In July 2015, former Enron board member, New York Times columnist, and champion of ever more government control of health care, Professor Paul Krugman, wrote a disturbing blog entry:

Wonkblog has a post inspired by the dentist who paid a lot of money to shoot Cecil the lion, asking why he — and dentists in general — make so much money. Interesting stuff; I’ve never really thought about the economics of dental care.

But once you do focus on that issue, it turns out to have an important implication — namely, that the ruling theory behind conservative notions of health reform is completely wrong.

For many years conservatives have insisted that the problem with health costs is that we don’t treat health care like an ordinary consumer good; people have insurance, which means that they don’t have “skin in the game” that gives them an incentive to watch costs. So what we need is “consumer-driven” health care, in which insurers no longer pay for routine expenses like visits to the doctor’s office, and in which everyone shops around for the best deals.

Krugman goes on to insist that dentistry is a consumer-driven market: Insurance is far less prevalent in dentistry than in medicine, and most dental care is routine and preventive. Yet, he points out, costs of dental care have risen at the same rate as costs of other health care, not at the rate of other consumer goods and services.

Capitalism doesn’t survive ten minutes in director Antoine Fuqua’s new remake of The Magnificent Seven. Mining baron Bartholomew Bogue (Peter Sarsgaard) stands before the residents of the western mining town of Rose Creek and proclaims that, because America has accepted capitalism, they have little choice but to submit to his economic predation on their livelihoods as small claims miners. When one of the townspeople stands up to him, Bogue shoots him at point blank range, killing him, while his henchmen attack and kill others to dash away any further thoughts of resistance.

The anti-capitalist backstory is clearly intentional, although its integration into the film’s narrative is awkward at best. “Capitalism” is not well defined in the film’s implied glossary, but the general meaning is clear. The opening scenes show abnormally thin men working Bogue’s mines as dynamite blasts through mining shafts under the hills. Men fall from wagons in their rush to collect meager earnings at day’s end. In the town-hall type meeting that Bogue crashes, the small-time miners are lamenting the grim reality that Bogue has bought out their friends, and they will have little choice but to follow suit. The implication is that power is concentrated in the hands of the few—the industrialist Bogue, in this case—while the many toil under the guns of the henchmen.

Workers—err, miners—of the world unite!

But The Magnificent Seven’s backstory is not without merit, although it follows a populist storyline rather than one embraced by economic historians. (See historian Burton Folsom, Jr., here, on the Myth of the Robber Barons.) The 2016 remake is set in 1879, squarely in the Gilded Age of America’s industrial revolution and five years after the Panic of 1873. The Panic ushered in a deep, five-year economic depression, and was triggered by the collapse of railroad stocks after a decade of overbuilding (heavily subsidized by the federal government) and the collapse in global demand for silver. Arrested economic development, falling wages in the railroads, and high unemployment triggered social unrest, including the Great Railroad Strike of 1877 (also called the Great Upheaval).

In the new film, Bogue is specifically referred to as a Robber Baron, even though his industrial background is murky and only visually implied through a glimpse at his vast mansion in Sacramento, California. Bogue nevertheless appears to have a historical analogue in copper-mining tycoon William A. Clark. After starting out as a miner during the Montana gold rush, Clark switched to banking and grew his business by repossessing properties held by miners who had defaulted on their loans. He also seemed prone to the Gilded Age excess that likely rankled the sensibilities of those less fortunate. Historically, however, the vast majority of the so-called Robber Barons (a derogatory term coined by the popular press, not economists) were railroad tycoons.

All these historical subtexts and tensions unfold in one way or another on screen, although they seem more a distraction than elements that propel plot. Bogue’s particularly psychotic ruthlessness never plays out as anything more than a uniquely villainous personality. When he criticizes John D. Rockefeller (oil) and Cornelius Vanderbilt (shipping and railroads) for building their success through political connections and government, Bogue claims in his next breath that he will ground his success in the real capitalist way of simply taking it. (I would have laughed, but this is a serious drama.)

This rich backstory, although one-sided and inconsistent with mainstream interpretations of America’s industrial revolution, seems squandered. The film’s lead characters are a motley bunch of vigilantes, not too dissimilar from characters in the 1960s film. They aren’t really motivated by political economy or a political philosophy. In fact, their motivations are strangely obtuse and unclear. The gambler (Josh Faraday, played by Chris Platt) seems mostly concerned about getting back his horse. An outcast Comanche warrior (Red Harvest, played by Martin Sensmeier) might be looking for some form of redemption, but the viewer has to fill in the blanks to make that leap. Ethan Hawke’s sharpshooter-turned-vigilante, Goodnight Robicheaux, is one of the few characters with a genuine arc, as he wrestles with nightmares and demons from killing too many people during the Civil War. He is trying to resurrect his own sense of honor and redeem himself after falling from past glories. The leader of the Magnificent Seven is a bounty-hunter named Sam Chisholm (played by Denzel Washington, in his first Western movie role) is more purpose-driven, although his motivations are never really clear until the end of the film.

Fortunately, The Magnificent Seven is saved by its outstanding cast. Denzel Washington shows again why he can open big films. Vincent D’Onofrio plays an aging tracker, named Jack Horne, with enough quirks and innate sense of justice to keep audiences rooting for the vigilantes. The film also mixes it up with new characters who are more than just nods to diversity, including Red Harvest, an ambiguously Asian assassin (Billy Rocks, played by Byung-hun Lee), and a Mexican outlaw (Vasquez, played by Manuel Garcia-Rulfo).

Thus, The Magnificent Seven does, in the end, become an engaging modern Western, particularly when it features lots of guns blazing that take out villains, cool stunts on horses, and a kill ratio worthy of a video game. The seven gunslingers dispatch 20 of Bogue’s top henchman while the tycoon is away in Sacramento, giving the townspeople of Red Rock a feeble glimpse of hope. But Brogue returns with an army of 140 fighters, raising the stakes for everyone involved. Since this film is a remake, it’s probably not much of a spoiler to observe that Bogue is unsuccessful in retaking the town. None of Bogue’s army survives, thanks in part to the ultimate sacrifices of several noble townspeople and just four of the Magnificent Seven.

Film buffs hoping for a faithful adaptation of Akira Kurosawa’s Seven Samurai, the pioneering 1954 Japanese film that prompted the 1960 Western, will likely be disappointed by the new film because it strays even further from the original in both substance and form. In Kurosawa’s film, masterless samurai (ronin) are outcasts in a very structured social hierarchy, and they seek to restore their noble names by protecting the disenfranchised. They adhered to a very strict code of honor, obligations, and responsibilities. Killing to avenge dishonorable acts was justified as a way to bring balance to Japan’s feudal social order. Each of Kurosawa’s seven samurai was on a quest for personal salvation, and the protection of the village was a means to achieve redemption.

The 1960 remake (directed by John Sturges) used similarly redemptive motives for most of the gunslingers enlisted to protect a Mexican village from a pillaging gang of bandits. This nobility is absent from the 2016 remake, however, in part due to a poorly executed attempt to shift the story’s theme from one of personal salvation or redemption to one of political economy. Sam Chisholm’s pursuit of Bogue hinges on revenge—a staple of every vigilante film—for an earlier slaughter, righting a personal wrong rather than rectifying a social injustice. No noble motivations, sense of honor, or paean to social justice unifies the 2016 remake. Ultimately, it will go down in film history as just another entertaining box-office success once it breaks the $100 million revenue mark.

The Health Care Cost Institute has released its analysis of claims data for the years 2010 through 2014, comparing consumer-driven health plans (CDHPs, which HCCI defines as High-Deductible Health Plans coupled with Health Savings Accounts or Health Reimbursement Arrangements). HCCI examines a database of claims submitted by Aetna, Humana, Kaiser Permanente, and UnitedHealthcare for their employer-sponsored group plans.

CDHPs shift payment from third-party bureaucracies (that is, insurers) back to patients directly. The results continue to impress:

• In every year studied, the non-CDHP population had total per capita spending higher than the CDHP population.
• The CDHP population had rates of utilization nine percent to 13 percent lower than the non -CDHP population for all categories of health services outside of brand prescriptions, which was 21 percent lower.
• The CDHP population spent an average annual $343 per capita more out of pocket than did the non-CDHP population.
• The non-CDHP population was responsible for an average of 14% of their medical costs out of pocket, whereas the CDHP population paid for 24% of their medical costs.

In 2014, per capita spending for the non-CDHP population was $659 greater than that for the CDHP population: $5,140 and $4,481, a reduction of one-eighth.

The Goldwater Institute has had great success getting states to pass “Right to Try” laws. Right to Try allows a desperately sick patient to take an experimental new medicine before the FDA has approved it.

Since I last wrote about this in May 2014, 31 states have passed Right to Try. Further, U.S. Senator Ron Johnson (R-WI) has tried to get a federal Right to Try law through the U.S. Senate.

However, there has been pushback. According to Allison Bateman-House of NYU Langone Medical Center, “there is no confirmed instance of anyone getting a drug through Right to Try.” In addition, Jonathan Friedlaender, a survivor of advanced metastatic melanoma, has written a compelling essay in Health Affairs, which concludes Johnson’s proposed federal law would not improve access to experimental medicines.

The problem has two parts. First, research-based drug companies do not distribute drugs under Right to Try because the drugs are usually appropriate for small populations of patients. Every patient who receives an experimental dose outside a randomized-control trial (RCT) is a patient who cannot be enrolled in an RCT. RCTs are very expensive and it is very hard to recruit enough patients. The smaller the pool, the more loathe the drug company is to shrink it by distributing drug early.

The Kaiser Family Foundation/Health Research Educational Trust has released its 2016 Employer Health Benefits Survey. The survey covers almost 1,900 private and public (non-federal) employers. The results show Obamacare has not reduced premiums, which have increased by one-fifth for family plans since 2011.

The good news is that the proportion of beneficiaries with “High-Deductible Health Plans with a Savings Option” (HDHP/SOs) has increased from 20 percent to 29 percent in two years. Only four percent of covered workers were in such plans in 2006, and 17 percent in 2011. (In 2015, a HDHP had to have a minimum deductible of $1,300 for single coverage and $2,600 for family. The “Savings Option” would be a Health Savings Account or Health Reimbursement Arrangement.)

These plans were first available in 2005, and their increased adoption over the years corresponds with an immediate slowdown in the growth rate of employer-based benefits. In real terms (adjusted for changes in the Consumer Price Index), annual premium increases dropped from double digits in the early 2000s to single digits after 2005 and bottoming out at an increase in premium of just two percent in 2009. There was an immediate jump of 11 percent in 2011, Obamacare’s first year. Since then, both High Deductible Health Plans and the burden of Obamacare have continued to grow. This struggle has resulted in mid-single digit premium growth (Figure I).

Source: Author’s calculations from 2016 Employer Benefits Survey (Kaiser Family Foundation, 2016). Adjusted by Consumer Price Index (2016=100).

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For the pivotal alternative to Obamacare, please see the Independent Institute’s widely acclaimed book: Priceless: Curing the Healthcare Crisis, by John C. Goodman.

The result of Colombia’s plebiscite on the peace accord signed by the government and the FARC, the narco-terrorist organization, was a stunning surprise. More than 60 percent of the country abstained from Sunday’s referendum and, in a major blow to the polls, 50.2 percent of those who voted rejected the deal.

Two major aspects of the deal disturbed many Colombians. One was the high level of impunity granted to those who committed crimes during the fifty-year internal war. The other is the fact that the government guaranteed the drug-funded FARC leaders broad political participation, perhaps putting them on the path to victory in future elections.

There is no denying the immorality of the amnesty that would have been granted to thousands of guerrillas and of the very limited sanctions, which would have excluded prison terms, for the worst offenders who admitted their crimes. This concession was the result of the fact that the authorities were not able to defeat the FARC militarily. More than 200,000 deaths and several million displaced people are a horrific toll. The FARC would have continued to inflict horrendous punishment on Colombians were it not for the severe setbacks they suffered under President Alvaro Uribe (a critic of the current deal). Uribe’s successor, current President Juan Manuel Santos, would never have brought the FARC to the table if the terrorist organization had not felt compelled to negotiate.

This week we saw the first presidential debate between Democratic nominee Hillary Clinton and Republican nominee Donald Trump. Despite knowing better, I watched the whole thing. For over 90 minutes I watched as the two candidates went back and forth, offering generic, unclear policy prescriptions, took jabs at one another, and offered unnecessary personal anecdotes in an attempt to make themselves relatable to a broader audience. It’s the type of political show that I frankly despise.

But the worst part of the debate for me was listening to the candidates propose patently backward economic policies. The sad truth is that any good economics professor could construct a semester-long course based on the fallacies presented during the debate. To make matters worse, said professors would have enough material to fill the course within the first five minutes.

September 29 is the birthday of Ludwig von Mises, one of the giants of the Austrian School of economics. In my book Choice: Cooperation, Enterprise, and Human Action, I distill the work of Mises as presented in his masterpiece, Human Action. Elsewhere I have summarized his contributions to economic science, so in the present post I will focus on a single topic where Mises fundamentally changed my own worldview: the military and the market.

Before I encountered Mises’s analysis, I was a young conservative/libertarian with a strong affinity for the free market. However, although I knew that (say) minimum wage laws wouldn’t really help unskilled workers, and that rent control laws weren’t effective ways to provide affordable housing, nonetheless I made a big exception for genuine emergencies like a world war. In particular, I was not confident in trusting “market forces” with resource allocation for a major undertaking such as fighting the Nazis. In this situation (so I thought), of course you would need a powerful federal government to override price signals and make sure enough steel, rubber, gasoline, etc. went into the war effort.

(To avoid confusion, in this post I am not commenting on the legitimacy or wisdom of the U.S. government’s entry into World War II.  I am merely taking that decision as granted, and then looking at the economics of fighting a war. This is a topic on which I clearly remember learning from Mises’s writings.)

I didn’t fully recognize the remarkably pervasive anti-gun statement embedded in the well-received film Hell or High Water until my morning jog the following day. The message is so subtle, so nuanced, and so expertly executed, this movie could be used as a textbook case for how narrative filmmaking can promote policy positions. And it could well be an Oscar winner.

Hell or Highwater chronicles Toby and his ex-convict brother as they rob unsophisticated backwater banks in small West Texas towns. Their goal is to steal just enough money to pay off the mortgage on the family farm and Toby’s unpaid child support. The movie has been billed as a modern-day Western.

The anti-gun message is masterfully layered into the story through a parallel structure that builds tension throughout the film, peaking at about the same time as the movie’s climactic scene. Here’s a six point guide to how the anti-gun message is built into Hell or High Water’s story:

Posturing politicians on Capitol Hill conducted a hearing a few days ago during which they grilled Heather Bresch, CEO of Mylan N.V., maker of EpiPens. Prices of EpiPens have skyrocketed in the past few years (which I have discussed here and here).

The politicians were more interested in wagging their fingers and tut-tutting at Ms. Bresch for the amount of money she has made, than actually figuring out a way to lower the price of EpiPens. (By the way, Ms. Bresch testified she has no intention of reducing prices in response to their badgering.)

If the politicians ever decide to do something serious, here is a proposal: Repeal Durham-Humphrey!

Huh? That doesn’t sound like much of a rallying cry. The Durham-Humphrey Amendment gave the federal government (via the Food and Drug Administration) the power to decide whether a drug is available only by prescription or over-the-counter (OTC). The law passed in 1951, half a century after the FDA was instituted. Even if you believe Congress should keep drugs off the market until the FDA has proven their “safety and efficacy” (which I do not), that does not necessarily imply the FDA should decide whether the drug should be prescribed or dispensed OTC.

The Durham-Humphrey Amendment was passed to increase control over the distribution of amphetamines, but it quickly metastasized to a general federal control over prescribing. Whether it solved the inappropriate consumption of amphetamines is not the topic of this entry, but the continuing flurry of legislation attempting to control the opioid epidemic suggests government has not quite figured out how to deal with drug abuse.