decade and a half of the Euro has not been a happy experience, taken as a whole. But these are difficult times for developed world economies. In these circumstances the Euro remains a good idea, and indeed eastern European countries are still queuing to join. In the rough, interconnected world that is the modern economy, living with a freely floating currency is much harder than many would have you believe.

The GDP obsession

Today initial estimates of Britain’s quarterly GDP figures have been published. It has become a very silly circus. The BBC Today programme was giving it a lot air time this morning, in spite of not knowing what the crucial number was. Instead they made do with economists’ guesses. This is what they usually do, in spite of the fact that the guesses are often very wrong – though this time they were spot on. A much more informative discussion will be possible once the figures are released, and experts have had a chance to root around the detail. But by then it won’t be news, and the BBC won’t cover it. Meanwhile some even more meaningless political posturing is taking place. I just wish economists, journalists and politicians would show a bit of humility on the topic. As a measure GDP is not all it is cracked up to be.

The first problem is that, although it is quite a simple concept in theory, it is very complex in practice, making the implications of movements difficult to understand. In the UK economists have been puzzling over the fact that the current economic downturn (often trumpeted as being one of the worst in history) has not affected jobs nearly as much as previous downturns. This is often articulated as a “productivity gap”, since if income, and hence production, is falling faster than the number of jobs, productivity (production divided by jobs) must be falling. The Institute of Chartered Accountants’ Economia magazine ran a vey interesting article on this (Measure for Measure), which simply asked a whole series of prominent economists what they thought was going on. It was very revealing. Quite a few took a very superficial view, without probing behind the numbers much, speculating a bit, and then launching into some hobby horse or other, such as the need to stimulate aggregate demand, or let companies go bust more readily. But a number had clearly taken some trouble to get behind the numbers to understand what was going on. And when they did this, they picked up a very complicated picture, and they started to worry that the numbers were at all meaningful or accurate. Several speculated that the official figures were understating the level of GDP because they were not measuring some aspect of the economy properly, usually associated with services and new technology. They further speculated that, though GDP was artificially low now, this would be corrected in due course, when artificially high growth numbers would come through.

Another point that came through was that a large part of the “gap” arose from the fact that North Sea oil and financial services had shrunk. These sectors gave rise to a lot of product (albeit largely fictitious in the case of financial services) but not many jobs. Which leads me to a second problem with GDP: it doesn’t measure economic wellbeing very well. If these two sectors shrank, and it mainly affected a small number of very wealthy people, surely we can take its loss with a bit of a shrug? A big problem with the growth before the downturn in 2007 was that it benefited so few people (especially a problem in the US). Median real incomes and unemployment levels tell you a lot more. (There is an interesting article in todays FT by Richard Lambert on this). And, of course, there is the whole issue of wider wellbeing, which depends on the quality of personal relationships, the environment, and so on.

So, where does that leave any assessment of the current state of the British economy? The first point is that, although GDP numbers may not be as bad as we thought, economic wellbeing is not good for large parts of the population. Pay is not keeping up with prices. It is particularly hard for those with public sector jobs or dependent on benefits. A little bit of confidence is returning, and this will be good if, and only if, it leads businesses to invest more. If ordinary people simply decide to save less, and spend more, we will get a short-term lift to economic wellbeing, but it will not be sustainable.

Well, that is my personal view. Optimists, like the Observer commentator William Keegan, who also writes an article in Economia, think that there is a lot of spare capacity in the economy (people who are underemployed, for example, and working part time) so that any lift in demand will be self-sustaining, and that it doesn’t matter where it comes from – his preferred choice being from government, by cutting VAT and slowing down government cuts. Once this capacity is being used, we will be in a better position to reduce the size of government, if that is what is needed to make the economy sustainable in the long term. You hear a lot of this sort of view from professional economists, even very distinguished ones. To such an extent, indeed, that austerity policies are described as “discredited” by many, on the grounds that they have not delivered the steady GDP growth that these economists say is feasible.

Supporters of austerity are gloomier about the longer term economic outlook. The spare capacity highlighted by Mr Keegan and his friends is illusory: it is mainly in the wrong places. The economy before the crisis was unsustainable: too dependent on borrowing and a trade deficit. Furthermore, there are huge headwinds, in particular from an aging population and a workforce that will shrink (though Britain is not as badly off in this respect as many other economies, thanks in large part to a more liberal view of immigration, which politicians now regret). The economy has to be rebalanced and made more efficient: that means destroying a lot of the less efficient jobs, and creating new ones elsewhere. The wrong sort of economic growth will slow this down and simply create a bigger crisis later. There is no alternative to a slow and painful path of adjustment.

It is an old argument, with resonances of that between Keynes and the Treasury in the 1930s. Keynes is usually held to have been right then: the main problem was lack of demand, and it just needed to be kicked into place by government action. Many economists use this as evidence that we should repeat that prescription this time. But the world was a very different place then; there is no equivalent of the incipient manufacturing revolution to sustain growth now.

And this seems to be the biggest cost to an obsession with GDP. It gives economists the illusion that the issues are much the same, regardless of what is happening in the real economy. It is only when you try to get behind the numbers and ask searching questions, that you can start to understand the real policy options. Today’s figures will tell us very little.

Is there a case for complementary medicine on the NHS?

Last weekend there was outrage from The Daily Mail that Prince Charles had being lobbying government ministers to give more space for complementary medicine on the NHS. This provoked a piece on the BBC Today programme (at 0833) on Saturday morning. In this UCL’s Professor David Colquhoun made short work of Tory MP David Tredinnick, who was attempting to defend homeopathy, the target of choice of those wanting to drive complementary medicine to the lunatic fringe. Indeed, very few advocates of complementary techniques do a decent job of defending them in public forums, quickly resorting to dodgy mumbo-jumbo and dubious scientific studies. And yet there is a case to be made.

I find it a bit awkward to make this case myself. I have not used such therapies, and nor am I likely to. I am simply in too deep with conventional scientific scepticism to give any credence to their supporting patter – “energy fields”, “life forces”, or homeopathy’s “like cures like”. And without that, I suspect the techniques lose a lot of their impact. However, people I like and respect do use selected complementary techniques, and they have value.

The best way to start a defence of complementary medicine is attack. Conventional, evidence-based medicine has its own weaknesses. The technique depends on breaking health issues down into bite-sized problems, and then testing therapies to treat them using statistical tests against a placebo. Once a therapy passes this test, it then gets rolled out to anybody suffering from the condition concerned. This approach benefits from scientific rigour, and has steadily improved the effectiveness of conventional medicine over the generations. More recently the focus of the technique has been more on finding what works than necessarily why. This makes it less vulnerable to dismissing therapies that do not work in theory (as happened in some spectacular early medical failures in the 19th century over the importance of hygiene and clean water). But it has certain blind spots designed into it.

The first problem concerns placebos. The reason why this is the null hypothesis against which therapies are tested is that placebos have a measurable beneficial effect in many cases. The main scientific sceptical explanation for any benefits of complementary therapies is that it is a placebo effect. A supporter might go further: complementary therapists understand how placebos work better than conventional therapists: it isn’t just a placebo, it’s a top class placebo. But you can’t test a placebo against a placebo. Back in the 1980s a practicing GP told me how one of his favoured techniques was to prescribe harmless sugar pills to his patients, and he claimed great benefits from doing so. Surely if that sort of thing is allowed on the NHS, why can’t other placebo therapies? And the answer isn’t to ban all placebos – though doubtless that is the approach taken by conventional medicine advocates; something tells me that my GP wouldn’t be allowed to prescribe his sugar pills nowadays.

The second problem is the fragmentary approach of conventional medicine. Fragmentation has been elevated to a positive religion in the NHS. You can’t experience the service without being handed to several different professionals of different shapes and sizes, each with their carefully rationalised boundaries. Each handoff creates risks, and stories of catastrophic breakdowns in hospital treatments abound – patients left for hours on trolleys, starving to death, or forced to drink water from plant pots – and even more cases where post hospital after care breaks down. One of the few common themes across complementary disciplines is that they are holistic. Indeed the very idea of holistic treatments (now very much part of modern management jargon) was originally derived from complementary medicine, or that is where I heard it first, anyway. You see a single therapist, who gathers as much information about you and your condition as she can, integrates it, and then moves on to treatment. The diagnosis is likely to be a large part of the cure in its own right. And yet scientific testing of complementary therapies is liable to start only after the diagnosis has ended. All this proves is that if you go out to a shop and buy homeopathic remedy, you are on to a hiding to nothing. That does not prove that the complete homeopathic therapeutic process is useless.

There is a third problem. Evidence has to be gathered by using large numbers of people. In this process there is very limited opportunity to distinguish between the different needs of individuals. As a result the evidence tends to show not that the therapy works for everybody, or even most people, but that on average it is better than the placebo. The result is that lots of people are prescribed treatments that are, for them as individuals, useless. How many people do you know who complain of medication that gives unpleasant side-effects but does not seem to be doing them any good? The scientific evidence says they could be right, but is rather helpless after that. Complementary therapies are much less likely to have side effects, though they don’t have the proven benefits either. I do wonder whether for some conditions the overall cost-benefit balance of complementary therapies against conventional ones is constructed fairly.

And finally we need to address the question that few advocates of scientific method will admit to. That scientific rigour has its costs. There are areas of potential knowledge into which it is incapable of reaching. The higher your standard of rigour, the less that is capable of being revealed. The method is too blunt an instrument to deal with many types of issue. It can’t handle too many variables at a time, especially if they are interdependent; and any ideas that mess with constancy of the laws of nature are ruled out a priori. It struggles to find ways of testing mind over matter propositions, which often play a part in complementary medicine’s thinking. How many people do you know who feel unwell, go to doctor, who commissions tests that just don’t find anything? You don’t have to take on mystical ideas to see that the bluntness of conventional diagnosis leaves huge areas of illness as a mystery. And when this happens conventional medicine is worse than useless. It creates stress and frustration, and doctors start to disbelieve the patient, making the problem worse, not better. Complementary techniques are much better at handling patients suffering from these sorts of problems.

So what are my conclusions? A little more humility on the part of the advocates of conventional medicine is warranted. They don’t know everything; they are not very good of handling conditions that are difficult to diagnose; they are too sanguine about the collateral damage arising from evidence based treatments on those they do not help; and they fail to see how the fragmentary way they handle problems is bad for patient health. With this humility they might understand that once they have eliminated the nice, well-defined illnesses in their comfort zone – cancer, heart disease, strokes, bacterial infections et al – being open to patients who want complementary treatments is often the best way forward. And I haven’t even mentioned the corrupting influence of big pharma.

Where Keynes and Beveridge turned out to be wrong

The Spring 2013 edition of the Journal of Liberal Democrat History has a fascinating article on the role of Maynard Keynes and William Beveridge in developing Liberal Party policy, culminating in the party’s manifesto for the seminal election of 1945. These men took the party’s thinking decisively into what is now called “social liberalism”. Their vision was inspiring and coherent; much of it is now simply accepted wisdom. But I detect a tendency to treat these men’s ideas as holy writ. But nobody can be right on everything, and the world was changing fast. It is interesting to pick out the places where they got it wrong. This will perhaps help us to reflect on the challenges we face today.

Beveridge (in his report to the wartime coalition government) memorably set out the challenges to society presented by the “five giants” of Want, Disease, Ignorance, Idleness and Squalor. The answer was to extend what we now call the Welfare State, establish the National Health Service, nationalise a series of critical industries (railways, coal and power in particular) and to adopt a system of macroeconomic demand management, which we know as “Keynesianism”. These policies were largely adopted by the subsequent Labour government, albeit with more enthusiasm for their collectivist aspects, and retained by the Conservatives that followed them. The success of their ideas on the wider political stage contrasts with the Liberals’ disastrous performance in the 1945, when Beveridge lost his seat, and the Liberal Party faced extinction – in a crisis that makes its successor party’s current woes look like a picnic. Which only goes to show that winning the battle of ideas and having coherent policies is on a small part of how a political party succeeds.

But what has gone wrong? The Welfare State grew to be a monster of a size that Beveridge would have been horrified at, though it made much headway in combating Want and Squalor. The contributory principle, central to Beveridge’s vision, has largely broken down, with entitlement being based on need rather than past contribution. It has never broken free from the dependency problem, where people don’t have enough incentive to sort out their own problems – an issue that Beveridge foresaw. It strikes me how Beveridge’s system was overwhelmed by the breakdown of the traditional family, and of traditional working class communities. These were inevitable consequences of economic progress, as well as the march of liberal social values. But needs that used to be met within the community were now thrown at the state’s door, and, perhaps, the breakdown of discipline in some communities (about starting families in particular) added to the problem. Beveridge’s carefully worked out system of benefits and entitlements was not equal to the task.

Nationalisation has proved another disappointment. Keynes was convinced that these critical industries would not be managed for society’s overall benefit if they continued in private ownership. He also wanted to incorporate them into his system of macroeconomic management. But the state proved inept at setting strategy, and was often a prisoner of the short term interests of managers and workers. Strategic decisions tended to be made badly, and investment declined. They were all subsequently privatised and, except arguably the railways, have performed much better since. Regulation has proved a much more effective answer than state management.

Keynesian economic management has proved highly controversial, after two major economic crises, in the 1970s and now. But it is clear that widespread adoption of Keynesianism has moderated the economic cycle, and this has been of huge benefit. We have to accept though that it cannot deliver full employment sustainably unless the overall economy is in the right shape. In the 1970s it was too dependent on cheap oil. Now it is too dependent on finance and government jobs and funding.

But it is interesting to read that in 1945 Keynes thought that the main means of managing the business cycle was investment. He understood that private sector investment tended to follow the cycle (i.e. increase in the good times, and fall back in the bad – just what we are currently experiencing), and so make it worse. Government investment should counterbalance this – and he wanted to nationalise key industries so that the scope of government investment increased. This just hasn’t happened. Instead the expansion of the welfare state has created a counter-cyclical dynamic (called “automatic stabilisers” by economists) that has proved perfectly sufficient until now, with a few tweaks here and there.

But since the size of the welfare state and government generally is now part of the problem, using it to manage the cycle has hit its limit without the job done. A lot of economists (like Martin Wolf of the FT) now urge that we go back to Keynes’s original idea and increase the level of government investment. But I suspect that the reason why governments did not follow Keynes’s original system, apart from the growth of automatic stabilisers, is that this is much more difficult in practice than in theory. Examples of where it has been tried, such as Japan in the 1990s, and China in the present crisis, are not particularly encouraging. Vested interested and construction businesses close to the government have reaped benefit, leading to wasted investment and a corrupted political system. As a developing country China’s investment needs are huge, so they may still end up ahead, but the case for developed economies is much weaker.

What does this say to us now? The five giants are still with us, although they may not loom as large as they did. But I think the era of grand political projects established by clever men from on high has run its course. What is needed is a reshaping of government to make it more local, participative and people centred. But that is a very long journey.

The NHS crisis: while politicians look the other way, what should we do?

The NHS is deep in a long term crisis. Last Thursday NHS England published a “call to action” outlining the emerging crisis. This attracted a day or so of news coverage, focusing mainly on a £30 billion funding gap. But there was no political debate, and the story quickly died. It was replaced yesterday by a story on the NHS’s abuse of the “Liverpool Care Pathway” for end of life care, and today by an investigation on struggling hospitals. Both stories are backwash form the continuing struggle of NHS management and staff with financial pressures. But where are the politicians? Labour are waiting to pounce on stories of struggling accident & emergency services to promote a general air of government incompetence on the NHS; the government try to play things down, blaming any problems on long standing issues not tackled by the previous government. A debate about the long-term options for the service it is not. So what should they be talking about?

The dimensions of the crisis are quite clear. Britain’s NHS is almost entirely funded from tax. But after the economic crisis of 2007-09 the tax base has shrunk. Furthermore a number of trends, not least the increasing proportion of older people, point to a slowing down of the overall rate of growth in the economy and hence taxes. And yet some of those same trends will create growing demand on the NHS. The government has promised to protect the NHS budget in real terms, much to the chagrin of right wing critics, but this will not solve the problem of rising demand. The NHS England report settled on a headline gap figure of £30 billion by 2021 – after toying with £60 billion by 2025, the number used by Health Service Journal (HSJ) in its preview.

The strategy is to buy time through efficiency savings. As a large, monolithic organisation, with weak accountability, inefficiency is rife. NHS top management has been ratcheting up pressure on the component services by progressively squeezing the available funding, , in a process known as “the Nicholson challenge” after NHS England’s chief executive, Sir David Nicholson. The NHS England report claims that this is on track to deliver its target of £20 billion efficiency savings by 2015, but there is plenty of reason to doubt its efficacy, as the number of crises with a financial root seems to grow.

But the strategic point is that efficiency is not a long term answer to the pressures. The NHS paper calls for fresh thinking, but seems to rule out most radical ideas, like charging for, or heavily restricting services, although in doing so it is only holding to the current political near-consensus (the far right does not go along with this, but everybody else does). Let’s take a step back and look at this.

The first point to make is that increased demand for health services in the economy will be met by increased supply. Occasionally you hear people suggesting that the economy can’t bear an increase. But there is no fundamental economic reason why the proportion of the economy taken up by health care cannot increase substantially. It does not depend overly on imports, and there are plenty of things the public can give up to make way (own fewer or cheaper cars or clothes, go out less, and so on and on). Healthcare offers the prospect of a longer life and less pain; it is a consumer proposition, as I have pointed out in an earlier blog, to die for. If there is demand, there will be supply. The only question is how that supply will be met.

There are broadly four ways the NHS will meet this crisis:

Taxes will be progressively increased so that taxpayer funded services maintain their current profile overall. This is clearly what is favoured by most NHS insiders, and left wing policy types who like the paternalist structure of the current NHS.
It will stratify into a class-based service, where only poorer people will use it, while richer people go private. This will happen because the NHS service will be considered dangerous, shoddy, and accessible only after an intolerable wait. This is largely what has happened to NHS dentistry, and it is what will happen if the NHS is allowed to muddle on with its current level of funding (or if funding is cut).
The NHS will concentrate on excellence in a smaller core of services, while letting people go private for others. However healthcare has few neat boundaries, and it is difficult to see how this would work in practice.
The NHS will start charging for more services, and accepting co-payments for cosmetic and other add-ons. This may be done with increased collaboration with the private sector, rather like NHS optometric services. This is the direction of travel favoured by the right, apart from those who secretly favour option 2.

These solutions are not mutually exclusive, and indeed option 3 is probably only viable in conjunction with 4.

The first strategic question is how far new taxpayer funding will be forthcoming. Many seem to assume that it will be. John Appleby, economist at the health think tank the King’s Fund, assumes this will be so: the economy will be growing again by 2025, and public demand for increases to real spending will return. I’m not so sure: the headwinds on the economy are severe, and I don’t see any return to the growth rates we have previously seen for more than a two or three years in a row. Meanwhile demand from other areas of public expenditure has been suppressed and could bounce back. And I think public attitudes to higher taxes have changed, after the general squeeze that has been put on living standards. Some left-wingers assume there is large pot of money available from taxing rich individuals and businesses. This is open to doubt, however, and it has proved a volatile source of tax revenue both Britain in the past, and to other economies, like California’s, whose public funding depends heavily on taxes on the rich.

Besides, I do not think that taxpayer funding is particularly efficient. It means that resources tend to be allocated top down according to political objectives, and not where it is really needed. And difficult problems tend to be left unsolved rather than confronted. My guess is that we will end up with option 4, after having given options 2 and 3 a try. It will continue to be a very bruising time for the NHS.

For those that want to avoid this, I think the most promising way forward is to bring health services into a complete rethink of public services to make them more integrated with each other, and centred on people rather than symptoms. And in case you think that sounds like motherhood and apple pie, its practical consequence means dismantling current power structures, and pushing towards democratically accountable local control. That will not be popular amongst NHS professionals, and we know how much noise they can make. Some on the left are starting to think this way, and while I don’t trust the left, with their penchant for paternalism, this may be the basis for a useful political coalition. One interesting aspect of this is that the other services (personal care, housing) with which the NHS would be integrated are not “free at the point of use”, considered so sacred in the NHS, which may allow the whole question of charging and co-payments to be fudged in a constructive way. Here’s hoping that something can be achieved along these lines.

The pensions blind spot

“All in it together? MPs WILL get a payrise worth up to 12%” thunders this morning’s Independent newspaper. While I’m not a big fan of our MPs, this headline has persuaded me that they deserve the payrise that apparently will be proposed by the independent body given the task of setting their pay. If even a supposedly more mature and considered newspaper like the Independent indulges in this kind of vindictive, misleading headlining, then something is clearly wrong.

This headline is revealing about how information is communicated in our society. First of all, no formal announcement has actually been made. The headline is based on a leak, which only reveals a partial picture. And yet by the time the full news is released, it will be old news. Speed trumps accuracy in the world of news media. The 12% figure is also misleading. It compares the proposed salary to be implemented in two years’ time to the current one. 9% is a more accurate number, and indeed this is what other organisations are reporting. Such considerations do not weigh heavily with headline writers.

But there is a further distortion. Apparently the proposal will be to reduce MPs’ pension entitlements at the same time – though the details don’t seem to have been leaked. So the total package will not be as generous as the headline writers make it sound. But here the journalists seem to be at one with the general public: treating pension entitlements as being of little real value, and failing to realise the implications of changes to it. Over the past couple of decades companies have been squeezing their employees’ pension plans hard, so that overall pension provision is now pretty meagre, when it used to be generous. This has barely reached the popular consciousness. Only public sector trade unionists have grasped that this is an fact a steady reduction in what people are paid.

There are in fact sound economic reasons for changes to pension arrangements. The proportion of pensioners to the working population is rising, and this makes pensions less affordable. Unfortunately high rates of pension saving don’t help change this dynamic much: this is one of those things that may work for individuals, but not for society as a whole. Pensions have to become less generous overall, and the collapse of private sector occupational pension plans is just part of that process.

But there is a big problem at the heart of it. Employers are in headlong retreat from pension provision, but individuals are not stepping forward into the breach to save more into personal pension plans. Even where they do, and they are being “nudged” into doing so by opt-out pension schemes, the amount being saved will go nowhere near providing for the scale of pensions the previous generation had been entitled to. This is sometimes offered as an example of irrational economic behaviour. But it isn’t. The transaction costs of saving weigh heavily on all but the very rich, and investment returns are dismal – even without the current regime of very low interest rates. Personal saving is a very inefficient way of delivering a pension for the majority.

It is better if the state steps in. A state-managed pay as you go scheme has comparatively low transaction costs, as well as reducing the risk to individual savers. Reforming the state pension is one of the more impressive achievements of the current Coalition government. It has been led by Lib Dem pensions minister Steve Webb, but it has not been politically contentious – the Conservatives deserve credit for letting him get on with the job – and Labour have not got in the way. Previous governments have changed their pensions ministers every year or so before any reform effort could get going. The focus has been on establishing a good basic pension to which everybody is entitled, which people can then top up through personal savings. Previous state schemes have tried to concentrate entitlement on the most needy, destroying the incentive to save, or to create complex entitlements based on income and contributions, which few understand because of the need not avoid double counting with subsidised private savings.

But the cost of this pension commitment will grow, and this is causing many sage heads to worry. Personally, I think we have to grin and bear it. If it looks as if it will run ahead of the ability to raise taxes, then we have to push the age entitlement back. But this is one of the critical strategic issues that our political leaders must grasp as our demography changes. Paying for the NHS is another.

These are weighty and important matters, which deserve much more attention than they get. They are much more important in the scheme of things than how much our MPs are paid. The country needs more MPs like Steve Webb, with both the intellectual and political skills to push forward difficult reforms like the one on pensions. We have a long way to go on that score.

Nowadays it seems to be the economists who are obsessed with the short term

The relationship between economists and politicians is often strained. It’s easy to think that economists are taking a detached view of public policy and its long term effects, while politicians simply jockey for advantage at the next election. But, strangely, that doesn’t seem to be the pattern right now. It’s the politicians who are urging short term pain for long term gain, while the economists say it can all be left for another day. It is the politicians who have a better grip on reality.

The nature of the relationship between political leaders and economists has changed as economics has evolved. I think it was President Truman in the late 1940s who said he wanted to find a one-handed economist, so fed up was he with his economic advisers saying: “One the one hand this, but on the other hand that”. He wouldn’t have that problem today: there is no species of public policy commentator that is more one-handed than an economist nowadays, so confident do they seem about what they are saying.

In the late 20th century supply-side economics took hold, after the economic traumas and stagflation of the 1970s. This held that the route to economic success was in making sure that markets worked efficiently and government expenditure kept on a tight reign. Economists bewailed the fact that their advice was so often ignored by politicians, who found their prescriptions unpalatable. Only the unelected President Pinochet seemed to take economists at their word, as he implemented a series of reforms in Chile. The expression “politically impossible” was frequently used in discussions of economics. In fact politicians, starting with Britain’s Margaret Thatcher, largely implemented the supply-side economists’ advice, but this was only really acknowledged by most economists after the event.

But things seem to have moved on again. Politicians in Europe, including Britain, are grappling with the size of government in the wider economy, and pushing ahead with supply side reforms. This is hard political work, with scant reward on offer at the ballot box. But do politicians get credit from professional economists? Not a bit of it. Instead austerity policies are blamed for anaemic growth and high unemployment. Scarcely a day goes by without some economist, like Paul Krugman, Martin Wolf or Samuel Brittan thundering away that all this is foolish and bound to end badly: looser fiscal and monetary policies are needed, and the problems of government deficits can be sorted out another day.

What accounts for this? It is tempting to conclude that there is simply a time lag in economic thinking between the academics and the politicians. In academic circles the supply-side mania has run its course. It was always incomplete, and too often, not least during the great economic crisis of 2007-09, it had very little of value to say. Neo-Keynesianism had taken hold, with an updated series of macroeconomic models designed to deal with the issues that arose in the 1970s. The politicians, perhaps, haven’t moved on.

But I think there is a different explanation. It is that the politicians are much more aware of what is really happening in our economies, and the changes that are needed, while the macroeconomists are blinded by their use of aggregate statistics. The politicians can see that there are some fundamental problems with the way their economies are functioning, especially here in Europe. The first problem is that the state has become too large and inefficient. A second is that the progressive aging of populations is progressively weakening economies. A third is that globalisation has changed the rules of economic management. I could add a fourth issue, which is that the world’s financial systems have become dysfunctional, except that I think this is confusing politicians and economists alike, and is not a driver of tension between the two.

Economists agree with this analysis of problems by and large, of course, except that I don’t think that most have woken up to the implications of globalisation, and its profound implications for the way prices and wages rates are set. What the politicians appreciate is that these problems are desperately hard to fix, and that putting off the evil day is not going to help. In particular the central problem is to shrink the state. Politically it is much easier to put through tough changes in hard times, and not when things seem to be ticking along nicely. And if you look at the political forces that seize on what the economists are saying, you will find that they are mainly those that do not see the need to shrink the state at all.

Alongside this disagreement about the best time to reform is an economic judgement. Politicians are sceptical that sustainable economic growth is at all easy to find. Many economists think back to the decade before 2007, when 2% annual growth was more or less taken for granted, and assume with a wave of the magic confidence wand, this growth will come back – and that we might even be able to make up some of the lost ground. Even now I have seen some economists who should know better projecting trend growth before the crisis, to estimate the true cost of the recession. So in the five years since the crisis, the economy should have grown by 10%, they say; in fact it has shrunk by 4% (I haven’t checked that number), so the crisis and bad economic management has cost the economy 14%! But what if that 2% tend growth wasn’t for real? What if it was simply pumped up by borrowing and trade deficits? And what if the progressive aging of the population makes sustainable growth of 2%, or even 1%, unreachable? Blinded by their aggregate statistics, not enough economists are asking these questions, and still less following through their implications. But it is all too obvious to most politicians, and businessmen, come to that.

The gap between politicians and economists isn’t helped by the fact that the former keep using government debt as the main driving force of their argument. This is politically convenient, but the economists rightly spot that it is insufficient of itself. If the economy could readily be kicked back into a 2% growth trend with a bit of fiscal pump-priming, then the debt argument would not hold water. In today’s FT Samuel Brittan accuses politicians of falling for the fallacy of composition: that whole economies work like family budgets. In fact there are deeper reasons for what politicians are doing.

There is further disagreement over investment spending. Many economists think that they have found the magic bullet. Government funded infrastructure investment can both act as a short-term fiscal stimulus while delivering longer term benefits to the economy. So why are the politicians so reluctant to spend more on capital projects, and even cut them back? And yet this is another blinded by aggregates issue. The economists’ argument only holds water if the investment projects actually deliver economic benefits. This is much more difficult in practice than it is in theory. Under the last government investing in hospitals must have looked a sure-fire winner, given the ever rising demand for healthcare services. But we are now finding, as hospitals are collapsing under unaffordable PFI debts, that it wasn’t so easy. Too often they built the wrong sort of facilities. This is situation normal. The usual result of a public sector infrastructure project is to end badly. Japan’s investment splurge in the 1990s, in similar economic circumstances, simply caused many “bridges to nowhere” to be built.

And so, in this debate, my sympathies are with our political leaders.

Labour will subscribe to Tory cuts: the battle for the next General Election warms up

Nobody should underestimate the Labour leadership’s will to win the next British General Election, which should be in May 2015. I have been away for a couple of weeks. Before I left I was wondering what Labour’s response would be to the current government’s public spending review for 2015/2016, which will be announced later this week. It has been clear and unequivocal: they will sign up to the deep cuts in public spending that this review is designed to produce. This is breath-taking. What does it mean for British politics?

The spending review looked like a trap being set by the Conservative and Liberal Democrat coalition for Labour. Ambitious targets for savings were set: but Labour would be left with an awkward choice. Up until now Labour has been quite happy to ride the anti-cuts anger. Public sector workers, and many people relying on benefits, and others in the general ecosystem which they inhabit, are livid. Many workers with young families and mortgages are losing their jobs and facing steep cuts in pay. This anger has been fuelled by a myth: that cutbacks in public expenditure were unnecessary and motivated by Tory ideology, with the treacherous Lib Dems meekly giving in so that they can play with the toys that being in government gives them. This myth seemed to be supported by a whole army of economists saying that the pace of the governments austerity policies was undermining growth and making things worse. The Labour leader Ed Miliband and the Shadow Chancellor Ed Balls did not quite subscribe to this view if you read their words carefully. But they dog-whistled full support. Every cut was opposed angrily; they used the slogan “too far, too fast”, and mercilessly criticised the government for the negligible rate of growth in the economy, which they put down to its austerity policies. There was a studied vagueness about what they would actually do themselves.

But the 2015/16 expenditure review presented a challenge. According to the anti-cuts movement, the best thing would be to reject it out of hand, promise to reverse the cuts in large measure, so as to stimulate the economy and set off a virtuous circle of growth that would restore government finances and get the economy back to where it was in 2008, before the bankers’ sabotage act and global crisis got started. But if Labour did this, or even if they continued with the ducking and weaving, they would be open to a counterattack: Labour will put up your taxes. And the signs are that most people do not accept the anti-cuts narrative, and are hard-pressed financially – so not in generous mood when it comes to tax rises. No doubt the memory of 1992 haunts Labour’s leaders, when Labour lost a very winnable election after the Tories attacked them in the last week with a campaign based on “Labour’s tax bombshell” by hyping up the vaguenesses in Labour’s plans. But signing up to the coalition’s cuts would be hard too. It makes the manufactured anger about their impact difficult to sustain. Many of their supporters will feel betrayed.

But sign up to the coalition’s plans, with a bit of trimming here and there, is exactly what Labour have done. First in a speech by Mr Balls, and then this weekend by Mr Miliband himself. The message in the media has been very clear. I don’t know how it is going down in Labour’s activist base. Polly Toynbee, who often rallies to the anti-cuts cause, seems be showing resigned acceptance, while hoping than the party will come up with other ideas that will motivate the left. It isn’t exactly a U-turn. The narrative is that the economy, after the coalition’s poor management, is now so weak it cannot support more spending. This is weak fare indeed, and only shows that Labour had in reality accepted the bulk of the coalition’s austerity plans, subject to really very minor variations (like a temporary VAT cut).

The political calculation is clear. The angry brigade have nowhere else to go than Labour. Lib Dems may feel vindicated by Labour’s stance, but their previous public sector supporters will still not forgive them, except maybe in hard-fought marginal seats where they are up against the Tories. Britain’s two party electoral system means that elections are won by wooing floating voters. And these seem convinced by the case for austerity, even if, like Ms Toynbee, you blame this on the relentless right-wing press and the TV coverage that tamely follows in its wake.

The battle ground for the 2015 election is getting clearer. It won’t be about whether there should be cuts, but on where they should fall. For somebody like this blogger who accepts the basic logic of austerity economics in the UK, that should take the political debate into interesting and constructive territory. But others will feel disenfranchised and betrayed. Things are warming up.

The Woolwich murder: time for solidarity not demonisation

A week ago a British soldier, Lee Rigby, was murdered in Woolwich, in southeast London. His murderers (subject to due process of law…) were two British black Muslim converts, who had taken up Jihadist views. Their methods were as low tech as possible, and they were happy to be caught, though they may have wanted to be killed by police snipers. For them the point was publicity. In this they have succeeded beyond their wildest dreams. The story was promoted massively by all media outlets, and it is still getting a lot of coverage – quite out of proportion to other deaths, of civilians in London, or of soldiers on active service. The whole episode has stirred passions, and the results are disturbing.

At first I tried to retain a sense of proportion on the affair. It was pretty horrid, but more a random act of violence than a systemic threat to our way of life. But I seem to have missed something; the episode has hit Britain’s pressured working classes in a sore spot. For reasons that future historians will debate, soldiers have become a working class icon here in Britain (and perhaps the US as well). Their travails in Iraq and Afghanistan seem to symbolise the general pressures that working class people face: sent to fight wars nobody understands, and generally let down by the elites that sent them there. They are referred to as heroes.

This seems very different to the ways soldiers used to be regarded. The heroism is based on the dangers that the soldiers face and the endurance they show, not on the number of enemy that they kill. There was a bit of embarrassment when Prince Harry, after serving in Afghanistan, confessed that his actions would have killed people. Soldiering is about meting out violence; but we don’t really talk about that aspect of their work. There are occasional efforts to demonise the enemy, but it all turns out to be a bit complicated when many of your local allies appear little better. It is perhaps interesting that I don’t remember anything like this public regard for British soldiers serving in Northern Ireland, though I do remember having those feelings myself. The violence they inflicted on people that looked very like us, with some inevitable innocents, was altogether more visible, and made people feel uncomfortable.

Be that as it may, the target of last week’s attack could not have symbolised the working class icon better. And the reaction has been anger. The nasty islamophobic English defence League (EDL) has seen its popularity rocket. Attacks and threats on Muslims have soared. This seems to be a mainly working class phenomenon, though middle class prejudices are perfectly visible too, judging by the odd Facebook comment.

This is very depressing. The demonisation of Muslims and the Islamic religion is grossly unjust. All it can do is push more young British Muslims, suffering similar working class pressures, into extreme views. But demonising the EDL’s supporter doesn’t help either, and quickly takes on an air of class prejudice.

The fact is that most of British working classes, of all colours and races, are under pressure. Technology is killing traditional working class jobs and pressuring wages; housing costs, at least in places where there are jobs, are steadily rising. Benefit and public service cuts add to the pressure: though their effect on the working classes as a whole is complex – resentment at people living on benefit runs high amongst working class people. The education system often lets them down.

There are no easy answers. Stoking up a sense of victimhood, and throwing in the odd benefit or tax credit entitlement, is a road to nowhere, though advocated by many Labour politicians. By and large we need people to take more control of their lives and education, not blame everybody else when things go sour. The education system is slowly being fixed, though not all the government’s ideas are helpful. We need more social housing in the southeast, building on greenbelts if necessary. That’s hard and the government is doing much too little, though I don’t hear much convincing or constructive coming out of the Labour side either.

But it helps to understand and to listen. About the only shaft of light to emerge over the last week was an act of reconciliation made by a mosque in York to EDL protestors. Tea and biscuits made the headlines, but the real progress was made when the two sides got into dialogue and discovered their shared interests. Too many people advocate intolerance and confrontation (“standing up for what you believe in”), which only promotes misunderstanding and division. What is needed is true working class solidarity across race and religion to press for changes that will improve life in all our pressured communities.

Japan: are there lessons for other developed economies?

A while ago I wrote that the radical economic policies of Japan’s new government under Shinzo Abe would be an interesting experiment for the world. They were much lauded by austerity sceptics, such as Paul Krugman, who drew attention to aggressive monetary policies and fiscal stimulus, which they were advocating for other developed economies. I was sceptical. But early results have exceeded expectations. There is a good analysis here from the Economist, which also discusses the new government’s nationalist tendencies. Is this evidence that the austerity policies being pursued by much of the rest of the developed world are mistaken?

My scepticism when I last posted was based on two things. First that the policies hinged on companies raising wages, when their profits were under pressure. Second was that, based on Mr Abe’s previous form, I did not think that structural reforms to Japan’s economy would be pursued with vigour. On both counts it looks as if I was too pessimistic. This means that Japan’s economy might well get a sustained period of growth, and that it will reduce the burden of government debt. But applying its policies to other developed economies is problematic. There are three reasons for this.

The first is that for longer term success it is still the element of structural reform that is critical. Mr Abe refers to his programme as “three arrows”, in reference to a Japanese folklore story that you can snap the shaft of a single arrow easily, but not three held together. These three are monetary easing, fiscal stimulus and structural reform. Austerity policies in Europe and America are firmly based on structural reform: especially in reducing the size of the state. Opponents of austerity tend to want to halt or slow down structural reform. Some say that it should wait until growth is resumed; others would rather avoid the reform process altogether. The three arrows approach would in fact promote reform, alongside the monetary and fiscal palliatives, and, indeed, the more considered critics of austerity do say this. But here there is a problem: Japan does not have an oversized state, so cutting back government expenditure is not a major reform priority, as opposed to opening the economy up to more competition and reforming corporate taxes. In Britain, France, Italy, Spain and so on the size state has run beyond what the economy can sustain, and so it has to be cut back, which in turn drains demand from the economy in the short term. There is good reason to doubt whether fiscal or monetary stimulus, beyond their current levels, are compatible with the need to shrink the state.

There is a second important difference in Japan. Its economy has a trade surplus and (which is linked) a savings surplus, albeit temporarily challenged as it has to import energy while its nuclear programme is in abeyance. That means that a fall in the exchange rate, as has happened to the Yen, will generate an immediate bonus to businesses, easily outweighing the extra costs imposed on the economy. This allows companies to put wages up. The savings surplus also means that the economy is not dependent on borrowing from overseas investors, who might be shaken by such currency depreciation. This is not the case with the austerity economies. Where their exchange rates have fallen, as in Britain, this has simply contributed to the squeeze on consumers without benefiting business to anything like the same degree.

Mentioning the exchange rate brings me to a third observation. It is that a lot of Japan’s success so far has less to do with with the country’s actual economic policies than with the effect of announcements on the zeitgeist. Implementation has hardly started, and yet the exchange rate has already plummeted and stock market risen, which is having the necessary warming effect, and set off a virtuous circle. The same can be said, in reverse, for austerity policies in the West, of course. But where reforms are necessarily painful, this is almost impossible to do. Economists have long been reluctant to admit the role of psychology in macroeconomic policy, and have let it in only gradually (through such ideas a inflation expectations). Governments and central banks have long known it – and Mr Abe’s government is acutely aware. The question for Europeans, in particular, is whether further aggressive monetary easing, linked to higher inflation expectations, combined with some fiscal stimulus would lift the zeitgeist and get the economies moving again. We have reason to be sceptical.

Almost all the developed economies in the world are experiencing difficulties. It is easy to fall in with the idea that this must be for similar reasons and that the solutions for each economy are similar. In fact each major economy is unique. And the differences between Japan and the others is amongst the largest. Abenomics may work for Japan, but that does not mean they will work anywhere else.