Macro Roundup

"...This response emerges from an insight that I like to callthe working hypothesis: that a labor market in which workers can support strong families and communities is the central determinant of long-term prosperity and should be the central focus of public policy.Genuine prosperity depends upon people working as productive contributors to their society, through which they can achieve self-sufficiency, support their families, participate in their communities, and raise children prepared to do the same. And it is the labor market that determines where, how, by whom and at what price most work gets done...."

Oren Cass, "The Communal Power of a Real Job," New York Times, August 3, 2019, https://www.nytimes.com/2019/08/03/opinion/sunday/workers-conservatives.html

The Communal Power of a Real Job

The conservative blueprint envisions a flourishing society built upon a foundation of strong families and communities, buttressed by a free market. But cracks in that foundation are widening, the structure is swaying, and market forces are providing little support. In response, conservatives are turning their focus to workers.

This response emerges from an insight that I like to call the working hypothesis: that a labor market in which workers can support strong families and communities is the central determinant of long-term prosperity and should be the central focus of public policy. Genuine prosperity depends upon people working as productive contributors to their society, through which they can achieve self-sufficiency, support their families, participate in their communities, and raise children prepared to do the same. And it is the labor market that determines where, how, by whom and at what price most work gets done.

The labor market’s outcomes, like any market’s, depend on the conditions in which it operates. Crucially, while a labor market left alone will seek an efficient equilibrium, economic theory never promises that the equilibrium will be a socially desirable, inclusive one. A genuine conservatism values markets as powerful mechanisms that foster choice, promote competition and deliver growth, but always in service to the larger end of a cohesive society in which people can thrive. Observing that deficiencies in the labor market’s outcomes have become acute, conservatives are beginning to ask which conditions are leading to those outcomes and how to change those conditions.

The Republican senators Marco Rubio and Josh Hawley are in the vanguard of that effort. Read Mr. Rubio’s report from May, “American Investment in the 21st Century,” which interrogates the business sector’s failure to make long-term investments in the nation’s economic future. Or watch Mr. Hawley’s maiden speech on the Senate floor, also from May, in which he excoriated the “new aristocrats” who “seek to remake society in their own image: to engineer an economy that works for the elite but few else.” Instead, Mr. Hawley said, “we need a society that offers rewarding work for every worker who wants it, wherever she is from, whatever degree he might have, whether their ambition is to start a business or to start a family.”

Intuitively, progressives might seem the likely vindicators of workers’ interests. But the serious structural changes that the labor market needs will entail real trade-offs with other priorities that progressives see as more important.

Consider the constellation of issues emphasized thus far in the Democratic Party’s presidential primary: free college and health care, relaxed or nonexistent immigration enforcement, and various “Green New Deals” whose explicit goal is suppression of the energy-producing and -consuming sectors that form the backbone of the blue-collar economy. Such policies are more likely to harm than benefit workers, in their capacity as workers. Offers to help come typically as redistribution to compensate for what people can no longer accomplish themselves.

The appeal of redistribution is its promise of painless progress. Yes, the winners have to compensate the losers. But so long as they pay their taxes, they can structure society however they like. Actually changing the conditions that weaken the labor market and harm those left behind, by contrast, requires real concessions from the people commanding society’s cultural, economic and political heights.

Conservatives will be the advocates for such concessions because theirs is the perspective that sees no alternative, while progressives will more likely be attracted to the possibility that some novel configuration of society could work just as well. Conservatives will tend to view human nature and abilities as a constant to which policy must adapt, while progressives will see greater potential for transformation. Progressives will trust social and economic progress to provide the foundation for a healthy society, while conservatives will argue that a healthy society must instead provide the foundation for any progress.

In some cases, this will lead conservatives in directions they might already lean. The United States has cleaned its air to the point that Brussels, headquarters of the European Union, would be our dirtiest city. Recognition of the enormous social value of well-paying jobs for less-educated workers in manufacturing, construction and resource extraction argues for tolerating more of the pollution that comes with them.

In other cases, conservatives will head in new directions or even reverse course. Our society’s intensive commitment to the college pathway might make sense if we plan to have the one-fifth of students who move smoothly from high school to college to career take care of everyone else. But an insistence that workers throughout the labor market share in productivity growth will shift the education system focus from college completion to alternative pathways from high school to productive careers.

Conservatives’ longstanding hostility toward organized labor will give way to an emphasis on reform. The 1930s-style unions mandated by the National Labor Relations Act have passed their expiration date, but new forms of organizing through which workers can support one another, engage with management and contribute to civil society should be a conservative priority.

Rather than focus safety-net debates on budget savings, conservatives will ask how to use existing budgets better — for instance, by transforming at least some portion of the safety net into a wage subsidy delivered directly into each low-wage paycheck, encouraging less skilled workers to enter the labor force and businesses to employ them. Mr. Hawley proposed such a work credit in his successful campaign to unseat Claire McCaskill.

And yes, conservatives will bring a skepticism of unfettered international trade and immigration to the discussion as well. If the emphasis is on a healthy labor market, rather than merely rising consumption, then borders matter. Few things could benefit American workers more than forcing companies to rely on them — something progressives always acknowledged in their calls for greater worker power, until it began conflicting with other priorities.

More trade is good, if that trade is balanced. But huge trade deficits represent supplies of foreign workers entering the United States market from afar with no commensurate rise in foreign demand for what American workers produce. Immigration, likewise, can be constructive — if those immigrants enter segments of the labor market where native workers are doing well. But if a lack of economic opportunity for less-educated Americans is seen as one of society’s great challenges, allowing yet more less-educated workers to enter the labor market won’t make sense.

Mr. Rubio has co-sponsored legislation with Senator Tammy Baldwin, a Wisconsin Democrat, to confront China’s unfair trade practices and held hearings and published research on its industrial policy. This past week, Mr. Hawley and Ms. Baldwin co-sponsored legislation that would require the Federal Reserve to close the trade deficit by taxing foreign purchases of American assets.

Political realignments occur when core values collide with changed conditions, creating rifts that both divide longstanding alliances and bring new sets of constituencies and concerns into contact. The one underway in America is frequently mischaracterized as pitting an “open” progressive side that favors desirable things like trade, immigration, the environment and college against a “closed” conservative side that finds them scary. But the actual divide is between a progressive enthusiasm for pushing ahead and a conservative concern about restoring fractured foundations.

Most conservatives see value in all those “open” priorities too, but their nonnegotiable starting point is a cohesive society built on work, family and community. Their task is to persuade enough Americans that building higher should be contingent on first establishing the strength of a sturdy base.

"...Academics debate why American workers are in many ways worse off than their counterparts elsewhere, but there is overriding agreement on one reason: Labor unions are weaker in the United States than in other industrial nations. Just one in 16 private-sector American workers is in a union, largely because corporations are so adept and aggressive at beating back unionization. In no other industrial nation do corporations fight so hard to keep out unions...."

Steven Greenhouse, "Yes, America Is Rigged Against Workers,"New York Times, August 3, 2019, https://www.nytimes.com/2019/08/03/opinion/sunday/labor-unions.html

Yes, America Is Rigged Against Workers

The United States is the only advanced industrial nation that doesn’t have national laws guaranteeing paid maternity leave. It is also the only advanced economy that doesn’t guarantee workers any vacation, paid or unpaid, and the only highly developed country (other than South Korea) that doesn’t guarantee paid sick days. In contrast, the European Union’s 28 nations guarantee workers at least four weeks’ paid vacation.

Among the three dozen industrial countries in the Organization for Economic Cooperation and Development, the United States has the lowest minimum wage as a percentage of the median wage — just 34 percent of the typical wage, compared with 62 percent in France and 54 percent in Britain. It also has the second-highest percentage of low-wage workers among that group, exceeded only by Latvia.

All this means the United States suffers from what I call “anti-worker exceptionalism.”

Academics debate why American workers are in many ways worse off than their counterparts elsewhere, but there is overriding agreement on one reason: Labor unions are weaker in the United States than in other industrial nations. Just one in 16 private-sector American workers is in a union, largely because corporations are so adept and aggressive at beating back unionization. In no other industrial nation do corporations fight so hard to keep out unions.

The consequences are enormous, not only for wages and income inequality, but also for our politics and policymaking and for the many Americans who are mistreated at work.

To be sure, unions have their flaws, from corruption to their history of racial and sex discrimination. Still, Jacob S. Hacker and Paul Pierson write of an important, unappreciated feature of unions in “Winner-Take-All Politics”: “While there are many ‘progressive’ groups in the American universe of organized interests, labor is the only major one focused on the broad economic concerns of those with modest incomes.”

As workers’ power has waned, many corporations have adopted practices that were far rarer — if not unheard-of — decades ago: hiring hordes of unpaid interns, expecting workers to toil 60 or 70 hours a week, prohibiting employees from suing and instead forcing them into arbitration (which usually favors employers), and hamstringing employees’ mobility by making them sign noncompete clauses.

America’s workers have for decades been losing out: year after year of wage stagnation, increased insecurity on the job, waves of downsizing and offshoring, and labor’s share of national income declining to its lowest level in seven decades.

Numerous studies have found that an important cause of America’s soaring income inequality is the decline of labor unions — and the concomitant decline in workers’ ability to extract more of the profit and prosperity from the corporations they work for. The only time during the past century when income inequality narrowed substantially was the 1940s through 1970s, when unions were at their peak of power and prominence.

Many Americans are understandably frustrated. That’s one reason the percentage who say they want to join a union has risen markedly. According to a 2018 M.I.T. study, 46 percent of nonunion workers say they would like to be in a union, up from 32 percent in 1995. Nonetheless, just 10.5 percent of all American workers, and only 6.4 percent of private-sector workers, are in unions.

But this desire to unionize faces some daunting challenges. In many corporations, the mentality is that any supervisor, whether a factory manager or retail manager, who fails to keep out a union is an utter failure. That means managers fight hard to quash unions. One study found that 57 percent of employers threatened to close operations when workers sought to unionize, while 47 percent threatened to cut wages or benefits and 34 percent fired union supporters during unionization drives.

Corporate executives’ frequent failure to listen to workers’ concerns — along with the intimidation of employees — can have deadly results. On April 5, 2010, a coal dust explosion killed 29 miners at Massey Energy’s Upper Big Branch coal mine in West Virginia. A federal investigation found that the mine’s ventilation system was inadequate and that explosive gases were allowed to build up. Workers at the nonunion mine knew about these dangers. “No one felt they could go to management and express their fears,” Stanley Stewart, an Upper Big Branch miner, told a congressional committee. “We knew we’d be marked men and the management would look for ways to fire us.”

The diminished power of unions and workers has skewed American politics, helping give billionaires and corporations inordinate sway over America’s politics and policymaking. In the 2015-16 election cycle, business outspent labor $3.4 billion to $213 million, a ratio of 16 to 1, according to the nonpartisan Center for Responsive Politics. All of the nation’s unions, taken together, spend about $48 million a year for lobbying in Washington, while corporate America spends $3 billion. Little wonder that many lawmakers seem vastly more interested in cutting taxes on corporations than in raising the minimum wage.

There were undoubtedly many reasons for Donald Trump’s 2016 victory, but a key one was that many Americans seemed to view him as a protest candidate, promising to shake up “the system” and “drain the swamp.” Many voters embraced Mr. Trump because they believed his statements that the system is rigged — and in many ways it is. When it comes to workers’ power in the workplace and in politics, the pendulum has swung far toward corporations.

Reversing that won’t be easy, but it is vital we do so. There are myriad proposals to restore some balance, from having workers elect representatives to corporate boards to making it easier for workers to unionize to expanding public financing of political campaigns to prevent wealthy and corporate donors from often dominating.

America’s workers won’t stop thinking the system is rigged until they feel they have an effective voice in the workplace and in policymaking so that they can share in more of the economy’s prosperity to help improve their — and their loved ones’ — lives.

“…Yet in industrialized Western countries, where bravado is often mistaken for strength, a slower, humbler, more deliberative approach to decision-making tends to garner little respect. Our schools still prize innate abilities over other skills, and most students are encouraged to believe that speed (in answering questions and processing information) is an essential and even fateful sign of superiority. We also prefer “strong” leaders who stick to their convictions, even though closed-mindedness typically leads to more aggressive tactics and occasionally calamitous misunderstandings….”

Emily Bobrow, "‘The Intelligence Trap’ Review: How Smart Is Too Smart?"Wall Street Journal, August 5, 2019, https://www.wsj.com/articles/the-intelligence-trap-review-how-smart-is-too-smart-11565045370

‘The Intelligence Trap’ Review: How Smart Is Too Smart?

Every year brings more books about how stupid we are. Apparently humans are impulsive, gullible and prone to making all sorts of bad decisions. We are also fascinated by our shortcomings, if the shelves at airport bookstores are anything to go by. The latest contribution to the pile is from David Robson, a London-based science journalist, who offers an intriguing angle on our flawed habits of mind. In “The Intelligence Trap,” he argues not only that we are walking, talking, error-making machines, but also that the cleverest among us may make the biggest mistakes.

Anyone who has spent time on a college campus has probably intuited that innate intelligence and common sense don’t necessarily go hand in hand. But Mr. Robson bolsters his case with a raft of studies that show all the ways in which a fine mind can trip up. People with high SAT scores, for example, are less likely to either take advice or learn from their blunders. Folks with multiple degrees and professional expertise are often blind to their own biases. The consequences of these gaffes are often merely personal and embarrassing, but sometimes they are catastrophic. In American hospitals, one in 10 patient deaths appear to be the result of diagnostic mistakes.

To help distinguish between smarts and wisdom, Mr. Robson offers the analogy of a car. A fast engine can get you around quickly, but horsepower alone doesn’t guarantee you’ll arrive at your destination safely. Without a proper understanding of the rules of the road, a speedy driver is, in fact, a menace. Philosophers have perceived the shortcomings of sharp minds for millennia, but the pursuit of “evidence-based wisdom” really gained steam after the financial crash of 2008, when nearly everyone suffered from the costly mistakes of “experts.” New institutions such as Chicago’s Center for Practical Wisdom now apply scientific techniques, including randomized control trials, to explore and understand human reason. “The study of wisdom now seems to have reached a kind of tipping point,” Mr. Robson tells us.

In keeping with the driving comparison, this book is most entertaining when it allows readers to rubberneck at the collisions. The author’s anecdotes about the missteps of masterminds offer plenty of opportunities for schadenfreude—although the assumption that these problems only afflict other people is a perfect illustration of the blind spots intelligent people often have about themselves. Arthur Conan Doyle, for example, was easily hoodwinked by photographs of some fairies frolicking in Cottingley, England. In reality these sprites were cardboard cut-outs, but Conan Doyle, a devoted spiritualist in addition to being a doctor of medicine and the creator of Sherlock Holmes (the “perfect reasoning and observing machine”), claimed that they offered evidence of a supernatural world, and used his superior analytical reasoning to dismiss the skeptics and rationalize his beliefs. When the girls behind the photos finally confessed to the hoax, one of them admitted her surprise that adults would be so easily fooled—“they wanted to be taken in,” she observed.

Beliefs often arise from emotional needs, which we intellectually rationalize post hoc. Clever people are as prone to irrationality as everyone else—a phenomenon called “dysrationalia”—yet they are often even more skilled at justifying their superstitions. College graduates are more likely than those with less education to believe in extrasensory perception and “psychic healing.” High-IQ types are just as likely to have financial problems, even though they often have better jobs with higher salaries. Because many “brainiacs” expect to outsmart others, they are often more heedless of risks and less aware of their own flaws in thinking. As the 19th-century psychologist William James once said, “a great many people think they are thinking when they are merely rearranging their prejudices.”

Mr. Robson offers some proven tricks for dodging these intellectual pratfalls. Many are familiar enough to be cliché: Be humble and keep an open mind; weigh opposing views with less emotion by taking a step back. These ideas may sound like common sense, but Mr. Robson convincingly shows us that they are not quite common enough. He cites the research of Eli Finkel at Northwestern University, who found that simply encouraging couples to view their conflicts from a more detached, dispassionate perspective helped them achieve greater intimacy and trust. Doctors who are pushed to analyze their gut responses and consider alternative hypotheses improve their diagnostic accuracy by up to 40%.

The good news is that wisdom, unlike intelligence, can be taught, and these lessons bear real fruit. People with superior reasoning skills are more content and generally happier with their relationships. Yet in industrialized Western countries, where bravado is often mistaken for strength, a slower, humbler, more deliberative approach to decision-making tends to garner little respect. Our schools still prize innate abilities over other skills, and most students are encouraged to believe that speed (in answering questions and processing information) is an essential and even fateful sign of superiority. We also prefer “strong” leaders who stick to their convictions, even though closed-mindedness typically leads to more aggressive tactics and occasionally calamitous misunderstandings.

What is fascinating is that IQ scores in industrialized countries have never been so high, rising the equivalent of 30 points in 80 years. Access to factual information has also never been so widespread. Yet we are no less susceptible to the allure of fake news and pseudoscience. We are as likely as ever to opportunistically prop up our own positions and take down those of our rivals. Clearly, we need to find new and better ways to teach critical thinking and measure good judgment. Reading David Robson’s book would be a good place to start.

"...Building one wind turbine requires 900 tons of steel, 2,500 tons of concrete and 45 tons of nonrecyclable plastic. Solar power requires even more cement, steel and glass—not to mention other metals. Global silver and indium mining will jump 250% and 1,200% respectively over the next couple of decades to provide the materials necessary to build the number of solar panels, the International Energy Agency forecasts. World demand for rare-earth elements—which aren’t rare but are rarely mined in America—will rise 300% to 1,000% by 2050 to meet the Paris green goals. If electric vehicles replace conventional cars, demand for cobalt and lithium, will rise more than 20-fold. That doesn’t count batteries to back up wind and solar grids...."

Mark P. Mills, "If You Want ‘Renewable Energy,’ Get Ready to Dig,"Wall Street Journal, August 5, 2019, https://www.wsj.com/articles/if-you-want-renewable-energy-get-ready-to-dig-11565045328

If You Want ‘Renewable Energy,’ Get Ready to Dig

Democrats dream of powering society entirely with wind and solar farms combined with massive batteries. Realizing this dream would require the biggest expansion in mining the world has seen and would produce huge quantities of waste.

“Renewable energy” is a misnomer. Wind and solar machines and batteries are built from nonrenewable materials. And they wear out. Old equipment must be decommissioned, generating millions of tons of waste. The International Renewable Energy Agency calculates that solar goals for 2050 consistent with the Paris Accords will result in old-panel disposal constituting more than double the tonnage of all today’s global plastic waste. Consider some other sobering numbers:

A single electric-car battery weighs about 1,000 pounds. Fabricating one requires digging up, moving and processing more than 500,000 pounds of raw materials somewhere on the planet. The alternative? Use gasoline and extract one-tenth as much total tonnage to deliver the same number of vehicle-miles over the battery’s seven-year life.

When electricity comes from wind or solar machines, every unit of energy produced, or mile traveled, requires far more materials and land than fossil fuels. That physical reality is literally visible: A wind or solar farm stretching to the horizon can be replaced by a handful of gas-fired turbines, each no bigger than a tractor-trailer.

Building one wind turbine requires 900 tons of steel, 2,500 tons of concrete and 45 tons of nonrecyclable plastic. Solar power requires even more cement, steel and glass—not to mention other metals. Global silver and indium mining will jump 250% and 1,200% respectively over the next couple of decades to provide the materials necessary to build the number of solar panels, the International Energy Agency forecasts. World demand for rare-earth elements—which aren’t rare but are rarely mined in America—will rise 300% to 1,000% by 2050 to meet the Paris green goals. If electric vehicles replace conventional cars, demand for cobalt and lithium, will rise more than 20-fold. That doesn’t count batteries to back up wind and solar grids.

Last year a Dutch government-sponsored study concluded that the Netherlands’ green ambitions alone would consume a major share of global minerals. “Exponential growth in renewable energy production capacity is not possible with present-day technologies and annual metal production,” it concluded.

The demand for minerals likely won’t be met by mines in Europe or the U.S. Instead, much of the mining will take place in nations with oppressive labor practices. The Democratic Republic of the Congo produces 70% of the world’s raw cobalt, and China controls 90% of cobalt refining. The Sydney-based Institute for a Sustainable Future cautions that a global “gold” rush for minerals could take miners into “some remote wilderness areas have maintained high biodiversity because they haven’t yet been disturbed.”

What’s more, mining and fabrication require the consumption of hydrocarbons. Building enough wind turbines to supply half the world’s electricity would require nearly two billion tons of coal to produce the concrete and steel, along with two billion barrels of oil to make the composite blades. More than 90% of the world’s solar panels are built in Asia on coal-heavy electric grids.

Engineers joke about discovering “unobtanium,” a magical energy-producing element that appears out of nowhere, requires no land, weighs nothing, and emits nothing. Absent the realization of that impossible dream, hydrocarbons remain a far better alternative than today’s green dreams.

"...Last year there were 1,187 drug-related deaths in Scotland, a record, and a staggering increase of 27 percent from the year before. Overdoses are more common in Scotland, by some measures, than even in the United States...."

As Scotland’s ‘Trainspotting’ Generation Ages, the Dead Pile Up

GLASGOW — Tony Nugent was clean for almost seven years before he relapsed.

He found that heroin, cruel to the young, is even less forgiving with age.

Mr. Nugent had been using the drug on and off since he was 19, but overdosed the first time he shot up again. He has overdosed three more times since last year.

“I’ve nearly died four times,” said Mr. Nugent, who turns 43 this month. “It’s getting harder for me to recover as I get older.”

Still, he considers himself lucky, especially living in what is now being called the “drug-death capital of the world.”

Last year there were 1,187 drug-related deaths in Scotland, a record, and a staggering increase of 27 percent from the year before. Overdoses are more common in Scotland, by some measures, than even in the United States.

“We’re seeing diseases that you would associate with old age in a lot of these middle-aged men with a long history of drug use,” said Dr. Carole Hunter, the lead pharmacist for Glasgow Addiction Services. “What your body tolerates at 18 it doesn’t tolerate at 38 or 48.”

Drug deaths aren’t new in Scotland. More than two decades ago, the grueling life of addiction in Edinburgh was the subject of the novel-turned-film “Trainspotting.”

What’s new is how many people are dying.

“I remember there was outrage when the headlines said ‘One Death Every Day From Drugs,’” said Andrew McAuley, a senior research fellow on substance use at Glasgow Caledonian University, referring to a national investigation into drug deaths in 2003. “That seems like glory days. We’re four times that now.”

There are almost 60,000 drug users in Scotland with routine and prolonged use of opioids or benzodiazepines. Many also suffer from physical and mental health issues too, putting them at greater risk of dying from an overdose.

Mr. Nugent is one of them. He has been treated for deep-vein thrombosis, hepatitis C and skin abscesses. Lately, he said, he had been urinating blood.

The United States is three decades into its own opioid crisis, and with its drug users aging, experts might do well to look at how Scotland responds. The United States has a much larger number of overall drug users, many of them are turning to deadlier drugs like fentanyl, and, in general, they have less access to drug treatment than users in Scotland.

“There are lessons to be learned internationally as many countries grapple with this,” said Dr. Jeffrey Samet, a professor at Boston University who specializes in substance use disorders.

Path to Trouble

Scotland wasn’t always the “sick man of Europe.”

Until around 1950, life expectancy there was on par with most of Western Europe, or better. But after World War II, things in Scotland improved more slowly than in any other Western European country.

“The jigsaw is complex,” said Dr. McAuley, the Glasgow researcher. “It’s our history, it’s the way we consume drugs, it’s the chronic underfunding and underperforming treatment services we have. Underline that with austerity and welfare cuts in recent years, and you’ve got the perfect storm for this to happen.”

Many of Scotland’s struggles grew out of social and economic policy changes made in the late 1970s, according to David Walsh, a researcher at the Glasgow Center for Population Health who has studied Scotland’s high mortality. The conservative government in London at the time considered industrial cities like Glasgow to be “declining” and pushed for rapid economic restructuring.

Scotland’s leaders made contentious policy decisions at home, too. In Glasgow in particular, said Mr. Walsh, officials prioritized commercial development and clearing slums, relocating entire communities to isolated public housing estates that were poorly maintained.

“There’s a very clear relationship between socioeconomic factors and health,” Mr. Walsh said. “Evidence shows people can turn to alcohol and drugs to cope with difficult circumstances.”

As far-reaching changes hit Scotland, heroin flowed into Europe. A supply route linking Afghanistan to Iran opened up in the 1980s, making the drug more available — and affordable — than ever. In Scotland, this produced what came to be known as the “Trainspotting” generation.

“Before 1980, our police drug squad said there were maybe 50 people in Edinburgh using heroin, and we knew them all,” said Roy Robertson, a professor of addiction medicine at the University of Edinburgh. “Then around 1980 there was this wave of drugs, and that availability stimulated the epidemic.”

Strides, and Stumbles

For years, Scotland made strides in curbing drug deaths.

Needle exchanges were introduced in the 1980s and naloxone, the lifesaving overdose medication, has been in widespread use since 2011. Opioid-substitute therapies like methadone — which is tightly regulated in the United States — are free and available at most pharmacies through the nationalized health care system.

But in 2016 the Scottish government cut funding to alcohol and drug prevention services by more than 20 percent, from 69 million pounds a year down to 54 million. The funding has since been restored, and the Scottish government pledged an additional 20 million pounds, starting this year.

“What would you expect to happen to a country with an opiate addiction problem if you progressively remove treatment? The death rate would steadily go up,” said John Strang, a professor at King’s College London who has researched addiction treatment for over 30 years.

About 40 percent of users in Scotland are currently in treatment, according to Dr. Lesley Graham of the National Health Services of Scotland. In England that figure is closer to 60 percent. The challenge for Scotland is to get more people into treatment — and to keep them there.

When Daniel Hamilton arrived at the Edinburgh Access Practice on a Monday afternoon, he didn’t think he’d leave that day with a prescription for methadone, the opiate substitute used to curb heroin cravings. In his hometown, Perth, getting a prescription can sometimes take months, he said. (A review of cases from the National Health Service found that the median wait for treatment in the region was eight weeks.)

“You could get a bad batch of heroin and die by then,” he said.

The Edinburgh Access Practice is trying to get people into treatment faster and start addressing the issues behind their drug use. Its staff includes a mental health team as well as social workers and housing and employment specialists.

But facilities like this one are rare. Experts say Scotland needs to scale up and improve access to existing services, and then introduce approaches like heroin-assisted treatment centers or supervised drug consumption facilities.

“We’ve managed to keep a lot of the aging cohort alive through our current drug treatment services, but they get to a certain point where that blanket is not enough,” Dr. McAuley said. “They need respiratory care, they need mental health care, they need help with housing, employment, welfare and a whole host of other things.”

Controlled substances like heroin, however, fall under the British government’s jurisdiction, and conservative lawmakers have resisted proposals for more progressive drug policy.

“The U.K. government has been clear that there is no legal framework for the provision of drug consumption rooms and there are no plans to introduce them,” the Home Office said in a statement.

Scotland’s public health minister, Joe FitzPatrick, lamented that position.

“I know the instinct from the U.K. government is that they don’t want to be seen in any way to be condoning illegal drug use,” he said. “But people are dying. We need to do things that at first feel difficult.”

Two Friends

Scotland has largely managed to avoid America’s deadliest opioid, fentanyl: Only 12 deaths last year involved any trace of the drug.

Health officials can do little but hope that remains the case.

“If fentanyl does come here, it will be kind of endgame type stuff,” Dr. McAuley said.

Mr. Nugent said he had not seen fentanyl in Glasgow yet. He’s more worried about the influx of “street Valium,” or etizolam. “People are dying with one bad pill,” he said. Etizolam was found in nearly half of all drug deaths in Scotland last year.

Mr. Nugent said he steered clear of it, but his best friend, James Muir, is less cautious. Mr. Muir is homeless in Glasgow; Mr. Nugent planned to check himself into a rehab center this fall.

He worries about what will happen to Mr. Muir when he’s gone.

“I don’t know what’s going to become of him,” he said. “I hope that someone will look after him the way I do.”

"...A better path of deterrence would be to focus on identifying potential risks and separating them from the means of harm. The use of Big Data by law enforcement to identify patterns of dangerous activity would be helpful….look to overhaul federal privacy laws that are a barrier to reporting potential threats. These include the Health Insurance Portability and Accountability Act (Hipaa) and the Family Educational Rights and Privacy Act (Ferpa). Federal law and Justice Department regulations disqualify individuals who have been committed to a mental institution or adjudicated as mentally deficient from owning firearms and are noted in the NICS checks. Yet state participation in NICS is voluntary, and many remain reluctant to submit health records for fear of violating Hipaa. A December 2018 report from the Federal Commission on School Safety noted that states and localities are also confused about when it is appropriate to share student records with officials or parents under Hipaa and Ferpa. The George W. Bush and Obama Administrations tried to clarify these rules related to public safety, but without apparent success. Congress should update them to reflect the danger from mass killers, and it can drag the 1974 Ferpa into the digital age, making data more easily manageable...."

Editorial Board, "Flagging Future Killers," Wall Street Journal, August 6, 2019, https://www.wsj.com/articles/flagging-future-killers-11565132691

Some useful steps to identify and deter dangerous individuals.

The Dayton and El Paso shootings have spurred familiar calls for more gun control, and by all means let’s have a debate. But the focus should be on denying weapons to the potential killers rather than on gun laws that may be politically satisfying but won’t make much difference.

Start with the calls for more “background checks,” which implies none now exist. Yet nearly all gun purchasers today have their backgrounds checked on the spot via the National Instant Criminal Background Check System (NICS). Most mass shooters obtained their guns through licensed dealers after checks, or from family members. The Dayton and El Paso killers, and the Gilroy, Calif., shooter of late July obtained their firearms legally.

Democrats want to expand background checks to person-to-person sales, though policing that would be a challenge as most such sales could be done off the books. They also want to extend to 10 days from three the amount of time dealers must wait to get a response from the background check system before proceeding with a sale. Senators Pat Toomey (R., Pa.) and Joe Manchin (D., W.Va.) want background checks to cover unlicensed sales at gun shows and online, but exempt sales between friends and family.

Congress should have that debate, but no one should think they would reduce the number of mass shootings. Most mass shooters don’t have a criminal history that would pop up in the background system. There is also no evidence that longer waiting periods reduce suicides, homicides or mass shootings. Determined killers can always get a weapon.

A better path of deterrence would be to focus on identifying potential risks and separating them from the means of harm. The use of Big Data by law enforcement to identify patterns of dangerous activity would be helpful, as Holman Jenkins Jr. notes nearby.

Congress can also look to overhaul federal privacy laws that are a barrier to reporting potential threats. These include the Health Insurance Portability and Accountability Act (Hipaa) and the Family Educational Rights and Privacy Act (Ferpa). Federal law and Justice Department regulations disqualify individuals who have been committed to a mental institution or adjudicated as mentally deficient from owning firearms and are noted in the NICS checks.

Yet state participation in NICS is voluntary, and many remain reluctant to submit health records for fear of violating Hipaa. A December 2018 report from the Federal Commission on School Safety noted that states and localities are also confused about when it is appropriate to share student records with officials or parents under Hipaa and Ferpa.

The George W. Bush and Obama Administrations tried to clarify these rules related to public safety, but without apparent success. Congress should update them to reflect the danger from mass killers, and it can drag the 1974 Ferpa into the digital age, making data more easily manageable.

Congress can also work with states and localities to pass emergency protection orders. Some 17 states and Washington, D.C., now have these “red flag” laws permitting police or family members to petition a judge to temporarily remove firearms from individuals deemed a danger to themselves or others.

South Carolina Senator Lindsey Graham this week said he has bipartisan support for legislation for grants to states enacting red-flag laws. Congress could also do a service by advising on model legislation. A good law would provide adequate due process that lets flagged individuals challenge the order; requires judges to rule on the basis of clear and compelling evidence; and includes criminal penalties for anyone bringing false accusations.

Red-flag laws should also go beyond mere firearm confiscation. The mental-health lobby is a more formidable obstacle here than the gun lobby. Most states refuse to reform their involuntary commitment laws, making it impossible to provide help for the severely mentally ill. Yet if an individual is dangerous enough to strip of a constitutional right, the government should also insist on treatment, and in some cases temporary commitment to a psychiatric facility.

There is no single answer to mass shootings, but most of the quick solutions on offer would provide false comfort. That’s true of gun restrictions short of outright bans or confiscation that would run afoul of the Second Amendment. The immediate priority should be to reform laws and practices to deny firearms to those who are a danger to the public.

matches Guzman's findings on the utility of R&D tax credits (though this paper doesn't include his research)

"....Market economies are likely to under-provide innovation, primarily due to fact that knowledge spills over between firms. This article has discussed the evidence on policy tools which aim to increase innovation. We condense our (admittedly subjective) judgements into Table 2, which could be used as a toolkit for innovation policymakers. Column 2 summarizes our read of the quality of the currently available empirical evidence in terms of both quantity of papers and credibility of the evidence provided by those studies. Column 3 summarizes the conclusiveness of the evidence - for example, although there are some credible approaches for estimating the impact of intellectual property, the policy implications of the available findings are unclear. Column 4 scores the overall benefits minus costs, in terms of a light bulb ranking where three is the highest; this is meant to represent a composite of the strength of the evidence as well as the magnitude of average effects.Columns 5 and 6 are two other criteria: first, whether the main effects would be short-term, medium term or long-term; and second, the likely effects on inequality. Different policymakers (and citizens) will assign different weights to these criteria....In the short-run, research and development tax credits or direct public funding seem the most effective, whereas increasing the supply of human capital (for example, through expanding university STEM admissions) is more effective in the long-run. Skilled immigration has big effects even in the short-run. Competition and trade policies probably have benefits that are more modest on innovation, but are cheap in financial terms and so also score highly. One difference is that R&D subsidies and trade policies are likely to increase inequality, partly through increasing the demand for highly skilled labor and partly, in the case of trade, because some communities will endure the pain of trade adjustment and job loss. By contrast, increasing the supply of highly skilled labor is likely to reduce inequality by easing competition for scarce human capital...."

Nicholas Bloom, John Van Reenen and Heidi Williams, "A Toolkit of Policies to Promote Innovation," Center for Economic Performance, July 2019, https://ideas.repec.org/p/cep/cepdps/dp1634.html

Though this would be of interest in context of op-ed draft. Though seems high

"...Only 38 percent of VC funds tracked over two decades produced gains exceeding the traditional 8 percent hurdle, according to a statement Monday from the alternative-assets data provider. Hurdle rates are time sensitive as they’re typically calculated as an internal rate of return....The average holding periods in venture capital have risen, according to eFront. Funds created from 1999 to 2012 backed companies for an average 5.7 years before an exit, up from 3.6 years for vintages tracked from 1992 to 1998, the firm found...."
Christine Idzelis, "Venture Capital Struggles to Meet Hurdle Rate,"Institutional Investor, July 15, 2019, https://www.institutionalinvestor.com/article/b1g92ldh2p8k2r/Venture-Capital-Struggles-to-Meet-Hurdle-Rate