David Cutler and Ed Glaeser on the Health and Wealth of Cities (Ep. 131)
Hello, everyone, and welcome back to Conversations with Tyler.
大家好,欢迎回到《与泰勒对话》。
Today I am here with two Harvard economists who have a new book out, co-authored.
今天,我和两位哈佛大学经济学家在一起,他们合着了一本新书。
The two economists are David Cutler and Ed Glaeser.
这两位经济学家是大卫·卡特勒和埃德·格莱泽。
The new book is called Survival of the City: Living and Thriving in an Age of Isolation.
这本新书名为《城市的生存:孤立时代的生活与繁荣》。
It’s about urbanism.
这是关于城市化的。
It’s about the pandemic.
这是关于大流行的。
It’s about healthcare economics and much more.
它涉及医疗保健经济学等等。
First, I will be starting with David Cutler, who is professor of economics at Harvard.
首先,我将从哈佛大学经济学教授大卫·卡特勒开始。
David is well known as simply being one of the very best healthcare economists ever.
众所周知,大卫是有史以来最好的医疗保健经济学家之一。
David, welcome.
大卫,欢迎。
Thank you very much for having me.
非常感谢你邀请我。
It’s a pleasure to be able to see and speak with you.
很高兴能够见到您并与您交谈。
Here are all the questions I want to ask you about your work.
以下是我想问您的有关您工作的所有问题。
To start, why does education predict health above and beyond its ability to predict health behaviors and to predict income?
首先,为什么教育对健康的预测能力超出了其预测健康行为和预测收入的能力?
One of the great — I was going to say great mysteries, but one of the most important things that we’ve observed about the world is that people who are better educated are in better health.
伟大的事情之一——我本来想说的是伟大的谜团,但我们观察到的关于世界的最重要的事情之一是,受过更好教育的人健康状况更好。
That’s true virtually systematically, and it’s increasingly so over time.
这实际上是系统性的,而且随着时间的推移越来越如此。
That is, the gap between people with a college degree and people without a college degree is growing over time, even as other gaps, for example, between whites and Blacks, are shrinking over time.
也就是说,拥有大学学位的人和没有大学学位的人之间的差距随着时间的推移而不断扩大,而其他差距,例如白人和黑人之间的差距,则随着时间的推移而缩小。
There are a few different things that are going on at the instrumental level in the sense of what that affects health is happening.
从影响健康的意义上来说,在工具层面上正在发生一些不同的事情。
Health behaviors are a part of it — things like smoking and obesity.
健康行为是其中的一部分——比如吸烟和肥胖。
So are things like environmental exposure, so exposure to pollution is lower for higher-SES people, both by where they live in the country, and even within a city by where they live.
诸如环境暴露之类的事情也是如此,因此对于社会经济地位较高的人来说,无论是在他们居住的乡村,还是在他们居住的城市内,污染的暴露程度都较低。
Stress levels seem to generally be lower for higher-SES people relative to lower-SES people, and chronic stress has a variety of adverse health impacts.
相对于社会经济地位较低的人来说,社会经济地位较高的人的压力水平似乎普遍较低,而且慢性压力会对健康产生各种不利的影响。
Access to medical care is better for people in higher socioeconomic groups relative to lower socioeconomic groups.
相对于社会经济地位较低的群体,社会经济地位较高的群体更容易获得医疗服务。
All of those contribute.
所有这些都做出了贡献。
If you step back even before those, it’s, I think, a setting where society has really made it much easier for high-income, high-SES people to be able to engage in the types of things and buy the types of things that are associated with improved health.
如果你退后一步,我认为,社会确实让高收入、高社会经济地位的人更容易参与和购买与改善健康相关的事物。
The nature of life, the nature of where people live, the nature of education, the nature of everything is such that it’s easier for higher-income people, higher-SES people to do well, and that, as I said, unfortunately, is increasingly so.
生活的本质、人们居住地的本质、教育的本质、一切事物的本质都是这样的,即高收入人群、高社会经济地位的人更容易取得好成绩,而且,正如我所说,不幸的是,这种情况越来越明显。
But even if we adjust for that, education seems to matter a lot.
但即使我们对此进行调整,教育似乎也很重要。
It’s also puzzling to me — in your own work, it matters more at younger ages.
这也让我感到困惑——在你自己的工作中,这在年轻时更重要。
You would think the returns are cumulative: it would really pay off when you’re 67 because you’ve invested in a stock portfolio for decades, but it matters most when you’re young.
你可能会认为回报是累积的:当你 67 岁时,它才会真正得到回报,因为你已经投资了股票投资组合数十年,但在你年轻的时候,这才是最重要的。
What’s your best micro account of that?
你对此最好的微型账户是什么?
One of the things that’s super interesting is that, for example, people who live in cities — where there are more better-educated people — smoke less, even conditional on your own education.
非常有趣的事情之一是,例如,生活在城市的人——那里有更多受过良好教育的人——吸烟较少,甚至以你自己的教育程度为条件。
The same thing is true about age and so on.
年龄等也是如此。
I think it’s partly that cities and areas are run by upper-middle-class folks often.
我认为部分原因是城市和地区经常由中上阶层人士管理。
For example, the environment is set up in a way that’s more conducive to health when you have more upper-middle-income people.
例如,当中高收入人群越多时,环境的设置就越有利于健康。
It’s much more difficult to smoke.
吸烟要困难得多。
There are healthier behaviors in general.
总体而言,存在更健康的行为。
There are parks and things like that.
有公园之类的东西。
I think part of it is just that society is shaped by higher-income, higher-SES people, and that can be good for everyone who lives around those areas.
我认为部分原因是社会是由高收入、高社会经济地位的人塑造的,这对生活在这些地区的每个人都有好处。
To the extent education makes you healthier by lowering your stress and raising your relative status — which is a possible hypothesis — what are the policy implications of that?
如果教育通过减轻压力和提高相对地位使你变得更健康 ——“这是一个可能的假设”—— 这对政策有何影响?
What should we do?
我们应该做什么?
Part of what we’re learning over time is that social insurance programs are actually having a bigger and more sustained effect on health than we had thought they did.
随着时间的推移,我们了解到,社会保险计划实际上对健康产生的影响比我们想象的更大、更持久。
For example, we’ve always thought of Medicare and Medicaid as being the primary social insurance programs that affect health, but then there’s research that the WIC program — Women, Infants, and Children — affects health, that food stamp programs affect health, that TANF benefits affect health, that housing policies can affect health.
例如,我们一直认为医疗保险和医疗补助是影响健康的主要社会保险计划,但后来有研究表明,WIC 计划——“妇女、婴儿和儿童”——影响健康,食品券计划影响健康,TANF 福利影响健康,住房政策可以影响健康。
And you think that’s through lowering stress as one mechanism?
您认为这是通过减轻压力作为一种机制吗?
As one mechanism, I think it’s through lowering stress.
作为一种机制,我认为这是通过减轻压力来实现的。
There are many other mechanisms as well.
还有许多其他机制。
What we’ve seen when we’ve looked more carefully at long-run data is that many programs really seem like they have a big impact over the course of the life cycle on people’s health.
当我们更仔细地观察长期数据时,我们发现许多项目似乎确实在生命周期中对人们的健康产生了巨大影响。
So I’m a big believer that one way to improve health is to help make sure that social insurance programs are reaching everyone they ought to and are doing it in the best way.
因此,我坚信改善健康的一种方法是帮助确保社会保险计划惠及每个应有的人,并以最好的方式进行。
What do you think is the health value of Google, either positive or negative?
您认为 Google 的健康价值是什么,是积极的还是消极的?
It’s the busiest doctor in our country, right?
这是我们国家最忙的医生,对吧?
How do we assess that?
我们如何评价这一点?
Oh, absolutely.
哦,绝对是。
Information technology is dramatically changing how people interact with the medical-care system.
信息技术正在极大地改变人们与医疗保健系统互动的方式。
I haven’t seen a formal study on this, but my sense is that Dr. Google has actually been pretty good for health because now you can find out things about where can I go to get a COVID test, or what about flu shots, and so on.
我还没有看到这方面的正式研究,但我的感觉是,谷歌博士实际上对健康很有好处,因为现在你可以找到关于我可以去哪里进行新冠病毒检测,或者流感疫苗注射等等的信息。
For many people who have difficulty finding a doctor and interacting with the medical system, that is very helpful.
对于许多难以找到医生并与医疗系统互动的人来说,这非常有帮助。
I will say, though, for example, if you look at — let’s just take the anti-vax community.
不过,我会说,例如,如果你看看 —— 让我们以反疫苗社区为例。
You say, “Well, maybe if the anti-vax community spent more time googling the CDC website, they would not be anti-vaxxers.” That actually turns out to be incorrect.
你说,“好吧,也许如果反疫苗社区花更多时间在 CDC 网站上搜索,他们就不会是反疫苗者了。”事实证明这是不正确的。
The vast bulk of people who are prolific in the anti-vax community know exactly what the CDC says.
反疫苗界的绝大多数活跃人士都清楚 CDC 的说法。
They just don’t believe it.
他们只是不相信。
It’s not that Dr. Google will solve all the problems, but for some people, it can be quite helpful.
谷歌博士并不能解决所有问题,但对于某些人来说,它可能会很有帮助。
Does that positive side show up in the numbers anywhere?
这种积极的一面是否体现在任何地方的数字中?
I haven’t seen a really good study that’s looked at access to the internet and health.
我还没有看到过关于互联网访问和健康的真正好的研究。
But one particularly good thing that’s come out of the COVID pandemic is that now telemedicine seems firmly implanted, and that’s really a result of improvements in IT and stuff.
但新冠疫情带来的一件特别好的事情是,现在远程医疗似乎已经牢牢扎根,这实际上是 IT 和其他方面改进的结果。
Your ability to see your doctor online has really been a blessing to a lot of people.
您能够在线看医生确实对很多人来说是一件幸事。
It’s not exactly Google, but it’s of the same spirit.
它不完全是谷歌,但它具有同样的精神。
If you could have new data to study one question in healthcare that so far has been hard to study, what would that be?
如果您可以使用新数据来研究迄今为止难以研究的医疗保健问题,那会是什么?
I think you hit on the big issue at the start, which is, how do you take people who have difficulty interacting with the medical system and for whom society has been somewhat unfair and at least try and improve some aspects — their health, their economic circumstances, but we’ll stick here with the health component.
我认为你一开始就触及了一个大问题,那就是,你如何对待那些难以与医疗系统互动以及社会对他们有些不公平的人,至少尝试改善某些方面——他们的健康、他们的经济状况,但我们将在这里坚持健康部分。
How do you reach people for whom society’s opportunities have not extended as much and do what you can to make their health be better?
您如何接触那些社会机会没有那么多的人,并尽您所能改善他们的健康?
What do you make of the Latino life expectancy paradox?
您如何看待拉丁裔预期寿命悖论?
Latino immigrants come to the US, often not speaking English, not well connected at all.
来到美国的拉丁裔移民通常不会说英语,也没有很好的人脉。
They often outlive people who are born here, but their descendants do less well.
他们往往比出生在这里的人活得更久,但他们的后代却过得不那么好。
You’re presupposing that it’s about the people not being well equipped to handle ordinary America, but Latinos seem to show the opposite trend.
你假设这是因为人们没有足够的能力来应对普通的美国,但拉丁裔似乎表现出相反的趋势。
First off, there’s a little bit of selection in terms of the Latino immigrants, but in part, also they bring behaviors that are typically from the countries where they are from.
首先,拉丁裔移民有一些选择,但在某种程度上,他们也带来了来自他们所在国家的典型行为。
Then second generation will be more like Americans and so on, in terms of smoking and obesity and a variety of adverse behaviors like that.
那么第二代就会更像美国人等等,在吸烟、肥胖以及诸如此类的各种不良行为方面。
I think that the closer you get to native Americans, the more you look like native American health issues.
我认为你越接近美国原住民,你看起来就越像美国原住民的健康问题。
Then there’s a mix, depending on the health behaviors that one brings from the country where you are from, some of which are favorable, some of which are less favorable.
然后是一种混合,取决于一个人从你所在国家带来的健康行为,其中一些是有利的,其中一些是不太有利的。
You’ve written some of the best-known papers on obesity and put forward the hypothesis that rising obesity is due, in part, to food preparation being quicker and easier.
您撰写了一些有关肥胖的最著名的论文,并提出了这样的假设:肥胖率上升部分是由于准备食物变得更快更容易。
If that’s true, why don’t diets work better?
如果这是真的,为什么节食效果不好呢?
Because food preparation lowers the relative price of eating, but if you just target the quantity directly by dieting, it seems that most people don’t lose weight by dieting.
因为准备食物降低了吃饭的相对价格,但如果直接通过节食来控制数量,似乎大多数人都不会通过节食来减肥。
It would be odd for the price to matter but the quantity not to matter.
如果价格重要但数量不重要,那就奇怪了。
I have puzzled over this a lot.
我对此感到很困惑。
What I think is happening is that it plays into our inability to delay gratification for periods of time.
我认为正在发生的事情是我们无法延迟一段时间的满足感。
What people say, including myself very frequently, is “I’m going to start dieting and exercising tomorrow or next week.” If I really am going to start dieting and exercising next week, then it really doesn’t matter what I eat this week because everything will be fine.
人们(包括我自己)经常说的是“我明天或下周要开始节食和锻炼。”如果我真的要在下周开始节食和锻炼,那么这周吃什么并不重要,因为一切都会好起来的。
The difficulty is that next week, I’ll say the same thing about the following week.
困难在于,下周,我会对下周说同样的话。
People have a very short-term horizon where they have difficulty understanding that if I don’t do it this week, I’m not going to do it next week, and then I’m not going to do it the following week.
人们的视野非常短,他们很难理解,如果我这周不这样做,下周我就不会这样做,然后下周我也不会这样做。
We could take all the time we’ve saved on food preparation and cleaning.
我们可以把节省下来的所有时间都花在准备食物和清洁上。
We could devote some of that time to exercising.
我们可以花一些时间锻炼身体。
We could work off the additional calories and still have time left over.
我们可以消耗掉额外的卡路里,并且仍然有剩余的时间。
As a society, we could do that, but we don’t do that, I think, in part, because every week we say, “Yes, I’m going to start that next week.”
作为一个社会,我们可以这样做,但我认为我们不这样做,部分原因是我们每周都会说:“是的,我要在下周开始。”
Why is obesity such a big problem in rural Mexico, say, Chiapas?
为什么肥胖在墨西哥农村地区(例如恰帕斯州)是一个大问题?
I mean, we know why — they drink too much Coca-Cola.
我的意思是,我们知道为什么 ——他们喝了太多可口可乐。
But structurally, why is that the case in terms of relative prices?
但从结构上看,为什么相对价格会出现这种情况呢?
What’s happened in a lot of countries is, as they get richer, they adopt more of a Western diet, particularly a US diet.
许多国家的情况是,随着他们变得更加富裕,他们更多地采用西方饮食,尤其是美国饮食。
You adopt a diet that’s high in corn syrup and fast food and salty foods and things like that.
您采用的饮食中含有大量玉米糖浆、快餐和咸味食物等。
You observe this in parts of rural Mexico when there’s some income.
当墨西哥农村地区有一些收入时,你会观察到这种情况。
You observe that a lot in islands in the Pacific that all of a sudden had mineral wealth, so people are endowed with a lot of money.
你观察到,太平洋上的许多岛屿突然拥有了丰富的矿产资源,因此人们被赋予了很多钱。
Then one of the things that they do is, their diet changes to a Western diet.
然后他们做的一件事就是将饮食改为西方饮食。
You have in some of these islands 80 percent obesity rates and all the diabetes that comes along with that.
其中一些岛屿的肥胖率高达 80%,而且糖尿病也随之而来。
Same thing in parts of Mexico, where again, the diet has changed very rapidly to a US-type diet and with it comes US-type health problems.
墨西哥部分地区也发生了同样的情况,那里的饮食再次迅速转变为美国式饮食,随之而来的是美国式健康问题。
What do you make of the data that suggests both pets and even lab animals are growing fatter?
您如何看待宠物甚至实验动物都在变胖的数据?
Food is much cheaper, right?
食物便宜得多,对吧?
We can afford much more of it.
我们可以负担得起更多。
But lab animals — we control what they eat, right?
但是实验动物 ——我们控制它们吃什么,对吧?
There’s some kind of regimen.
有某种养生之道。
And obesity seems to be rising in cases where relative prices facing humans are not obviously the culprit.
在人类面临的相对价格并不是明显罪魁祸首的情况下,肥胖率似乎正在上升。
Is it that people are buying more cat food, and labs are spending more for their rats?
是不是人们购买了更多的猫粮,而实验室在老鼠身上花费了更多的钱?
It seems odd.
看起来很奇怪。
Yes.
是的。
I don’t know quite about the labs.
我对实验室不太了解。
I presume that they’re feeding them more since my guess is the exercise is controlled, and there wouldn’t have been genetic change that rapidly.
我猜想他们给它们喂的更多了,因为我的猜测是运动是受控制的,而且基因变化不会那么快。
It could be that components of the food are different as well.
食物的成分也可能不同。
The first approximation what matters is total calories in, but they’re probably types of calories and combinations of calories that lead to more or less weight gain.
重要的第一个近似值是总卡路里含量,但它们可能是导致体重增加或减少的卡路里类型和卡路里组合。
It also depends on what time of day one eats and a variety of other things like that, too.
它还取决于一个人一天中的什么时间吃饭以及各种其他类似的事情。
What do you think of the — I call them the residual theories?
你如何看待 —— 我称它们为残余理论?
That there’s something unknown in the environment.
环境中存在未知的东西。
It could be a chemical, something in the way we live that’s causing obesity levels to increase, and we just haven’t identified it yet.
它可能是一种化学物质,是我们生活方式中的某种物质,导致肥胖水平增加,只是我们还没有识别出来。
Do you take this seriously?
你认真对待这件事吗?
Or are they just made-up stuff?
或者它们只是虚构的东西?
I do take it seriously as a theory, absolutely.
我绝对把它当作一种理论来认真对待。
One of the things that I think the literature has not been as good at as it could be is the impact of the environment — not just environment in terms of green space and ability to walk on the streets, but the impact of the environment in terms of pollution and exposure to various substances and what that may then do to health.
我认为文献没有充分关注的一件事是环境的影响 ——不仅仅是绿地和在街道上行走的能力方面的环境,还有环境在污染和接触各种物质方面的影响以及这可能对健康造成的影响。
Go back a ways.
往回走一段路。
It took a long, long time to figure out what it was in tobacco that led to cancer and heart disease and so on because there are just so many things out there, and you don’t really know all the combinations and what’s being burnt.
人们花了很长时间才弄清楚烟草中的什么物质导致了癌症和心脏病等,因为烟草中的物质太多了,而你并不真正知道所有的组合以及燃烧的是什么。
So, as theories, I absolutely think they’re important.
所以,作为理论,我绝对认为它们很重要。
At the moment, I don’t know of enough evidence to say for certain, these are some of the things that we need to worry about.
目前,我还没有足够的证据来肯定地说,这些是我们需要担心的一些事情。
There’s been much more on the pollution end with respiratory disease, where there’s obviously a very good link, but also, there have been recent hints about dementia and Alzheimer’s disease in the elderly.
关于污染与呼吸系统疾病的关系还有很多,这显然有很好的联系,而且最近也有迹象表明老年人患有痴呆症和阿尔茨海默病。
I wouldn’t be surprised if some of these environmental factors turn out to be bigger than we had thought, but I don’t have anything yet that I look at and say, “Okay, this is obviously definitive on this point.”
如果其中一些环境因素比我们想象的要大,我不会感到惊讶,但我还没有看到任何东西并说:“好吧,这在这一点上显然是确定的。”
Why is hospital price transparency so hard to achieve?
为什么医院价格透明这么难?
We’ve passed laws — good laws, in my opinion.
我们已经通过了法律——在我看来是好的法律。
The Trump people were for them and doubled down on the issue.
特朗普的人支持他们,并在这个问题上加倍努力。
When hospitals don’t do it, they get a slap on the wrist.
如果医院不这样做,他们就会受到惩罚。
Maybe they’re sent a letter in the mail.
也许他们会通过邮件收到一封信。
Voters seem to like the idea.
选民似乎喜欢这个主意。
Why has that been such a tough slog?
为什么这是一个如此艰难的过程?
It was one of the very few things that the Trump administration did that I really enjoyed, and that I give them credit for, was their attempt to push this.
这是特朗普政府所做的极少数让我真正喜欢并值得赞扬的事情之一,就是他们试图推动这一目标。
Everything that we know in healthcare is that people have difficulty choosing on the basis of price and quality.
我们在医疗保健领域所知道的一切是,人们很难根据价格和质量进行选择。
It goes back a little bit to some of the behavioral issues that we were talking about, but I think it’s slightly different.
这有点回到我们正在讨论的一些行为问题,但我认为略有不同。
If you go to the doctor, and the doctor says you should take medication X, and you go to the pharmacy, and the pharmacy says that’ll be $30, a fair number of people will walk away and say, “I don’t have $30.”
如果你去看医生,医生说你应该服用药物 X,然后你去药房,药房说要 30 美元,相当多的人会走开并说:“我没有 30 美元。”
What we would hope they would do is go to their doctor and say, “Doctor, is there any way that there could be a cheaper medicine that might work because $30 is hard for me this month?” In practice, people are extremely uncomfortable doing that.
我们希望他们去找医生说:“医生,有没有什么办法可以找到一种更便宜、有效的药物,因为这个月 30 美元对我来说很难了?”实际上,人们这样做非常不舒服。
They really don’t like to go to their doctor and say, “Doctor, how do I trade off the money here versus the medicine?”
他们真的不喜欢去看医生并说:“医生,我该如何权衡这里的钱和药物?”
As a result, they wind up not taking the medicine, and then they avoid the doctor because they’re ashamed to admit to the doctor.
结果,他们最终不吃药,然后因为羞于向医生承认而回避医生。
People really don’t like the money being involved in the medical care part.
人们真的不喜欢医疗保健部分涉及金钱。
They’re also very afraid of the quality part, of having that quality discussion.
他们也非常害怕质量部分,害怕进行高质量的讨论。
For example, before you’d buy a TV, you’d look up and see what are the different characteristics and so on.
例如,在购买电视之前,您会查找有哪些不同的特征等等。
Yet, before you do surgery, people rarely look up, how good is that surgeon?
然而,在你做手术之前,人们很少抬头看看,那个外科医生有多厉害?
What’s that surgeon’s record?
那个外科医生的记录是什么?
What questions should I ask of that surgeon?
我应该向那位外科医生提出哪些问题?
They’ll ask it of the TV.
他们会向电视询问。
They’ll ask it of the refrigerator, but they will not ask it of the surgeon, nor will they ask it of the referring doctor.
他们会向冰箱询问,但不会向外科医生询问,也不会向转诊医生询问。
They won’t say, “Doctor, are you sure this is the right person?” and so on.
他们不会说:“医生,你确定这是合适的人选吗?”等等。
It’s almost like they don’t want to put that doubt.
就好像他们不想提出这样的疑问。
They don’t want to say, “Look, I’m not sure you’re the right person or this is the right thing for me.”
他们不想说:“听着,我不确定你是合适的人选,或者这对我来说是正确的事情。”
The net effect is that when these data are out there, they just don’t get widely used.
最终的结果是,当这些数据出现时,它们只是没有得到广泛使用。
Hospitals don’t want to put it out there because they don’t want to be compared.
医院不想把它放在那里,因为他们不想进行比较。
If the patients are not going to complain that much, they say, “Fine, I’ll just do the minimum possible.
如果患者不会抱怨那么多,他们会说:“好吧,我会尽力而为。
Sometimes I won’t even comply.
有时我什至不会遵守。
There’s no burning need for me to put that information out there.”
我没有迫切需要将这些信息放在那里。”
How do we explain the cross-sectional variation there?
我们如何解释那里的横截面变化?
Because I agree with what you said, but if I look, say, today, at the vaccines, there are really quite a few Americans who obsess over Moderna versus Pfizer, this versus that.
因为我同意你所说的,但是如果我看看今天的疫苗,确实有相当多的美国人痴迷于 Moderna 与辉瑞,这个与那个。
Maybe some of what they think is wrong, but they spend enormous amounts of time on social media consuming information about vaccines.
也许他们认为有些内容是错误的,但他们花费大量时间在社交媒体上消费有关疫苗的信息。
They don’t seem to be put off by nervousness.
他们似乎并没有因为紧张而推迟。
Yet, when it comes to the brain surgeon, there’s nothing, right?
然而,对于脑外科医生来说,什么都没有,对吧?
Very hard to find out anything, and that’s endogenous because, in part, the demand isn’t there.
很难找到任何东西,这是内生的,部分原因是需求不存在。
What accounts for that difference?
造成这种差异的原因是什么?
You can sometimes get people to do shopping.
有时你可以让人们去购物。
Where people have time and settings, and it’s a very clear choice, you can get them to do someshopping, particularly if there are not people involved.
当人们有时间和环境,并且这是一个非常明确的选择时,你可以让他们去购物,特别是在没有人参与的情况下。
It helps if it’s a pill and not a person who you’re deciding between yes or no, and where you don’t feel like your doctor has a stake in it, something like that.
如果它是一颗药丸,而不是一个让你在是或否之间做出决定的人,或者你不觉得你的医生与它有利害关系,诸如此类的事情,这会有所帮助。
Ironically, on the vaccines, people mostly decided on their own, without a doctor’s recommendation, as to which one they wanted.
具有讽刺意味的是,在疫苗问题上,人们大多在没有医生建议的情况下自行决定他们想要哪种疫苗。
Therefore, they would go online and decide which of the different vaccines do they want.
因此,他们会上网并决定他们想要哪种不同的疫苗。
Sometimes you can do that.
有时你可以这样做。
The other famous example of where you can do that is, for example, in vitro fertilization, where the records of the different centers do seem to matter.
另一个著名的例子是体外受精,不同中心的记录似乎确实很重要。
That is, people will go more to the centers that have a good record because families are thinking about which centers should I go to and stuff like that.
也就是说,人们会更多地去有良好记录的中心,因为家庭正在考虑我应该去哪些中心等等。
For other things, particularly when it’s a surgeon who you feel you might be offending, or it’s a conversation with your doctor that you don’t feel comfortable with, then people are extremely loath to do that.
对于其他事情,特别是当你觉得你可能冒犯了一位外科医生,或者与你的医生的谈话让你感觉不舒服时,那么人们非常不愿意这样做。
I would say that in some settings, you can make it happen, but oftentimes, you can’t.
我想说,在某些情况下,你可以做到这一点,但很多时候,你做不到。
Why don’t we have more paying for healthcare outcomes?
为什么我们不为医疗保健结果支付更多费用?
I give my doctor a bonus if I stay healthy, for instance.
例如,如果我保持健康,我会给我的医生奖金。
More complex ways of doing it, using intermediaries, collective contracts, but there’s very little.
更复杂的方法是利用中介机构、集体合同,但这种方法很少。
Why?
为什么?
As you know, one of the books that I wrote really has a lot about pay for performance.
如你所知,我写的一本书确实有很多关于绩效工资的内容。
First off, the past decade, particularly the past five years or so, there’s been enormous experimentation with it.
首先,过去十年,特别是过去五年左右,对此进行了大量的实验。
There’s been quite a lot of paying for outcomes, not in massive ways but in reasonable ways.
人们为成果付出了相当多的代价,不是以大量的方式,而是以合理的方式。
For example, the accountable care organization movement that the federal government does for Medicare and that most private insurers do some of, and that many state Medicaid policies do.
例如,联邦政府为医疗保险开展的责任医疗组织运动,大多数私人保险公司也参与其中,许多州的医疗补助政策也参与其中。
That is very much involved in paying for performance.
这与绩效薪酬密切相关。
When people do bundled-care arrangements — like I’ll pay you a fixed amount for a knee replacement — they’ll always have quality indicators in there.
当人们进行捆绑护理安排时——比如我会支付固定金额的膝关节置换术——他们总会有质量指标。
For primary care doctors, contracts that are fixed contracts — we’ll give you a certain amount per patient per month — those often have quality indicators in there.
对于初级保健医生来说,合同是固定合同 ——“我们每月会给每个患者一定的金额”—— 这些合同中通常有质量指标。
They’re in there, but they haven’t dominated as extensively as people would like.
他们在那里,但他们并没有像人们希望的那样广泛占据主导地位。
The evidence on them is that they are effective in that when you put them in, quality improves, costs stay the same or decline.
证据表明,它们是有效的,因为当您投入它们时,质量会提高,成本会保持不变或下降。
As best we can tell, they’re very effective.
据我们所知,它们非常有效。
They’ve not turned out to be absolute, total game-changers.
事实证明,它们并没有成为绝对的、彻底的游戏规则改变者。
We haven’t yet found the thing in healthcare where we say, “If you do this, you will save 15 percent on dollars and quality will go through the roof.”
我们还没有在医疗保健领域找到这样的说法:“如果您这样做,您将节省 15% 的资金,并且质量将达到顶峰。”
If you were to express that in terms of the model, what’s the limitation in economic terms?
如果用模型来表达,那么经济方面的限制是什么?
Something we can’t measure, something that’s not contractible, or what?
我们无法测量的东西,不可收缩的东西,还是什么?
I think there are a couple of parts.
我认为有几个部分。
One part is that every individual insurer has their own system, so the doctor finds it very difficult to customize what they’re doing to every single insurer.
一方面是每个保险公司都有自己的系统,所以医生发现很难为每个保险公司定制他们正在做的事情。
They get one set of incentives from Medicare, and another set of incentives from the Blue Cross policy, and another one from the United policy.
他们从 Medicare 获得一套激励措施,从 Blue Cross 政策获得另一套激励措施,从 United 政策获得另一套激励措施。
Even within Blue Cross, it varies, depending on which plan you’re in.
即使在 Blue Cross 内,情况也会有所不同,具体取决于您所参与的计划。
That’s one, is that it’s very difficult when it is so diffuse.
其一,当它如此分散时,这是非常困难的。
I think the second one is that many of these are also coupled with systems where you can make more by making sure your patient appears to be sick.
我认为第二个是,其中许多还与系统相结合,通过确保你的病人看起来生病了,你可以赚更多钱。
Therefore, when they turn out okay, you get a lot of money.
因此,当他们表现良好时,你会得到很多钱。
A lot more effort nowadays is put into making sure you’re coding appropriately so that you get all the reimbursement for the sickness of the patient, as opposed to saying, “Okay, the patient is what the patient is, and the way I make money is by making sure they’re healthier.”
如今,人们需要付出更多的努力来确保编码正确,以便获得患者疾病的所有补偿,而不是说:“好吧,患者就是患者,我赚钱的方式就是确保他们更健康。”
In principle, you could have doctors do both of those — both worry about the coding and about the patient health.
原则上,你可以让医生同时做这两件事——既担心编码又担心病人的健康。
In practice, there’s much more effort put into the coding part, which has got a real easy return to it, than there is put into the health improvement part.
在实践中,编码部分投入的精力比健康改善部分投入的精力要多得多,而且很容易得到回报。
If we think about very wealthy individuals who could afford any scheme and really care about being healthy, and they have some form of concierge medicine, and possibly even a buyer agent working for them, what do those incentives look like?
如果我们考虑非常富有的人,他们可以负担得起任何计划,并且真正关心健康,并且他们有某种形式的礼宾医疗,甚至可能有为他们工作的买家代理,那么这些激励措施是什么样的?
Or what should they look like?
或者说它们应该是什么样子?
I think for everyone, there should be a fair component of performance-based payment.
我认为对于每个人来说,基于绩效的薪酬都应该有公平的组成部分。
I think it would be better if we made it easier to judge them.
我认为如果我们能够更容易地评判他们会更好。
For example, we use things from electronic medical records rather than doctors have to write everything down on pencil and paper and so on.
例如,我们使用电子病历中的内容,而不是医生必须将所有内容写在铅笔和纸上等等。
I think we’d be better if there were more coordination amongst them so that everyone is, in essence, rowing the same way, or that everyone in the orchestra is playing the same music, as opposed to people playing different pieces of music and expecting to hear it go well.
我认为,如果他们之间有更多的协调,这样每个人本质上都以同样的方式划船,或者管弦乐队中的每个人都演奏相同的音乐,而不是人们演奏不同的音乐并期望听到它顺利进行,那么我们会更好。
What people want from the medical system is to be healthy.
人们对医疗系统的期望是健康。
Anytime you’re not paying for what people really want, somehow you’re going to run into trouble.
每当你没有为人们真正想要的东西付费时,你就会遇到麻烦。
Let’s say you, David Cutler, have $100 billion, and you’ve hired a team of doctors to look after you.
假设你,大卫·卡特勒,拥有 1000 亿美元,并且雇佣了一组医生来照顾你。
What kind of contract do you write with them?
您与他们签订什么样的合同?
You’ve thought about this more and better than anyone.
你比任何人都想得更多、想得更好。
What would you do?
你会怎么办?
The kinds of contracts — based on the literature — I think are best, are you get paid a fixed amount for caring for the person.
合同类型 — 基于文献 — 我认为最好的合同是你因照顾该人而获得固定金额的报酬。
A per-member per-month fee for caring for the person.
每位会员每月的护理费用。
If you have an episode of care, there’s a fixed payment for the episode.
如果您有一次护理,则该次护理需要支付固定费用。
That encourages coordination across the episode.
这鼓励了整个情节的协调。
There’s a lot of outcome measurement, so that you can say, “If you really do a good job caring for the patients or the patient, then you’re going to earn a lot extra.”
有很多结果衡量标准,所以你可以说,“如果你真的很好地照顾病人或病人,那么你会赚很多额外的钱。”
You would hire a third party to assess how well your doctor had done?
您会聘请第三方来评估您的医生的表现吗?
Because the literature is not mainly based on people with $100 billion, right?
因为文献并不是主要以拥有1000亿美元的人为对象,对吗?
You’re designing something from scratch with extra resources.
您正在使用额外的资源从头开始设计一些东西。
Yes, although there are metrics out there that you can certainly use.
是的,尽管有一些您当然可以使用的指标。
Most conditions — there are reasonable metrics that if you put them together, the docs are generally happy with.
大多数情况 — 都有合理的指标,如果将它们放在一起,文档通常会感到满意。
They’re not perfect.
他们并不完美。
I think one could do pretty well by that.
我认为这样做可以做得很好。
If you captured a lot of the doc’s attention — for example, the way that you do better — if you look at organizations that do really well, the way the organization does it is, they go to the doctor and they say, “This is what we’re going to practice here.
如果你吸引了医生的很多注意力——例如,你做得更好的方式——如果你看看做得很好的组织,他们会去找医生说:“这就是我们要在这里实践的。
We’re going to do images in this circumstance.
我们将在这种情况下制作图像。
We’re not going to do them in this.
我们不会这样做。
We’re going to do this in this circumstance.
我们将在这种情况下这样做。
We’re not going to do it here.”
我们不会在这里这样做。”
Then, if the doctor says, “But that’s not the way I’ve been practicing,” you go to them, and you say, “Look, here’s the literature.
然后,如果医生说,“但这不是我一直以来练习的方式,”你去找他们,说,“看,这是文献。
Here’s the stack of articles that shows that this way is best.
这里有一堆文章表明这种方式是最好的。
Now, go ahead and read through them.
现在,继续阅读它们。
If you want to talk about them, and you don’t believe they’re right, let’s absolutely have that conversation.
如果你想谈论他们,并且你不相信他们是对的,那么我们绝对要进行对话。
But until we agree that there’s something better, this is how we’re going to practice.”
但在我们一致认为有更好的东西之前,我们将采用这种方式进行练习。”
It’s like the whole organization is invested in doing the right thing, and then it sets up its systems and processes so that it’s all geared towards the right thing.
就好像整个组织都致力于做正确的事情,然后建立自己的系统和流程,以便一切都朝着正确的方向发展。
As you probably know, from 1950 to 1990, American youth suicide rates tripled.
您可能知道,从 1950 年到 1990 年,美国青少年的自杀率增加了两倍。
Why did that happen?
为什么会发生这种事?
And they’ve gone up since then at various times.
从那时起,它们在不同的时间都在上涨。
Suicide rates are an extremely unfortunate poor outcome, and they have also been going up recently, particularly more among middle-aged folks, but also among younger folks as well.
自杀率是一种极其不幸的不良后果,而且最近自杀率一直在上升,尤其是在中年人中,但在年轻人中也同样如此。
As you’re alluding to, I’ve done some work on suicide.
正如你提到的,我做了一些关于自杀的工作。
There is a confluence of different factors.
这是多种不同因素共同作用的结果。
On the demand side, there is pain of various forms, and there’s demand for pain relief.
在需求方面,有各种形式的痛苦,也有缓解痛苦的需求。
Pain can be physical pain.
疼痛可以是身体上的疼痛。
It can be mental health impairment.
这可能是心理健康障碍。
It can be despair.
这可能是绝望。
I’m putting those all together as being pain.
我把这些都归为痛苦。
Then there’s, on the supply side, the ability to carry it out.
然后,在供应方面,还有执行它的能力。
In the case of suicides, it’s access to guns.
就自杀而言,就是获得枪支。
Guns are typically, particularly for men, how men go about killing themselves.
枪支通常是男人自杀的方式,尤其是对于男性来说。
Ready access to methods of acting on pain very rapidly.
随时掌握快速止痛的方法。
In other cases, people will take opioids, or they will overdose on other drugs.
在其他情况下,人们会服用阿片类药物,或者过量服用其他药物。
Again, the more handy they are, the more of that that occurs.
同样,它们越方便,这种情况发生的就越多。
Not all of those are rational decisions.
并非所有这些都是理性的决定。
Sometimes it’s just an intense response to pain and the need to self-medicate the pain that sometimes goes awry.
有时,这只是对疼痛的强烈反应,以及需要自我治疗有时会出错的疼痛。
Or sometimes it’s just, “I can’t handle it, and death looks good now.”
或者有时候只是,“我受不了了,现在死亡看起来不错。”
I think it’s both on the demand side and the supply side, and it varies for different types of things.
我认为这既是需求方的问题,也是供给方的问题,而且对于不同类型的事物来说,它是不同的。
My sense is, what’s true about kids is not necessarily true about people who are dying of opioid addiction, where I put a lot weight on the supply side and less on the demand side there.
我的感觉是,关于孩子的情况不一定适用于那些死于阿片类药物成瘾的人,我在供应方面给予了很大的重视,而在需求方面则不太重视。
How strong do you think is the evidence for the Twenge hypothesis that right now iPhone addictions are causing isolation, anxiety, mental illness in young people?
您认为 Twenge 假设的证据有多大,即目前 iPhone 成瘾正在导致年轻人孤立、焦虑和精神疾病?
Is that just two time trends in tandem, or is there actual evidence that’s true?
这只是两个时间趋势的串联,还是有实际证据表明这是真的?
It’s obviously time trends.
这显然是时间趋势。
The question is the evidence, and I haven’t been through the evidence thoroughly enough to have a firm view.
问题在于证据,而我对证据的了解还不够彻底,无法得出坚定的观点。
I know there are people who believe that it’s causal, but I myself don’t have a strong view as to what extent it’s causal versus correlational.
我知道有人相信这是因果关系,但我自己对于因果关系与相关关系的程度并没有强烈的看法。
In 2006, you wrote a famous paper, “Why Americans Smoke Less.” You argue it’s because they better understand the health effects of smoking.
2006 年,您写了一篇著名论文《为什么美国人吸烟较少》。您认为这是因为他们更好地了解吸烟对健康的影响。
Since 2006, anecdotally, I observe Western Europeans smoke much less than they used to.
有趣的是,自 2006 年以来,我观察到西欧人的吸烟量比以前少了很多。
Is that because they’ve acquired a similar understanding?
是因为他们有相似的认识吗?
Or for other reasons?
还是因为其他原因?
You started this off in one of the most amazing places, which is that, 40 years after the US surgeon general conclusively demonstrated that smoking was bad for you, and 50 years after it really was known that smoking was bad for you, Americans had cut smoking in half, and people in Western European countries had not.
你从最令人惊奇的地方之一开始,那就是,在美国卫生局局长最终证明吸烟对你有害 40 年后,在人们真正知道吸烟对你有害 50 年后,美国人已经将吸烟量减少了一半,而西欧国家的人们却没有。
How can that persist?
这怎么能坚持下去呢?
It’s not that in Germany they had no idea that smoking was bad for you, and so on, or in France or anything.
这并不是说在德国,他们不知道吸烟对你有害,等等,或者在法国或其他地方。
But in part, it’s the social norms and the peer-type influences, and that shows up through public policy as well.
但在某种程度上,这是社会规范和同侪类型的影响,这也通过公共政策表现出来。
In the US, we have periodically raised taxes on cigarettes.
在美国,我们定期提高卷烟税。
We have put in restrictions where you cannot smoke inside buildings, you can’t smoke in public places.
我们制定了限制措施,不允许在建筑物内吸烟,也不能在公共场所吸烟。
All of that discourages smoking a lot.
所有这些都阻止了人们大量吸烟。
Smoking is also a social activity, so if your friends are smoking, and you don’t have restrictions on where you can smoke, then people are more likely to start smoking and continue smoking.
吸烟也是一种社交活动,因此,如果您的朋友在吸烟,并且您对吸烟地点没有限制,那么人们更有可能开始吸烟并继续吸烟。
Smoking, even though it’s a sort of individual act, it displays a lot of these external consequences, these external effects, and they hit very much sooner in the US than in other countries.
吸烟,尽管它是一种个人行为,但它会带来很多这些外部后果,这些外部影响,而且这些影响在美国比在其他国家要早得多。
That is, people in the US really responded quite rapidly, and it took people in other countries a longer period of time.
就是美国人民的反应确实很快,而其他国家的人民则需要更长的时间。
For that matter, it also took, for example, youth in the US a longer period of time.
就这一点而言,例如美国的年轻人也花了更长的时间。
If you look, youth smoking was rising through the 1990s until the late 1990s, with the Master Settlement Agreement between the tobacco companies and the states.
如果你仔细观察,就会发现,随着烟草公司与各州之间达成《总和解协议》,从 20 世纪 90 年代到 90 年代末,青少年吸烟人数一直在上升。
And all of a sudden all this information came out about how the tobacco companies were lying to people, and they were pretending that they didn’t know smoking was bad, even though they knew smoking was bad.
突然间,所有关于烟草公司如何对人们撒谎的信息都出来了,他们假装不知道吸烟有害,尽管他们知道吸烟有害。
That just turned off so many people — particularly younger people — that youth smoking has begun a two- to three-decade decline since then.
这让很多人——尤其是年轻人——望而却步,自那时起,青少年吸烟率开始在两到三年内下降。
You can have the peer effects, if you will, writ large.
如果你愿意的话,你可以发挥同伴效应。
Information can be ongoing and have huge impacts.
信息可以持续存在并产生巨大影响。
And I think that’s what we’re picking up between the US and other countries.
我认为这就是我们在美国和其他国家之间所看到的。
Turning to your book with Ed, which again, is Survival of the City, just coming out — putting aside anti-COVID measures, which we’re all familiar with, how can cities be made less contagious for disease in America?
转向你与艾德合作的书,这本书又是《城市的生存》,刚刚出版 —— 抛开我们都熟悉的抗新冠措施,如何才能让美国城市的疾病传染性降低呢?
We learned a couple of things about cities and contagiousness of disease.
我们了解了一些有关城市和疾病传染性的知识。
One is that poor health anywhere is poor health everywhere.
一是任何地方的健康状况不佳就是到处的健康状况不佳。
I may be totally selfish.
我可能完全是自私的。
Go back to when you endowed me with a lot of income.
回到你给我很多收入的时候。
I may care only about myself.
我可能只关心我自己。
Until a couple of years ago, that meant I didn’t have to care about the health of people in poorer parts of Boston.
直到几年前,这意味着我不必关心波士顿贫困地区人们的健康。
Of course, I do care about them, but continuing the analogy, now I really have to care about them.
当然,我确实关心他们,但继续类比,现在我真的必须关心他们。
I have to worry a lot, are people obese?
我很担心,人们肥胖吗?
Because obesity is associated with the spread of COVID-19.
因为肥胖与 COVID-19 的传播有关。
Are people smoking?
人们吸烟吗?
Because smoking will predispose to other types of illnesses.
因为吸烟会导致其他类型的疾病。
Are people IV drug users?
人们是静脉注射吸毒者吗?
Because that’s going to spread HIV, and that’s going to mean that heroin is all over, and so my kids are going to be exposed to it in school, and so on.
因为这会传播艾滋病毒,这意味着海洛因已经消失,所以我的孩子们将在学校接触到它,等等。
Are people using electronic cigarettes?
人们使用电子烟吗?
All of a sudden, I have to worry about all of that.
突然之间,我不得不担心这一切。
I think that has enormous implications for public policy in terms of what public policy needs to think about.
我认为,就公共政策需要考虑的问题而言,这对公共政策具有巨大的影响。
I also think that it changes the conversation from when we think of medical care as being, what’s my policy towards doctors, and what’s my policy towards hospitals, and so on.
我还认为,它改变了我们对医疗保健的看法,我对医生的政策是什么,我对医院的政策是什么,等等。
We need to reinvigorate more of the public health infrastructure.
我们需要重振更多的公共卫生基础设施。
What’s happened over time is that as infectious disease has declined, we’ve spent less and less money and less and less attention on the public health system until, basically, parts of it collapsed in COVID, and we realized, “Oh my God, it’s a bad idea to have a nonfunctioning public health system.” So we’re going to have to rebuild that, and that’s going to mean a lot more money, but that’s going to be essential in reducing the spread of infectious diseases.
随着时间的推移,随着传染病的减少,我们在公共卫生系统上花费的钱越来越少,关注也越来越少,直到基本上,部分公共卫生系统在新冠疫情中崩溃了,我们意识到,“天哪,一个不起作用的公共卫生系统是个坏主意。”因此,我们将不得不重建它,这将意味着更多的资金,但这对于减少传染病的传播至关重要。
What’s wrong with, say, the CDC?
比如说,疾病预防控制中心出了什么问题?
Their budget in real terms has gone up quite a bit.
他们的实际预算增加了很多。
This morning — the day we’re recording — they issued a warning to Americans not to travel to Canada, which is literally insane.
今天早上——“我们录制的那天”——他们向美国人发出警告,不要前往加拿大,这简直是疯了。
It’s the Biden administration now for some time.
拜登政府已经有一段时间了。
I’m broadly libertarian, skeptical about government — even I was shocked when that happened.
我基本上是自由主义者,对政府持怀疑态度——甚至当这件事发生时我也感到震惊。
What’s the model that explains how something like that can come about?
解释这样的事情如何发生的模型是什么?
There are two different types of things.
有两种不同类型的事物。
Sometimes there’s just bad luck.
有时只是运气不好。
For example, the CDC’s first tests for COVID got contaminated, and it took them a while to figure out what was the contamination, and stuff like that.
例如,疾病预防控制中心对新冠病毒的首次检测受到了污染,他们花了一段时间才弄清楚污染是什么,诸如此类的事情。
There’s just bad luck.
只是运气不好而已。
Then sometimes it’s systemic in that — an agency is falling apart, or it’s not sure about its mission or anything else, and then it’s a structural problem.
有时它是系统性的——一个机构正在分崩离析,或者它不确定自己的使命或其他什么,然后这是一个结构性问题。
One of the things — and I’m sure the libertarian in you wants to go there as well — is, I think, in general, it’s a bad idea where all of the public health of the country hangs on one agency so that if that agency has bad luck or bad leadership or just whatever happens, the power goes out, then nothing can happen.
其中一件事——“我确信你内心的自由主义者也想去那里”——我认为,总的来说,将国家的所有公共卫生都依赖于一个机构是一个坏主意,因此,如果该机构运气不好或领导不佳或发生任何事情,就会断电,那么什么都不会发生。
It’d be as if there were one hospital in Boston that could do cardiac surgery, and if the doctor was sick that day, “I’m sorry, we just can’t do cardiac surgery and emergencies that day.”
这就好像波士顿有一家医院可以做心脏手术,如果医生那天生病了,“对不起,我们那天不能做心脏手术和急诊。”
I think in general, it’s just a bad idea when everything is stretched so thin that it’s hanging from a thread.
我认为总的来说,当所有东西都被拉得很薄以至于挂在一根线上时,这是一个坏主意。
I don’t know about how it’s functioning now.
我不知道它现在运作得如何。
I haven’t done any looking or reading, but the agencies, all of the agencies of the public health system were so beaten down by the Trump administration that good people had left.
我没有看过或读过,但是公共卫生系统的所有机构都被特朗普政府打垮了,好人都离开了。
It was difficult to do anything.
什么事情都很难做。
They were just getting stigmatized, and they crawled into bunkers, and so on.
他们刚刚受到侮辱,然后爬进掩体,等等。
It takes an enormous amount of time to recover from that sort of thing, so that there can be enormous lasting harm from even a few years or a few months of just completely awful policy.
从这种事情中恢复需要花费大量的时间,因此即使是几年或几个月的完全糟糕的政策也可能会造成巨大的持久伤害。
Take a given family — they’re thinking about the health tradeoff of moving to the suburbs.
以某个家庭为例,他们正在考虑搬到郊区对健康的影响。
What would you advise them?
你会给他们什么建议?
What’s the main cost?
主要费用是什么?
What’s the main benefit?
主要好处是什么?
Moving out of a city and into a suburb —
离开城市进入郊区 —
Moving out of a city, not Manhattan, but a large city.
搬出一个城市,不是曼哈顿,而是大城市。
— as opposed to moving from a rural area.
— 与从农村地区搬来相反。
Right.
正确的。
Moving from one of the top 10 cities to an upper-middle-class suburb.
从十大城市之一搬到中上阶层郊区。
What’s the health tradeoff?
健康权衡是什么?
Probably not much in the sense that most of their behaviors will be the same.
从他们的大多数行为都相同的意义上来说,可能并没有多大区别。
The exposure to infectious disease, in general, is higher within cities.
一般来说,城市内的传染病暴露率较高。
If you look, this was not too early on in COVID-19, but it’s become more so, which is that increasingly urban areas are easier to spread infectious disease because there’s more close contact.
如果你仔细观察的话,你会发现,在 COVID-19 中,这种情况并不算太早,但现在变得更加严重,越来越多的城市地区更容易传播传染病,因为有更多的密切接触。
You’re taking subways, things like that.
你正在乘坐地铁之类的东西。
I would say probably, on that count, there would be a little bit less exposure.
我想说,就这一点而言,曝光可能会少一些。
On the other hand, one of the things I’ve always found interesting is that people say they’ll be happier when they move to more space, but when you actually ask them before and after, they’re not much happier.
另一方面,我一直觉得有趣的一件事是,人们说当他们搬到更大的空间时他们会更快乐,但当你真正问他们之前和之后时,他们并没有更快乐。
The reason for that, at least in part, is that people get very stressed out by commutes.
其原因(至少部分原因)是人们因通勤而感到压力很大。
They don’t realize how much they’re going to be stressed out by that.
他们没有意识到他们会因此承受多大的压力。
They think about, “I’ll have a nice lawn and a backyard and so on.” They don’t realize that five days a week, they’ll be spending a lot of time in a car commuting.
他们想,“我会有一个漂亮的草坪和一个后院等等。”他们没有意识到,每周有五天,他们会花很多时间在汽车上下班。
I would think that that would be an issue for moving out to the suburbs, which is, is there going to be a lot of frustration and stress involved in some aspects of it that one hasn’t thought about?
我认为这对于搬到郊区来说是一个问题,也就是说,在某些方面是否会有很多人们没有想到的挫败感和压力?
Within cities, are there high returns or low returns to making travel through the city easier?
在城市内部,让城市出行变得更便捷的回报是高还是低?
Basically, you would get people to the emergency ward faster if they had a gunshot wound or a heart attack.
基本上,如果人们遭受枪伤或心脏病发作,您可以更快地将他们送往急诊室。
Does that matter much, or that’s seventh order?
这很重要吗,还是七阶?
No, that matters quite a lot.
不,这非常重要。
Having a well-functioning emergency system is extremely important.
拥有一个运转良好的应急系统极其重要。
Just take one example.
只举一个例子。
When the marathon bombings occurred in Boston a few years ago, the number of deaths was very small.
几年前波士顿发生马拉松爆炸事件时,死亡人数非常少。
I think it was two or three deaths.
我认为有两三个人死亡。
No one who made it to a hospital alive died.
被送往医院的人中没有一人死亡。
That was because the emergency system had practiced intensely, how do you handle a mass casualty situation?
因为应急系统已经演练得很紧张了,出现大规模伤亡的情况怎么处理?
Where do you get people to?
你把人们带到哪里?
What do you do once they’re there?
他们到达后你会做什么?
There should have been way more deaths than there were, but it was because of the ability of the system to handle it that we wound up doing better.
死亡人数本应比实际情况多得多,但正是由于系统处理死亡的能力,我们最终做得更好。
I think, for any city, figuring out how to get emergencies treated right away and to the right places, and then having those places do the right thing, is really important.
我认为,对于任何城市来说,弄清楚如何立即在正确的地方处理紧急情况,然后让这些地方做正确的事情,非常重要。
If we put aside the fact that you likely have personal connections where you live right now, as many of us do, just in the abstract, as you grow older, where in this country would you most want to get sick?
如果我们抛开这样一个事实,即您可能像我们许多人一样,在您现在居住的地方有个人联系,只是抽象地讲,随着年龄的增长,您最想在这个国家的哪个地方生病?
Say I have to move from Boston.
假设我必须从波士顿搬走。
I can’t really know very much.
我真的不知道太多。
The upper Midwest has very good healthcare if you think about the Minnesota-Wisconsin area.
如果您考虑一下明尼苏达州 - 威斯康星州地区,中西部北部地区的医疗保健非常好。
Extremely good healthcare pretty much across the board.
几乎全面的医疗保健都非常好。
The gradients there are not as big as you’ll see in other areas in terms of the care received.
就所接受的护理而言,那里的梯度并不像您在其他地区看到的那么大。
They don’t go wild on doing stuff.
他们不会疯狂地做事。
Life expectancy is high, not all because of the medical care system, but likely a little bit of it is because of the medical care system.
预期寿命高,并不全是因为医疗体系,但可能有一点是因为医疗体系。
There’s more of a social ethic to the system in terms of we care about people and people as a whole, and stuff like that.
从我们关心人和整个人的角度来看,这个系统更多的是社会道德,诸如此类。
I would say that’s probably where I would go if you forced me to move.
我想说,如果你强迫我搬家,我可能会去那里。
What’s the risk that VIPs get worse care because they’re overtreated?
VIP 人士因受到过度治疗而获得较差护理的风险有多大?
For some things, reasonably high.
对于某些事情来说,相当高。
What would those things be?
那些东西会是什么?
Excessive testing is a big one.
过度测试是一个大问题。
For example, excessive PSA testing for men potentially with prostate cancer.
例如,对可能患有前列腺癌的男性进行过多的 PSA 检测。
It’s not even recommended that you get tested any more.
甚至不建议您再进行测试。
It’s just recommended that you talk to your doctor about testing.
只是建议您与您的医生讨论测试事宜。
Or excessive biopsies in, let’s say, women, where you might suspect breast cancer.
或者对女性进行过多的活检,您可能怀疑患有乳腺癌。
What you do after biopsy?
活检后做什么?
It’s the cascade.
这是级联。
People talk it about in terms of a cascade.
人们用级联来谈论它。
The first thing is never that bad, but then it leads to the next thing and the next thing and so on.
第一件事永远不会那么糟糕,但它会导致下一件事,然后下一件事,依此类推。
If you look at people who go into a hospital — we were talking about Minnesota or Wisconsin or so on versus higher-spending areas.
如果你看看去医院的人——我们谈论的是明尼苏达州或威斯康星州等与支出较高的地区。
In the higher-spending areas, “Well, gee, we noticed this slight little thing on your CT scan.
在消费较高的区域,“好吧,天啊,我们在你的 CT 扫描上注意到了这个小问题。
It’s not related to why you’re in here, but maybe we ought to bring in the specialists to look at it.” “Maybe we ought to take that out a little bit.” Or “maybe we ought to do this.”
这与你来这里的原因无关,但也许我们应该请专家来看看。” “也许我们应该把它去掉一点。”或者“也许我们应该这样做。”
You wind up with this whole cascade of things that are completely unrelated to what was going on — or only tangentially related — that cost a lot but bring anguish and sometimes worse health outcomes as a result.
你最终会遇到这一系列与正在发生的事情完全无关的事情——或者只是无关紧要的事情——这些事情花费了很多钱,但却带来了痛苦,有时甚至会带来更糟糕的健康结果。
As you know, early in the 20th century, recent immigrant arrivals to the United States clustered together fairly tightly in terms of living in the same areas, often within cities.
如您所知,20 世纪初,新抵达美国的移民相当紧密地聚集在一起,居住在同一地区,通常是在城市内。
That trend then weakens throughout much of the 20th century, and in the last few decades, it’s been re-emerging.
这种趋势在 20 世纪的大部分时间里逐渐减弱,但在过去的几十年里又重新出现。
Why is it coming back?
为什么它又回来了?
There’s a line of work that, at least on the health end, comes from Anne Case and Angus Deaton.
安妮·凯斯 (Anne Case) 和安格斯·迪顿 (Angus Deaton) 的一系列工作,至少在健康方面是这样。
They and a colleague, Arthur Stone, wrote a Proceedings of the National Academy of Sciences paper last year, where they argued basically, my shorthand is that education is the new race, that we’re learning how to dismantle some of the barriers that have existed by race, certainly not all of them, but some of them.
他们和同事阿瑟·斯通(Arthur Stone)去年在《美国国家科学院院刊》上发表了一篇论文,他们在论文中基本上认为,我的简写是,教育是新的种族,我们正在学习如何消除种族存在的一些障碍,当然不是全部,而是其中一些。
What’s coming up is that education is increasingly associated with where you live, what resources you have access to, and so on.
即将发生的事情是,教育越来越与您居住的地方、您可以获得的资源等等相关。
I think that maybe some of what’s going on — which is that society is bifurcating along the haves and the have-nots based on socioeconomic status as opposed to race — that the have-nots are really a large share of the population, and the have-nots can’t afford to live in Silicon Valley, and they can’t afford to live in the Boston metro area, and they can’t afford to live in New York.
我认为,也许正在发生的一些事情——“社会正在根据社会经济地位而非种族而分裂为富人和穷人”——穷人确实占人口的很大一部分,而穷人负担不起在硅谷的生活,他们负担不起在波士顿都会区的生活,他们也负担不起在纽约的生活。
If you look, mobility used to be everyone moved to the high-wage areas, but now the high-wage areas have such high house prices that nobody can afford to live there except if you’re extremely wealthy.
你看,以前的流动就是大家都搬到高工资地区,但现在高工资地区的房价那么高,除非你非常有钱,否则没有人住得起。
If you want to move, you’re getting compressed into areas where there are more lower-income people as opposed to more high-wage stuff.
如果你想搬家,你就会被压缩到低收入人群较多的地区,而不是高工资地区。
I’m really quite worried that society is becoming a kind of insider’s game as opposed to a situation where outsiders get to play as well.
我真的很担心社会正在成为一种内部人的游戏,而不是局外人也可以玩的游戏。
We, alas, have time for only two more questions.
唉,我们只剩下时间再问两个问题了。
Your book with Ed, Survival of the City — if you had to pick an area — it doesn’t have to be disagreement, though it could be, but simply something you and he see differently.
你和艾德合着的书《城市的生存》————如果你必须选择一个领域————这不一定是分歧,尽管可能存在分歧,而只是你和他的看法不同而已。
What would that be, of the topics in the book?
书中的主题是什么?
And where does that difference come from?
这种差异从何而来?
We had incredibly interesting discussions about if businesses left cities because workers decided to move to the suburbs, what would that mean for cities?
我们进行了非常有趣的讨论,如果企业因为工人决定搬到郊区而离开城市,这对城市意味着什么?
Would that be like mass terrible?
那会像大规模恐怖吗?
Would that be not so bad?
那不是那么糟糕吗?
I had originally thought, “Oh my gosh, it would be terrible for cities if all the jobs moved out.” And Ed convinced me that my views were certainly way overstated.
我原本想,“天哪,如果所有的工作岗位都搬出去,对城市来说将是可怕的。”埃德让我相信我的观点肯定被夸大了。
Maybe there was not nothing to them, but certainly, they were way overstated.
也许他们并不是什么都没有,但可以肯定的是,他们被夸大了。
To give one example, if you move 10 percent of businesses out of cities, a couple of things could happen.
举个例子,如果将 10% 的企业迁出城市,可能会发生一些事情。
One is, that’s roughly two or three years of growth, typical growth by business.
一是,这大约是两三年的增长,典型的业务增长。
So within two or three years, you’re back to where you were.
所以两三年之内,你就会回到原来的状态。
Another thing that can happen is, you can turn commercial real estate into residential real estate.
另一件可能发生的事情是,你可以将商业房地产转变为住宅房地产。
That’ll make cities cheaper for people who really want to live in cities — younger people, people who don’t need a lot of space, who don’t care about a lawn, and so on, but people who really want to live close by other people.
对于那些真正想住在城市的人——年轻人、不需要太多空间的人、不关心草坪的人等等,但那些真正想和其他人住得很近的人来说,这将使城市变得更便宜。
That’s one situation where my view changed because of conversations that the two of us had, just fantastically interesting conversations.
在这种情况下,我的观点因为我们两个人的对话而改变,非常有趣的对话。
Last question.
最后一个问题。
To improve the US healthcare system, if you could offer one nonobvious recommendation — not so much on political agendas right now — but something we could do that would just flat-out be better, what would that be?
为了改善美国的医疗保健体系,如果你能提供一项不明显的建议 ——“目前在政治议程上还不太重要”—— 但我们可以做的事情会变得更好,那会是什么?
There are so many things that one thinks about.
一个人思考的事情有很多。
I would say the be-all and end-all of healthcare is the money that’s spent.
我想说,医疗保健的最重要和最终目的就是所花的钱。
When you spend so much money, you can’t direct the system well.
当你花那么多钱的时候,你就不能很好地指挥这个系统。
You can’t insure people.
你无法为人们提供保险。
You can’t invest in the kinds of things you want.
你不能投资你想要的东西。
After COVID, I would focus, first order, on reducing spending, and there are two areas that I would address uppermost in my mind.
在新冠疫情之后,我的首要任务是减少支出,其中有两个领域是我最关心的问题。
The first one is certain pharmaceuticals that are way overpriced relative to what they deliver because of whatever gaming and so on.
第一个是某些药品,由于游戏等原因,相对于其提供的产品而言,其价格过高。
The second one is the administrative costs of healthcare that are absolutely absurd, that drive up prices so people can’t afford it, that frustrate people and doctors, that make it be extremely difficult for people to get the care they need, and don’t do anything valuable.
第二个是医疗保健的行政成本,这绝对是荒谬的,它推高了价格,让人们负担不起,这让人们和医生感到沮丧,这使得人们很难获得他们需要的护理,而且没有做任何有价值的事情。
Those are the two areas.
这是两个领域。
I would show that, once I could save there, I could make the medical system be better and cheaper, and then that would start the ball rolling on everything else.
我会证明,一旦我能在那里存钱,我就能让医疗系统变得更好、更便宜,然后这就会开始推动其他一切。
A real pleasure.
真是一种享受。
David Cutler, thank you very much.
大卫·卡特勒,非常感谢你。
Again, David’s new book with Ed Glaeser is Survival of the City: Living and Thriving in an Age of Isolation.
再次,大卫与埃德·格莱泽的新书是《城市的生存:孤立时代的生活与繁荣》。
It’s been a pleasure to be with you, thank you so much.
很高兴和你在一起,非常感谢。
Now we have Ed Glaeser.
现在我们有埃德·格莱泽。
Ed is professor of economics at Harvard University, and most importantly, he is arguably the greatest urban economist ever to have lived.
埃德是哈佛大学经济学教授,最重要的是,他可以说是有史以来最伟大的城市经济学家。
Ed, welcome.
艾德,欢迎。
Thank you very much, Tyler.
非常感谢你,泰勒。
Thank you for that distinctly over-the-top introduction, but I’m very grateful.
感谢您的过度介绍,但我非常感激。
Let’s start with a simple question.
让我们从一个简单的问题开始。
All this enthusiasm about cities and agglomeration benefits — the pandemic comes along.
所有这些对城市和集聚效益的热情————流行病随之而来。
A lot of people transition to work from a distance, and then we see big measured productivity gains.
许多人转向远程工作,然后我们看到了生产力的大幅提高。
What has gone on there?
那里发生了什么事?
It reminds us that for many jobs, in a static sense, you can do this long-distance.
它提醒我们,对于很多工作来说,从静态意义上来说,你可以进行这种远距离的工作。
You can make things work.
你可以让事情顺利进行。
I think many of us found this.
我想我们很多人都发现了这一点。
We wrote this book in eight months over the pandemic year, distinctly away from each other, partially because there were no distractions, and all that was good.
我们在流感大流行的一年里花了八个月的时间写了这本书,彼此分开,部分原因是没有干扰,一切都很好。
However, you also need to recognize the limits of long-distance living.
然而,您还需要认识到长途生活的局限性。
The most important of those limits is just it’s much less fun.
这些限制中最重要的是它的乐趣要少得多。
It’s much less joyful, but while it seems as if it’s fine for static productivity, it seems distinctly more problematic for people learning and for onboarding new talent.
它不那么令人愉快,但虽然它似乎对于静态生产力来说没什么问题,但对于人们的学习和新人才的入职来说,它似乎显然更成问题。
Let me just give you two types of studies, one of which is we have the call center studies.
让我给大家介绍两种类型的研究,其中之一是我们的呼叫中心研究。
The father of that was the Nick Bloom paper, which was a randomized control trial in China.
其鼻祖是尼克·布鲁姆 (Nick Bloom) 的论文,这是一项在中国进行的随机对照试验。
A more modern version is done by our students, Natalia Emanuel and Emma Harrington, which looks into American call centers.
我们的学生 Natalia Emanuel 和 Emma Harrington 完成了一个更现代的版本,该版本研究了美国呼叫中心。
Both of them find the same thing in terms of static productivity.
他们在静态生产力方面发现了相同的情况。
If anything, it goes up, but the workers who go remote are much less likely to be promoted in both studies.
如果说有什么不同的话,那就是这个数字有所上升,但在这两项研究中,远程办公的员工晋升的可能性要小得多。
One interpretation of this is that promotion in the call center work means that you actually are given the job of handling more difficult calls.
对此的一种解释是,在呼叫中心工作中晋升意味着你实际上得到了处理更困难呼叫的工作。
How would your boss know that you are good at handling difficult calls if they weren’t in the same room with you?
如果你的老板不和你在同一个房间,他们怎么知道你擅长处理棘手的电话?
How would you learn how to do those difficult calls if you weren’t around other people?
如果你周围没有其他人,你将如何学习如何拨打这些困难的电话?
So while the static productivity remains, you lose the dynamic benefits of being around other people.
因此,虽然静态生产力仍然存在,但你却失去了与其他人在一起的动态好处。
Second piece of evidence it comes from Burning Glass Technologies and new hires.
第二个证据来自 Burning Glass Technologies 和新员工。
Even though Microsoft tells us that its programmers were just as productive, overall, new hires for programmers were down 42 percent between November 2019 and November 2020.
尽管微软告诉我们,其程序员的生产力同样高,但总体而言,2019 年 11 月至 2020 年 11 月期间,新聘用的程序员数量下降了 42%。
Firms were clearly unwilling to take the same kind of risks of hiring new workers that they couldn’t inculcate in their corporate culture or screen them properly, or do any of those other things.
公司显然不愿意冒同样的风险来雇用新员工,因为他们无法在企业文化中灌输新员工,也无法对他们进行适当的筛选,或者做任何其他事情。
Even though measured productivity did well during the pandemic, there were still lots of disruptions.
尽管在大流行期间衡量的生产力表现良好,但仍然存在很多干扰。
In particular, many younger workers who came of age really lost out as a result of this.
尤其是很多成年的年轻工人,确实因此受到了损失。
If work from a distance goes fine in the short run, what’s the cross-sectional prediction about where it will persist in the future?
如果远程工作在短期内进展顺利,那么对未来它将持续存在的横截面预测是什么?
Is it firms facing bankruptcy, firms with immediate projects now, possibly start-ups who will then later transition to all being together in one big happy family, but they’re afraid they’re going to fail before then?
是面临破产的公司、现在正在开展项目的公司,还是可能是初创企业,这些公司后来将过渡到一个幸福的大家庭,但他们担心在那之前他们会失败?
What should we expect?
我们应该期待什么?
I think we should expect young workers to be more likely to be brought together.
我认为我们应该期待年轻工人更有可能聚集在一起。
Young firms, as well, because you’re very much at this learning, creative phase.
年轻的公司也是如此,因为你正处于这个学习、创造的阶段。
I think the optimal work-from-home strategy is a couple of partners who are in an accounting practice and have decided they know each other perfectly well and are delighted to Zoom it in from wherever they are.
我认为最佳的在家工作策略是几个从事会计业务的合作伙伴,他们认为彼此非常了解,并且很高兴从任何地方放大它。
I think, unquestionably, working from home will remain a part of the economy.
我认为,毫无疑问,在家工作仍将是经济的一部分。
It may well be many workers end up spending 20 percent of their time working from home, even if they’re part of a generally full-time job.
许多员工很可能最终会花 20% 的时间在家工作,即使他们的工作通常是全职工作。
But for younger workers, for firms that are just getting started, I think being live is likely to continue being a major part of the work environment.
但对于年轻员工、刚刚起步的公司来说,我认为现场生活可能会继续成为工作环境的重要组成部分。
It also depends a lot on what your home environment is like.
这在很大程度上取决于您的家庭环境。
If you’re like us — if you are a middle-aged professor who’s likely to have a comfortable home office, and maybe even not having kids at home anymore, certainly not kids who are crying all the time at home anymore — working at home is a lot more pleasant than if you’re a 23-year-old and live in a studio apartment in Somerville or New York or London.
如果你像我们一样 ——如果你是一位中年教授,可能有一个舒适的家庭办公室,甚至可能不再有孩子在家,当然不再是那些总是在家里哭的孩子 —— 在家工作比你是一个 23 岁的住在萨默维尔、纽约或伦敦的单间公寓的人要愉快得多。
So, which countries will benefit the most from this?
那么,哪些国家将从中受益最大呢?
If a Silicon Valley firm can now hire top talent from Mumbai or Delhi, and everyone’s used to the Zoom call, even if most of the people in the home office are back to being together, what’s that going to matter for geopolitically?
如果一家硅谷公司现在可以从孟买或德里聘请顶尖人才,而且每个人都习惯了 Zoom 通话,即使总部的大多数人又回到了一起,这对地缘政治有何影响?
So, for sure, this is going to continue the rise of places like Bangalore.
因此,可以肯定的是,这将继续推动班加罗尔等地的崛起。
The ability to connect over long distances helps really educated people in India.
远距离连接的能力有助于印度真正受过教育的人们。
It doesn’t necessarily help the bulk of 1.1 billion Indians who do not sit with computers on their desk and are not going to be natural software programmers.
它不一定能帮助 11 亿印度人,因为他们办公桌上没有电脑,也不会成为天生的软件程序员。
In general, you’d think educated areas will benefit from this more than less educated areas would.
一般来说,您可能认为受教育程度较高的地区比受教育程度较低的地区更能从中受益。
There was a huge educational digital divide during the period of Zoom.
Zoom 时期存在巨大的教育数字鸿沟。
In May 2020, 68.9 percent of Americans with advanced degrees were telecommuting; 5 percent of high school dropouts were telecommuting; 15 percent of people who just had high school degrees were telecommuting.
2020 年 5 月,拥有高等学位的美国人中有 68.9% 进行远程办公; 5% 的高中辍学者选择远程办公; 15% 刚刚获得高中学位的人进行远程办公。
The skill divide on this is enormous.
这方面的技能差距是巨大的。
We shouldn’t possibly think that in a world of universal telecommuting, that’s going to do anything for the bottom third of the American skill distribution.
我们不应该认为,在普遍远程办公的世界里,这会对美国技能分布中排名倒数三分之一的人产生任何影响。
We should expect, across cities, that cities that are attractive and are natural places where educated people want to locate, well, they may be in the US, or they may be elsewhere.
我们应该期望,在各个城市中,那些有吸引力的城市,并且是受过教育的人自然想要定居的地方,嗯,他们可能在美国,也可能在其他地方。
I don’t think the model is that your Silicon Valley startup says, “Oh, just phone it in.” But I do think, you have eight people and you say, “Boy, we really love skiing.
我不认为这种模式是你的硅谷初创公司说的:“哦,打电话就行了。”但我确实认为,你有八个人,你会说:“天哪,我们真的很喜欢滑雪。
Why don’t we go to Vail?” Beaches?
我们为什么不去韦尔?”海滩?
“Why don’t we go to Hawaii, or Bali for that matter?” I would expect a reallocation towards high-quality-of-life areas and high-quality-of-life countries.
“我们为什么不去夏威夷或巴厘岛呢?”我预计会向高生活质量地区和高生活质量国家进行重新分配。
And this helps Britain and Ireland because of the English language?
这对英国和爱尔兰有帮助是因为英语吗?
Or not?
或不?
Cements English as a global language?
巩固英语作为全球语言的地位?
Absolutely.
绝对地。
Once we get past the chaos related to Brexit, sure.
当然,一旦我们摆脱了与英国脱欧相关的混乱。
Why not?
为什么不呢?
Ireland is both a very attractive place to live, and it has lots of great English speakers and is very technologically savvy.
爱尔兰不仅是一个非常有吸引力的居住地,而且拥有许多英语说得很好的人,并且非常精通技术。
Now, if I walk around Paris, London, New York, Dublin — almost any city you care to name — I see beautiful, older urban neighborhoods, not everywhere, but really quite a few of them if the city has not been bombed into oblivion.
现在,如果我在巴黎、伦敦、纽约、都柏林——几乎所有你能说出名字的城市走一圈——我会看到美丽、古老的城市街区,虽然不是到处都有,但如果这座城市没有被炸毁的话,确实有不少这样的街区。
But I don’t see newly created, wonderful, beautiful urban neighborhoods really anywhere.
但我在任何地方都看不到新建的、美妙的、美丽的城市社区。
Why is that?
这是为什么?
I’m not sure that I agree with you.
我不确定我是否同意你的观点。
Certainly, the older cities of this country have regulated themselves into stasis.
当然,这个国家的老城市已经自我调节到停滞状态。
We don’t get beautiful new neighborhoods because historic preservation is a completely binding rule in London, in Paris, and in New York.
我们得不到美丽的新社区,因为在伦敦、巴黎和纽约,历史保护是一条完全具有约束力的规则。
It’s just very difficult to change the neighborhood in a way that works.
以有效的方式改变社区是非常困难的。
In terms of newer neighborhoods, more generally, part of the issue is that we always build our cities around the transportation technology that is dominant in the era in which it’s being created.
就较新的社区而言,更普遍的是,部分问题在于我们总是围绕交通技术来建设我们的城市,而这种技术在其创建的时代占据主导地位。
For the past 80 years, the dominant technology has been the car, which means there are lots of nice places for you to drive around in America, but there aren’t that many new pedestrian neighborhoods for you to walk around.
在过去的 80 年里,占主导地位的技术一直是汽车,这意味着美国有很多适合您开车游览的好地方,但没有那么多新的步行街区可供您步行。
But there have been plenty of buildings, say, outside of the central core of Paris, sometimes even in the Paris region, but all sorts of other parts of France, and it’s never beautiful.
但是,在巴黎市中心之外,有时甚至在巴黎地区,但在法国的所有其他地方,都有很多建筑物,而且从来都不是美丽的。
The French have an incredible culture, an amazing eye, highly sophisticated, maybe willing to sacrifice cheapness for beauty.
法国人拥有令人难以置信的文化,令人惊叹的眼睛,高度复杂,也许愿意为了美丽而牺牲廉价。
Yet, they seem incapable of building new, beautiful neighborhoods, whether they’re walkable.
然而,他们似乎无法建造新的、美丽的社区,无论它们是否适合步行。
We have old people’s homes which are completely walkable.
我们有完全适合步行的老人之家。
They’re never beautiful.
他们从来都不是美丽的。
Nothing’s beautiful.
没有什么是美丽的。
My father was an architectural historian, Tyler.
我的父亲泰勒是一位建筑历史学家。
He was a curator of the Museum of Modern Art.
他是现代艺术博物馆的馆长。
So, I have a certain feeling that we as economists are not necessarily the best judges of the beautiful.
所以,我有一种感觉,作为经济学家,我们不一定是美的最佳评判者。
What’s your view of the Centre Pompidou?
您对蓬皮杜艺术中心有何看法?
Do you think beautiful or not beautiful?
你觉得美还是不美?
What’s your view on Renzo Piano?
您对伦佐·皮亚诺有何看法?
I think there are many excellent individual buildings.
我认为有很多优秀的单体建筑。
Bilbao Guggenheim.
毕尔巴鄂古根海姆。
There’s a long list, but neighborhoods is where we’re falling short, not individual buildings.
名单很长,但我们的不足之处是社区,而不是个别建筑。
Renzo Piano — amazing.
伦佐·皮亚诺——太棒了。
Zumthor — go all the way down the list.
卒姆托 — 一直沿着列表往下走。
But neighborhoods — I don’t see them.
但街区 —— 我看不到它们。
How about Barcelona, the parts of Barcelona that were built after the Olympics?
巴塞罗那怎么样,奥运会后建造的巴塞罗那部分?
That’s a perfectly walkable neighborhood and not a terribly unpleasant place.
这是一个完全适合步行的社区,而不是一个非常不愉快的地方。
“Great to live in, not terribly unpleasant” is a wonderful description of it.
“住得很舒服,不是很不愉快”是对它的精彩描述。
That’s the best we can do?
这是我们能做的最好的事情吗?
We’re so much wealthier.
我们非常富有。
It’s crazy.
太疯狂了。
I don’t get it.
我不明白。
It’s an interesting question.
这是一个有趣的问题。
What about areas in Asia?
那么亚洲地区呢?
All of Seoul is new.
首尔的一切都是新的。
There are no blocks in Seoul that you find inspiring?
首尔有没有让你觉得振奋的街区?
I like them.
我喜欢他们。
I enjoy Seoul, but the really beautiful parts of Seoul seem to be the older remnants, which are not many at this point.
我喜欢首尔,但首尔真正美丽的部分似乎是古老的遗迹,目前并不多。
I will say, one of my favorite architectural moments in Boston is where H.H.
我想说,我在波士顿最喜欢的建筑时刻之一是 H.H.
Richardson’s Trinity Church abuts against the Hancock Tower.
理查森三一教堂毗邻汉考克塔。
Agree, I love it.
同意,我喜欢它。
I actually think that that juxtaposition is stunning, and it’s exactly when you get this dialogue between an architect of the past and an architect of the present when really magical things happen.
事实上,我认为这种并置是令人惊叹的,而正是当你在过去的建筑师和现在的建筑师之间进行对话时,真正神奇的事情发生了。
Which global city of any age is most underrated for its beauty?
哪个时代的全球城市因其美丽而被最低估?
For its beauty.
为了它的美丽。
Again, you want me to make beauty statements —
再说一次,你想让我发表美丽的言论 ——
Beauty statements.
美丽的陈述。
— that are —
— 那是 —
This is a podcast.
这是一个播客。
If we want to talk about the most efficient, we can all agree on Singapore.
如果我们要谈论效率最高的国家,我们都会同意新加坡。
Now, I don’t know how underrated it is, but the last place I saw you live is a particular favorite of mine, which is Edinburgh.
现在,我不知道它被低估了多少,但我最后一次见到你居住的地方是我特别喜欢的一个地方,那就是爱丁堡。
I don’t know whether it’s underrated or not, but it’s certainly spectacular.
我不知道它是否被低估,但它确实很壮观。
I would say, actually, there are parts of Glasgow which are definitely underrated, but the physical bones of Glasgow are magnificent.
我想说,实际上,格拉斯哥的某些部分绝对被低估了,但格拉斯哥的物质骨头是宏伟的。
I would say, more generally, there are lots of American Rust Belt cities where the physical bones are fantastic.
我想说,更一般地说,美国有很多铁锈地带城市的骨骼都很棒。
Part of the South Side of Chicago — not exactly Rust Belt — but the buildings along the lake — a little bit too monumental, not necessarily built on a human scale, but stunningly beautiful in the way that they work with the water.
芝加哥南区的一部分 ——不完全是铁锈地带—— 而是湖边的建筑 —— 有点太宏伟了,不一定是按照人类规模建造的,但它们与水的互动方式却令人惊叹的美丽。
Parts of Detroit — old buildings, meaning from before World War II, where it really works as space unbelievably well, even if the city is facing the woes that Detroit has faced for 70 years.
底特律的部分地区——老建筑,指的是二战之前的建筑,尽管这座城市面临着底特律 70 年来所面临的困境,但它们作为空间的效果确实令人难以置信。
Your father was an architectural historian.
你的父亲是一位建筑历史学家。
What did you learn from him about the economics of building that has fed into your work?
您从他那里学到了哪些关于建筑经济学的知识并融入到了您的工作中?
I learned nothing .
我什么也没学到。
.
。
.
。
Well, the only thing I remember about my father telling me was, he had a model of housing cycles, which was not particularly rational, but it was a model that said that you always started buildings during the boom, which means you always ended up completing them during the bust, which means you always ended up losing money on the buildings because you got the timing all wrong.
好吧,我父亲告诉我的唯一一件事是,他有一个住房周期模型,这不是特别合理,但这个模型说,你总是在繁荣时期开始建造建筑物,这意味着你总是在萧条时期完成它们,这意味着你总是在建筑物上赔钱,因为你把时机搞错了。
Now, I didn’t know at the time how to think about this.
现在,我当时不知道该如何思考这个问题。
There’s some truth to this.
这有一定道理。
It’s not totally wrong in terms of housing cycles.
就住房周期而言,这并非完全错误。
But my economics I learned from my mother, who got her MBA at Columbia and worked in capital markets for Mobil for many years.
但我的经济学是从母亲那里学来的,她在哥伦比亚大学获得了 MBA 学位,并在美孚公司的资本市场工作了多年。
I still remember this epiphany when she explained to me .
我仍然记得她向我解释时的顿悟。
.
。
.
。
I still remember where it was — on 3rd Avenue between 63rd and 64th Streets, she explained Bertrand competition to me.
我仍然记得它在哪里——在 63 街和 64 街之间的第三大道上,她向我解释了伯特兰竞争。
It was the most magical thing in the world, this idea of these two shoemakers, as she told it, who are competing on price and somehow or other, you’re getting down to the actual cost.
这是世界上最神奇的事情,这两个鞋匠的想法,正如她所说,他们在价格上竞争,不知何故,你正在降低实际成本。
Can larger cities succeed over the longer term with dysfunctional public schools?
从长远来看,大城市能否通过功能失调的公立学校取得成功?
It is amazing how underperforming cities are for providing upward mobility for poor kids.
令人惊讶的是,城市在为贫困儿童提供向上流动性方面表现不佳。
It is the facts that came out of Raj Chetty and Nathan Hendren and John Friedman’s Opportunity Atlas.
这是来自 Raj Chetty、Nathan Hendren 和 John Friedman 的机会地图集的事实。
At the metropolitan area level, density and size are both negatively associated with performance.
在大都市区层面,密度和规模都与绩效呈负相关。
Within metropolitan areas, density and proximity to a city center are both negatively correlated with upward mobility.
在大都市区内,密度和距市中心的距离都与向上流动性呈负相关。
There’s a huge cliff right at the edge of the central city’s school district, where if you’re out of the central city school district, you do much better economically and you’re much less likely to be incarcerated as an adult.
市中心学区的边缘有一个巨大的悬崖,如果你离开了市中心学区,你的经济状况会好得多,成年后被监禁的可能性也会小得多。
It’s the modern version of Lincoln Steffens’s The Shame of the Cities, the fact that we have had this problem for decades and have been unable to fix it.
这是林肯·斯蒂芬斯的《城市之耻》的现代版本,事实上我们几十年来一直面临这个问题却无法解决。
Yes, our cities manage to succeed despite that, but it is, I would say, in terms of our new book, the part I feel least hopeful about is the school problem.
是的,尽管如此,我们的城市还是取得了成功,但我想说,就我们的新书而言,我最不抱希望的部分是学校问题。
In some sense, one of the stories that we tell is that every city is going to be — every place is more vulnerable to natural disaster if its existing social institutions are weaker.
从某种意义上说,我们讲述的故事之一是,如果现有的社会制度较弱,每个城市都将更容易受到自然灾害的影响。
What’s your political economy model of the persistence of that problem?
对于这个问题的持续存在,你的政治经济学模型是什么?
Why doesn’t the median voter in the city just fix that?
为什么该市的中位选民不解决这个问题呢?
We all want better schools.
我们都想要更好的学校。
I think it’s very hard to change things because there are very powerful entrenched interests in schools and because schools are somewhat complicated.
我认为改变事情是非常困难的,因为学校里有非常强大的根深蒂固的利益,而且学校有些复杂。
Unlike policing, principals cannot immediately tell teachers how to change their behavior, whereas police chiefs can actually change what their officers do on a dime.
与治安不同,校长不能立即告诉老师如何改变他们的行为,而警察局长实际上可以立即改变警察的行为。
It’s very, very hard to get teachers to change.
让老师改变是非常非常困难的。
Consequently, working change in the schools is incredibly hard.
因此,学校的变革工作非常困难。
Now, we could move much more radically to vouchers to add competition.
现在,我们可以更彻底地采用优惠券来增加竞争。
I think, in many cases, that would be a great thing to do, but it’s been very hard to move that politically, partially because of the strong opposition of the teachers’ unions.
我认为,在很多情况下,这将是一件伟大的事情,但在政治上推动这一点非常困难,部分原因是教师工会的强烈反对。
One of the things that we push in our book is something that feels more like wraparound, after-school, summertime vocational training, competitively sourced, pay-for-performance because you know, when someone’s a plumber, whether they’ve learned how to do this or not.
我们在书中推动的事情之一,感觉更像是一种包罗万象、放学后、暑期职业培训、竞争性采购、按绩效付费的方式,因为你知道,当某人是一名水管工时,他们是否学会了如何做到这一点。
You allow a full degree of competition, and you can do it in a way that completely bypasses the unions.
你允许充分的竞争,并且你可以以完全绕过工会的方式做到这一点。
I’ve been on the edges of this reform movement for 20 years now, and it’s hard to be very hopeful about it, in part because the political economy is just difficult because there are teachers who vote who are very anxious not to see change, even as they are often doing heroic work in the classroom themselves.
20年来,我一直处于这场改革运动的边缘,很难对此抱有很大希望,部分原因是政治经济很困难,因为有些投票的老师非常渴望看到变革,尽管他们自己经常在课堂上做出英勇的工作。
Are cities, as a result, just population sinks?
结果,城市只是人口下降吗?
If you think of population shrinkage as a major problem in parts of the developed world — obviously Japan, Italy, Singapore, South Korea, maybe the United States — and fertility in cities is below replacement level.
如果你认为人口萎缩是发达国家部分地区的一个主要问题——“显然是日本、意大利、新加坡、韩国,也许还有美国”——而且城市的生育率低于更替水平。
Aren’t cities a big problem, and our founding fathers were right?
城市不是一个大问题吗?我们的开国元勋是对的吗?
We should be suspicious of cities?
我们应该对城市持怀疑态度吗?
They can’t fix their own schools.
他们无法修复自己的学校。
Education is super important.
教育非常重要。
They’re taking away people, which is also a fiscal problem.
他们正在带走人员,这也是一个财政问题。
Unlike many of our colleagues, Tyler, I think I am actually with you in that.
与我们的许多同事不同,泰勒,我想我实际上同意你的观点。
I’m, in my heart, a natalist, just to be entirely clear.
需要明确的是,在我内心深处,我是一个自然论者。
It’s part of believing in agglomeration economies that I just like having more people.
我喜欢拥有更多的人,这是我相信集聚经济的一部分。
Even if I weren’t worried about Social Security paying for itself, I think each new human on this planet is a new source of creativity that can work some magic.
即使我不担心社会保障本身的费用,我认为这个星球上的每一个新人类都是一个新的创造力源泉,可以发挥一些魔力。
Now, it is absolutely true that suburban living has often been a complement to having kids, partially because the space is cheaper, and certainly, that’s always going to exist.
现在,郊区生活确实是养育孩子的一种补充,部分原因是空间更便宜,而且当然,这种情况永远存在。
But if you think about it, the part of the cities that are really detrimental to fertility — I think it’s got to be the schooling.
但如果你仔细想想,城市中真正不利于生育的部分 —— 我认为一定是学校教育。
It’s got to be the people living in cities don’t think they have access to great public schools, unlike people living in suburbs, which leads us back, yet again, to think that the most important thing going forward for this issue, as for so many others, is to improve the quality of urban schooling.
与居住在郊区的人们不同,生活在城市的人们认为他们无法进入优秀的公立学校,这让我们再次认为,对于这个问题,以及其他许多问题来说,未来最重要的事情是提高城市学校教育的质量。
Why does it seem that urban crime has moved upward again?
为什么城市犯罪似乎又上升了?
And, at least possibly, this seems to predate the pandemic.
而且,至少有可能,这似乎早于大流行之前。
What’s our best model of that?
我们最好的模型是什么?
Most of the changes in crime are very hard to explain with very much.
犯罪的大多数变化都很难解释。
I wrote a paper almost 30 years ago now, called “Crime and Social Interactions,” that goes back to observations that early 19th-century French social scientists made, basically that the existence of pure effects in crime means that you just get lots of variation that’s not very easy to explain.
大约 30 年前,我写了一篇论文,名为《犯罪与社会互动》,该论文可以追溯到 19 世纪初法国社会科学家的观察,基本上认为,犯罪中纯粹效应的存在意味着你会得到很多不容易解释的变异。
I think we shouldn’t also, though, forget that it’s possible that some of this has to do with changes in policing practices.
不过,我认为我们也不应该忘记,其中一些可能与警务实践的变化有关。
The evidence on policing practices leading to the reduction in crime is actually pretty thin.
关于治安实践导致犯罪减少的证据实际上非常薄弱。
Most of the people who dabble in this area believe that there’s an elasticity of crime with respect to the quantity of cops that seems pretty strong.
大多数涉足这一领域的人都认为,犯罪率相对于警察数量的弹性似乎相当强。
That comes from just various quasi-experiments, like throwing more cops at the neighborhood seems to reduce crime, but the styles making a difference is much harder to tell.
这只是来自各种准实验,比如在社区部署更多警察似乎可以减少犯罪,但产生影响的风格却很难说。
There’s a great paper by my colleagues, Roland Fryer and Tanaya Devi, that shows that after there were pattern-of-practice investigations of police forces that followed a viral incident of a police shooting, that crime rates spiked enormously, apparently, because police stopped going to high-crime areas when they came under investigation.
我的同事罗兰·弗莱尔(Roland Fryer)和塔纳亚·德维(Tanaya Devi)写了一篇很棒的论文,该论文表明,在一起病毒式的警察枪击事件之后,对警察部队的实践模式进行了调查,犯罪率显然急剧上升,因为警察在接受调查时不再前往犯罪率高的地区。
I think that’s the kind of thing that would make me very worried about things like defund the police.
我认为这种事情会让我非常担心诸如取消警察经费之类的事情。
While I think it’s absolutely true that we should demand that police treat every citizen with respect, and we should have metrics that keep them under account, and we should have a system of incentives for police chiefs to require this, we certainly can’t defund the police.
虽然我认为我们确实应该要求警察尊重每一位公民,我们应该制定衡量标准,让他们受到问责,我们应该建立一个激励制度,让警察局长提出要求,但我们当然不能取消对警察的资助。
In fact, in general, if we’re going to ask the police to both prevent crime and to behave more respectfully to everyone, that’s going to require more funding for the police, not less, because I don’t believe there’s a free lunch here, as I don’t believe there’s one anywhere else.
事实上,总的来说,如果我们要要求警察既防止犯罪,又要更加尊重每个人,那就需要为警察提供更多的资金,而不是更少,因为我不相信这里有免费的午餐,就像我不相信其他地方有免费的午餐一样。
Will NIMBY come to dominate the American Southeast?
邻避(NIMBY)会统治美国东南部吗?
Is that the political equilibrium everywhere once you get enough development?
一旦获得足够的发展,这就是政治均衡吗?
This is the worry, Tyler.
这就是担心,泰勒。
The beauty of the Southeast has been, it has been the land of free development, where ordinary Americans can buy a home at a reasonable price because you haven’t fettered the developers.
东南部的美妙之处在于,它一直是自由开发的土地,普通美国人可以以合理的价格购买房屋,因为你没有束缚开发商。
Yet, in place after place, in Austin, Texas, in central Atlanta, we’re seeing the NIMBY walls go up.
然而,在德克萨斯州奥斯汀和亚特兰大市中心,我们看到邻避墙在一个又一个地方拔地而起。
We’re seeing more and more barriers to tearing down and rebuilding.
我们看到拆除和重建的障碍越来越多。
I’m worried about this.
我很担心这个。
I hope the answer is no, but it certainly is something that would be very bad for America if we stopped having at least some parts of America that make it easy enough to build so that ordinary people could buy housing at a decent price.
我希望答案是否定的,但如果我们不再让美国的至少某些地区变得足够容易建造,以便普通人能够以体面的价格购买住房,这对美国来说肯定是非常糟糕的。
If cities can’t fix their schools, and can’t fix their NIMBY problems, and are super expensive, and don’t produce enough human beings, isn’t there a funny second-best defense of “let’s keep people out of the cities”?
如果城市无法修复他们的学校,无法解决邻避问题,而且成本非常高,并且不能产生足够的人口,那么难道没有一个有趣的第二最佳辩护“让我们把人们赶出城市”吗?
The NIMBY is okay, keeps them in the suburbs, better for them anyway.
邻避还好,让他们留在郊区,无论如何对他们更好。
There’ll be a higher birth rate.
出生率将会更高。
You need to have someone keep those cities going, but write them off a bit.
你需要有人让这些城市继续运转,但也要把它们注销掉。
Maybe they’re just not fixable.
也许它们只是无法修复。
Remember, I’m an economist, which means that, like you, I believe that the real desiderate is choice.
请记住,我是一名经济学家,这意味着,像你一样,我相信真正的愿望是选择。
What we want is to make sure that people have options.
我们想要的是确保人们有选择。
And there are some Americans that want to live in cities, and some are going to want to live in suburbs, and some are going to want to live in low-density rural areas, and that’s just great.
有些美国人想要住在城市,有些人想要住在郊区,有些人想要住在低密度的农村地区,这很好。
We don’t, in any sense, want to do away with any of that.
从任何意义上说,我们都不想消除这些。
I don’t want to give any sense in which that’s not at the heart of what I believe.
我不想给出任何不是我所信仰的核心的意义。
At the same time, I think that cities — lots of areas are doing a crappy thing by making it too difficult to build.
与此同时,我认为城市——很多地区都在做一件糟糕的事情,让建设变得太困难。
I think there are social welfare benefits by freeing up developers.
我认为通过释放开发人员可以带来社会福利。
I think, in general, it’s awful that cities aren’t doing a better job with their schools, and we should fight against those things.
我认为,总的来说,城市在学校方面没有做得更好是很糟糕的,我们应该反对这些事情。
We’re not doing it just so that more people will come to cities, or that that would be the right result.
我们这样做不仅仅是为了让更多的人来到城市,或者这是正确的结果。
We’re doing it primarily because the kids who are going into the schools are getting a raw deal, and we want them to get a better deal.
我们这样做主要是因为进入学校的孩子们得到了不公平的待遇,我们希望他们得到更好的待遇。
In general, one of the themes of the book is America has done an amazing job over the last 40 years of protecting its insiders at the expense of its outsiders.
总的来说,这本书的主题之一是,美国在过去 40 年里在以牺牲局外人利益为代价保护其内部人士方面做得非常出色。
Schooling, NIMBYism are all examples of cases in which our cities have become — and our suburbs — machines for protecting entrenched interests of middle-aged, middle-class people, and making it difficult for the people who come and start with less to find a brighter future.
学校教育、邻避主义都是我们的城市——以及我们的郊区——成为保护中年、中产阶级既得利益的机器,让那些出身贫寒的人很难找到更光明的未来的例子。
What’s your underlying political model of why so many cities, especially coastal ones, have become so politically clustered along some particular dimensions.
为什么这么多城市,尤其是沿海城市,在某些特定维度上变得如此政治聚集,你的基本政治模式是什么?
It didn’t use to be this way, right?
以前不是这样的,对吧?
The model I have of this is “Strategic Extremism,” which I published in the Quarterly Journal of Economics in 2005.
我的模型是“战略极端主义”,我于 2005 年在《经济学季刊》上发表了它。
That model emphasizes communication.
该模型强调沟通。
In that model, you had people clustering all along religion — as opposed to other cultural dimensions — on the right because there were people who were speaking to Republican voters who had religiously oriented microphones.
在该模型中,人们沿着宗教 (与其他文化维度相反)聚集在右侧,因为有人正在向持有宗教导向麦克风的共和党选民讲话。
By contrast, the left tended to be more dominated by economic issues because the left had the unions, and the unions were the primary communication device.
相比之下,左派往往更受经济问题的支配,因为左派有工会,而工会是主要的沟通工具。
That’s a model that emphasizes communication as the ultimate determinant of the way that partisan divides happen.
该模型强调沟通是党派分歧发生方式的最终决定因素。
What do you predict is the final equilibrium?
您预测最终的平衡是什么?
Is it self-reversing, or does it just keep on going and going?
它是自我逆转,还是一直持续下去?
Which could give you another reason to be skeptical of cities.
这可能会给你另一个对城市持怀疑态度的理由。
I don’t think this is just cities.
我不认为这只是城市。
Were you asking a question — I missed you for a second — about partisan divides or about geographic divides in partisanship?
你问的问题是 —— 我有一瞬间想念你 —— 关于党派分歧还是关于党派之争的地理分歧?
Well, I think it’s better for states and cities if they have two political parties and the two parties compete no matter what your particular views may be.
嗯,我认为,如果州和城市有两个政党,并且无论您的具体观点是什么,两个政党都会竞争,这对州和城市来说更好。
So if cities don’t give us this, isn’t that another problem with cities?
那么,如果城市不给我们这个,这难道不是城市的另一个问题吗?
And if they keep people out, maybe that’s not a terrible thing.
如果他们把人们拒之门外,也许这并不是一件可怕的事情。
I believe very strongly that some form of competition — That’s a major theme in this book, that in fact, cities are more vulnerable than ever, even if face-to-face learning comes back.
我坚信,某种形式的竞争 ——这是本书的一个主题,事实上,即使面对面的学习回归,城市也比以往任何时候都更加脆弱。
It’s never been easier for people to leave the city.
人们离开这座城市从未如此简单。
Treating your rich, treating your businesses like they’re a piggy bank is a terrible mistake.
像对待存钱罐一样对待你的富人、你的企业是一个可怕的错误。
I’m a traditional East Coast Republican, all right, Tyler?
我是传统的东海岸共和党人,好吗,泰勒?
I believe that there should be Republicans in cities, and in fact, I often have been one.
我相信城市里应该有共和党人,事实上,我也经常是其中之一。
I think this is a good thing to have, but I’ll settle for a robust pragmatic wing of the Democratic Party debating against a robust progressive wing of the Democratic Party.
我认为这是一件好事,但我会接受民主党中强大的务实派与民主党中强大的进步派进行辩论。
That’s partially what the book is arguing for — that city governments really need to be pragmatic because cities are vulnerable.
这就是本书所主张的部分内容——城市政府确实需要务实,因为城市很脆弱。
Unless they make sure that they’re actually providing decent schools and safe streets, and doing so in a reasonable, cost-effective way, people will just run away.
除非他们确保确实提供体面的学校和安全的街道,并且以合理、具有成本效益的方式做到这一点,否则人们就会逃跑。
And unlike you, I don’t believe that’s a good thing because I think that when our geographic movements are determined by political dysfunction instead of economic reality, that’s bad.
与你不同的是,我不认为这是一件好事,因为我认为当我们的地理运动是由政治功能失调而不是经济现实决定时,那就不好了。
Putting aside COVID policy, which of course is important, what else can we do to make our cities healthier?
抛开新冠肺炎政策(这当然很重要),我们还能做些什么来让我们的城市变得更健康?
In terms of the things that we talked about primarily in the book, around housing and policing and schools, which we have already discussed — we do not do a lot in the book on transportation, but I certainly join the crowd of economists who have argued that congestion pricing is the best way to deal with urban traffic jams.
就我们在书中主要讨论的问题而言,围绕住房、治安和学校,我们已经讨论过——我们在书中并没有对交通做太多讨论,但我当然加入了经济学家的行列,他们认为拥堵收费是应对城市交通拥堵的最佳方式。
There’s no reason not to charge people for the social cost of their actions on that.
没有理由不向人们收取其行为的社会成本。
And giving away street space for free is just crazy, especially since we now have technologies that can handle this.
免费赠送街道空间简直是疯狂,特别是因为我们现在拥有可以处理这个问题的技术。
And if we introduce autonomous vehicles without congestion pricing, you have just lowered the cost of sitting in traffic, which means the first-order behavioral response is that more people will sit in traffic, and our congestion will get even worse unless we introduce this from the beginning.
如果我们引入没有拥堵费的自动驾驶汽车,那么你就降低了堵车的成本,这意味着第一阶行为反应是更多的人会堵车,除非我们从一开始就引入这一点,否则我们的拥堵将会变得更糟。
So I think pricing is really good.
所以我认为定价真的很好。
I think it’s also key that we start thinking about — we have new transportation technologies in a way that we haven’t in a long time.
我认为我们开始思考“我们拥有新的交通技术,这是我们很长一段时间以来没有的”,这一点也很关键。
We have new autonomous vehicles, and it seems to me very odd that we’re still thinking that the right technology for connecting cities is the 19th-century technology of trains.
我们拥有新的自动驾驶汽车,但在我看来,我们仍然认为连接城市的正确技术是 19 世纪的火车技术,这似乎很奇怪。
Envision single, dedicated lanes for autonomous buses that go 150 miles an hour.
设想为时速 150 英里的自动驾驶公交车提供单一专用车道。
This is going to be more flexible.
这会更加灵活。
It’s going to be cheaper.
会更便宜。
It’s a 21st-century technology as opposed to a 19th-century technology.
这是一项 21 世纪的技术,而不是 19 世纪的技术。
I’ve seen the 1959 Brazilian movie, Black Orpheus, set in Rio de Janeiro, and the hills are empty and the city is beautiful.
我看过 1959 年的巴西电影《黑色奥菲斯》,以里约热内卢为背景,山上空无一人,城市却很美丽。
Now, if you fast-forward to Rio today, it’s a war zone, and it’s extremely densely populated.
现在,如果你快进到今天的里约,那是一个战区,而且人口极其稠密。
Is Brazil a good example of failed YIMBY policy?
巴西是 YIMBY 政策失败的一个很好的例子吗?
No, no. I think that those favelas are providing upward mobility for millions and millions of Brazilians.
不,不。我认为这些贫民窟正在为数以百万计的巴西人提供向上流动的机会。
The overall track record of cities as a tool for turning poor farmers into middle-class urbanites is phenomenal.
城市作为将贫困农民转变为城市中产阶级的工具的总体记录是惊人的。
The one failure of Brazil’s cities is that their police have failed, and that’s the one failure that I would say.
巴西城市的一个失败就是他们的警察失败了,这就是我要说的一个失败。
When you look at the failures of developing-world cities — and there are plenty — there are demons that come with density, as you pointed out.
当你观察发展中国家城市的失败时————而且有很多————正如你所指出的,城市密度越高,恶魔就越多。
There’s crime; there’s contagious disease; there’s traffic congestion.
有犯罪;有传染性疾病;交通拥堵。
But the right answer is not to look at those and say, “Oh, better you just stay on the farm.” There’s no future in rural poverty in these places.
但正确的答案不是看着这些然后说:“哦,你最好留在农场。”这些地方的农村贫困是没有未来的。
The right answer is to do battle against the demons that come with density.
正确的答案是与密度而来的恶魔进行战斗。
But think of your own earlier paper on “Urban Giants” from 1995.
但想想你自己 1995 年发表的关于“城市巨人”的早期论文。
A major city can be too densely populated for rent-seeking reasons.
出于寻租的原因,大城市可能人口过于稠密。
Mexico City, arguably, is too large.
可以说,墨西哥城太大了。
You’d rather have more people in Monterrey and Guadalajara.
你宁愿在蒙特雷和瓜达拉哈拉有更多的人。
Rio, arguably, is too large.
可以说,里约太大了。
Shouldn’t Brazil, many other countries, Austria, have a more even distribution of city sizes, more like Zipf’s law, which sometimes they don’t have?
巴西、许多其他国家、奥地利难道不应该有更均匀的城市规模分布吗?更像齐普夫定律,但有时他们却没有?
I don’t think there’s anything normative about Zipf’s law.
我认为齐普夫定律没有任何规范性。
I think, in general, we should fight against the tendency to distribute extra rents to particular localities.
我认为,总的来说,我们应该反对向特定地区分配额外租金的倾向。
That is certainly right.
这当然是对的。
It was almost surely a good thing that Rio stopped being the capital of Brazil about 60 years ago, and that those rents went to Brasilia, which is now, currently, too large, relative to its economic functioning because it’s a political hub.
大约 60 年前,里约热内卢不再是巴西的首都,而这些租金流向了巴西利亚,这几乎肯定是一件好事,而巴西利亚现在相对于其经济功能来说太大了,因为它是一个政治中心。
I don’t think that you can leap from saying, “Oh, we want to restrict Washington’s tendency to pour rents on Washington, DC” — you shouldn’t then move from there to saying, “Oh, I’m going to have a national spatial policy.
我不认为你可以直接说“哦,我们想限制华盛顿向华盛顿特区倾倒租金的倾向”——然后你不应该从那里转向说“哦,我将制定一项国家空间政策。
New York, you’re slightly too big.
纽约,你有点太大了。
Chicago, you could be 30 percent larger.” How are we going to know this?
芝加哥,你的体型可能会大 30%。”我们如何知道这一点?
We don’t have any way, as social scientists, to actually know this exactly, and we should resist any urge to try and micromanage the locations of firms and individuals.
作为社会科学家,我们没有任何办法真正准确地了解这一点,我们应该抵制任何尝试对公司和个人的位置进行微观管理的冲动。
If we think of the United States — as you know, in 1910, there’s a high degree of immigrant segregation.
如果我们想想 1910 年的美国——正如你所知,移民隔离程度很高。
People from the same country living next to each other — lower East Side, wherever.
来自同一个国家的人们彼此相邻——无论在下东区,无论在哪里。
That declines throughout most of the 20th century, and now it’s come back.
在 20 世纪的大部分时间里,这一数字都在下降,现在又回来了。
Why is that?
这是为什么?
Why the change?
为什么要改变?
Immigration has come back .
移民回来了。
.
。
.
。
Even adjusting for numbers, it seems there’s more clustering.
即使根据数字进行调整,似乎也有更多的聚类。
How you adjust for numbers — it’s never entirely clear.
如何根据数字进行调整 — 从来都不是完全清楚的。
Remember, David and I struggled with this in our 100 years of American segregation.
请记住,大卫和我在美国 100 年的种族隔离中一直在为此奋斗。
It’s very hard to know exactly how to adjust for numbers.
很难确切地知道如何根据数字进行调整。
It’s also a question of how linguistically distinct the immigrants are, how educationally distinct the immigrants are.
这也是一个关于移民在语言上有多么独特、在教育上有多么独特的问题。
Our view was that, in general, segregation is more harmful the less educated the group is.
我们的观点是,一般来说,受教育程度越低的群体,种族隔离的危害性就越大。
We should particularly worry about the segregation of those groups that have less skills, and maybe take policies to fight against it.
我们应该特别担心那些技能较差的群体的隔离问题,也许可以采取政策来对抗它。
Although it’s not clear, apart from policies that ban outright housing discrimination — which, of course, has been illegal for 50 years — it’s not quite clear what strong policies we have for reducing levels of segregation within cities.
尽管还不清楚,但除了禁止彻底的住房歧视的政策(当然,这在 50 年来一直是非法的)外,我们还不清楚我们有哪些强有力的政策来减少城市内的隔离程度。
How dense should Los Angeles become?
洛杉矶应该变得多稠密?
I don’t have a view about how dense it should be.
我不知道它应该有多密集。
I have a view about how regulated it should be, Tyler, and I think it should be less regulated.
我对应该如何监管有自己的看法,泰勒,我认为应该减少监管。
How dense would it then become?
那么它的密度会是多少?
What would it look like?
它会是什么样子?
Would it all look like Culver City?
这一切看起来会像卡尔弗城吗?
This is exactly the same point as Marty Feldstein made, starting in the 1970s, that for many public policy problems, you don’t need to know where you want things to end up because it’ll never end up close to where you want it to end up.
这与 Marty Feldstein 从 20 世纪 70 年代开始提出的观点完全相同,即对于许多公共政策问题,你不需要知道你希望事情的结果如何,因为它永远不会接近你希望的结果。
All you need to know is the right direction.
您需要知道的只是正确的方向。
I feel entirely confident, given how much demand there is for Los Angeles, given how productive Los Angeles is, that we should have more homes in Los Angeles.
考虑到洛杉矶的需求量和洛杉矶的生产力,我完全有信心我们应该在洛杉矶拥有更多的住房。
Whether or not that means ubiquitous skyscrapers everywhere or more duplexes, I don’t know.
我不知道这是否意味着无处不在的摩天大楼或更多的复式公寓。
We’re only likely to get the increase in duplexes.
我们只可能增加复式公寓。
For example, the California law that was put in, I guess, a week and a half ago — I don’t know if Gavin Newsom has signed it yet — that allows much easier permitting for two-unit projects.
例如,我猜一周半前颁布的加州法律 ——“我不知道加文·纽瑟姆是否已经签署了”—— 这使得两单元项目的审批变得更加容易。
That’s hailed as a huge triumph because it makes it easier to build projects with exactly two units.
这被誉为一个巨大的胜利,因为它使得用两个单元建造项目变得更加容易。
This is what we’re actually talking about.
这就是我们实际上正在谈论的。
I feel confident that I’m in favor of two-unit projects.
我有信心支持两个单元的项目。
I think there are lots of core areas in downtown LA that would probably be well served by having some more high-rise condos than they currently have now.
我认为洛杉矶市中心有很多核心区域,如果拥有比现在更多的高层公寓,可能会得到很好的服务。
As you know, there are quantitative attempts to estimate the cost of NIMBY policies, most notably by Moretti among others, but those attempts don’t typically take into account the fact that the US is uniquely bad at building cheap infrastructure.
如您所知,有人尝试对邻避政策的成本进行定量估算,尤其是莫雷蒂等人,但这些尝试通常没有考虑到美国在建设廉价基础设施方面的独特劣势。
If we made New York, San Francisco, LA, other cities much larger, we would have to expand infrastructure, but that’s one of the things we’re worst at.
如果我们让纽约、旧金山、洛杉矶和其他城市变得更大,我们就必须扩大基础设施,但这是我们最不擅长的事情之一。
To what extent would the potential gains from YIMBY dwindle if we take costly infrastructure into account?
如果我们考虑到昂贵的基础设施,YIMBY 的潜在收益会减少到什么程度?
I agree with you in terms of the cost of American infrastructure.
我同意你关于美国基础设施成本的看法。
It’s a shocking thing how expensive it is to build.
建造它的成本是多么令人震惊。
In some cases, for example, if you expand density in core areas of Manhattan, many of those people can commute to work by walking and the sidewalks are not overburdened.
例如,在某些情况下,如果扩大曼哈顿核心区域的密度,其中许多人可以步行上班,人行道也不会负担过重。
Those are areas which do not require huge amounts of extra infrastructure to build.
这些领域不需要建设大量额外的基础设施。
Often, if you think about the infrastructural requirements in the center and on the edge, it’s not totally obvious that it’s higher in the center than on the edge.
通常,如果您考虑中心和边缘的基础设施要求,并不完全明显中心的基础设施要求高于边缘。
In many cases, you can take into account existing economies of scale.
在许多情况下,您可以考虑现有的规模经济。
In cases like Los Angeles, where the gap between valuation and construction costs are so large, even if you say you’re going to spend on infrastructure twice as much as on physical cost, you’ve still got a lot of social value that you created by opening up a little bit.
在像洛杉矶这样的情况下,估值和建设成本之间的差距如此之大,即使你说你要在基础设施上花费是物理成本的两倍,你仍然通过一点点开放创造了很多社会价值。
How much, right now, are we exporting American poverty to American suburbs?
目前,我们正在向美国郊区输出多少美国贫困?
And are our suburbs capable of handling that?
我们的郊区有能力处理这个问题吗?
That’s just not at all the way that I think.
这根本不是我想的那样。
Say there’re some people who just aren’t that productive.
假设有些人的工作效率不高。
They’re priced out of cities.
它们的价格超出了城市。
They move to suburban or exurban areas.
他们搬到郊区或远郊地区。
Social services are weaker, the bus network doesn’t work so well, there are problems getting your car fixed at an affordable price, and in some ways, their poverty problems become worse.
社会服务较弱,公交网络运行不佳,以实惠的价格修理汽车也存在问题,在某些方面,他们的贫困问题变得更加严重。
Should we build suburbs to be better geared to handle people who will have low incomes?
我们是否应该建设郊区以更好地适应低收入人群?
Ideally, the answer is you want political or public policy-based reasons to relocate, but I don’t have a view beyond that in where I want poor people or rich people to locate.
理想情况下,答案是你希望基于政治或公共政策的原因进行搬迁,但除此之外我没有其他观点,即我希望穷人或富人搬到哪里。
I think, in general, it’s a matter for their individual choice.
我认为,总的来说,这是他们个人选择的问题。
If you’re telling me that it’s much more expensive to deal with poor people in suburban areas — something which I’m not totally confident that it is, but certainly, I believe that access to public transit is one reason why poor people tend to live in cities, then maybe you want to lean slightly against suburbanization of poverty.
如果你告诉我,与郊区的穷人打交道的成本要高得多 ——我并不完全相信这一点,但当然,我相信获得公共交通是穷人倾向于居住在城市的原因之一,那么也许你会稍微倾向于反对贫困的郊区化。
But this is an area which I would have very little confidence in terms of applying on any public policy whatsoever.
但我对这一领域应用任何公共政策都没有信心。
It just doesn’t feel to me like I have a strong view on where people should live.
我只是觉得我对人们应该住在哪里没有强烈的看法。
Every day, I get a spammy phone call.
每天我都会接到垃圾电话。
Someone wants to buy my house.
有人想买我的房子。
BlackRock, more seriously, is buying up a lot of housing.
更严重的是,贝莱德正在购买大量住房。
Is this a worry?
这是一个担忧吗?
Or is this just the market working?
或者这只是市场在起作用?
It’s not something I worry about very much.
这不是我很担心的事情。
I don’t necessarily see a market failure in here in any way or the other.
我并不一定认为这里存在任何形式的市场失灵。
What do you think BlackRock is going to do with your house?
您认为贝莱德将如何处理您的房子?
They’re going to rent it out, or they’re going to tear it down and build something even fancier than the Cowen homestead?
他们要把它租出去,还是把它拆掉,建造比考恩庄园更豪华的东西?
If they’re allowed to, they would build a much nicer structure.
如果允许的话,他们会建造一个更好的结构。
I won’t do that because I have to worry about where do I put my things in the meantime, and I’m focused on the short run.
我不会这样做,因为我必须担心同时把东西放在哪里,而且我专注于短期。
I’m not worried about it.
我并不担心。
My worry is that no one wants to buy my house, right?
我担心的是没有人愿意买我的房子,对吗?
That seems right.
看来是对的。
No, I certainly don’t worry about someone wanting to buy your house, whether it’s a company or an individual.
不,我当然不担心有人想买你的房子,无论是公司还是个人。
I just didn’t know if there was some externality in the back of your mind on this that I wasn’t aware of, but given that I’m not hearing any, I don’t know why I should worry about it.
我只是不知道你内心深处是否有一些我没有意识到的外部因素,但考虑到我没有听到任何外部因素,我不知道为什么我应该担心它。
Parking minimums — how much do they matter?
最低停车位 — 它们有多重要?
Maybe BlackRock wanted to put lots of sewage treatment plants in your area that were going to spew particulate things on your neighbors, and maybe we might want to have a policy controlling that.
也许贝莱德想在您所在的地区建立大量污水处理厂,这些处理厂会向您的邻居排放颗粒物,也许我们可能希望制定一项政策来控制这一点。
Some people say it’ll be a new housing bubble.
有人说这将是一个新的房地产泡沫。
Some, if it’s like the Airbnb complaints, that you have buyers who then rent, and there’s a positive externality from homeowners.
有些人,比如 Airbnb 的投诉,是有买家然后租房的,房主有积极的外部性。
That’s possible.
这是可能的。
I don’t dismiss those arguments.
我并不否认这些论点。
I’m not personally worried, but you’re the urban economist.
我个人并不担心,但你是城市经济学家。
I’m asking you.
我问你。
Can I proceed in my blind state of unworry?
我可以在盲目无忧的状态下继续前进吗?
The area where you hear this most is when you get the absentee buyers in places like Vancouver.
您最常听到这种说法的地方是当您在温哥华等地遇到缺席买家时。
That’s when you hear that.
那就是你听到的时候。
“You build these fancy towers .
“你建造这些奇特的塔楼。
.
。
.” It’s often used as an argument against new construction.
”。它经常被用作反对新建筑的论据。
“We built this sparkling new tower in Vancouver or New York, and it’s just being owned by Russian oligarchs who aren’t even there.”
“我们在温哥华或纽约建造了这座闪闪发光的新塔,但它的所有者却是根本不在那里的俄罗斯寡头。”
Now, I usually say in response to this, “If you tell me you’re selling a $50 million apartment to someone and they’re never there, and you’re unhappy about that, I’d tell you you’re not charging enough in property taxes.” Because by and large, you’ve just actually made a huge amount of money on property taxes and you’re not delivering any city services whatsoever.
现在,我通常会这样回答:“如果你告诉我你正在向某人出售一套价值 5000 万美元的公寓,而他们却根本不在那儿,而你对此并不满意,我会告诉你,你收取的财产税不够。”因为总的来说,你实际上只是在财产税上赚了一大笔钱,而且你没有提供任何城市服务。
So from the Tyler Cowen fear of extra infrastructure, it’s ideal because these guys don’t require anything because they’re never there.
因此,从泰勒·考恩 (Tyler Cowen) 对额外基础设施的恐惧来看,这是理想的,因为这些人不需要任何东西,因为他们从来不在那里。
There’s an old joke, by the way, in the real estate circle that one of Donald Trump’s clever ideas when he was a real estate developer — and I have no idea if there’s any truth in this — was that he figured out you needed fewer elevators when your owners, when your residents were mostly absentee, so you can actually reduce the cost on elevators.
顺便说一句,在房地产圈子里有一个老笑话,唐纳德·特朗普(Donald Trump)在担任房地产开发商时提出的一个聪明想法(我不知道这是否属实)是,他发现当你的业主、当你的居民大多缺席时,你需要更少的电梯,这样你实际上就可以降低电梯的成本。
Again, I have no idea if it’s true, but if so, it’s clever.
再说一遍,我不知道这是否属实,但如果是这样,那就很聪明了。
The one area which I do worry slightly about in the tall buildings that are unoccupied is — for someone who likes to make the case over and over again, the way to promote affordability is to allow more construction — an apartment building that has 10 apartments for oligarchs does nothing on that front.
在空置的高层建筑中,我确实有点担心的是 ——对于那些喜欢一遍又一遍地讲道理的人来说,提高负担能力的方法就是允许更多的建设—— 一栋拥有 10 套寡头公寓的公寓楼在这方面没有任何作用。
I still want it because I want to tax them.
我仍然想要它,因为我想对他们征税。
I want to use them to fund city services, but they’re not actually a solution for any affordability.
我想用它们来资助城市服务,但它们实际上并不是任何负担能力的解决方案。
Let’s say we abolished all parking minimums.
假设我们废除了所有停车最低标准。
How big would the gains be?
收益会有多大?
Are there potential problems from parking overflow?
停车位溢出是否存在潜在问题?
Not if you’re charging for the use of city streets, there isn’t.
如果您对城市街道的使用收费,则不会。
The problem is here, we’ve had some starting point, which we think people should have the right to park anywhere they want for no cost or for some severely subsidized amount.
问题就在这里,我们已经有了一些出发点,我们认为人们应该有权在他们想要的任何地方停车,而无需支付任何费用或获得一些严格的补贴。
In a world in which city space is scarce, you want to charge as much, if not more, for parking in a slot on the city streets as the person who has a structured parking lot charges for their space.
在城市空间稀缺的世界里,您希望对城市街道上的停车位收取与拥有结构化停车场的人一样多的停车费,甚至更多。
I think once you charge people for their space, there’s no reason to impose extra regulations on free parking.
我认为一旦你向人们收取停车位费用,就没有理由对免费停车施加额外的规定。
The overall quantity of social benefit, you’ve got to ask the great Don Shoup for that.
社会福利的总量,你得去问伟大的唐·舒普(Don Shoup)。
He’s the one who’s written the book on the high cost of free parking.
他写了一本关于免费停车费用高昂的书。
Let’s say it’s a suburban development.
假设这是一个郊区开发项目。
It’s Tysons Corner.
这是泰森斯角。
Someone wants to open some kind of big-box store, and you tell them, “You have to have X number of parking spaces because otherwise, people will park in front of homes.” Maybe there’s some abstract equilibrium where all parking is charged for, but practically speaking, that’s not going to happen, right?
有人想开一家大型商店,你告诉他们,“你必须有 X 个停车位,否则,人们会把车停在家门口。”也许存在某种抽象的平衡,即所有停车收费,但实际上,这不会发生,对吗?
I am not very worried.
我不太担心。
In fact, I don’t think big-box stores really need much of an incentive on this, as they seem to be pretty good at recognizing that their customers demand parking close by, and they seem to be pretty good at imposing it on their own.
事实上,我认为大型商店实际上并不需要太多的激励措施,因为他们似乎非常善于认识到客户需要在附近停车,而且他们似乎非常善于自行实施。
Yes, if you are repeatedly relying upon an action which inconveniences the neighbor, you might lean slightly against that, but it doesn’t feel to me like a huge first-order issue.
是的,如果你反复依赖给邻居带来不便的行为,你可能会稍微反对这一点,但对我来说,这并不是一个巨大的一阶问题。
Certainly, in city streets, yes, we really can charge everywhere.
当然,在城市街道上,是的,我们确实可以随处充电。
There’s really no reason why there should be a single block in Manhattan in which it’s free to park.
曼哈顿确实没有理由只存在一个可以免费停车的街区。
There’s no reason why you need that.
您没有理由需要它。
Some of your best-known and most cited pieces — they’re from the 1990s, and they’re on institutions and legal origins.
您的一些最著名和被引用次数最多的文章 ——它们来自 20 世纪 90 年代,并且涉及制度和法律起源。
Since that time, how have you changed or developed your mind on those issues compared to what you thought back then?
从那时起,与您当时的想法相比,您对这些问题的看法有何变化或发展?
I don’t know.
我不知道。
That stuff is 1999, 2001.
那是1999年、2001年的事。
I don’t know if they’ve changed a huge amount.
我不知道他们是否改变了很多。
I thought more just about cities per se.
我更多地考虑的是城市本身。
One of the mantras that I keep with me is, city government capacity is more important than policy.
我心中的口头禅之一是,市政府的能力比政策更重要。
As academics, we’re very big on what’s the right policy, but in fact, if you’ve got a mayor who has, at most, two people who will do anything that the mayor tells them to do, it doesn’t make any difference what policy you tell him or her because she’s not going to be able to get it done.
作为学者,我们非常看重什么是正确的政策,但事实上,如果你的市长最多有两个人会做市长告诉他们做的任何事情,那么你告诉他或她什么政策没有任何区别,因为她将无法完成它。
So understanding the institutional restraints that particular leaders have is a big deal.
因此,了解特定领导人所面临的制度限制是一件大事。
I spent a lot of the past five years, at least pre-COVID, worrying about cities in the developing world.
过去五年,至少在新冠疫情爆发之前,我花了很多时间担心发展中国家的城市。
Their institutions are quite important.
他们的机构非常重要。
I certainly have the view that cities are one of the places in which we actually get better institutions.
我当然认为城市是我们实际上拥有更好机构的地方之一。
One of the stories I tell in the new book is the urban fights of the 19th century to deal with contagious disease.
我在新书中讲述的故事之一是 19 世纪城市中应对传染病的斗争。
This was a moment in which urban, upper-middle-class civic leaders came together to fight for sewers, to fight for aqueducts.
在这个时刻,城市中上阶层的公民领袖聚集在一起,为下水道、渡槽而战。
In some sense, this is the moment in which governments stop, cease from being just an agent of death.
从某种意义上说,这是政府停止充当死亡代理人的时刻。
It’s a bit of an exaggeration to say governments pre-1800 were essentially only agents of death, but it’s only a small exaggeration to say that.
说 1800 年之前的政府本质上只是死亡的代理人有点夸张,但这样说也只是轻微的夸张。
Over the course of the 19th century, governments actually start doing some good, and most of it is involved in delivering sewers and fighting against contagious disease in cities, and developing the institutions that went along with that infrastructure was a big deal.
在 19 世纪的过程中,政府实际上开始做一些好事,其中大部分涉及城市中的下水道建设和抗击传染病,而发展与基础设施相配套的机构是一件大事。
If we look at, say, Latin America, maybe Curitiba, Monterrey would be some of the more successful cities.
如果我们看看拉丁美洲,也许库里蒂巴和蒙特雷会是一些更成功的城市。
You bet.
你打赌。
What is city success correlated with institutionally in Latin America?
拉丁美洲的城市成功与制度有何相关性?
I have rarely seen things that are good quantitative studies.
我很少看到好的定量研究的东西。
I can tell you things that I’ve certainly seen in Monterrey.
我可以告诉你我在蒙特雷亲眼所见的事情。
The Medellín story is amazing.
麦德林的故事令人惊叹。
If you think about Medellín going from the city of Pablo Escobar to today, a lot of it often has to do with relatively pragmatic business leaders who wanted a safe and competent public sector that could enable their business growth.
如果你想到麦德林从巴勃罗·埃斯科瓦尔市发展到现在,很大程度上往往与相对务实的商业领袖有关,他们希望有一个安全、有能力的公共部门来促进他们的业务增长。
I think that’s a lot of the Monterrey story.
我想这就是蒙特雷故事的大部分内容。
Monterrey also has a very empowered university that’s highly competitive as well, that I think partially a force for good.
蒙特雷还有一所实力雄厚、竞争激烈的大学,我认为这在一定程度上是一股向善的力量。
There’s a story that I’ve heard that I’ve never been able to independently confirm, but the role of the business community coming together to fight crime in Monterrey, to fight the gangs, which if true, is an amazing tale.
我听说过一个我一直无法独立证实的故事,但商界在蒙特雷联合起来打击犯罪、打击帮派所发挥的作用,如果这是真的,那是一个了不起的故事。
The business community played a role in terms of crime fighting in Colombia as well.
商业界在哥伦比亚的打击犯罪方面也发挥了作用。
Do you hold out any hope for charter cities like Próspera in Honduras?
您对洪都拉斯普罗斯佩拉这样的特许城市抱有希望吗?
Can that work, or is it futile?
这能行吗,还是没用?
I think it’s very hard for governments to keep their hands off the golden egg.
我认为政府很难不去碰金蛋。
The beauty of Hong Kong was it had the British Navy protecting it for most of its history, so there was no way that China or anyone else was going to grab it.
香港的美妙之处在于,它在其历史的大部分时间里都受到英国海军的保护,因此中国或其他任何人都无法夺取它。
But it’s very, very hard.
但这非常非常困难。
I think that the story in Honduras shows that, that it’s very, very hard for a country to say, “Oh, we’re going to have this different jurisdiction run the city, and it’s going to be much more successful than the rest of the country, and we’re going to think that that’s okay.” It’s just very hard to see how the populist political dynamics don’t cause it to become unraveled.
我认为洪都拉斯的故事表明,一个国家很难说,“哦,我们将让这个不同的管辖区来管理这座城市,它会比该国其他地区更成功,我们会认为那没关系。”很难想象民粹主义政治动态不会导致它瓦解。
It worked for UAE.
它对阿联酋有效。
Dubai is massively successful.
迪拜取得了巨大成功。
UAE allows it to continue.
阿联酋允许其继续下去。
That’s all quite —
这一切都相当 ——
Yes, but the rest of UAE is incredibly rich, too.
是的,但阿联酋其他地区也非常富有。
I don’t think generalizing from UAE is very easy, Tyler.
泰勒,我认为从阿联酋进行概括并不容易。
It’s not wealthy only because of oil.
它不仅仅因为石油而富有。
It’s a banking center, service center.
这是一个银行中心、服务中心。
Someone let that happen.
有人让这种事发生了。
UAE could have gone much worse under our normal rent-seeking institutionalist story, and it didn’t.
在我们正常的寻租制度主义故事下,阿联酋的情况可能会变得更糟,但事实并非如此。
So, if there’s hope for UAE, is there hope for charter cities?
那么,如果阿联酋有希望,那么特许城市也有希望吗?
Or is there some difference that makes one more plausible than the other?
或者是否存在某种差异使得其中一个比另一个更可信?
There is always hope, but everything is easier if you have trillions and trillions of dollars in oil wealth.
希望总是存在的,但如果你拥有数万亿美元的石油财富,一切都会变得更容易。
But it’s also harder, right?
但这也更难,对吧?
There’s a resource curse.
有一个资源诅咒。
If you’re not Norway, the resource curse seems like a negative.
如果你不是挪威,资源诅咒似乎是负面的。
My view is the resource curse tends to be in the intermediate levels, that once you have just an unbelievable amount of it, it tends to be much less of an actual resource curse.
我的观点是,资源诅咒往往处于中间水平,一旦你拥有令人难以置信的数量,它往往就不是真正的资源诅咒。
Will there be a new major American city started in this century?
本世纪会出现一个新的美国主要城市吗?
Assuredly, but I have no idea where.
当然可以,但我不知道在哪里。
Let’s say you’re investing.
假设您正在投资。
Where would you put your money?
你会把钱放在哪里?
I think there’s a lot to like in the highly educated pro-business cities of the South.
我认为南方受过高等教育的亲商城市有很多值得喜欢的地方。
Traditionally, this was Austin.
传统上,这里是奥斯汀。
Again, I worry about NIMBYists in Austin, but I think the place to combine education .
我再次担心奥斯汀的邻避主义者,但我认为这是一个将教育结合起来的地方。
.
。
.
。
Atlanta is about as well educated as Boston is, but on the other hand, they just have a very different atmosphere towards free enterprise than Boston does.
亚特兰大的教育程度与波士顿差不多,但另一方面,他们对自由企业的氛围与波士顿截然不同。
Those are the things that I think of as being really powerful.
这些是我认为真正强大的东西。
Because they’ve embraced a certain amount of economic freedom, they make it a lot easier for people to buy housing.
因为他们接受了一定程度的经济自由,所以他们让人们更容易购买住房。
I basically have a two-factor model of economic growth, Tyler.
我基本上有一个经济增长的双因素模型,泰勒。
My model is always, it’s about education, and it’s about institutions that are relatively pro-free market, relatively pro-business.
我的模式始终是,与教育有关,与相对支持自由市场、相对支持商业的机构有关。
Can Miami become a tech hub?
迈阿密能成为科技中心吗?
They have a bunch of schools; you might say none are quite top-notch.
他们有很多学校;你可能会说没有一个是一流的。
Sympathetic mayor, right?
市长很有同情心吧?
Sure.
当然。
It’s certainly possible.
这当然是可能的。
There appear to be certain weather issues with Miami, which I’m not going to have any strong views on…
迈阿密似乎存在某些天气问题,我不会对此有任何强烈的看法......
There are earthquakes in San Francisco.
旧金山发生地震。
They’re surrounded by raging fires.
他们被熊熊大火包围。
They’re in a desert.
他们在沙漠里。
The Colorado River is problematic.
科罗拉多河有问题。
So why not be more bullish on Miami?
那么为什么不更加看好迈阿密呢?
It’s not my business to predict the climate, but yes, there’s a lot to like about being this connected to all of Latin America.
预测气候不是我的事,但是,是的,与整个拉丁美洲的联系有很多值得高兴的地方。
Of course, but you don’t sound onboard.
当然可以,但你听起来并不认同。
I don’t think at all it’s impossible.
我认为这根本不是不可能的。
I’m just resisting the urge to be confident about this.
我只是抵制对此充满信心的冲动。
Putting aside Boston and Cambridge, which are doing great, what can the rest of New England do to stay vibrant?
撇开表现出色的波士顿和剑桥不谈,新英格兰其他地区可以做些什么来保持活力呢?
Same mantra as everyplace else.
和其他地方一样的咒语。
Attract and train smart people and get out of their way.
吸引和培训聪明人,并为他们让路。
Won’t they just leave for Boston and Cambridge?
他们不会直接去波士顿和剑桥吗?
No. Anyway, the pandemic has been good for low density in New England in terms of quality of life.
不。无论如何,就生活质量而言,这场大流行有利于新英格兰低密度地区的生活。
You need a little bit less regulation and lots of spaces.
你需要更少的监管和更多的空间。
You need to make it easier to make fun in these areas, to be an entrepreneur of entertainment, which means starting restaurants, bars, food trucks, et cetera.
你需要让在这些领域更容易获得乐趣,成为一名娱乐企业家,这意味着开办餐馆、酒吧、餐车等等。
It’s hard, the further you get north.
越往北走,越难。
The climate is again holding detriment in parts of Maine or parts of northern New Hampshire, but I think most of New England is doing pretty well.
缅因州部分地区或新罕布什尔州北部部分地区的气候再次受到损害,但我认为新英格兰大部分地区的情况还不错。
Now we’re almost out of time, but two closing questions, and this one I asked David also.
现在我们快没时间了,还有两个结束语,这个问题我也问过大卫。
If you take your book with him, Survival of the City: Living and Thriving in an Age of Isolation, I’m not necessarily looking for a disagreement, though that would be okay, but an area where you and he still see things differently — in the book, from the book.
如果你带着你的书《城市的生存:孤立时代的生存与繁荣》,我不一定是在寻找分歧,尽管那没关系,但在一个领域,你和他仍然以不同的方式看待事物——在书中,与书中。
What would that be?
那会是什么?
He has still not convinced me on single payer healthcare.
他仍然没有说服我接受单一付款人医疗保健。
We do not say anything about that, deliberately, so that’s an area we certainly had not yet come eye to eye.
我们故意没有对此发表任何言论,因此我们在这个领域当然还没有达成共识。
I should say he’s a great expert on this, and I’m not, so I’m not trying to convince anyone that he’s wrong.
我应该说他是这方面的伟大专家,而我不是,所以我不想让任何人相信他错了。
I’m just saying that in 30 years of friendship, he has not yet persuaded me on this.
我只是说,在30年的友谊中,他还没有在这一点上说服我。
I don’t know if we actually differ on the weight that we would put on security versus respect of the policing.
我不知道我们在安全与尊重警务方面的权重是否真的存在分歧。
I’m not totally sure about that.
我对此不太确定。
I’m not sure that he’s onboard for a bit of my gung-ho “let’s permit every new business that we can.”
我不确定他是否会同意我的“让我们尽可能允许每一项新业务”的热情。
Let me take this — in our work on obesity and our work on opioids, I am still less comfortable with the view that you’re going to have paternalistic policies that really push people to be thinner than they currently are.
让我接受这一点——在我们关于肥胖的工作和关于阿片类药物的工作中,我仍然对这样一种观点感到不太舒服:家长式政策确实会促使人们比现在更瘦。
I am never going to be as comfortable with that, despite the fact that I agree strongly that America and obesity is one of the health problems that made COVID so difficult here.
尽管我强烈同意美国和肥胖是导致新冠疫情如此困难的健康问题之一,但我永远不会对此感到满意。
Last question — what will you be doing next?
最后一个问题 — 你接下来要做什么?
I am going to be serving as the chair of my department and enjoying all the fun of administrative meetings on end for the next three years.
我将担任我所在部门的主席,并在接下来的三年里享受连续不断的行政会议的所有乐趣。
Ed Glaeser, thank you very much.
艾德·格莱泽,非常感谢你。
Again, Ed’s book with David Cutler: Survival of the City: Living and Thriving in an Age of Isolation.
再次,埃德与大卫·卡特勒合着的书:城市的生存:孤立时代的生活和繁荣。
Thank you so much for doing this, Tyler.
非常感谢你这么做,泰勒。
Very much appreciate it.
非常感谢。
Photo credit: Briana Moore
照片来源:布莱恩娜·摩尔