#100wordreview – The Undercover Economist Strikes Back (Tim Harford) [Book]

Tim Harford brings us some macro. For me, a less interesting topic than those of his previous books. Nevertheless, he’s a great writer with a knack for simplifying tricky concepts and, as with his previous books, this is an enjoyable read. Harford only really dips his toe into the complexities of macroeconomics, but I was still able to gain a better perspective on the current debates; the different arguments being stripped – as far as possible – of the politics that envelop them. The book is exhaustively researched and the reader is treated to plenty of interesting factual and historical tidbits throughout. 

#100wordreview – The Flatliners: “Dead Language” [Music]


At first listen you may think that the new album from The Flatliners lacks the heat of their last, but in a few spins you’ll realise that Dead Language lacks nothing. The variety of tempo and style demonstrated on Cavalcade is replaced by an assured step towards a more consistent and measured sound, which does cause the album to sag as we approach the climactic closers. Still, Chris’s growl has developed into a roar and ensures that none of the tracks feel weak. The album hosts some of the band’s best songs to date and I, for one, am relieved.

[youtube=https://www.youtube.com/watch?v=y5fe6DLZ5wc]

#100wordreview – The Humble Economist (Tony Culyer) [Book]

A collection of 21 abridged essays summarising Tony Culyer’s most important contributions. Fellow health economists may have already read the book’s constituent parts, but much can be gained from digesting them in this form. The book presents Culyer’s work as a cohesive set of ideas, woven together in his unmistakable style and approach; best characterised by the book’s title. For non-economists interested in health research, the book disarms economics of its alienating features that lead to confusion and misunderstanding about what economists actually do and why they do it. For economists, herein lies an exemplar approach to your discipline.

#100wordreview – Never Again? The story of the Health and Social Care Act 2012 (Nicholas Timmins) [Book]

I increasingly find politics a bore, even in relation to health and economic policy. Timmins’s Never Again? precludes my usual reaction, providing a lucid and engaging narrative. The story guides us through the Act’s conception, rejection, amendment and assent, identifying the key players from academia and Westminster along the way. The book enables you to leave your political inclinations at the door, and at times I found myself sympathising with Lansley! It also provides a nice overview of the ultimate nature of the Act at the end of its tumultuous journey; something I struggled to figure out at the time.

New article – Generic Preference Based Measures: how economists measure health benefit

I was invited to write a short review article for Advances in Clinical Neuroscience and Rehabilitation, and it’s just been published in their latest issue. You can view the article online here.

The article gives a very brief introduction to the use of generic preference-based measures and highlights their use in relevant clinical fields such as stroke, multiple sclerosis and Parkinson’s disease.

ACNR is a professional journal distributed free to neurologists, rehabilitation specialists and allied professionals in the UK.

One suggestion for a new model of academic publishing

Problems exist with various aspects of academic publishing: open access, peer review, publication bias. I’m not going to go through all the issues here, as they’ve been covered eloquently elsewhere. I suggest reading The Scholarly Kitchen. Anyway, here’s me weighing in with a possible new model that could solve most of the problems with academic publishing*.

A simple regulatory framework

Regulation is costly to maintain and enforce, so it’s often best to try and keep it to a minimum. Nevertheless, academic publishing is big business, so pussyfooting around won’t achieve much; strong policies need to be drawn up. In my proposed model, research resulting from government funding (and government funding resulting from research) should be subject to two conditions:

  1. All outputs must be published with open access and
  2. <peer review of all publications must be handled by an independent third party.

These two requirements would be enforced by bodies that fund research, such as the NIHR and Research Councils UK, or the NIH in the US. They would also be necessary criteria for inclusion in REF (and its international equivalents). We’re close to achieving the first criteria, but I’m not aware of any discussion of the second.

The ideal outcome

I think this environment could result in desirable outcomes. The new pressure upon academics from universities and funding bodies to conform to the two conditions above would lend to a system in which academics cease to submit articles to journals. Instead, journals would ‘bid’ for papers. They would compete in various ways; on quality, distribution and price. The price would be in the form of the publication fees charged; The American Economic Review could demand a higher fee than The Journal of Health Economics. New journals looking to build credibility could even pay the academics for the right to publish their paper. Universities would pay publication fees on behalf of academics. It’s also likely that they would fund the peer review process through subscription fees to the companies providing it. A lot of time and money would be saved by enabling the transferability of reviews and removing the need for academics to make multiple submissions. I also suspect that, not having to go through this rigmarole, academics would be more inclined to publish negative results.

In this world, the process of publication would go as follows:

  1. Academic writes paper;
  2. Academic submits paper to peer review company;
  3. Peer review company obtains reviews from numerous academics, including reviews of reviews;
  4. Journal editors are given access to the manuscript and all reviews;
  5. Journal editors ‘bid’ for the right to publish the article;
  6. Academic selects journal for publication;
  7. Paper is published.

The necessary organisations for this model already exist. Creative commons provides a variety of open access licences. Companies like OAK have popped up to deal with the administration of publication fees. Peerage of science is a company providing portable peer review, with growing interest from open access publishers. As the market expands, other companies would inevitably enter the arena.

Maybe the ‘simple regulatory framework’ set out above wouldn’t result in the ‘ideal outcome’ described… but I reckon it might.

*this model may very well have been proposed elsewhere, but I am unaware of it.

doi: 10.6084/m9.figshare.1101321

New working paper – ‘Happy and healthy: a joint model of health and life satisfaction’

Mónica Hernández-Alava, Allan Wailoo and I have just released a new working paper. You can access it through RePEc here. The paper builds on previous work (mainly by Paul Dolan) looking at subjective well-being as a potential means of valuing health benefits. Our study, however, identifies a number of limitations of these existing studies and offers a solution to some of their problems. Furthermore, our findings contradict some of those reported in previous studies.

Here’s the abstract:

Subjective well-being has been proposed as an alternative to preference based values of health benefit for use in economic evaluation. We develop a latent factor model of health and well-being in order to compare reported satisfaction with life, satisfaction with health and SF-6D responses. This approach provides a coherent, integrated statistical framework for assessing differences between these outcomes on the same scale. Using panel data from the British Household Panel Survey we find that SF-6D and satisfaction with health are influenced to a similar degree by changes in latent health and satisfaction with life is less responsive. For the average individual, there are no substantial differences in the relative impacts of physical versus mental health conditions between the three measures. These findings suggest that the differences between experienced and hypothetical values of health and life satisfaction may not lead to substantial differences in the assessment of value from health technologies.

This paper has been a long-time coming, and is barely recognisable from its earlier incarnations. It started out as my MSc dissertation, which was completed in 2010. Since then a slightly improved version appeared at HESG in Exeter earlier this year, after which the study got something of an econometric makeover. Please do have a read of the paper if you’re interested in this area of research and we’d welcome any comments you might have.

#100wordreview – Sundials: “Always Whatever” [Music]


On this collection of unreleased or otherwise-unnoticed songs, Sundials demonstrate that 90s-rock-influenced punk bands needn’t be boring. The band exhibits less of their indie college rock influence and instead brings the pop-punk; the homage to Alkaline Trio extending beyond the cover art. Their last album didn’t do much for me, so I’m surprised how much I appreciate ‘Always Whatever’. You’ll find the tracks worming their way into your head and providing the soundtrack to your day. Predictably the record doesn’t flow as an album, but the tracks will be brightening up playlists for years to come.

[bandcamp width=100% height=42 album=2135795581 size=small bgcol=ffffff linkcol=0687f5]

What would an evidence-based health service really look like?

I’m talking about the big stuff. If we were to scrap the NHS and design a new service from the ground up, what would an evidence-based health service look like? Who should fund services? Who should provide services? Who should be accountable to patients?

It seems that many developing countries actually face this challenge of building a health service from scratch. I hope they have a better grasp of the evidence than me.

There are probably some issues on which the evidence would be clear; universal coverage would be an obvious starting point. Public financing solves a lot of problems (demand-side socialism, as Tony Culyer puts it). Beyond that I’m left wondering. A number of sources summarise some of the evidence on NHS reforms, such as Cam Donaldson’s Credit Crunch Health Care, but I can’t find anything comprehensive. I’d really like it if somebody could recruit a PhD student to review all the evidence for the design of a health service and summarise where the evidence is strong and where it is weakObviously this would require a definition of objectives and decision rules. Simultaneously maximising health, equality of health and access to services seems a relatively uncontentious goal. So what kind of service would best provide this?

We have some idea of what the service shouldn’t look like, and that’s what they have in the United States. Little else is certain. The debate over the changes to the NHS brought in by the Health and Social Care Bill 2010 was relatively light on evidence, though a few issues were brought to the table. In a poll on the Academic Health Economists’ Blog, a majority voted that the Health and Social Care Bill should have been rejected. I’d like to think that this was at least partly informed by the readers’ understanding of the evidence. However, for someone to reject a bill does not mean that they can offer a better alternative, even if they do have some idea about the evidence. Maybe if we had a better grasp of the evidence we’d have a better idea of what we want our health service to look like.

#100wordreview – Chewing on Tinfoil: “Marrowbone Lane” [Music]


Chewing on Tinfoil aren’t the first punk band in the last few years to graduate from ska beginnings, but Marrowbone Lane could make them a contender for the most successful transition (…The Flatliners?). It isn’t just the Dublin accent that sets this band apart; their rhythm-driven punk style is relatively unique and succeeds in holding together a wide variety of styles and influences. The album swings from energetic punk rock to more sensible pop melodies and indie riffs, folky twangs and the occasional sing along chorus for good measure. Start to finish, there isn’t a wasted track on here.

[bandcamp width=100% height=42 album=1370466169 size=small bgcol=ffffff linkcol=0687f5]