Featured Articles: Introducing #PlatformPitches

#PlatformPitches is the name we’ve given to our new series of articles, offering suggestions to the Republican ticket. There are now three articles in the series:

Introducing #PlatformPitches: Our Suggestions for the Republican Ticket

#PlatformPitches: Time For A New COPS Program

NEW: #PlatformPitches: You Want Price Controls? I’ll Show You Price Controls

Why This Cardiac Care Proposal Misses a Beat

Like many on the right, on the center, and even on the sane left, I am an enormous admirer of Bjorn Lomborg. The Swedish statistician has made a name for himself by responding to the craziest claims and prescriptions of radical environmentalists regarding topics such as climate change, with sober analysis.

An argument Lomborg often makes–a very simple one, but one so consistently overlooked by activists–is that each spending decision also carries an opportunity cost. In other words, the gigantic sums of money that activists want us to spend on climate change are money that’s not going to be spent on other interventions, and there are many, many interventions that would save or improve a lot more lives in the here and now than the theoretical future lives saved by anti-climate change initiatives.

This is why we were excited to see this article by Lomborg on a supposedly low-hanging fruit of global health, and on how we could save many lives in the developing world with little money. Such low-hanging fruits do exist: the most famous one is the most universally-praised Bush Administration program: PEPFAR, the President’s Emergency Plan for AIDS Relief, which paid for AIDS medications for poor people around the world, which has saved over 25 million lives, primarily in sub-Saharan Africa–and for very little money.

If they are effective and provide value for money, these programs are good not just for humanitarian reasons, but from much more cold-hearted and pragmatic reasons of national interest and American soft power.

So we were excited and intrigued to see Lomborg propose a kind of “PEPFAR for heart disease” (our expression, not his).

We think of cardiovascular disease as a rich world’s problem, but Lomborg informs us that it also wreaks havoc in poor countries, and that there are easy, cheap fixes. Unfortunately, we ultimately found that Lomborg’s prescription suffers from the problems of the activists he so readily skewers: long on the wishing, short and vague on the prescription.

Lomborg points out that cardiovascular disease is one of those “lifestyle diseases” and wants us to spend money on “initiatives that educate the public about healthy lifestyles, encourage regular check-ups, and provide access to affordable healthcare options.” Forgive us for finding this vague.

While education is important, evidence for the effectiveness of broad public health campaigns in changing behavior and health outcomes is mixed at best.

Meanwhile, regular health check-ups sound like a common-sense solution, but research has shown that general health checks do not significantly reduce morbidity or mortality from cardiovascular causes.

Finally, Lomborg’s suggestion to “provide access to affordable healthcare options” is vague and likely underestimates the true cost and complexity of implementing such a system. While he correctly points out that some blood pressure medications are inexpensive, the infrastructure needed to diagnose, prescribe, and monitor their use effectively is much more costly and complex. Lomborg’s claim that controlling high blood pressure in poorer countries would cost only $3.5 billion annually seems unrealistically low. This figure might refer to a very specific, targeted intervention rather than a comprehensive solution. The true costs of implementing effective, sustainable cardiovascular health programs on a global scale are likely to be much higher–if possible at all, given that they would have to go through one of the infinite, money-sucking aid bureaucracies.

There may be a simpler, less ambitious but more tailored proposal, however, focusing specifically on increasing access to blood pressure medications.

Hypertension is often called the “silent killer” because it typically has no symptoms but significantly increases the risk of heart disease and stroke. It’s also one of the most treatable risk factors for cardiovascular disease. Many effective blood pressure medications are now off-patent and very inexpensive. A targeted program that combines community-based blood pressure screening with direct provision of these low-cost medications could potentially save many lives at a relatively low cost.

Such a program would need to be carefully designed and implemented, with attention paid to issues like medication adherence, regular monitoring, and integration with existing health systems. It would not be a complete solution to global cardiovascular disease, but it could produce actual results.

Policy News You Need This Morning

#Space – The totally-not-stranded stranded astronauts will come back on SpaceX’s Dragon capsule, reports Ars Technica’s Senior Space Editor Eric Berger. We have been covering this story for some time now and expecting this result, which is a further humiliation for Boeing.

#Immigration – X dot com was set aflame over the weekend after a prominent Indian-American VC shared a guide to immigrating to the US that recommended committing scientific fraud. Remember that this is what’s considered “high-skill immigration” nowadays.

#TheScience – Speaking of scientific fraud, it turns out the science on beta blockers for heart surgery was based on fraud. Europe changed its medical guidelines based on this research, when beta blockers actually increase the risk of death by 27%. Scientific fraud is ripe, and it kills.

#Immigration – And also, speaking of immigration: Joe Guzzardi at the Institute for Sound Public Policy sets the record straight on the infamous border bill that the Biden Administration promoted. It did not provide for securing the border.

#Healthcare – At Health Affairs, Benedic Ippolito and Joseph F. Levy estimate the cost of expanding Medicare coverage of anti-obesity medicines. They come up with the figure of “$3.1 to $6.1 billion” per year. Less than we would have guessed. Interesting.

#TaxPolicy – If you’ve ever been an entrepreneur or a small business owner like us, this will pique your interest. It’s technical but important. From AEI’s Kyle Pomerleau: “The Tax Cuts and Jobs Act introduced a 20 percent deduction for qualified business income to maintain rough “parity” between pass-through businesses and C corporations. However, the deduction fails to ensure parity and exacerbates existing distortions. Given the deduction’s impending expiration, lawmakers have an opportunity to consider alternatives—one of which is corporate integration, a set of policies designed to standardize business taxation.”

#StateCapacity – Due to a recruitment crisis, “the US Navy is planning to mothball seventeen fleet auxiliaries – including an entire class of new fast transports.” More here.

#ElectionIntegrity #StateCapacity – In Virginia, the Youngkin Administration “removed 80,000 dead voters and 6,000 non-citizens from Virginia’s voter rolls.” (Via) In related news, in a recent Rasmussen poll of Arizona voters, 3% of respondents said they were not citizens and yet vote in Federal elections. We’re aware Rasmussen is a controversial pollster, but they have often produced good work. In any case, we report, you decide.

#FinReg – ATM fees hit record high for 4th straight year. One problem with “banning fees” is that you’ll just get more of other fees.

#Tech – Interesting article from RAND: Four Fallacies of AI Cybersecurity.

Chart of the Day

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