November 16, 2024

Economic View: To Fix Social Security, Use the Right Wrench

Congress seems to want a ruse to disguise a cut in benefits as something else — like the discovery of a technical error that, once corrected, would let the government write smaller checks without taking the blame for cutting benefits.

In a spirit of compromise, President Obama has proposed changing how inflation is measured in benefit calculations. In his 2014 budget proposal released in April, he proposed that retirees’ Social Security benefits be indexed to something called the Chained Consumer Price Index for All Urban Consumers or C-CPI-U, rather than the current benchmark, the Consumer Price Index for Urban Wage Earners and Clerical Workers, or CPI-W.

This seems to correct a real technical error. Economists have argued that the current index overstates the actual inflation rate, and that a switch to the C-CPI-U would make the inflation indexing more accurate, seemingly justifying the resulting gradual reduction in benefits. (And it would be a reduction, to the point that someone retiring today would be receiving about 5 percent less in 20 years.)

But here is the rub: the proposal solves the wrong problem and, in doing so, undermines the integrity of the Social Security system.

The purpose of Social Security is to help families. It reinforces the intergenerational sharing that families already — though imperfectly — provide. It helps retirees by stabilizing their income, and it helps their grown children, who are relieved of any excessive burden of supporting them. This purpose strongly suggests that the Social Security benefits should be indexed to some measure of the available, aggregate economic pie. That means a formula that looks completely different from the ones being discussed today.

Clearly, something needs to be done: if nothing changes, and the trust fund runs out in 2033, the system would be able to pay only about 75 percent of promised benefits.

The issues are complex, as economic theorists like Henning Bohn at the University of California, Santa Barbara, have shown. But now that an index change is on the table, we should take this opportunity to get it right.

One alternative that we should consider is a different kind of index switch, linking retirees’ benefits to gross domestic product per capita, in current dollars. This measure responds to inflation just as the C-CPI-U does, but, in contrast, it also responds to changes in the nation’s resources, as measured by real G.D.P. There could also be corrections for other factors, like the dependency ratio, which compares the number of “dependents” (retired people and children) to the number of working adults.

Such an index switch, however, has received hardly any public discussion, and that fact alone will make some people think that something is wrong with it. But political talk is limited; it is too focused on the identified problem of somehow fixing the projected Social Security insolvency. While this new idea won’t solve insolvency — we may need to raise Social Security contributions to do that — it would support the principle that one generation shouldn’t be more burdened than another.

Before 1972, Social Security wasn’t indexed at all, and there was little public talk about tying it to inflation despite periodic, inflation-induced disasters for retirees. Congress simply made occasional, ad hoc, upward adjustments in the benefit formula. Proponents of these adjustments often justified the increases as offsetting the rising cost of living. But at the same time, they also described retirees as needy, suffering hardships and deserving dignity. While there were no explicit references to G.D.P., it’s plausible that their sense of “needy” was influenced by comparison with the rising American standard of living for working adults. As a matter of fact, total Social Security benefits more than kept up with the rapid G.D.P. growth in the couple of decades before they were indexed to inflation.

Now that inflation indexing has been in place, some people see the formula as always providing the scientifically “right” amount of benefits. They don’t think much about other factors that might enter into the determination of benefits. And, in fact, since 1982, Social Security benefits as a fraction of G.D.P. have generally been falling, at least until the latest recession.

The fact is that per capita G.D.P., in current dollars, has grown 1.2 percent faster a year, on average, than the CPI-W in the last 20 years, despite the Great Recession. If we indexed Social Security benefits to G.D.P. per capita, and not to the C-CPI-U, people who retire today and live 20 additional years would get a third more in real, inflation-corrected benefits — provided, of course, that the next 20 years are like the last.

If the economy grew unusually rapidly, however, they might get 50 or 60 percent more, in real terms. But even that wouldn’t break the budget of the Social Security system, because contributions would be higher, too, in response to the greater economic growth. And if the economy stagnated in a deep depression in the next 20 years, retirees might see no growth at all, or conceivably even a decline, in real terms. That’s O.K., too, because everyone else would be suffering as well. We have other programs, like Medicare, that deal with any extreme hardships that some older Americans with special conditions might encounter.

THE point of G.D.P. indexing is to align the interests of the retired with society as a whole. Older Americans should share both the windfalls and the losses with other generations — with working adults, and with children. It shouldn’t be otherwise. If the system’s rules force us to maintain the real benefits of retirees at all costs, we may find ourselves, in difficult times, taking excessively from our children via cuts in education, or from our working adults. Why should retired people feel no effect at all from the recession while younger people are left suffering? They should be sharing the hardships, if we have familial feelings for one another.

The issue is especially salient today because the demographics have shifted: the aging of the baby boomers will create many retirees relative to adults who are still working. This huge shift could not have been foreseen by Social Security’s designers.

Achieving the right benefit formula while fixing Social Security’s solvency problem might require increasing the contribution rate — now in the form of 6.2 percent taxes on employees and employers. But so be it. We need to say what is right, keeping our eyes on the integrity of Social Security, which is crucial to our identity as a civil society.

Robert J. Shiller is Sterling Professor of Economics at Yale.

Article source: http://www.nytimes.com/2013/06/09/business/to-fix-social-security-use-the-right-wrench.html?partner=rss&emc=rss

Genentech to Appeal to F.D.A. for Breast Cancer Drug

Genentech this week will step up its efforts to keep the drug Avastin available as a treatment for breast cancer, urging the Food and Drug Administration to give it one more chance to prove the medicine works.

At a hearing on Tuesday and Wednesday in suburban Washington, Genentech will ask the F.D.A. to reconsider its proposal last December to revoke the approval of Avastin for breast cancer on the grounds that new studies did not confirm that the drug helped patients.

Genentech’s approach seems intended to broaden the terms under which Avastin can remain available. The company is arguing that even if the F.D.A. reaffirms that data do not support Avastin’s effectiveness, the approval should be retained while Genentech does one more clinical trial. Avastin has remained available for breast cancer pending the appeal process.

Avastin was put on the market under an accelerated program begun in the early 1990s that allows drugs for serious diseases to be approved with less than the usual amount of evidence, subject to further studies. Dozens of drugs have been approved this way, and in at least a couple of cases approvals have been withdrawn. But this is the first time the F.D.A. will hold a hearing to consider a company’s appeal.

The debate over Avastin has evoked passions on both sides among those involved in women’s health issues. Some patient advocates argue that the F.D.A. needs to revoke the approval to maintain the integrity of the accelerated process and to ensure that cancer patients receive drugs that work.

But some breast cancer patients are expected to testify at the hearing that the drug should be kept available because it helps some women, even if not all.

“It’s so depressing to think that a federal agency can make a decision that can potentially cause me to die,” said Crystal Hanna, 35, a mother of two from Parkersburg, W.Va., who said Avastin has kept her cancer under control for almost a year.

The public comments sent to the F.D.A. before the hearing at its campus outside Washington, overwhelmingly support retaining the approval. Many of them, using virtually identical language, cite the case of Ms. Hanna, who drafted a comment for friends that circulated widely on the Internet.

Even if approval as a breast cancer treatment is ultimately rescinded, Avastin will retain approval to treat lung, colon, kidney and brain cancers. So doctors will be able to use it “off label” to treat breast cancer. But insurers might no longer pay for it for that use, putting the drug, which can cost $88,000 a year, out of reach for many women.

The Avastin issue has become caught up in the politics of overhauling health care, with some critics saying the decision not to pay for it represents rationing and others saying that Medicare should not pay for a drug that does not work. The F.D.A. maintains that it is not permitted to consider costs.

The ultimate decision will be made by the F.D.A. commissioner, Dr. Margaret A. Hamburg, who appears to have some latitude. The rules say that the F.D.A. “may” revoke the approval of a drug, but does not have to.

“Even where F.D.A. determines that confirmatory trials do not establish clinical benefit, withdrawal is not required and instead should be based on the public health considerations that motivate the accelerated approval statute,” Genentech argues in a summary of its arguments filed before the hearing.

But the F.D.A.’s drug division views the company’s request as a stalling tactic. “How many bites of the apple do you get?” Dr. Richard Pazdur, the director of the agency’s oncology drug division, said in an interview at a cancer conference early this month.

The agency, in a summary of its arguments, says that because it has already determined that the benefits of Avastin do not outweigh the risks, retaining the approval while the new study is conducted “would not be in the interest of the public health and would jeopardize the integrity of the accelerated approval program.”

Genentech and its parent company, Roche, could lose as much as $1 billion in annual sales if the breast cancer approval were revoked. Already Avastin sales for treatment of breast cancer have started declining. The drug is the world’s best-selling cancer drug, with sales last year of roughly $7 billion.

The F.D.A. approved the drug for advanced breast cancer in February 2008, after one clinical trial showed that combining Avastin with another drug, paclitaxel, delayed the median time before tumors worsened by 5.5 months, compared with using paclitaxel alone. But the women who got Avastin did not live significantly longer than those who got only paclitaxel, which is also known by the brand name Taxol.

Subsequent trials, in which Avastin was combined with different chemotherapy drugs, showed a much smaller delay in tumor progression, ranging from less than 1 month to 2.9 months. And again there was no improvement in survival for those receiving Avastin.

Based on those results and on the fact that Avastin has some life-threatening side effects, including bowel perforation and hemorrhaging, the F.D.A.’s cancer drug advisory committee voted 12 to 1 last July that the approval for the treatment of breast cancer be revoked.

The hearing this week will be before the same committee, which will make recommendations to the F.D.A. commissioner. Of the six voting committee members expected to attend, five voted to revoke the approval last July. The sixth was not at that earlier meeting. Since the data have not changed, Genentech, in the summary of its arguments, concedes it is not likely to change the committee’s mind about the benefits of Avastin.

Instead it will argue that the drug with which Avastin is combined matters. Therefore, the company should be given a chance to do another trial in which Avastin is combined with paclitaxel, as in the original trial that led to the drug’s approval.

Article source: http://feeds.nytimes.com/click.phdo?i=7155623df69d31a2535f9e954a20fb09

Corner Office: Byron Lewis Sr.: Got an M.B.A.? Great, but I Prefer Uncommon Sense

Q. How do you hire? What qualities are you looking for?

A. I’m looking for entrepreneurial capabilities. I’m looking for integrity.

Q. How do you tell if somebody has integrity?

A. We ask them for references, but it’s also an intuition you need to have. Many people who come to us don’t have traditional backgrounds. I’m looking for people who have ideas. I’m looking for people who can move the agency forward. I am looking for people who are different but different within the context of a business.

Q. Can you elaborate on that last point?

A. I’m looking for people who are not siloed. You have to know how to work with the creative people. You have to know how to bring the best out of them.

Q. What’s your advice for getting the most out of creative people?

A. Creative people never know when or where the inspiration will come from, and leaders should understand that. The best way to build a team is to let the creative people feel that you understand them, and if they want to go off strategy, let them have their commercial or two, but make sure you have what the client asks for. The best creative also comes from good strategic planning and staying on point.

Q. Let’s say you just hired me, and I ask you, “What’s it like to work for you?”

A. Well, I’m a piece of work. You have to understand that I never worked for an advertising agency or a mainstream marketing company. It might be difficult because I built this company and I’m a nontraditional person. I’m looking for ideas, and I’m looking for people who go beyond. When the thought hits me, I want to share it, and I’ll call a meeting in a moment. Working with me would be challenging, but rewarding.

Q. What’s your advice on how to lead and manage?

A. What I’ve learned is that what I value the most is common sense. When you really find a leader, that person has uncommon sense. I do not believe in formulas. I believe in integrity. Integrity is that you feel a loyalty not only to the company but also loyalty to an idea. I’m driven by ideas and I want people to be open and honest with what they believe, because I’ve learned to listen and value ideas. My company depends upon innovation. That’s how we started, and the older we get, the more important innovation becomes. Change can only come from people who feel free and have the courage to stand up for what they believe.

Q. How has your leadership style evolved?

A. To be candid, I used to tell people that you have to be able to stand me — I am insistent on doing things a certain way because I knew they worked. But that wasn’t necessarily creating harmony, and now I’m aware that I want to hear from others. I want them to feel free to be honest about what they think.

Q. How do you create a culture of honesty?

A. The truth is, people need to see their ideas being used. I used to insist upon doing it my way. Now, I’m much more interested in seeing that they do it their way.

Q. And when did that change happen?

A. It’s happened much more recently. I’m pretty clear about who I am. I’m very clear about where I stand. I think my brand is, “Byron is kind of difficult but he’s interesting.” People are aware that I’m difficult, but they also see that it works.

Q. And why are you difficult?

A. As a start-up company, I was desperate to make sure that we would be successful. I did a lot of things myself, and it’s difficult to move away from that, partly because I managed to keep the company going during some tough times.

But it is very important that we have mutual respect. It’s particularly important because UniWorld is truly diverse. Our people bring different perspectives and customs that really contribute to our understanding of what we do.

People who work here know the history of the company, and that is our culture. It’s about innovation and change. There’s no formula, but that’s what we’ve created, and there is respect for individual people and where they come from. In another sense — I’m not as interested in M.B.A.’s as I might have been. I respect people for what they bring. I’m looking for people who have common sense, common decency. But I’m primarily looking for people who have uncommon sense because that’s where genius comes from.

Q. Talk more about that phrase, if you would.

A. Uncommon sense is what Bill Gates and certain people have. Sure, they went to college, but they didn’t even finish because they created an idea. They had a vision and acted upon it.

I don’t claim to be on that level, but with my history and my company’s history, that’s in our DNA and it works, particularly in these times. I’m open to ideas as long as they’re strategically sound.

People of color — because of their background — they’re used to hard times and hard living. Hard times and hard living create the originality and individuality that you find among black athletes, black musicians, jazz and hip-hop artists. That’s what I’m looking for in my space. Jazz musicians do not think traditionally. They are creative people. That’s what makes this music, makes our culture global. I’m looking for those characteristics.

Uncommon to me is where genius comes from. Uncommon people, in our culture, get the most traction, and we see that today, where Mary J. Blige, P. Diddy and Jay-Z are now considered fashion icons. A person like Queen Latifah — who would ever have imagined that she would be an iconic figure for P. G.’s CoverGirl brand? She has an uncommon background, an uncommon view of the world. Strangely enough, those views resonate across all spaces.

This interview has been edited and condensed. A collection of past interviews, searchable by topic, is at nytimes.com/corneroffice.

Article source: http://feeds.nytimes.com/click.phdo?i=b69b9b0fbb3bf8d140a2b502e7007c41