Tax Revenue for 2010 will fall below €30 billion

As of today I predict that Exchequer tax revenues for 2010 will be less than €30 billion for the first time since 2002 (€29.3 billion).  This was fine to fund 2002 expenditure but not for the 2010 expenditure which is nearly twice as big.  The Department of Finance still believe the figure will be above €31 billion but are getting closer to the truth.

A week before December’s Budget the Department released the Book of Estimates for 2010. In this short document the Department give their forecasts for the coming year under the prevailing policies.  On page 5 the prediction for tax revenue for 2010 is given as €31.9 billion – a drop of just 4.5% on the 2009 outturn.

At this point it may be worth noting the uselessness of Department of Finance predictions. 
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Outpatients Department in CUH: Moving in the right direction

It was announced this week that the Outpatients Department at Cork University Hospital (CUH) are changing their appointment system for patients attending the Department. The new system comprises of a timed appointment system only. Not much different to the previous system I hear you say.

Previously patients were given an appointment time, however upon presenting at the Department they were seen at a first come first served basis (regardless of their appointment time) – resulting in strong incentives to come before your time and queue to be seen.

So what does this tell us about the Irish health care system?

Queues and waiting lists are all forms of rationing – an activity which is an integral part of a public health care system such as Irelands’ where demand exceeds supply and resources are scarce.

Using gate-keeping systems, whereby appointments for consultants in outpatient departments are made on behalf of the patient in Emergency Departments or by GPs, aims to reduce inappropriate uses of specialists for generalist advice. Patients are directed towards specialists in outpatients as deemed necessary.

The experienced in CUH to date where people physically waited to be seen on a given day is comparable to the rationing mechanism referred to as queuing. Here allocation of health care services is based on the patients’ willingness to allocate time to queuing for services. This demonstrates the relationship between willingness to allocate time and the social value placed on the service. For example those who place a high value on their time (someone in full time employment; full time care giver etc.) will want to spend the least time queuing.

Such a system is inefficient and inappropriate for the delivery of health care services. It offers a means of maximising efficiency of the health care providers’ time rather than a means to ration services and distribute them fairly and efficiently.

The revised appointment based system implemented in CUH is similar to waiting lists which in principle avoids prioritising higher value demands. Here the underlying assumption is that all cases receive the same weight on the list. Thus it aims to be a fairer means of rationing scarce resources among cases of equal social value.

Despite the fairness of a waiting list system, one could assume that lengthy waiting lists are evidence of inadequate resource allocation within the health service. Thus suggesting more resources are required.
However, is this always the most appropriate solution? If one focuses attention instead on those who are controlling the rationing of resources it could be argued that such decision makers may face perverse incentives. The allocation of additional resources based on the length of waiting lists could be viewed as rewarding inefficient service provision. Such a basis for allocation would create little incentives for service providers to increase productivity and efficiency in outpatient departments.

So what do we learn about the Irish health care system from what appears to be a minor change in service delivery at CUH’s Outpatients Department?

Well Ireland’s health care system is predominantly a public health care system characterised by “under funding” and scarce resources, where demand outstrips supply. This provides an adequate basis for rationing health services. Achieving optimal rationing however is a difficult task but moving from a queue based to waiting list/appointment based system is a step in the right direction. In allocating scarce resources amongst services, decision makers must strive for efficiency and value for money, while providing life saving health services in an equitably and effective way.

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Crisis in Economics

http://www.guardian.co.uk/business/audio/2009/nov/25/business-podcast-economics-john-maynard-keynes

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Changing Picture of Irish Unemployment

This is an interesting (and scary) visual representation of how Irish unemployment has changed on a county by county basis since April 2005.

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Getting smarter?

In last week’s Budget Brian Linehan formally introduced the 50c per medical prescription for medical card holders that had been flagged over the previous few weeks. It seems we are taking at least one leaf out of the Singapore book. Well a bit of a leaf anyway. Singapore combines government subsidies with patient co-payment for virtually all medical care.

When a consumer is insulated from cost they have no incentive to weigh up the costs and benefits of a decision. Once the costs are zero any benefit (or even a perceived possible) benefit will encourage over-utilisation. This is what has happened when medical prescriptions have been free with people collecting the prescription even if they didn’t actually need it. In a letter to The Irish Independent one person wrote.

As a public health nurse visiting homes on a daily basis, it is astonishing to note the vast amounts of excess and unnecessary medication which accumulates in people’s homes.

There is also other anecdotal evidence of the families of recently deceased relatives returning thousands of euro worth of prescribed medicine to the HSE that had been collected but never used, simply because there was a prescription for it. As the HSE can not vouch for the medicine it must be destroyed. The above letter continues

Despite the fact that many monthly prescriptions are not used in their entirety, and despite both patient and pharmacist being alerted to this, the system allows the entire monthly prescription to be reissued regardless. There is little or no appreciation or consideration of the cost, particularly as this flawed system is paid for by the taxpayer, who, by the way, is not entitled to free medical care or medications.

Many years go when I lived and worked in the UK, a charge was payable for each prescription. The busy GP might have been quick to issue the prescription but I had a little more time to consider if the purchase was essential enough for me to hand out the charge rather than the easier option of obtaining the item, knowing someone else was paying for it. The 50c per item fee is negligible and will go some way to reducing the vast mount of unnecessary prescribing and waste.

This public health nurse would make a fine economist.

We are finally cottoning on to the idea that anything free will be over-utilised. And that even a small charge can have a big impact. The blight of plastic bags was “cured” when a small charge was introduced that made people consider whether it was actually worth using a plastic bag to bring home a pint of milk and a packet of biscuits. When A&E visits were free (in money terms) many patients who should have gone to their GP made unnecessary trips to an Accident and Emergency Departments in situations that were neither an accident nor an emergency.

Of course, the issue of setting the appropriate charge remains. The plastic bag levy began at 15c in 2002 and is due to be increased to 44c next year. A&E charges currently stand at €100 compared to an average of €60 for a visit to the GP.

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Gender wage discrimination starts early

The BBC report the results of the 2009 Halifax Pocket Money Survey. Halifax have been carrying out the survey since 1987 and have found that over that time pocket money has increased by more than four times the rate of inflation. Halifax are most interested in the savings behaviour shown but there are some other interesting findings.

The UK average pocket money for 2009 is £6.24 a week which is an 11p or 1.8% increase on the 2008 figure but is still substantially below the 2005 high of £8.37 a week. The UK’s Office of National Statistics combined the Halifax survey with their own data to create the following graph.

Children with family incomes in the highest income decile received the biggest amount of pocket money. Interestingly, the next highest recipients were children whose family incomes were in the lowest income decile. The data do not allow us to determine if pocket money is a substitute for or additional to other expenditure by parents across the income deciles.

The higher than inflation increases in pocket money have not been evenly distributed with those in the 8-11 age group getting an average of £4.80 a week in 2009 which is some 425% above the 1987 figure of £1.13 reported here. Those in the 12-15 age bracket are getting the higher amount of £7.44 a week but this is “only” some 215% higher than the £3.46 their counterparts from 1987 were receiving. The survey also reports big regional variations across the country but one of the more standout findings is that:

Across the country, boys received an average of £6.88, compared with girls’ £5.58.

This difference of £1.30 per week equates to a pocket money differential of about 23%. Gender wage discrimination, it seems, starts early!

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Who’s smart?

New Geography has just released a survey of the world’s smartest cities and lists “the ’smartest’ cities not only by looking at infrastructure and livability, but also economic fundamentals”.  Singapore comes out on top with Amsterdam the only European entry, though the list is a little Americentric with seven cities (four US, one Mexico, one Brazil and one Canada) on the list.

  1. Singapore:  The 21st-century successor to 15th-century Venice, this once-impoverished island nation now boasts an income level comparable to the wealthiest Western countries, with a per-capita GDP ahead of most of Europe and Latin America. Singapore Airport is Asia’s fifth-largest, and the city’s port ranks as the largest container entrepot in the world. Over 6,000 multinational corporations, including 3,600 regional headquarters, are located there, and it was recently ranked No. 1 for ease of doing business.

This country has an aspirational plan based around Building Ireland’s Smart Economy.  Maybe Ireland (population 4.45 million) should be having a look at what Singapore (population 4.75 million) is doing to smarten up.  Reading Singapore’s Success: Engineering Economic Growth would be a good start. This reveals that Singapore implements many economically efficient (though politically unpopular) policies so that Singapore:

  • has unilateral free trade
  • admits unusually large numbers of immigrants
  • supplies most medical care on a fee-for-service basis
  • means-tests most government assistance
  • imposes peak load pricing on roads, and
  • fights recessions by cutting employers’ taxes

Brian Caplan offers three possible explanations of the paradoxes of Singaporean political economy.

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Ian Plimer and John Gibbons on RTE Radio

Professor Ian Plimer of the University of Adelaide will be taking part in a debate on climate change organised by the Economics Society in UCC on Thursday 3rd December at 7.30pm in Boole 4.  On the day before Prof. Plimer was on The Pat Kenny Show on RTE Radio 1 debating with John Gibbons of The Irish Times. You can listen to the full discussion by going here.

In an email exchange in UCC, Denis O’Connell wrote

John Gibbons from the Irish Times was on Pat Kenny this morning representing the climate change side in a debate with Professor Plimer. Gibbons’ performance was the worst display of bad manners and arrogance I’ve heard in a public forum in years. He attacked both Plimer and Kenny personally and was totally unable to deal with Plimer’s arguments.

Many more seem to support the view above.  Unsurprisingly, Gibbons himself has a different take on the conversation which he provides here and he seems extra agitated in the article he wrote for the following day’s Irish Times.  When talking about the forthcoming climate change summit in Copenhagen he writes:

Success would be a vindication of human ingenuity and adaptability – the attributes that brought us such evolutionary success. Failure would condemn us to a trajectory that leads from climate chaos to economic disaster and towards the abyss this century.

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Serious floods lead to broken windows

In an article in yesterday’s Irish Times, the ESRI’s Prof Richard Tol suggests that the clean-up operation may boost the economy.  A short extract gives the main details.

Prof Richard Tol of the Economic and Social Research Institute (ESRI) has said that while the flooding has caused widespread damage, there may be an unexpected fillip to the economy once the clean-up operation begins.  “Floods are bad but flood restoration can actually provide a stimulus to the economy,” said Dr Tol.

Dr Tol pointed out that he was not downplaying the impact the floods had on people who lost their homes and businesses, some of whom were not insured. However, he said that one of the unusual consequences of the restoration work, once it begins, is that it will provide an economic stimulus, generating local work and business in construction, engineering and in retail sales.

“What the water has done is it has destroyed many things. But once insurance is paid, there will be a lot of money coming into the country. Most of the funds will come not from Irish insurance companies but will be called in from international reinsurers. So it will be mostly coming from abroad, which is a stimulus.”

He said that consumption would increase in affected areas as restoration work began, providing a measurable boost. “As such there is a silver lining to the flood,” he added.

A silver lining! An estimated €250 million euro worth of property has been destroyed and Tol finds a “silver lining”.  Quick, get the ESB to open up more dams! The path out of the recession has been found.  Surely they’d be able to cause at least double the damage again in no time at all and we’d have twice as much of this “silver lining”.  And don’t send the army in to help people.  Have them get out the heavy artillery (they do have guns, don’t they?) and blow up buildings and stuff on high grounds that escape the floods.  Pretty soon we’ll have enough “silver lining” for everybody.

Richard Tol, what are you at?  Yes the floods will lead to expenditure on repairs but that money will come from reduced expenditure elsewhere.  Open your other eye!  Have you every heard of The Lesson which Hazlitt brought to us from the work of Federic Bastiat.  You must have!

Here is Hazlitt’s piece on the simplest application of The Lesson as proposed by Bastiat.  The Broken Window is short enough to reproduce here in it’s entireity. Read it. Think of the €250 million that will be spent on flood repairs. Read it again.

Let us begin with the simplest illustration possible: let us, emulating Bastiat, choose a broken pane of glass.

A young hoodlum, say, heaves a brick through the window of a baker’s shop. The shopkeeper runs out furious, but the boy is gone. A crowd gathers, and begins to stare with quiet satisfaction at the gaping hole in the window and the shattered glass over the bread and pies. After a while the crowd feels the need for philosophic reflection. And several of its members are almost certain to remind each other or the baker that, after all, the misfortune has its bright side. It will make business for some glazier. As they begin to think of this they elaborate upon it. How much does a new plate glass window cost? Two hundred and fifty dollars? That will be quite a sum. After all, if windows were never broken, what would happen to the glass business? Then, of course, the thing is endless. The glazier will have $250 more to spend with other merchants, and these in turn will have $250 more to spend with still other merchants, and so ad infinitum. The smashed window will go on providing money and employment in ever-widening circles. The logical conclusion from all this would be, if the crowd drew it, that the little hoodlum who threw the brick, far from being a public menace, was a public benefactor.

Now let us take another look. The crowd is at least right in its first conclusion. This little act of vandalism will in the first instance mean more business for some glazier. The glazier will be no more unhappy to learn of the incident than an undertaker to learn of a death. But the shopkeeper will be out $250 that he was planning to spend for a new suit. Because he has had to replace a window, he will have to go without the suit (or some equivalent need or luxury). Instead of having a window and $250 he now has merely a window. Or, as he was planning to buy the suit that very afternoon, instead of having both a window and a suit he must be content with the window and no suit. If we think of him as a part of the community, the community has lost a new suit that might otherwise have come into being, and is just that much poorer.

The glazier’s gain of business, in short, is merely the tailor’s loss of business. No new “employment” has been added. The people in the crowd were thinking only of two parties to the transaction, the baker and the glazier. They had forgotten the potential third party involved, the tailor. They forgot him precisely because he will not now enter the scene. They will see the new window in the next day or two. They will never see the extra suit, precisely because it will never be made. They see only what is immediately visible to the eye.

Aren’t all these international insurance companies nice to be giving us this “stimulus” money to pay for the flood repairs and they’d never want it back. Would they?

UPDATE: Prof. Tol took his ideas from the paper of record and put them over the airwaves with George Hook on Newstalk’s The Last Word.  You can listen to the short interview by going here.

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After Dubai – Ireland?

The New York Times seems to think Ireland is a candidate to default just like Dubai. The Irish government may want Irish commentators to ‘wear the green jersey’ and do the economic analysis equivalnent of smiling and nodding – but then those pesky Americans go and mention the unmentionable.

Posted in Banking Crisis, Fiscal Policy | 2 Comments