At the Square: The Economics of Roe v. Wade Transcript

DANISHA SNELL: Hey, there. Welcome back to another episode of both sides from American Public Square at Jewell. My name is Danisha Snell, Director of Programs here at American Public Square. The fall of Roe V Wade had immediate sweeping impacts on reproductive rights across the nation. In this episode of both sides, we are joined by doctor David Slusky. Doctor Slusky is an applied micro economist, whose research focuses on health economics, labor economics, and public policy. At the University of Kansas, doctor Slusky is affiliated with the Department of Economics, the Department of Population Health, and the Institute for Policy and Social Research. 

We'll link some of doctor Slusky's work in the show notes. Let's join the conversation. 

Okay, so I'm so glad to be here with you guys today. I know normally you hear Allan and Mike on both sides. Today, Danisha gets to join into the conversation, and we are welcoming doctor David Slusky to talk about women's reproductive rights, because this is in front of mind for everybody. So doctor Slusky, we know, is an economist here in the states. Well, he's not in the states right now, but he's an economist. And we really want to talk about the economics of women's reproductive rights. So I want to personally start this conversation with talking about, you know, people are normally caught up in the emotions tied to women's reproductive rights. But I think this is so important to study. Doctor Slusky, why is it important for us to study or understand the economics of women's reproductive rights?

DAVID SLUSKY: So first of all, thank you so much for having me here. I've been a big fan of you all for a long time, and it's great to get to talk to you, especially about such an important topic. I think economics is useful in a couple of lenses here. One is that one's own reproduction is part of one's economic circumstances and economic outcomes on every side of it, right?

That children we say children are our future, but children are literally our economic future. But also households of adults, adults or potentially there as parents, potentially there as individuals carrying future children, and are there as workers in the economy as well. And some of those things can't be done at the same time. And so one's reproductive situation and control over one's reproductive situation is intimately tied to one's ability to be productive in our economy. The second thing is that I think economists bring a lens to research that really compliments the medical and pharmaceutical world.

So the medical and pharmaceutical world, I think are very good at two things. They're very good at randomized control trials. We all have that graph from the Pfizer trial in our head that showed that the Pfizer vaccine against COVID 19 was much more effective that was going on in the Placebo group, and they're really good at observational studies, correlation studies. Think about the famous Surgeon General's report from 1960. About cigarette smoking and cancer. There was no randomized experiment there. There was no attempt at really causal inference. There were just overwhelming correlations that cigarette smoking was associated with cancer. What all of us do in my part of economics is causal inference from observational settings.

This is so important that we just want a Nobel prize on it. The Nobel prize given out last year in economics was on this. You've heard of Freakonomics, if you've heard of natural experiments, this is what we're talking about. And in this particular space where we can't run this experiment. We can't randomly close half the abortion clinics in the country. We can't randomly put people in treatment and control groups so if you get an abortion and you don't. We can't do that for obvious ethical and logistical reasons. But we need to know what is going to happen, what is happening right now in our country and what will happen in years to come. And economists in the way economists have tried to get causality out of observational settings, is a crucial part of this conversation.

ALAN KATZ: So let's talk about it. So, Oh, well, I was just going to cut to the chase. So can you describe how some of these studies have been conducted and what they found?

SLUSKY: Yeah, the large, I think, most amazing set of them is one that a sociologist, sociologist named Diana Green Foster, who did something called the Turnaway study. Turnaway study about 10 - 15 years ago, went to abortion clinics in 30 states across the US and talked to women who just made or just missed the gestational cut off for an abortion. 

So quick primer on how this works. We count weeks of pregnancy from the start of Woman's last menstrual cycle, not because you could be pregnant before ovulation, but because it is an easily observable point to everyone, unlike ovulation, which is not without modern medical technology. And then many procedures, and many of the bands you're hearing across the country are set by those weeks. But you don't get an adjustment for length or regularity of an individual menstruating person's cycle.

And so what these researchers found was they found individuals who showed up at the clinic, either just too far along or just not far enough along to get or not get an abortion. And most of the people who didn't get abortions subsequently had children. They then took these thousand women and matched them up to their credit bureau files with Experian. And the way they didn't tell Experian who wanted an abortion was they hid them within 50,000 other women's data they bought from a marketing firm. With this, you can now do two things. One is you can look backwards, you can validate the natural  experiment by saying in the years leading up to the attempted abortion, do their credit reports look similar, and they do. But then looking forward, you've seen enormous divergence.

You see the individuals who wanted and didn't get an abortion have much worse household financial situations across a variety of measures versus ones that do for as many years as you can study in this piece, which I think was at least five years. So that's the first big piece of work.

The second piece of work is one that I've done and others that look at preventive care rate. So here we look at clinics and when abortion clinics close, and many abortion providers will tell you that they are the only doctor that women see in the year, that's  healthy women of reproductive age, the only ones they see in the year. And many of us have shown is that when clinics close and driving distance to the nearest clinic increases, preventive care rates go down. Rates of professional breast exams and PAP tests and mammograms go down because individuals are not going to those clinics. 

MIKE MCSHANE: And can we get some scope? For listeners, maybe they're unfamiliar with this topic. We're talking about just like numbers around abortion in America. How many women are there? How many abortions take place? I mean, just to get some scale with as the number of zeros at the end roughly roughly.

SLUSKY: Yes. So I should say, first of all, that people who don't identify as women and are not women can still get pregnant and can still have abortions. I will do my best to when I'm talking generally, say pregnant individuals, and when I'm talking about a specific study, use the language of that study, and if they say women, I will say women, so I representing their results accurately. I'm not perfect, but I'm going to try and I ask you forgiveness if I slip up in my language here.

So Caitlyn Myers, is the best person on this, and she has done the best research on exactly how many abortions will not happen because of this. In general, in the US, there's somewhere 600000-900000 thousand abortions in a year. Different states count differently the CDC, aggregates the data. They don't get all of the numbers in there, but we're talking about something on the order of half 1 million to 1 million per year.

And that compares to about 3.5 million live births in the US in a year. So if every single one of those abortions carried through to term, which is, you know, an overrestimate, right, we're talking about something on the order of 15 to 30% increase in the number of births in the US, the years. It's a large number. The general estimate that were done right before all of the figure laws went into place were a substantial decrease in the number of abortions and increase the number of births. And those of us who looked at this using birth certificates, generally find that that increase is not uniform across the population.

Much of the research suggests that half the women getting abortions have income under the federal poverty level and three quarters have it under twice the federal poverty level, which is generally the threshold for low income. And so that the birth rate would increase, at least in my research be found to mostly to unmarried mothers. And broadly, the individuals who have the least financial resources by any metric to take care of these children.

KATZ: So let me David, follow this up. If I understand what you're saying that the primary significantly high percentage of people who get abortions or people who are on the edge economically.

SLUSKY: Yes. And that directly follows from the socioeconomic gradient in the ability of an individual to control fertility.

KATZ: Okay. So ahead. Ahead.

SLUSKY: Just meaning to say that, that poverty is also associated with unexpected pregnancy, unintended pregnancy. And that in the US, at least in the most recent data we have, which is almost 10-years-old at this point, you know, unexpected pregnancy, I think was about a third unwanted anytime, two thirds unwanted at that time, and about half of half of pregnancies less maybe 40% were unintended, about half of those are ending in abortion.

Now you get about one and four pregnancies ending in abortion, which nicely hits the number I said before about the increase in births. And the other ways, if you then play that out over the general fertility rates across the population, what you'll get is about a quarter of women by age 45 who had an abortion. So if I remember talking about this in a large room, or if there are a lot of people listening to this, look around to your metaphorical co listeners. Odds are very high that someone here had an abortion hasn't told you about it.

KATZ: So let me take that got two questions on that then. First of all, does any of the data indicate that not having not being eligible for the abortion puts people who are not in poverty into poverty? In other words, sort of push them over the edge? We have data on that. And the second question is, which I don't I don't know the answer to and hopefully, you do is what has been the trend in terms of the number of abortions since Roe? Now I'm sure the first few years probably I don't know what we've got. But the question is, you said that we have between I think your numbers were 6 and 900,000 and 800,000 abortions per year. How is that a constant? Has it gone up? Has it gone down or do we not know?

SLUSKY: Great. So lots of questions there. I think Experian does do an imputed income. So your income is those who looked at your credit report recently, your income is not on your credit report. But they have imputed it. I'm trying to get it for another project. I don't think the researchers who did this piece on the Turnaway study, which is Laura Weary and Sarah Miller, two of my favorite economists, I don't think they looked at that variable. But if you would have looked at it, I think what you would have found not necessarily an income decrease, but certainly a disposable income decrease. And that just makes households much less able to deal with all kinds of shocks. Before the pandemic and before all of the income substitute programs in the pandemic, there was a staff and survey of consumer finance that a large share of Americans and it's about 40 or 50% couldn't deal with an unexpected expense, I think greater than 4 or $600. So that number just shows you how close to the precipice many people are. 

The number of abortions over time is generally, I think increased substantially, but I think peaked in the mid 90s. I think there are many reasons for it peaking in the mid 90s, one that we've seen in other states. So Colorado Title ten program funded IUDs, and there's been other really excellent research done on that showing that that substantially reduced teen pregnancy. So I think one of the reasons that the abortions have come down substantially in the last 30 years is not just trap logs, targeted restrictions of abortion providers, but also we have a lot of much better forms of contraceptives that are much better targeted.

My favorite metaphor about the original birth control pill is it's like cutting off the power to the whole block to turn out the light in your house. I'll get the light out, but it's a pretty blunt measure. And I think since then, with the Nuva rings and the patches and the better IUDs and the implants, we have much better, more targeted, very, very effective forms of contraception, and I think that's one of the things helping as well.

SNELL: So, doctor Slusky, there's being the only woman on here and a Black woman at that. I've had the opportunity to sit in rooms and listen to conversations and be privy to conversations where this becomes a racial issue. This becomes a you should have personally, you know, this is your fault, I shouldn't have to pay for something that you... I know that in some of your studies you've done, you've talked about women who have abortions come from a wide variety of backgrounds. Could you talk about that?

I know that I've had some conversations with some girlfriends, and we're like, you know, Black women, we're Black folks are 13% or less of the total population. How is it that it seems like everybody thinks it's Black and brown people having abortions. So could you just talk about the variety of backgrounds and dig just a little bit more into that socioeconomic part as well?

SLUSKY: So I think the first thing to say is that unintended pregnancy can happen to anyone. No method of contraception is foolproof. And I would even argue to say that no attempted abstinence, in most cases is fool proof either. And so this can happen to anyone.And that's the first thing to say.

I think the second thing to say is just how I am not a person of color nor a person to become pregnant, but to be both in America is terrifying. That the rates of maternal morbidity and mortality for pregnant people of color are enormous in America, much higher than they are for others, and we actually don't fully know why. Because even famous rich people of color have higher rates of maternal morbidity in America. So it's not only about income and access and affluence. So that's the first thing, and that's tied up here because if a person has to stay pregnant, then that person is at more risk. You know, you go all the way back to Queen Elizabeth the argument that one of the reasons Queen Elizabeth did not marry, did not try to have children was that she wanted to be able to be queen for a long time. And in the Renaissance world, for a woman who wanted to live a long time, not trying to have children was a way to do that, was a really good strategy for that, actually.

So in survey data on rates of unintended pregnancy, they are about twice as high for Black Black non Hispanic women versus white non Hispanic women. And I think part of that is lack of access to, long acting reversible forms of contraception, and also lack of access to sterilization. And part of that is because there's a real terrible, terrible history of forced and coerced sterilization on women of color. So much so that the Medicaid program, the consent rules are so onerous as to potentially make things even more difficult, to potentially do more harm than good.

I have a friend, Havi Parkowski, who's a high risk OBGYN, should all read her book high risk, which is spectacular. But she talks about these papers that if you are on Medicaid, and you want to tubization directly after delivery after a Ceasarian section, when it's a less risky procedure on the margin. You have to have signed these consent formed a certain number of hours before. You can't sign them in. And she has talked about tearing up an entire nurse station in a labor delivery unit, trying to find that paperwork and failing and being unable to do the procedure at that point in time.

SNELL: So here's my follow up question. All that is super interesting because, yes, I know that no matter your education, I mean, the most famous person I guess right now would be Serena Williams, who talked back she almost passed away, having a having her child. I experienced the same thing, although I'm not that famous and no certainly not instead of a tennis.

SLUSKY: A little bit little bit. 

MCSHANE: Yet.

A little bit. Yeah.

SNELL: Yet. I'm on my way there. But I think too, just to broaden this a bit, we know that education doesn't matter, you know, doubly degreed up, stuff. It didn't matter. I still almost passed away having a child, right? So that doesn't matter. But let's look outside of that and broaden that up a little bit. If women did not have. So we know for a fact that women earn less on the dollar than men, right? White women earn less, Black women earn way less, Brown women earn even less, right?

If women are denied access to family planning, and you've stated that and I'm reading in some of your articles that, these clinic closures not just affect abortion, but they affect other types of family planning. What does that look like as we continue in our country where we it's extremely expensive. It cost what to for somebody to take care of a newborn, daycare, it's a mortgage payment or higher, right?

We have less access to that. How do we, as a country, from economic standpoint? How do we begin to do these other things to support families and to support women?

So, if you're looking at credit reports and credit scores and income, if I have to have a baby, send her to daycare, which I did in college, and then try to catch up with income. And I'm still trying to, how does that look? How does this all come together?

SLUSKY: So it's not magic. Not just, you know, like Sweden can get it together in America can't, we did it in the pandemic. We drastically lowered child poverty in the pandemic by increasing the child tax credit, like that. And it's a one line bill. The child tax credit will now be, and you just put a different number in there. It's not you don't need 700 pages to do this, and we did it, and we let it expire. So, if we wanted to say as a country, we know there will be more children. We know there will be more children born to people with less resources to take care of them, who might not even don't think they have the resources to take care of them. We could provide more resources. And that's, you know, cash works, Childcare works, health care works. I mean, we know there are lots of papers about the long term benefits of access to Medicaid as a child. And many of which actually show that the government long term saves money because it actually prevents future health problems for those individuals who have access to health care as children. So Yes.

KATZ: I was just to say if I were to say to you, ok, we know after the Dobbs decision, that abortion access is clearly going to be more restricted. We don't know what the particulars are. Different we'll find out more. But if we were to say as a national policy, we want to encourage people to have more children. This for us, we believe is a national value from the economic standpoint, what is a reasonable amount that each family should receive every month for each child up to a certain age that would in some ways, blunt the devastating impact of children coming into families. I would sort say I wouldn't worry so much about an income threshold simply because I think in many ways, it costs more money to administer that than it actually costs you the amount of money that you pay now. And there's a certain question, and I think that it's much easier for people who maybe don't need the money to not resent the people who are getting the money if they're also getting the money.

SLUSKY: So several things on this. So one of them is, you know, I'm in Stockholm right now still finishing up my sabbatical. And many European countries have birth rates that are falling through the floor. It's a race to zero. Not Sweden. Everybody's pregnant or pushing around brands in Sweden, it feels like. And it's not just cash, it's a whole suite of things, a big one of which is parental leave, and parental leave that has birth parent and non birth parent components that cannot be traded. And we know this from the US. We don't have to look a Sweden. We can look at California. We look at other states that have done it. And what those states actually find is that the biggest benefit is for the lowest income workers, many of whom did not have that benefit already available to them, or whom the relatively low maximums on income replacement are actually still a lot of money for them.

So I'm not going to give you a cash number because I think it's actually the suite of policies has to be slightly larger than that to make sure that we're doing this properly. And one of the things that parental leave does is it actually means you don't need infant daycare as much because many more children are home for those crucial few months. And right. This also increases breastfeeding rates, right because birth mothers are home parents are home with their children, and those who can do that are able to.

So I think that there are a variety of policies, and these policies happen by inches. Right? They don't just happen. We're not going to go to 12 months of paid parental leave overnight, but slowly states are increasing this. I mean, you have the Senator Gillibrand and congressman, my old Congresswoman Duro from when I used to live in in New Haven, it's a relatively simple plan. It's what DC tried to do.

You raise the payroll tax by 20 basis points. And that's basically enough to fund this through the disability system. It's not complicated. The other thing I'd mentioned, though, right, is that one of the problems here is this is a consequence of legislating through the judicial branch. The Judicial branch can't say, okay, we are going to return abortion to the states, and we're going to make available the following amount of federal money that will pay for increased child tax credits in states that don't have abortion. The Supreme Court can't do that. They can't legislate.  And so the fact that we are making policy, this is the same thing with the ACA and the partial Medicaid expansion. Supreme Court couldn't say, and for States that don't expand Medicaid, we are going to extend subsidies down to 0% of the federal poverty level. They don't have the legal authority or the constitutional authority to do that. Right? And so to some extent, the reason we get this patchwork policy goes back to our representatives and our senators and our voters for letting our legislative branch kind of abdicated responsibility.

MCSHANE: I have a question more, even like a methodological question about doing research on abortion, because it seems to me there's sort of one side of the ledger of looking at mothers, right? And the economic costs to having a child. But we mentioned at the beginning, and I'm kind of circling back to that, this idea that children are our economic future. And it seems to me those 600 to 900,000 children that are aborted every year would be born, would grow up, would work, would earn money, would pay taxes. Are those taken into account in these models? How do we think about the that affecting the kind of equilibrium?

SLUSKY: Yeah, so I want to broaden this even further, which is this actually gets the immigration policy as well. Meaning, if we wanted a.

MCSHANE: That's where I was actually going with this because I was thinking I was like, I research on immigration policy, and I was like, it seemed like the same like a similar logic would follow.

SLUSKY: I either picked up the ball or fell into your trap depending how you want to look at it. But I think the way I would say this is, children are our economic future, but immigrants are amazing because somebody else invested in them, and then we get the return. Right? Somebody else built the house, and we have we get to live in it, right?

You want another million workers in the economy. There are 1 million people all around the world right now who want high skill or low skill or special visas or all kinds of things who want to come here right now and can't get the proper visas to do so. So, I think until we have gotten something much closer to the equilibrium there, right? I don't have a lot of patience for the argument of these more children will definitely be an economic bonus because we'll have more workers in 20 years.

MCSHANE: No, I wasn't even making an argument. I was just talking in the economic models, Is that taken into account in any way?

SLUSKY: So it's a good question, and I think there, this is a macroeconomist microeconomist debate. Macro economists which I am not, are much more trying to build these multi economy models of people moving and such. Micro economists, these days, especially applied ones, are much more in the natural experiment framework. Right? We're much more in the what happened when the H one B cap went down in the outs, right? What happened during the great recession to H1 Bs? I think that's the high skill visas. That's much more the margins we're looking at, and we can get a much better causal estimate at the cost of not having as much to say about these kind of broader equilibrium questions that you're asking.

KATZ: Okay. So, you know, because you're an economist, I think I can ask you this question. As you know, every time there's a merger of large corporations, there's what they call the frictional cost. The cost that's going to be there that you don't measure in sort of the balance sheets. There is clearly going to be a frictional cost in our society with this decision. And the question in terms of, is it going to, will we wind up as a result of this actually having fewer live births because the availability of abortion is going to be restricted, which would make people more you concerned about having family planning available to them. Economically, what do you see as if at all, the frictional cost of this change?

SLUSKY: So several things. One of them is if you look at Google Trends data, which is amazing and free, you should all spend time looking at the Google Trends data. The spikes in people Googling, sterilization and vasectomy, and tubiligation, after the Dobbs decision were enormous. So that's the first piece. The second is, I mean, right? Kansas has a constitutional amendment. Kansas has a constitutional amendment on the ballot in August. And if that amendment passes, Kansas will very likely ban almost all abortions. And that will make it just as an economic friction, harder for us to hire more women in the economic department at KU. Like, I think we would love to have more women I would love to have more women on the faculty in my department. I think it's hugely important to perspective wise. It's hugely important mentor wise. It's hugely important in everything we do.

And if Kansas does this, I and the legislature follow suit, We will have fewer women applying to jobs to work with us. We will have fewer women accepting interviews, and I will sit across the table at dinner with them and have to convince them to come to Kansas anyway. And I'm not sure I'm going to be able to, and that's going to be terrible for my university. 

SNELL: Aside from that, I'm sitting here and I'm looking at these three guys on here, and I'm thinking to myself, I'm, we're talking a lot about women, which is right really so. Have you all looked at the economics or how this would affect men? What does this mean? If we talk family, men have something to do with this.

SLUSKY: So in Europe, right we have these QR codes with our COVID vaccination proof. I think in America, you're still using papers from the 19th century, but it's okay. So somebody said on Twitter, it was very smart. When are we going to have a QR code to prove you had a vasectomy? Right? For example, right? And it doesn't have to be a vasectomy, right? I mean, that Vasa gel thing in India that's like, always five years away from market for the last 20 years, right? Is this finally going to push along some kind of it's a substance that's injected in the scrotum that you then can inject like citric acid or something very simple to reverse that is basically a reversal kind of male contraceptive. It doesn't have hormonal consequences. Right? Is this finally going to spur research to make that happen? And then, so you're not taking a guy's word for it. Is he going to be able to produce proof that he actually had that and it's active as, like, one simple example. And frankly, is it going to go the other way, right?

Is proof of an IUD or proof of a tubiligation or something like that, right? Are men going to say, you know, I'm not I don't want kids. I don't want to be involved in this. I don't want unintended kids. You know, how this how is this going to work?

SNELL: So, I noticed the guys have all gotten quiet, Alan.

MCSHANE: I was just I want my first reaction to that, is that sounds like insane and dystopian, right? Like showing your QR codes for those things, like my first reaction to that. I saw she mad with her hands mine was like recoiling and disgust because I'm like, that sounds dystopian. But that's just my first blush.

KATZ: By, well, let me just of say that because I'm the oldest person on this call, that I had friends who were single when AIDS first came on the scene. And literally people before they would become intimate with their partners, they wanted a blood test, a current blood test to show that they were not infected. And I thought it was sort of crazy at the time, that I wasn't, you know, I wasn't out there in the marketplace, so to speak, but I think that for people who were, they told me it was just like because, again this is the beginning of age when everyone we basically, if you got AIDS, you died.

SLUSKY: I would actually say even I'm old enough. I'm not sure what the youngest or one of the youngest on this call, but even I'm old enough to, like, in the mid aughts before we had really fully rolled out anti retroviral treatments. Even me and people I know would do things like that at the beginning of a relationship. That's not crazy.

And I think also the way that COVID has made us even more measurement aware, right? You know, I don't know what your social circles dinner parties are like about how many nose swabs are happening with where everybody sits down together. But that's a real thing and not a very expensive or uncomfortable thing. I think that way of measuring and communicating about yourself is more and more a function of where we are.

KATZ: Yeah, I would also add that I think it's to Mike's point, it's a little more dystopian to sort of having people tracking people as they go out of state and having having women having to track their menstrual cycles to make some government, you know, sure that they're not actually violating the law of say of Texas and getting an abortion in Illinois.

SLUSKY: I want to visit me here on that because I've done research with that data, right? I have a paper that's under review where we looked at how states that, there are many more than half the states delayed elective medical procedures in the pandemic, you probably remember, and about a dozen of them explicitly included surgical abortions in elective procedures to be delayed. And we used that kind of cell phone location data in anonymized aggregated form to look at visits to abortion clinics during that period because that data is never tracked, and even the state level abortion counts weren't available, we started writing the paper. We now want to use that data to try to look at how flows of patients are changing as states go dark at the level of a county to an area to a square mile around a clinic.

Here, and what we're trying to discuss with these providers of data is we want data that is research useful, but legally useless. Right? We want to thread the needle where this data is sufficiently granular that we can help measure in almost real time what is going on around us so that policymakers can use that, but is sufficiently coarse that were we to be were someone to hit us with a search warrant or a subpoena for that data, it wouldn't be of any use to anybody trying to prosecute an individual person. That is always true. It's true when I work with hospital discharge records. It's true when I work with individual birth certificates, it's true when I work with insurance claims. There's true when I work with restricted census data. There is a trade off between privacy and research. It's why when I got special sworn status with the US Census, right? I have agreed to pay penalties for the rest of my life and go to prison if I do things. I know, Alan, you know, in your work as an ambassador, with the kind of clearance you had, right?

There were things that you had to be able to do your job that was worthwhile to the country. And there was a cost to giving them to you and we decided that was a justifiable cost.

SNELL: Doctor Slusky, I want to ask. I know you talk about policy a lot. For my you know, I may sit around with my friends. I have two young daughters. We talk about this stuff. What are the things that we could be doing? We know that none of us think about going into economics and thinking about it from this way. But what is it that we could do to help to further this cause and help to support mothers and children and families? What can your everyday average person do?

SLUSKY: So first of all, I think the Amicus brief that 154 economists signed, including me is quite readable to any educated person. So maybe can put a link in the show notes or something like that. So that Amicus brief, I would start there. And the second thing is, there is a whole this is a metaphor to say on a podcast, but there is a whole podcast industry about economics research, generally made by individuals who don't have a graduate degree. The people writing about economics research for Fox and the New York Times and Slate and the Washington Post and making the Freakonomics podcast series. Most of them don't have graduate degrees and are able to interpret this research, something I teach my undergraduates.

My seniors is how to read a paper in the original and communicate it to everybody else. You want to produce a paper. Now you've got to go to graduate school. We can talk about that. But if you want to read and consume a paper, that's something you can do. And one of my missions as an educator is to increase research consumption and to convince everyone that research consumption is actually in their grasp. So, I'm the executive director of the America Society of Health economists and we are right now putting together a Zoom panel of a variety of researchers. Some of I mentioned on this call, some others working in this area, and we're going to put a recording of that on our website.

And that's something as well that I highly recommend you all watch once that's available the next few months and get your head around this research as well. I think that we have an obligation as citizens to understand the consequences of the policies we're making. And we might then say the other benefits of this justify these consequences, and I'm okay with them, or might say they justify them, but I'd like to do other things to mitigate them. This gets back to my point before about trying to convince our legislators to legislate. And I think that's our obligation as an informed citizenry and something that you all do very well in all of this kind of work on a whole variety of topics. 

KATZ: Okay, let me say this then. And Mike I don't know whether you have anything to add. But I want to thank you, David for joining us this morning from Stockholm. And We look forward to your return to the United States, maybe more so than you do. I don't know. But I look forward to having you back and involving you in a wide variety of conversations that we want to have. You've graced our panels in the past with your presence, and I think we all have learned from it. I don't think today is any exception. So I want to thank you very much.

SNELL: And I think I just want to say thank you, doctor Slusky, and thank you both to Allen and Mike for allowing me to come in here and run my mouth today. I normally am behind the scenes. And so thank you for allowing me to turn on my microphone and talk today. 

KATZ: Well, thank you. Thank you, Tenisha, and really, you know, it would have been it would have been something essentially wrong about having this conversation without having a woman participating in it. 

SLUSKY: Great. Thank you so much, really a pleasure.

KATZ: Thank you very much. Bye bye.

MCSHANE: Well, Alan, I know you're back in Kansas City, but I don't know if you've seen the news. I think that we've just done a lot of domestic policy, so maybe we'll shift a little bit to foreign policy here. But it looks like the mop topped Boris Johnson has seen the end of his time as the Prime Minister of the United Kingdom. I don't know if you've been watching that at all, if you've seen anything or if that's been covered in America a lot.

I mean, I think it's important because Great Britain is obviously an incredibly important ally to the states, but I don't know if you had a take on that one.

KATZ: Yeah, no, I've been watching that what's interesting is that, you know, initially, there were a lot of people who made comparisons between Trump and Johnson. And what we're seeing here is that the reason Johnson is gone or about to be gone, I should say, is because his party abandoned him or he felt they abandoned them, whatever the reason was, he no longer has the support inside of the Conservative party to remain in office. And clearly Trump continues to have support among Republican Party in the United States. So I don't know whether it's a result of the difference in a parliamentary system versus a non parliamentary system. What's your take on it? 

MCSHANE: So this is the thing, and it was funny because I've seen some of the sort of hot take from American people who have like, Oh, see this is like a proper country where politicians resign because they're like, you know, somehow better people or whatever, and I was like, have you ever heard about Boris Johnson? I was like, I don't think like honesty and what are his strong suits. You know, what I think look, parliamentary system, I think definitely plays part of it, but one of the big advantages that places like the UK. And actually, I think most European countries have are strong political parties. So the Conservative Party, as you mentioned, you know, if you listen to Boris Johnson's resignation speech, like, the second line is, I lost the confidence of the Conservative party. And the beauty of it is that the conservative party, when it loses confidence in someone,  can do something about it because the conservative party selects, they don't have primaries, right?

So they get to select everybody who's running in every jurisdiction when all of his ministers decide to resign on him, they don't have to pay a consequence for that. In some ways, they've set it up such that doing the right thing doesn't have as high a cost. As I look at the United States, and other, someone like Liz Cheney or Adam Kinzinger, people who are doing the right thing, it's all set up that they have to pay the highest cost for doing that, and doing the wrong thing is the easiest thing to do. But when you have strong political parties like that, they have a huge incentive to not put any one individual before the good of the party in general.

And so I think, you know, that's an advantage. I mean, you look at all of the things that have happened in the states. How many people are coming out of these primary elections, probably more on the Republican side than the Democrat side, but I think a few have happened on the Democrat side as well, that the parties don't want. They like, I don't think the Republican Party wants Doctor Oz to run in Pennsylvania. I don't think they want Herschel Walker to run in Georgia. I definitely don't think that they want Eric Greitens to run in Missouri. I mean, it's been very obvious. They've been clear about that fact. But they're powerless because of the primary systems.

Then again, you have a primary like in Missouri's, which is lunacy, which, Alan, you could, you could, as someone who's been affiliated with and worked with the Democratic Party for your entire adult life, you could walk into a polling place, pull up a ballot and say, I'm a Republican today. I'm going to vote for this person. It's crazy. It's absolutely crazy. And so I think having stronger political parties that are able to pick who gets to run in elections makes it easier for people to do the right thing, and our kind of wide open primary system and weak political parties make it much harder to do the right thing.

KATZ: Well, I agree with you. In fact, there was the day we're recording this. There was a poll just published by the New York Times that shows that among Democrats asked the question, do you want President Biden to run for reelection? He received, again, we're talking about Democrats here, a resounding 24%. So, theoretically, under a British system, that comes about as close to a no confidence vote as you can get. Now, I wrote a piece for Newsweek recently that encouraged him to announce he wasn't going to run as soon as possible, simply because I think it would help the Democrats in the midterms.

But I do think that there is a strong sense of dread in this country that we're going to see a rematch of Biden and Trump. And according to the same poll, while Biden was three points ahead, there were over 10% of the people who basically sort of saying, neither or I'm not voting or I've got to find someone else. So I think most of the lack of enthusiasm among Democrats for Biden, even though it was sort of apparent. And I think that clearly among certain subset of Republicans, the same thing is true about Trump. But I think that what you have in the United States is you're exactly right. We have a system that does not reward people for good behavior, rewards them for bad behavior politically. And until we change that, why would we expect people to behave any differently?

MCSHANE: Yeah. I mean, and as we look forward towards the mid term elections and others, I was looking at some polling data recently because just in the last three or four months, Biden's approval rating has gone down, President Biden's approval rating has gone down. All of the sort of negatives about countries on the wrong track have gone up and I was like, Wow, that is a really rapid change. Then it's fascinating because if you overlay that on people's opinions about the economy, they're almost perfectly linked with one another.

It's inflation, and it and it's sort of economic stuff. And that seems to be consuming it's interesting. We obviously spent all this time just talking about abortion. But obviously, with the shooting in Uvalde, Texas, there's guns, there's war in Ukraine. There's all of these things. And I find it fascinating that it's just I mean, there was the old saying, it's the economy stupid, but it's the economy. I mean, that just just swamps everything. And when the economy is going well and inflation is lower, people are more likely to be optimistic. But when gas prices go up and all of that stuff, all of that other stuff just starts to fade away. 

KATZ: No. And it's interesting because the macroeconomic numbers are all relatively good in terms of employment. 

MCSHANE: It's so weird, right? Job Joblessness is low.

KATZ: No, I know. And I think what's happening, I think that the Biden administration is making a fundamental error, trying to convince people that things are really good. You know. I think frankly, one of the things that Biden when, Biden ran against Trump in 2020 was the notion that he was empathetic, that he could understand what people were going through. And I think if we had a little more of that, he would probably do better. I think that the Democrats are really in very difficult position. The other thing it was interesting about the survey though is that for the first time gun violence was among the top four concerns, which it's never been there before.

And when you look at the issue of abortion and abortion rights and you look at women and people in general under the age of 35, it's a very, very big issue. I think that what happens is we'll see on November the eighth. But I think the remaining hope for the Democrats is that the abortion decision and will motivate people in such a way. That voters who might normally not show up young people to show up, that it may mitigate the way things are going. But I think and to your point, and by the way, on some of the Republican candidates, I mean, Herschel Walker was endorsed by not only Donald Trump but Mitch McConnell. So I think that what we have there is that and I think that frankly, he'll lose that race, which was a winnable race, which will be the third senate race in a row that the Republicans have lost in Georgia, that they should have won. 

MCSHANE: So I mean, if you think about the tail wins that Democrats have, poor candidate selection is towards the top of that list.

KATZ: Yeah. I was going to say Because I think that all other indications are the Republicans are going to do very well, simply because people are not comfortable with where the country is going, and I think that what the Biden administration has failed to do with a singular exception of Ukraine is they have failed to get in front of any of these issues. They've always been pushing.

MCSHANE: Why do you think that's happening? Like, is he gets he have bad people like he has some experienced hands around him? Like, why do you think that's happening?

KATZ: You know, I mean, I I've written that I think that part of the problems of the people around him are that they think the only people that know anything live in Washington and they're behaving that way, and I think that the cost of that politically is going to be very high for Democrats across the country. But I do think that I do think that as of today, Biden thinks he's running again, and I think that if the poll that came out today, if this maintains its same level of lack of enthusiasm for him, I think he'll be challenged for the nomination. And he may actually be this actually is encouragement to get people, not just people who you would normally not think of would ever run for president, who typically challenge an incumbent president of their own party, you know, A la, Gene McCarthy, Pat Buchanan, et cetera. And I think that you may have some mainstream Democrats just sort of saying, Joe, you've done a great job, but you know what you can't win. So we got to replace you. So we'll see what happens.

MCSHANE: I got to know. So early runners here, do you have some ideas for people you think again, not necessarily people you would support, but if you were replacing some futures bets here. 

KATZ: You've got three governors out there who clearly are interested, you have JB Pritzker from Illinois, you have Roy Cooper from North Carolina, and I think you have Phil Murphy from New Jersey, all of whom basically have a start. And, you know, doesn't. And again, what you always find out about candidates is whether or not they are I'm sorry. Whether or not they are how they're going to how it's going to work. They have to be tested out there, campaign. I think Amy, Amy Klobuchar would like to run again. And someone said to me the other day, they said, they think she'd be a good candidate and he said, I don't think I want to work for, you know, I do think that she could be a good president. So I think that you have the people from. I do think there is an interest the one senate race I think that people are not paying attention to, which could be a problem for the Democrats is Colorado.

I think that it's going to be a much closer race than a lot of people think it's going to be because Michael Bennett is not that popular even though I happen to think he does a good job, and the Republicans actually nominated a real person. So I think that it's going to be an interesting race.

MCSHANE: Well, lots of interesting times ahead. We'll have to see in one of these future ones, we can do our whole 20, 22, mid terms handicapping. I think there's still a couple more primaries to happen. So when we know the full field kind of. 

KATZ: After Labor day is the time to do that. Arizona still has to choose a Republican nominee, and the Democrats are cheering for one of the crazier people out there. So we'll see what happens, and it will be interesting to watch. As of today, I would say the Democrats will lose the House. The Senate is a pick 'em, and so we'll see what happens.

MCSHANE: Well, I would say, I'm handicapping that the same way at this one. I think it's pretty clear. Republicans will take the House, Senate to toss up. And the only thing I can count on is it is only going to get weirder and crazier from now until then. I think we're going to see some gaffs, we're going to see some debate moments. We're going to see some stuff that is going to be truly off the wall. 

KATZ: And the other thing, Michael, I think that's going to happen in the next three or four weeks, and of course, it may prove me wrong.  It's always dangerous to predict these things. And I think the Trump will announce he's running for president in 2024. As a way of nothing else to deflect the January 6 news. 

MCSHANE: So we boy. We live in interesting times. Well, Allen, as always, it was wonderful talking with you and Danisha. It was great to have you. We need to do that more often on more issues, not just like when it comes to women's issues or something. We love your opinion on everything. You could jump up whenever the heck you want to. 

SNELL: I love that. Thank you. Okay.

KATZ: We'll see you guys. Take care.

SNELL: Thank you for joining us for another episode of both sides from American Public Square Jewell. To learn more about American Public Square, visit our website at Americanpublic square dot O R G. To stay connected, follow our handle AM Public Square on Twitter, Instagram and Facebook.

Thank you again for listening and join us next time as we continue conversations from both sides.