Macro Roundup

J. Peder Zane, “Physics, Biology and Economic Inequality,”Wall Street Journal, February 1, 2019, https://www.wsj.com/articles/physics-biology-and-economic-inequality-11549061005

Physics, Biology and Economic Inequality

As we move toward our seats for lunch at Duke University, Adrian Bejan says he’s studied the Journal’s Weekend Interviews and that they usually begin with the subject declaring “what everybody else believes is wrong.”

“So I made a list for you,” says Mr. Bejan, 70, a professor of mechanical engineering. He disputes a set of ideas that have shaped Western thought at least since Darwin: that nature is unpredictable, that evolution is random, and that the world is on a steady march toward disorder.

“This couldn’t be more incorrect,” he says. “It is at odds with the purpose of science, which is useful precisely because it allows us to predict what’s going to happen, but with the evidence we see all around us that nature and human society are steadily and measurably evolving in ways that are better for everyone and everything that moves—not because of chance.”

Now, there’s an icebreaker, and from a man who’s been breaking ice in science for some time. Born in Romania, Mr. Bejan came to the U.S. at 19 to study at the Massachusetts Institute of Technology. He specialized in thermodynamics—the study of heat, power and other forms of energy—but a “Eureka!” moment in 1995 broadened his horizons. It happened in France as he listened to a lecture by Ilya Prigogine, winner of the 1977 Nobel Prize in Chemistry. Prigogine asserted that the treelike shapes that abound in nature—in lightning bolts and river basins, in our circulatory systems and the neural networks of our brains—arise by “throwing the dice,” without rhyme or reason.

“I knew he was wrong,” says Mr. Bejan, who had already created his own trees, “not by accident but from an idea,” while working to cool computer systems. Flow systems arise to move a current from here to there; Mr. Bejan imagined correctly that tree-shaped pieces of highly conductive material would convey heat away from the circuits more easily.

In a flash, he knew that his insight applied to—well, everything. On the flight back to the U.S., he formulated what he called the “constructal law”: “For a finite-size flow system to persist in time (to live), it must evolve with freedom in such a way that it provides easier access to the imposed currents that flow through it.”

In layman’s terms, that means all shape and structure—all “design” in nature—evolves in a predictable direction: toward facilitating the movement of whatever flows through it. Designs evolve by configuring and reconfiguring themselves to move more stuff more easily. The world around us reveals a story of movement, flow, life, order and change. “You can’t take a picture of reality,” Bejan says, “because it’s a movie, or a cartoon, depending on your sensibility.”

Sometimes this evolution happens over millions of years. Raindrops don’t merely puddle and seep across the ground—an inefficient way to move. Instead they self-organize into the familiar treelike river basins that cover the globe—the networks of brooks, streams, large tributaries and main channels, such as the Mississippi or the Danube—that move more water more quickly from the plain to the river’s mouth. The circulatory systems of humans and other animals have a similar configuration, with a single main channel, the aorta, that pumps blood throughout the body through networks of arteries, veins and capillaries.

This evolutionary phenomenon can also happen in an instant, as when treelike lightning bolts flash across the sky, an efficient design for moving electricity from a cloud to the ground or to another cloud.

If Darwin knocked humans off our pedestal by suggesting we’re not so different from monkeys, the constructal law teaches that we are not so different from trees or rivers. “Life is not a strictly biological phenomenon. Life is movement, and all movement is physics,” Mr. Bejan says. “It’s about moving stuff from here to there. The constructal law observes the natural tendency of everything to evolve freely to keep moving. When that movement stops, whether it’s a human being or a dried river bed, it is ‘dead,’ according to thermodynamics.”

The religiously inclined might see the unity of this theory as pointing toward an idea about God. That’s not Mr. Bejan’s view. “There is design change—evolution—but no designer,” he says. “People ask me, ‘Why does this design happen?’ The answer is it just does, which is why it is a law, a property of nature.”

Yet the constructal law also applies to the products of human design. “What nature tends to do on its own, we tend to do in our life movement, because we too are part of the flowing nature,” Mr. Bejan says. Think of roads. Highways move large numbers of vehicles quickly, but the design also includes avenues, streets and lanes, and the paths we walk to get to our vehicles.

“We can all witness evolution in new speed records at the Olympics, and in the shapes and speeds of new airplane models,” he continues. “There is evolution galore in our textbooks on the history of civilization, which chronicle humanity’s successful efforts to construct designs—laws and transport systems, infrastructure, architecture, art, language, economic and political systems, communication networks—to move more people, goods and ideas more easily and with greater lasting power.”

Mr. Bejan says engineers are beginning to apply his insights. “For example, now we know that the engines on future commercial airplanes should be one-tenth of the size of the whole body, and that the wingspan should be the same as the fuselage length. For future helicopter designs, we know in advance that the rotor diameter should match the length of the body. We know that future ice-making machines should discharge ice with a particular rhythm, just like a lung that exhales with a particular rhythm.”

Mr. Bejan’s big-picture work stands in contrast with the trend in science toward asking ever-smaller questions—in physics, seeking answers on a subatomic scale. “I invented the field of life and evolution as physics—to look at life and evolution as natural phenomena everywhere and in all realms,” he says. “This new physics is not strictly about tree-shaped flows. It is about all the morphing architectures that are macroscopic, free, observable and measurable—for example, the round cross-sections we find in blood vessels, subterranean rivers and the tunnels dugs by worms; or the seemingly precise rhythms of breathing, running, wings flapping, flags waving and smoke plumes dancing. The science of form comes predictively from principle, not from analogy. Evolution is physics, not opinion.”

Although his ideas are new, he says people have long had “good hunches” about them. Idioms such as “go with the flow” and “path of least resistance” reflect colloquial efforts to describe this phenomenon. Popular writers, including Steven Pinker (“Enlightenment Now”), Matt Ridley (“The Evolution of Everything”) and even Jordan B. Peterson (“12 Rules for Life”) have also touched on the same idea. But that work “is descriptive,” Mr. Bejan says. “It provides the observation that certain patterns and trends emerge. The constructal law is theoretical. It is a purely mental viewing of what should happen, and these predictions are later tested empirically.”

Mr. Bejan says all this with a smile, in part because he loves the battle, but also because after years in the wilderness, he is seeing scholars in a variety of fields embrace his revolutionary views. Conferences on his work are held regularly throughout the world—the 12th is slated for Brazil in March. Last year he was awarded one of the most prestigious prizes in science, the Benjamin Franklin Medal, for the constructal law and a body of work that includes more than 650 peer-reviewed papers and 30 books, including “The Physics of Life” (2016) and the one we wrote together, “Design in Nature” (2012).

The constructal law also has implications for social sciences, including economics. Whereas Darwinism and Marxism stress competition and zero-sum outcomes, the constructal law observes that individual entities, including human beings, have a natural tendency to join groups because it helps each of them “flow” more easily.

“Everywhere,” Mr. Bejan says, “we see this phenomenon: a few large movers and many smaller ones, all working together for the good of the whole. The large channels are not robbing the smaller ones; both are serving each other.” That leads to what may be Mr. Bejan’s most provocative claim: that economic and social inequality is the inevitable result of physical laws. “Hierarchy is not imposed, it is natural,” he says. “Equality, however, is artificial, because it violates the law of evolution in nature.”

Mr. Bejan emphasizes that he does not mean this as a political statement or a moral defense of inequality: “Physics is not about justice or fairness, but about what happens in nature.” The “physics origin” of inequality, he says, “is that nothing moves unless it is pushed. Pushing comes from power, and power comes from fuel for machines and food for animals. Fuel use is the physics measure of movement, and, like movement, fuel use is distributed nonuniformly around the globe.

“Next, because the amount of fuel consumed annually by a population is directly proportional to its annual wealth, the GDP, the life movement of a population—the economy—becomes hierarchical naturally, with a few large and many small movers. So physics and economics are two sides of the same coin. The same hierarchical-flow architecture accounts for both.”

Harnessing that power rather than fighting it, Mr. Bejan argues, is a better way of helping the disadvantaged. “If we think about inequality as a physical phenomenon, perhaps that can inform the discussion, so that instead of trying to erase these differences, we can see how to connect the slow-moving pockets of society to the big-flow architecture,” he says. “Artificial constraints that limit the freedom of a system to change might work for a while. But they are ultimately doomed because they are not just fighting against the will of the people but the laws of physics.”

Systems must evolve and build on the designs already in place. Thus it is folly to think one can impose radically new political and economic systems on different nations. It’s not just the lack of a specific political tradition and the absence of the channels needed to move people, ideas and goods, Mr. Bejan says: “The chief impediment is the absence of a culture that encourages and rewards freedom to question authority, to speak up, inquire, innovate and implement change.”

“…., he formulated what he called the“constructal law”: “For a finite-size flow system to persist in time (to live), it must evolve with freedom in such a way that it provides easier access to the imposed currents that flow through it.” In layman’s terms, that means all shape and structure—all “design” in nature—evolves in a predictable direction: toward facilitating the movement of whatever flows through it. Designs evolve by configuring and reconfiguring themselves to move more stuff more easily. The world around us reveals a story of movement, flow, life, order and change. “You can’t take a picture of reality,” Bejan says, “because it’s a movie, or a cartoon, depending on your sensibility.” Sometimes this evolution happens over millions of years. Raindrops don’t merely puddle and seep across the ground—an inefficient way to move. Instead they self-organize into the familiar treelike river basins that cover the globe—the networks of brooks, streams, large tributaries and main channels, such as the Mississippi or the Danube—that move more water more quickly from the plain to the river’s mouth. The circulatory systems of humans and other animals have a similar configuration, with a single main channel, the aorta, that pumps blood throughout the body through networks of arteries, veins and capillaries. This evolutionary phenomenon can also happen in an instant, as when treelike lightning bolts flash across the sky, an efficient design for moving electricity from a cloud to the ground or to another cloud. If Darwin knocked humans off our pedestal by suggesting we’re not so different from monkeys, the constructal law teaches that we are not so different from trees or rivers. “Life is not a strictly biological phenomenon. Life is movement, and all movement is physics,” Mr. Bejan says. “It’s about moving stuff from here to there. The constructal law observes the natural tendency of everything to evolve freely to keep moving. When that movement stops, whether it’s a human being or a dried river bed, it is ‘dead,’ according to thermodynamics.”…”

“…According to the Gallup poll, 70 percent of Americans with private insurance rate their coverage as “excellent” or “good;” 85 percent say the same about the medical care they receive. The Kaiser poll found that the percentage of Americans who support a national health plan drops by 19 percentage points when people hear that it would eliminate insurance companies or that it would require Americans to pay more in taxes…”

Jonathan Martin and Abby Goodnough, "Medicare for All Emerges as Early Policy Test for 2020 Democrats,"New York Times, February 2, 2019, https://www.nytimes.com/2019/02/02/us/politics/medicare-for-all-2020.html

Medicare for All Emerges as Early Policy Test for 2020 Democrats

WASHINGTON — Senator Elizabeth Warren spoke at length this week about her vision for improving the American health care system, like strengthening the Affordable Care Act and making prescription drugs more affordable. Twice, though, she ignored a question posed to her: Would she support eliminating private health insurance in favor of a single-payer system?

“Affordable health care for every American” is her goal, Ms. Warren said on Bloomberg Television, and there are “different ways we can get there.”

To put it another way: I am not walking into that political trap.

Ms. Warren of Massachusetts and three other liberal presidential candidates support a Medicare for All bill, which would create a single-payer health plan run by the government and increase federal spending by at least $2.5 trillion a year, according to several estimates. But Ms. Warren’s determination to sidestep an essential but deeply controversial issue at the heart of the single-payer model — would people lose the choices offered by private insurance? — illustrated one of the thorniest dilemmas for several Democrats as the 2020 primary gets underway.

Their activist base, inspired by Senator Bernie Sanders of Vermont, believes that the party should unabashedly pursue universal health care, ending private insurance entirely. But polls indicate that the broader electorate, particularly the moderate- and high-income voters who propelled the party’s sweeping suburban gains in the midterms, is uneasy about this “Medicare for all” approach in which many would lose their current insurance options and pay higher taxes.

Senator Kamala Harris of California drew immediate attacks from Republicans this week by taking on the issue that Ms. Warren dodged. Ms. Harris breezily acknowledged in a CNN town hall forum that she would “eliminate all of that,” referring to ending private insurance in a country where almost 60 percent of the population receives coverage through an employer.

Her remark triggered an intraparty debate about an issue that until now had been largely theoretical: A decade after Democrats pushed through the most significant expansion of health care since the Great Society, should they build incrementally on the Affordable Care Act or scrap the insurance sector entirely and create a European-style public program?

Four Democratic presidential candidates — Ms. Harris, Ms. Warren, Senator Kirsten Gillibrand of New York and Senator Cory Booker of New Jersey — are among the co-sponsors of Mr. Sanders’s Medicare for All bill, which would replace the Affordable Care Act with a single government health plan for all Americans. Medicare is the federal program providing health coverage to people 65 and older.

The concept of Medicare for all has become popular with Democrats: 81 percent support it, according to a recent Kaiser poll. Yet voter opposition to surrendering the insurance they are used to led to a backlash over President Barack Obama’s repeated promise that “if you like your plan, you can keep your plan” after it proved false for several million people under his health law. Many Democrats are keenly aware of that backlash, and the 2020 presidential race will be the first where many of the party’s leading candidates will have to explain and defend the meaning of Medicare for all.

For now, as Ms. Warren demonstrated, many candidates do not want to wrestle publicly with the details. After Ms. Harris’s comment, her aides hastened to add that she would also support less sweeping changes to health care; like most other candidates, Ms. Harris declined an interview request. And by Friday, Mr. Booker, hours after announcing his presidential bid, sought to curtail the matter by offering a brisk “no” when asked if he supported eliminating private coverage.

Yet there is one likely 2020 contender who is thrilled to discuss Medicare for all.

Mr. Sanders, in an interview, did not mince words: The only role for private insurance in the system he envisioned would be “cosmetic surgery, you want to get your nose fixed.”

“Every candidate will make his or her own decisions,” Mr. Sanders said, but “if I look at polling and 70 percent of the people support Medicare for All, if a very significant percentage of people think the rich, the very rich, should start paying their fair share of taxes, I think I’d be pretty dumb not to develop policies that capture what the American people want.”

But Michael R. Bloomberg, the former New York City mayor who is considering a 2020 bid on a centrist Democratic platform, said it would be folly to even consider a single-payer system. “To replace the entire private system where companies provide health care for their employees would bankrupt us for a very long time,” Mr. Bloomberg told reporters in New Hampshire on Tuesday.

The Congressional Budget Office has not scored Mr. Sanders’s Medicare for All bill, but a study last year by the Mercatus Center of George Mason University predicted it would increase federal spending by at least $32.6 trillion over the first decade. The cost could be even greater, the study says, if the bill overestimated the projected savings on administrative and drug costs, as well as payments to health care providers.

The divide between Mr. Sanders, a democratic socialist, and Mr. Bloomberg, a Republican-turned-independent-turned-Democrat, reflects the large chasm in a party that has been reshaped by President Trump.

The president’s hard-line nationalism has simultaneously nudged Democrats to the left, emboldening them to pursue unambiguously liberal policies, and drawn independents and moderate Republicans to the party because they cannot abide his incendiary conduct and demagogy on race. These dueling forces have created a growing but ungainly coalition that shares contempt for Mr. Trump but is less unified on policy matters like health care.

And these divisions extend to what is wisest politically.

Liberals argue that the only way to drive up turnout among unlikely voters or win back some of the voters uneasy with Hillary Clinton’s ties to corporate interests is to pursue a bold agenda and elevate issues like Medicare for all.

“Those who run on incremental changes are not the ones who are going to get people excited and get people to turn out,” said Representative Pramila Jayapal of Washington, the co-chair of the Congressional Progressive Caucus.

And by preserving their options, Democrats risk alienating liberal primary voters, some of whom consider support for Medicare for all a litmus test.

“The center is not a good place to be on these policies anymore,” said Mary O’Connor, 61, a substitute teacher and horse farmer in Middleburg, Va., who wants a single-payer system. “I’ll be watching extremely closely, and I will most likely jump on board and volunteer for whoever it is that’s going to be the most forceful for this.”

But moderates believe that most Democratic primary voters are more fixated on defeating Mr. Trump than applying litmus tests — and that terminating employer-sponsored insurance would only frighten the sort of general election voters who are eager to cast out Mr. Trump but do not want to wholly remake the country’s health care system.

“Most of the freshmen who helped take back the House got elected on: ‘We’re going to protect your health insurance even if you have a pre-existing condition,’ not ‘We’re going to take this whole system and throw it out the window,’” said Kenneth Baer, a Democratic strategist.

While polling does show that Medicare for all — a buzz phrase that has lately been applied to everything from single-payer health care to programs that would allow some or all Americans to buy into Medicare or Medicaid — has broad public support, attitudes swing significantly depending on not just the details, but respondents’ age and income.

On the House side, a bill similar in scope to Mr. Sanders’s is under revision and will soon be reintroduced with Ms. Jayapal as the main sponsor. Other Democrats have introduced less expansive “Medicare buy-in” bills, which would preserve the current system but would give certain Americans under 65 the option of paying for Medicare or a new “public option” plan. Another bill would give every state the option of letting residents buy into Medicaid, the government health program for poor Americans.

The buy-in programs would generally cover between 60 and 80 percent of people’s medical costs and would require much less federal spending because enrollees would still pay premiums and not everyone would be eligible. Some proponents, like Senator Jeff Merkley, Democrat of Oregon, have described them as a steppingstone on the way to a full single-payer system; some of the Democrats running for president are co-sponsoring these “Medicare for more” bills as well as Mr. Sanders’s.

Mr. Sanders has suggested options to raise the money needed for his plan, such as a new 7.5 percent payroll tax and a wealth tax on the top 0.1 percent of earners. He has also predicted several trillion dollars in savings over 10 years from eliminating the tax exclusion that employers get on what they pay toward their workers’ insurance premiums, and other tax breaks.

But Robert Blendon, a health policy professor at Harvard who studies public opinion, said it would be wise not to delve into financing details for now.

“The reason it failed in Vermont and Colorado was taxes,” Professor Blendon said, referring to recent efforts to move to a near-universal health care system in those states, which flopped resoundingly because they would have required major tax increases. “But Democratic primary voters will not go deep into asking how these plans will work. What they will say is, ‘Show me you have a principle that health care is a human right.’”

The general election will be a different story, Professor Blendon added. If Ms. Harris were to become the Democratic nominee and keep embracing the idea of ending private coverage, he argued, “she’s going to have terrible problems.”

The difficulty for Democrats, added Ezekiel Emanuel, a former Obama health care adviser, is that many voters look at the health care system the same way they view politics. “They say Congress is terrible but I like my congressman,” as Mr. Emanuel put it.

According to the Gallup poll, 70 percent of Americans with private insurance rate their coverage as “excellent” or “good;” 85 percent say the same about the medical care they receive. The Kaiser poll found that the percentage of Americans who support a national health plan drops by 19 percentage points when people hear that it would eliminate insurance companies or that it would require Americans to pay more in taxes.

Among those who make over $90,000 a year — the sort of voters in the House districts that several Democrats captured in the midterms — those surveyed in the Kaiser poll were particularly wary of an all-government system: 64 percent in this income group said they would oppose a Medicare for all plan that terminated private insurance.

“My constituents are tired of bumper sticker debates about complex issues,” said Representative Lizzie Pannill Fletcher of Texas, a freshman from an affluent Houston district. “We don’t want ideologues in charge.”

In Vermont, where former Gov. Peter Shumlin shelved his ambitious plan for a single-payer system in 2014 after conceding it would require “enormous” new taxes, advocates for universal health care are now resigned to a more incremental approach.

Dr. Deb Richter, a primary care doctor who helped lead the state’s single-payer movement, said that while the Democratic field is “going to have to face the T word,” being upfront about the required tax increases, she now thinks phasing in a government-run system is a better approach.

“There’s ways of doing this that don’t have to happen all at once,” she said, pointing to a push in Vermont to start with universal government coverage for primary care only. “But you need to talk about the end goal: We are aiming for Medicare for all, and this is a way of getting it done.”