In this essay, I will offer a theory of slow progress based on the maxim, “It is often easier to fail conventionally than to succeed unconventionally.” My claim will be that in health care, education, and construction/infrastructure, the consuming public is more receptive to conventional failure than unconventional success. This is less the case in other realms, so progress is faster in those realms. We are willing to try ride-sharing apps or airbnb, but no middle-class parent wants to tell their peers that their kids are not going to an established college.
In the Zuckerberg-Cowen-Collison conversation, Zuckerberg repeatedly asks why costs are high in health care, education, and rent.
So you were talking a minute ago about the explosion in costs in healthcare. And right now, I think one of the defining aspects of the moment that we’re in is a lot of the basic costs of living for a lot of people have just increased a lot. . .things that matter so much like healthcare, education, rent–those things have generally just increased, right? And the normal dynamics that you’d be hoping would play out aren’t. And to some degree, for the quality of life for a lot of people, the increases in those costs may even be dwarfing all the other advances in everything else
1. As I was listening, I was frustrated, because I wanted to point to my essay What Gets Expensive, and Why?. There I include the Baumol effect, but note my critical comments on the attempt by Alex Tabarrok to put it all on the Baumol effect.
2. Patrick notes that our ability to do large construction projects has declined over the past 70 years or so.
it’s very clear that our productivity has fallen off a cliff and for reasons that we can be pretty sure are not that it’s getting intrinsically harder. And so, for example, when New York decided to build the subway in 1900…4.7 years later, they opened 23 subway stations, and in 2019 dollars, they spent just over a billion dollars doing so. … When New York decided to build the Second Avenue subway in the year 2000, 17 years later they opened three stations and they spent $4 1/2 billion doing so. And so our productivity in subway construction has, at least in New York, decreased by a factor of 40. … California, you have high speed rail where… when France decided to build the TGV, its high speed rail, it opened the first line after five years. California started pursuing high speed rail 11 years ago. They forecast–we forecast–being finished in 2033. So we project a 25-year project, but of course, that’s a projection. It’ll probably end up being much longer
3. I already gave away my instinct on this when I wrote,
my inclination is to focus on broader cultural values. The enemies of progress are fear of novelty and envy of success. My thinking is that when those enemies hold sway, progress will be slow. When those enemies are weak, progress will be rapid.
I agree with Tyler that there is a lack of will. In the case of infrastructure projects or housing development, we now have a culture of conventional failure. Look at how hard it has been for Google to try to find a city that will allow it to experiment with a city of the future. Cities are only willing to approve politically correct development–bicycle lanes, as opposed to dedicated lanes for self-driving cars.
4. Patrick says,
empirically the entry costs of forming a new university are really high, but that’s not because there’s a kind of formal toll you have to pay. It’s not like zoning where there are deliberate, specific legal restrictions that prohibit you from doing so. But just as a practical matter sociologically, institutionally, accreditation dynamics, who knows, it’s apparently almost impossibly difficult to create a successful new university today.
Again, that is because we prefer conventional failure to unconventional success. I recently was hosted by a family in Texas. The oldest daughter was in the midst of applying to college. I wanted to scream “No! Don’t do it!” I do not believe that she is ready to go to college. I think she would be much better off just working at a low-paying job for a year or two and living on her own. I believe that is true for the vast majority of high school seniors these days.
Patrick is in the business of making it easier to start a company. Suppose he were in the business of making it easier to start a university. From the standpoint of technology, that seems like a very plausible business. Tools exist to deliver education in different ways. Look at Tyler’s and Alex’s MRU. The barriers are mostly cultural. Nobody wants to be the parent whose child succeeds unconventionally by taking a nontraditional approach to higher education.
I also want to scream “No!” when I see wealthy donors giving money to universities. The top schools have these enormous endowments already, which act like moats protecting them from competition. Don’t help them fill their moats! Instead, put that money into higher education start-ups. But if you give to your alma mater or to create a research institute at an established university, you can enjoy conventional failure. That seems to be more appealing to philanthropists than unconventional success.
Tyler and Patrick offer some provocative views about the way that success in research tends to come from less conventional institutional processes. But people stick with the conventional. For example, Tyler says
So I think in general, big questions are under-studied– the tenure system, I think, increasingly is broken. A lot of academics do work pretty hard, but that so much of your audience is a narrowly defined set of peers who write you reference and tenure letters–I think we need to change. And the incentive for academics to integrate with practitioners and learn from them and actually try doing things–we need more of that. I’ve often suggested for graduate school, instead of taking a class, everyone should be sent to a not-so-highincome village for two weeks. They can do whatever they want. Just go for two weeks, think about things. No one wants to do this. No one wants to experiment with it.
And I would add, require internships for economists. You can learn a lot while working in business.
Turning to health care, I think that Zuckerberg over-states the amount of money wasted in futile care in the last six months of life. But I think that the point is correct that we undergo many procedures with high costs and low benefits. I strongly believe that if we took away dollars at the margin from medical procedures and put those dollars into public health measures, the net effect would be positive. But wasting money on medical procedures with high costs and low benefits is a way to fail conventionally.
In short, when it comes to urban construction/civil engineering, education, and health care, we have evolved cultures of conventional failure. Innovation and entrepreneurship are discouraged. The heavy influence of government in these sectors probably serves to reinforce this. But ultimately the political process gives us something like what most people want. As Pogo would put it, we have met the enemy of progress, and he is us.