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All of us in evidence-based policy should contemplate Krugman's column

Blog Post5 min read

I’ll paste it below. The concerns he raises have been at the front of our minds here at r.i.c.e. – alas, we see that “the control of infectious disease” made his list of domains in which policy-making appears disconnected from evidence.

Perhaps there is little reason to be surprised at all of this. Yet, it stands in glaring contrast to the stories we tell ourselves, especially in international development after the evidence revolution. We write about our policy impact if we are grant recipients, or we request reports if we are donors, and we all convene to talk about it six times a year. These expenses – and livelihood choices – are surely well-justified if evidence is changing policy to improve or even save lives (even if the effects are uncertain). But if not, we should think deeply about Krugman’s observations.

Krugman highlights one candidate explanation from politics: many political actors reason backwards to their beliefs from their policy convictions, and many of these convictions favor the privileged. It is not difficult to find cases which are surely just that.

But this cannot be the whole story. While Krugman focuses on the cases where the evidence is unambiguous, I think we also learn something important from the cases where evidence is incomplete. Sometimes, based on the evidence, the right answer is “I don’t know.” But that is no way to get promoted, to get your next grant, or to impress your government contact. You have to say something, and once you say something, you are likely to stick with it. I was in a meeting recently which came to a crashing halt when I made the social blunder of explaining that, despite having been thinking about open defecation in rural India for most of the last three years, I have often been wrong, and I now have essentially no certainty about how to stop rural open defecation in India on a large scale.

I like to make the comparison with HIV/AIDS research in the mid 1980s, the period covered in And the Band Played On. Researchers knew a lot of things, but they did not know as much as is now known about how to treat AIDS. Humanity would not have been served by pretending that AIDS then was a solved problem. Of course, Krugman would surely point out that the ups and downs of that story were not only about career and institutional incentives – broader politics mattered then, too.

Hating Good Government - Paul Krugman

It’s now official: 2014 was the warmest year on record. You might expect this to be a politically important milestone. After all, climate change deniers have long used the blip of 1998 — an unusually hot year, mainly due to an upwelling of warm water in the Pacific — to claim that the planet has stopped warming. This claim involves a complete misunderstanding of how one goes about identifying underlying trends. (Hint: Don’t cherry-pick your observations.) But now even that bogus argument has collapsed. So will the deniers now concede that climate change is real?

Of course not. Evidence doesn’t matter for the “debate” over climate policy, where I put scare quotes around “debate” because, given the obvious irrelevance of logic and evidence, it’s not really a debate in any normal sense. And this situation is by no means unique. Indeed, at this point it’s hard to think of a major policy dispute where facts actually do matter; it’s unshakable dogma, across the board. And the real question is why.

Before I get into that, let me remind you of some other news that won’t matter.

First, consider the Kansas experiment. Back in 2012 Sam Brownback, the state’s right-wing governor, went all in on supply-side economics: He drastically cut taxes, assuring everyone that the resulting boom would make up for the initial loss in revenues. Unfortunately for his constituents, his experiment has been a resounding failure. The economy of Kansas, far from booming, has lagged the economies of neighboring states, and Kansas is now in fiscal crisis.

So will we see conservatives scaling back their claims about the magical efficacy of tax cuts as a form of economic stimulus? Of course not. If evidence mattered, supply-side economics would have faded into obscurity decades ago. Instead, it has only strengthened its grip on the Republican Party.

Meanwhile, the news on health reform keeps coming in, and it keeps being more favorable than even the supporters expected. We already knew that the number of Americans without insurance is dropping fast, even as the growth in health care costs moderates. Now we have evidence that the number of Americans experiencing financial distress due to medical expenses is also dropping fast.

All this is utterly at odds with dire predictions that reform would lead to declining coverage and soaring costs. So will we see any of the people claiming that Obamacare is doomed to utter failure revising their position? You know the answer.

And the list goes on. On issues that range from monetary policy to the control of infectious disease, a big chunk of America’s body politic holds views that are completely at odds with, and completely unmovable by, actual experience. And no matter the issue, it’s the same chunk. If you’ve gotten involved in any of these debates, you know that these people aren’t happy warriors; they’re red-faced angry, with special rage directed at know-it-alls who snootily point out that the facts don’t support their position.

The question, as I said at the beginning, is why. Why the dogmatism? Why the rage? And why do these issues go together, with the set of people insisting that climate change is a hoax pretty much the same as the set of people insisting that any attempt at providing universal health insurance must lead to disaster and tyranny?

Well, it strikes me that the immovable position in each of these cases is bound up with rejecting any role for government that serves the public interest. If you don’t want the government to impose controls or fees on polluters, you want to deny that there is any reason to limit emissions. If you don’t want the combination of regulation, mandates and subsidies that is needed to extend coverage to the uninsured, you want to deny that expanding coverage is even possible. And claims about the magical powers of tax cuts are often little more than a mask for the real agenda of crippling government by starving it of revenue.

And why this hatred of government in the public interest? Well, the political scientist Corey Robin argues that most self-proclaimed conservatives are actually reactionaries. That is, they’re defenders of traditional hierarchy — the kind of hierarchy that is threatened by any expansion of government, even (or perhaps especially) when that expansion makes the lives of ordinary citizens better and more secure. I’m partial to that story, partly because it helps explain why climate science and health economics inspire so much rage.

Whether this is the right explanation or not, the fact is that we’re living in a political era in which facts don’t matter. This doesn’t mean that those of us who care about evidence should stop seeking it out. But we should be realistic in our expectations, and not expect even the most decisive evidence to make much difference.


r.i.c.e. is a non-profit research organization focused on health and well-being in India. Our core focus is on children in rural north India. Our research studies health care at the start of life, sanitation, air pollution, maternal health, social inequality, and other dimensions of population-level social wellbeing.

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