Posts tagged with: charity

Blog author: jballor
posted by on Monday, July 31, 2006

At least, the title of this post is typical of the mantra against the practices of drug pharmaceutical companies, according to Peter W. Huber’s “Of Pills and Profits: In Defense of Big Pharma,” in Commentary magazine (HT: Arts & Letters Daily).

Huber, a senior fellow of the Manhattan Institute, summarizes in brief the anti-drug company argument, and then goes on to examine what truth there is in such claims. He says of the difference between creating and administering drugs, “Getting drug policy right depends mainly on getting that difference straight—the difference, that is, between ministering to the sick and making medicines—and grasping its implications from the start. Big Pharma’s critics do not even try.”

He goes on:

Pricing is indeed the key. Whether the first pill typically costs $100 million or $1 billion to develop, replicating it costs less—a thousand times less, or perhaps a million times less. This slope—precipice, really—is far steeper than most of the other hills and valleys of economic life. It complicates things immeasurably. It also largely explains the gulf between the industry’s perception of reality and that of the critics.

Huber gives some explanation of the function of the price mechanism in pharmaceutical markets, and says, “Economists have established—as rigorously as things ever get established by the dismal science—that there is no efficient price, no ‘right’ price. Any scheme is, from one perspective or another, inefficient, unreasonable, or worse.” He argues that the high prices for boutique drugs like Viagra in the developed world help fund the provision of desperately needed drugs in the developing world. This is the situation created by so-called “price discrimination”.

The situation he says, is similar to that of airline travel: “Business travelers get soaked, college students fly almost for free, and the jumble of prices in between drives most people nuts. But the planes are packed full, and that drives the average price of a ticket way down. The rich fly, and the much less rich fly, too.” There is, I would think, a similar model at play in the work of plastic surgeons who charge Hollywood millionaires huge sums to do face lifts and tummy tucks, and then use a portion of the money they make doing that to do pro bono work for burn victims and deformed children.

The complexity of the pricing situation is what critiques of drug companies tend to ignore. Concludes Huber, “This kind of behavior is not aberrant or anomalous—it is an inevitable and essential part of groping toward the right price where there is no right at the end of the tunnel. Somehow or other, the average price of the pill has to end up high enough to pay off the up-front cost.”

If Huber’s analysis is correct, it is interesting to see how a nonprofit drug company, like the one profiled in today’s New York Times article, “A Small Charity Takes Lead in Fighting a Disease,” fits into the picture. The NYT article itself exemplifies many of the criticisms against pharmaceuticals that Huber summarizes.

Huber points to the vagaries of government regulation and private insurance, which greatly affect the drug market. One explanation for the situation that a nonprofit drug company like OneWorld Health attempts to address is that “big drug companies shun some drugs and embrace others because, collectively, the FDA, doctors, patients, insurers, and juries push costs higher, and prices lower, on some categories of drugs and not on others, to the point where some make economic sense and some do not.”

Indeed, OneWorld Health is working with a drug for black fever that, according to the NYT, administered “a series of cheap injections was identified decades ago but then died in the research pipeline because there was no profit in it.” There is, effectively, a partnership at play between for profit and nonprofit drug companies. OneWorld Health didn’t develop the drug in the first place, but on that point is dependent on the work of for profits.

Huber says:

Universities and small biotechs license their innovations to Big Pharma because they lack the capital, scale, and expertise required for mass manufacturing, because they wouldn’t know how to sell the same drug five times in succession (to the FDA, doctors, patients, insurers, and juries), and because a vast and swampy system separates pharmaceutical innovation from the treatment of real patients at prices that will cover cost and earn a profit. The little guys just don’t have what it takes to finish the job.

But OneWorld Health, in the case of the drug mentioned above (paromomycin), “has conducted the medical trials needed to prove that the drug is safe and effective. Now it is on the verge of getting final approval from the Indian government. A course of treatment with the drug is expected to cost just $10, and experts say it could virtually eliminate the disease. If approval is granted as expected this fall, it will be the first time a charity has succeeded in ushering a drug to market.”

Huber concludes that in the future “we will fare better, much better, if we streamline regulation, curb litigation, and unleash prices to make vaccines as alluring to Big Pharma as Viagra and Vaniqa.” But in the meantime, it may be that efforts like OneWorld Health can help at least some of those who fall through the cracks. Says Dr. Ahvie Herskowitz, one of the backers of OneWorld Health, “We fill a gap pharma companies cannot because they have to make a profit.”

And on the biggest obstacle to getting vaccines and drugs like paromomycin to those who need it, for profit and nonprofit drug companies seem to agree: “The government will be the biggest challenge,” says Dr. C. P. Thakur, a former Indian health minister who oversaw a OneWorld Health trial of paromomycin.

Blog author: jspalink
posted by on Wednesday, July 12, 2006

Philanthropy, for all its good intentions, does not necessarily imply a personal connection with the needy person. It can and often does, but it doesn’t have to. Philanthropy is the more institutional, “big-picture” cousin of charity, which is the personal and direct connection to those in need. Andrew Carnegie building hundreds of libraries with the wealth he made in the steel industry, and being celebrated for it to this day, is philanthropy. Your Aunt Evelyn volunteering at the local church-operated hospice and sending the facility an annual donation of $150, in perfect anonymity, is charity.

Karen Woods examines Warren Buffett’s gift to the Bill and Melinda Gates Foundation and discusses the importance of his philanthropy while at the same time emphasizing the need for support of smaller, local charities that interact directly with those they help, creating accountable and personal relationships that effect change in people.

Read the complete commentary here.

Blog author: jballor
posted by on Friday, June 16, 2006

A recent NYT article outlines some recent research showing that many people who give to charity “often tolerate high administrative costs, fail to monitor charities and do not insist on measurable results — the opposite of how they act when they invest in the stock market.” Tyler Cowen writes in “Investing in Good Deeds Without Checking the Prospectus,” about the research of John A. List, a professor at the University of Chicago, which “implies that most donors do not respond when they have opportunities to be more effective in their giving.”

Cowen, who is a professor of economics at George Mason and blogs here, concludes, “If donors do not abandon failing causes, those efforts will continue. Perhaps the content of donor pride needs to change. Rather than taking pride only in their generosity, donors should also take pride in their willingness to confront unpleasant news.”

The bottom line is that when you give to charity, you have a responsibility to give to charities that are good stewards of the money, thereby rewarding good charities and punishing bad ones. Doing this gives the proper incentives for charities to work well.

Part of the problem is that people may not really know how to measure the effectiveness and stewardship of a given charity. The Acton Institute’s Samaritan Guide is a tool designed to assist donors in meeting this responsibility.

Indeed, Acton’s effective compassion initiatives, based on Marvin Olasky’s seven principles for effective compassion, are largely based on providing the education that donors need to find out the sort of issues and questions that they should be asking.

HT: EconLog

Blog author: jballor
posted by on Wednesday, June 14, 2006

Joe Knippenberg, who blogs at No Left Turns, provides a thoughtful and engaging analysis of the particulars of the recent Iowa court decision finding against InnerChange Freedom Initiative, an outreach of Prison Fellowship Ministries. In “Penitents in the Penitentiary?,” at The American Enterprise Online, Knippenberg writes, “Despite my general support for the faith-based initiative, and for religious efforts to put the penitence back in penitentiaries, I’m inclined for the most part to agree with Judge Pratt. In this particular case, where the state and Prison Fellowship self-consciously tested the outer bounds of current church-state jurisprudence, they went too far.”

Reaction from PFM’s president Mark Earley is available here and at the special IFI verdict page. I have written before in support of work of PFM, and this decision does nothing to change my mind on that score.

It does expose the real complexities involved with taking for Christian ministries, even those that have a strong social service component. As Knippenberg writes, InnerChange staff ran up against the difficulties of abiding by what I consider to be the increasingly rigid and invalid separation of secular and sacred elements: “Where so much of the program is devoted to inculcating a Christian worldview, it is difficult, if not impossible, to precisely delineate what portion of a staffer’s time, or what fraction of a piece of equipment’s value is devoted to secular, as opposed to religious, purposes.”

I’ve written more about the entanglements and effects of the faith-based initiative in the case of the Silver Ring Thing, and there’s conversation between myself and Knippenberg on this linked here, here and here.

Blog author: jballor
posted by on Friday, June 9, 2006

“Should I not be concerned about that great city?” asks God of the prophet Jonah about Nineveh, which “has more than a hundred and twenty thousand people who cannot tell their right hand from their left, and many cattle as well.”

God is rebuking the recalcitrant prophet, who only carried out his assigned proclamation in Nineveh after a rather harrowing adventure on the high seas. After Jonah delivered his message, “Forty more days and Nineveh will be overturned,” the Bible tells us that “Jonah went out and sat down at a place east of the city. There he made himself a shelter, sat in its shade and waited to see what would happen to the city.”

If Jonah embodies the spirit of withdrawal and the desire for God’s wrathful judgment on sinful human society, think of Tim Keller as the anti-Jonah. As he’s introduced in a piece he wrote for a recent issue of Christianity Today, “For 17 years, he has been preaching at Redeemer Presbyterian Church in Manhattan, distilling biblical teaching into arrestingly simple phrases that convey the radical surprise and gracious truth of Christian faith.”

Photo Credit: US National Oceanic and Atmospheric Administration

Keller’s ministry is vital and engaged: “Keller’s vision of a church keenly committed to the welfare of its city attracts 5,000 worshipers each week to Redeemer’s four rented locations, sends them out into many forms of charitable service through the church’s ministry Hope for New York, and fuels a church-planting effort that embraces Baptists and Pentecostals as well as Presbyterians, immigrant neighborhoods as well as Manhattan.”

Keller writes in the piece, “A New Kind of Urban Christian,” that for the Christian church to properly and effectively engage culture, “We need Christian tradition, Christians in politics, and effective evangelism.” But these alone or combined are not enough. Keller believes that “as the city goes, so goes the culture. Cultural trends tend to be generated in the city and flow outward to the rest of society.” Large cities tend to attract young and vibrant people, who influence the course of the broader culture.

The sad fact is that the Jonah phenomenon has had an impact on evangelical Christianity in America. “Do I mean that all Christians must live in cities? No. We need Christians and churches everywhere there are people! But I have taken up the call of the late James Montgomery Boice, an urban pastor (at Philadelphia’s Tenth Presbyterian Church) who knew that evangelical Christians have been particularly unwilling to live in cities,” he says. (more…)

Blog author: jballor
posted by on Wednesday, May 3, 2006

This section from Reinhold Niebuhr’s Moral Man and Immoral Society: A Study in Ethics and Politics strikes me as quite true:

The coercive factors, in distinction to the more purely moral and rational factors, in political relations can never be sharply differentiated and defined. It is not possible to estimate exactly how much a party to a social conflict is influenced by a rational argument or by the threat of force. It is impossible, for instance, to know what proportion of a privileged class accepts higher inheritance taxes because it believes that such taxes are good social policy and what proportion submits merely because the power of the state supports the taxation policy. Since political conflict, at least in times when controversies have not reached the point of crisis, is carried on by the threat, rather than the actual use, of force, it is always easy for the casual or superficial observer to overestimate the moral and rational factors, and to remain oblivious to the covert types of coercion and force which are used in the conflict.

This obfuscation of motives is part of what differentiates charity from taxation. True charity cannot be coerced.

See also: Reinhold Niebuhr Today, ed. Richard John Neuhaus (Grand Rapids: Eerdmans, 1989).

Blog author: jballor
posted by on Thursday, April 20, 2006

Here’s an article in the Washington Post recently that I want to pass along, “Tithing Rewards Both Spiritual and Financial,” by Avis Thomas-Lester.

Among the highlights are the Rev. Jonathan Weaver of Greater Mount Nebo African Methodist Episcopal Church, who says, “Some people have a sense that pastors are heavy-handed . . . in the use of the Scripture to insist that people tithe. But we are not encouraging people to give 10 percent. We want them to be effective managers of the other 90 percent. God wants us to be effective managers of what He has entrusted us with.”

The story also points out the critical function that churches serve in the relief of the poor: “Long before government programs were put in place to help the poor and the needy, black churches were responsible for assisting their congregations with everything from food and shelter during Reconstruction to legal help during the civil rights movement. Money dropped into the offering plate wasn’t just for the building fund. Black churches paid to help poor and disenfranchised citizens at a time when no other help was available, experts said.”

The article goes on to observe some of the potential pitfalls of tithing, namely giving only “under the belief that the members will prosper financially in return.” This is part of a larger “prosperity gospel” movement, and as this piece illustrates, is not restricted to churches in the US.

For more about how the principle of the tithe can function in helping the poor and those who need it the most, see my “The North American Church and Global Stewardship,” and “Building on the Tithe.”

Blog author: jballor
posted by on Thursday, March 30, 2006

Pat Nolan, president of Justice Fellowship, writes about the challenges that non-profits face in seeking funding, in the latest Justice eReport, “Equpping the Armies of Compassion.” Nolan highlights the Acton Institute’s Samaritan Guide and We Care America, which has a grant center that assists charities in getting proposals together.

And on a related note, Joe Knippenberg at No Left Turns critiques an article by Amy Sullivan in The New Republic, “Patron Feint,” which depicts the faith-based initiative as a mere political tool to satisfy the GOP’s evangelical base.

Blog author: jballor
posted by on Thursday, March 23, 2006

Joe Knippenberg raises three issues with respect to my critique of the faith-based initiative (here and here). He writes first, “any activity that depends upon money is potentially corrupting, whether the source is governmental or private…. Why governmental money is different from private in this regard isn’t clear to me.”

I agree that the potential for corruption is present in both cases, but the immediate constituency differs from private to public funds. For the former, the donors are the immediate stake-holders and the charity is accountable to them. For the latter, politicians and bureaucrats are those who hold the charity immediately accountable.

Despite the best intentions of many people who work in government, special interests and ideologies can skew their proper stewardship of taxpayer money, and does not always represent the interests of the citizenry. Since taxpayer money is mediated through the government, there is another layer of institutionalization that serves to increase the distance and thus the accountability between the charity and the donor constituency.

This raises another important issue, which is that strictly speaking taxpayers shouldn’t be considered “donors” in the traditional sense at all. Paying taxes is enforced by the power of the state in a way that voluntary donation to private charities is not. One aspect of this is the distancing effect I just pointed out, but another effect is that the moral virtue of the act of giving is displaced by the coercive nature of the taxpayer/government relationship. Surely those who voluntarily give even more to charities than they are required by taxation are worthy of even greater praise because of this, but nevertheless the nature of the money flowing in to charities from these two sources is quite different. One is coerced the other is voluntary. (more…)

Blog author: jballor
posted by on Thursday, March 23, 2006

My commentary last week on the situation of the Silver Ring Thing has occasioned some conversation on the LewRockwell.com Blog (here, here, here, and here). The consensus on the faith-based initiative seems to be that, in the words of William L. Anderson, they “were pointing out at the beginning that this was a bad idea, and that taking the state’s money ultimately would mean that the state would be interfering with the larger mission of these religious groups.”

Contrariwise, Joseph Knippenberg, who blogs at No Left Turns and is a professor at Oglethorp University, writes in this week’s The American Enterprise online column that the faith-based initiative is being undermined by partisan Democrats and that it will have to continue under the diligent faithfulness of Republicans.

Citing the differences between the Republican and Democratic approaches, he writes of the former, “because the shekels come without unnecessary shackles, the effect of government funding isn’t necessarily homogenizing or secularizing. In a nutshell, this co-religionist hiring exemption enables government to cooperate with, but not dominate, a vigorous and diverse private philanthropic sector.”

The danger is, in Knippenberg’s view, that the faith-based initiative will become dominated by Democratic partisans, who “would force every government contractor into essentially the same bureaucratic mold. Every recipient of government funding would ultimately be simply an extension of the government, offering more or less the same services in more or less the same setting.”

But even if Knippenberg is right, and there is this vast difference between the approaches of the two parties, it merely serves to underscore my point about the unreliability of government funding. He is responding in part to this Washington Post story which notes the boon that Bush’s faith-based initiative has been to certain conservative-minded charities. (more…)