Does Costco Cause Cancer?

By Alex Tabarrok.

"In December 2025, researchers led by Yazan Alwadi at Harvard’s T.H. Chan School of Public Health published a paper in Environmental Health that claimed to find that cancer incidence increased for people living closer to nuclear power plants in Massachusetts. In March, the same researchers published an expanded nationwide study claiming a similar result—this time looking at cancer mortality rates, rather than incidence—in Nature Communications. This was followed by a paper in the Journal of Exposure Science & Environmental Epidemiology that looked at associations of lung, breast, and colon cancers. Most recently, a study of total mortality, not just cancer, was published in the European journal Environmental Epidemiology.

The problem? Using the same methods pretty much everything causes cancer. An amazing takedown from Deric Tilson and Adam Stein:

For instance, living near a private four-year university is associated with a 15-fold increase in cancer mortality when compared to living near a nuclear power plant.

Costco has the largest effect of all the locations we have tested. Over 2.2 million cancer deaths can be attributed to Costco; that’s more than 20% of all cancer deaths between 2000 and 2018. Hot dogs, bulk spices, and reasonably priced clothes come with a cost.

What went wrong?

[The authors] chose nuclear power plants because a story could be built around that framework. When the researchers got positive results across our nation’s nuclear power plants, they didn’t check what their shiny new methodology would do using other landmarks. This is their pitfall: by taking the easy way out—getting results and making up a story around those results without double-checking their method—the authors could have no idea that what they were actually capturing was the methodology itself.

…The attributable number of deaths from this methodology is probably zero, but the attributable number of bad papers is at least four."

Here are two more excerpts from the Deric Tilson and Adam Stein paper:

"But proximity is not exposure. We have methods of measuring exposure for nuclear power plant workers. While the radiation exposure of nuclear workers will always be greater than or equal to that received by the surrounding public, most of the closely monitored US nuclear workforce receive no measurable annual dose. When workers are exposed to radiation, the average dose received is only 2 percent of the occupational limit. If operators and workers who are on-site at nuclear power plants receive an annual dose between zero and one-fiftieth of the occupational limit, how is it possible that residents 5, 10, 25, 50, 120, or 200 kilometers away would receive any measurable dose from the same plant?"

"In our original rebuttal, we remarked that the studies can’t prove their assertions because they lacked proper control. It seems they also neglected to do any placebo testing. They chose nuclear power plants because a story could be built around that framework. When the researchers got positive results across our nation’s nuclear power plants, they didn’t check what their shiny new methodology would do using other landmarks. This is their pitfall: by taking the easy way out—getting results and making up a story around those results without double-checking their method—the authors could have no idea that what they were actually capturing was the methodology itself. In our replication and expansion, we have shown that choosing a number of sites and landmarks from capitals to warehouse stores can all yield a positive result without any reasonable pathway for American citizens to become exposed to radiation, develop cancer, and then die. The variations are random noise, all sloping in a positive direction. Even when using randomized outcomes, the methodology outputs positive results.

The papers by Alwadi et al. don’t show a novel mechanism by which nuclear power plants meaningfully contribute to cancer mortality; instead, they show an association of data points across 400 km-wide circles. 48,519 square miles, about the size of Mississippi, is a massive area to claim any kind of exposure. Most studies measuring distance-based exposures look at much smaller distances, such as under 10 km (an area of 113 square miles). The methodology is blind, which can be a feature in research areas needing to avoid bias, but in this case it is a bug; it doesn’t understand radiation exposure or dose. All it understands are its inputs: coordinates, proximity, covariates, and cancer deaths. From these, it can give you a number and even a positive result, but it cannot explain why that result exists. It is still an ecological study, one with a sophisticated statistical technique, but not a very useful one."

Justin Wolfers Recognizes His "Libertarian Friends Were Right" About Government Power

Wolfers is the latest of several prominent left-liberals to make similar admissions.

By Ilya Somin. 

"In a recent post, prominent left-liberal economist Justin Wolfers (University of Michigan) concedes that his "libertarian friends" were right about the dangers of government power:

My libertarian-leaning friends have consistently argued against a powerful federal government in favor of individual freedoms. I had — somewhat naively — never taken their views seriously enough. My friends who worked in government were good people, I reasoned, and surely that's true more broadly.

But I've had to admit to my libertarian friends that they were right. Concentration of power can be abused. We're seeing it happen right now.

Last year, I wrote about similar admissions by two other prominent left-of-center figures: famed legal scholar Cass Sunstein and economic policy commentator Noah Smith. I commend Wolfers and the others for being willing to admit error and learn from it. All too many intellectuals and political commentators never do. I am a longtime fan of Wolfers' writings, and now am even more of a fan than before.

It is often the case that people become more aware of the dangers of government power when that authority is wielded by their political opponents. Even some libertarians tend to ignore or overlook abuses of power when perpetrated by the side of the political spectrum they identify with. The Trump era has been a particularly significant wake-up call for some on the left, because he has engaged in so many abuses, especially in his second term.

But it is important to recognize that the problems here are systematic, not confined to the misdeeds of any one politician, even one so egregious as Trump. As James Madison famously warned, "[e]nlightened statesmen will not always be at the helm." Distinctly unenlightened demagogues like Trump all too often reach high political office. That's in large part because voters often do a poor job of choosing leaders, thanks to widespread political ignorance and bias. Trump's return to power in 2024 showed that these problems are even more severe than I had previously thought.

Wolfers adds that his newfound appreciation for libertarian concerns have made him "more small-c conservative":

The old conservative idea was that we have rules of the game that have served us well for generations. We should be slow to change them. Our children should be handed the same set of opportunities we had, if not better ones.

I only partially agree. Where established institutions constrain government power and protect liberty, we should indeed conserve them. But, in too many ways, those safeguards have been eroded over the last 100 years or more, thereby creating the very dangers of abusive government power that Wolfers rightly decries. To fix that, we in some instances need to restructure the current "rules of the game," and impose much tighter constraints. For example, we should roll back federal power to impose immigration restrictions (which was not part of the original Constitution), and have much stronger enforcement of constitutional constraints on delegation of legislative power to the executive. The growth of delegation and federal immigration powers is at the heart of the many of the worst abuses of the Trump Administration, and creates severe problems even under more conventional administrations.

Similarly, the growth and institutionalization of government control over land use is at the heart of the housing crisis that besets many parts of the US. We should roll that back too, in part by enforcing federal and state constitutional protections for property rights.

Elsewhere, I have explained how these issues and others like them can be the basis of a useful alliance between libertarians and "abundance liberals" (see also my exchange with Matt Yglesias on that subject). I suspect Wolfers may be sympathetic to the abundance liberal movement.

We're not likely to agree on every issue. But there is enough consensus to enable some useful cooperation between these groups. At the very least, we have common enemies in the form of two prominent political movements that very much don't appreciate the need for significant constraints on government power: MAGA nationalists on the right, and "democratic socialists" on the left." 

The Limited Efficacy of Social Media Bans for Teens

From Jeffrey Miron.

"The Jonathan Haidt-pilled among us shouldn’t celebrate Australia’s social media ban for teens just yet.

New evidence suggests that the ban has neither gotten teens off social media nor changed the culture around its use.

The ban

imposed few practical costs on teenagers who wanted to continue using social media: 75 percent described circumventing the restrictions as easy or very easy. … Among teenagers still using banned platforms, 52 percent gave a social reason, most often that their friends were still on the platforms or that they feared missing out.

The collective action problem remains and

the existing adherence rate may not last. On average, affected teenagers said that roughly two-thirds of their peers would have to adhere before they would adhere themselves. Yet they believed that only about 30 percent of their peers were adhering, close to our estimated rate of 27 percent. … Unless enforcement or social norms changed, we therefore expected adherence to decrease rather than increase.

Alternative

approaches include coordinated time limits, … campaigns that make nonuse visible and socially rewarded, incentives for reduced social media use, and organized activities that replace time and interaction lost online.

Of course, teens will likely find reasons and ways to circumvent these policies as well."

Billionaires are consistent with the institutions that underlie economic prosperity.

See Billionaires by Tino Sanandaji & Peter T. Leeson.

"Existing studies of entrepreneurship focus on entrepreneurs whose individual contribution to wealth creation is typically trivial: self-employed persons. This article investigates entrepreneurs whose individual contribution to wealth creation is enormous: billionaires. We explore the relationship between economic development, institutions, and these contrasting kinds of entrepreneurs. We find that the institutions consistent with self-employed entrepreneurs differ markedly from the ones consistent with billionaires. Further, only the latter are consistent with the institutions that underlie economic prosperity. Where well-protected private property rights and supporting, market-enhancing institutions flourish, so do billionaires. But self-employed entrepreneurs do not. Where private property rights are weakly protected and interventionist institutions flourish, so do self-employed entrepreneurs. But billionaires do not."

Public Sector Unions Undermine Accountability

Research on schools, policing, and government spending is clear: public sector bargaining forces taxpayers to finance the erosion of their rights.

By Jason Sorens of AIER. 

"This November, Vermont will vote on Proposal 3, a legislatively referred constitutional amendment to entrench collective bargaining rights in the state’s constitution. If it passes, the Vermont legislature would be barred from adopting any law that “interferes with, negates, or diminishes the right of employees to collectively bargain with respect to wages, hours, and other terms and conditions of employment and workplace safety.” 

The most immediate impacts of Proposal 3, if it passes, would be to authorize unionization for farmworkers and supervisors, the two categories of employees currently exempt from collective bargaining under state and federal law, and to effectively end the ability of the legislature to limit the scope and terms of public sector collective bargaining. The latter change is an especially big problem, because a growing body of evidence demonstrates that public sector collective bargaining undermines accountability to taxpayers and users of public services.

Take public education. Teachers unions exist to promote the interests of teachers, not students, and their activities have damaged school performance and raised costs for taxpayers. Sophisticated empirical studies have repeatedly confirmed these findings.

Stanford economist Caroline Hoxby used state “duty-to-bargain” laws as an instrument to predict the timing and geographic scope of collective bargaining in K-12 education. She found that collective bargaining increased per-student spending but also increased the high school dropout rate, especially in places where there is less competition among public schools.

Political scientist Terry Moe examined “restrictive” collective bargaining contracts in California and found sharply negative effects on student test scores in larger districts. The negative effects on performance were most pronounced for minority students. “Restrictive” contracts are ones that provide due-process protections against firing bad teachers, limit the role of merit rather than seniority in determining assignments, promotions, and layoffs, and cap work and training hours.

A recent national study of the effects of duty-to-bargain laws in the prestigious American Economic Journal: Economic Policy found that the laws had long-term harmful effects on the labor-market success of men who were students at the time that these policies were enacted, with total negative effects on earnings of more than $200 billion every year.

It’s important to acknowledge that one of the authors of that study previously found null effects of union certification elections in Iowa, Indiana, and Minnesota on per-student spending and dropout rates. It could be that effects differ across states or in the long run versus the short run. That’s the reason why social scientists say “read literatures, not papers.” The overall evidence on public sector unionization is firmly negative.

In general, unionization in public schools seems to reduce accountability to parents. School district unionization rates predicted longer school closures during the COVID pandemic, resulting in massive and possibly irreversible learning loss. More unionized schools were less likely to require teachers to teach in person during the pandemic. Stronger unions are associated with fewer effective literacy programs — though this relationship is a rough correlation, not a sophisticated study.

Public safety is another area where collective bargaining has proven harmful. Union contracts frequently shield police from legitimate accountability. Collective bargaining contracts include “delay privileges” that require investigators to wait a certain period before interviewing a police officer who engaged in the use of force. These delay privileges obstruct investigations, reduce the odds that officers face internal discipline, and normalize the excessive use of force.

According to a survey by law professor Stephen Rushin, a whopping 88 percent of police union contracts contain at least one provision that could thwart legitimate disciplinary action, such as mandatory destruction of disciplinary records, bans on civilian oversight, prohibitions on anonymous civilian complaints, and time limits on internal investigations.

Collective bargaining rights increase police misconduct. That’s the conclusion of an empirical study that leveraged a 2003 Florida Supreme Court decision expanding collective bargaining to sheriffs’ deputies. After the change, there was a substantial increase in reports of “violent misconduct” by sheriffs’ offices relative to police departments.

The negative consequences of collective bargaining for the taxpayer are also evident in police and firefighter contracts, according to a causally identified study in the ILR Review. Collective bargaining substantially increases firefighter pay and more modestly increases police pay and reduces their workweek. A well-designed synthetic control analysis published by the Heritage Foundation found that collective bargaining increases the cost of government on average across the US by about $600 to $750 per person per year.

Why are public sector unions so harmful? The biggest reason is that unions are often on both sides of the negotiating table. They fund politicians’ campaigns and lobby them for favorable legislation. In low-turnout local elections, they can be the dominant force. So it’s no surprise that local elected officials give the unions exactly what they want.

The science is clear: public sector unions are bad for taxpayers and the people they are supposed to be serving and protecting. Abolishing public sector collective bargaining is necessary to make government a servant of the people, rather than its master."

Eliminating Corporate Subsidies in Canada: An Opportunity to Boost Growth

By Alex Whalen and Milagros Palacios.  

Though widely used in Canada, economic literature suggests corporate subsidies are a wasteful use of taxpayer dollars that do not boost economic growth.

Subsidies are often unfair to businesses that do not receive them, and substitute the government’s judgment for consumers’ judgment, rewarding firms that create value for politicians rather than those that create value for consumers.

Federal and provincial spending on corporate subsidies has increased substantially over time, with a marked increase beginning in 2015. Between 2007 and 2015, spending on subsidies increased from $22.2 billion to $25.1 billion (inflation-adjusted), or 12.8 percent. From 2015 until 2019, spending increased more rapidly, such that the 2019 level was 44.2 percent more than in 2015. After the pandemic, spending on corporate subsidies increased in 2022, 2023, and 2024. The inflation-adjusted level of spending in 2024 stood at $87.7 billion, more than triple the level observed in 2015.

Even when accounting for both inflation and population, spending on subsidies has increased in every province and at the federal level between 2015 and 2024.

The increased spending on corporate subsidies has occurred in Canada during a period of economic stagnation and renewed interest in policies that can drive economic growth.

Governments in Canada have an opportunity to substantially boost economic growth by eliminating corporate subsidies and directing the savings to broad-based business tax relief.

Medicare for All—with No New Taxes?

By John C. Goodman.

"Democratic candidates and activists appear all-in on “Medicare for All.”

Many supporters of the idea envision a nationwide universal healthcare system that would be financed primarily by increasing taxes on the super-rich. A recent Echelon Insights poll, for example, found that 74% of voters who support Medicare for All believe it could be financed entirely by raising taxes on billionaires.

This is a pipe dream. No country in the world makes health care universally free, paid solely by their wealthiest taxpayers.

The latest Medicare Trustees Report predicts that Medicare’s Part A Trust Fund (hospital insurance) will be exhausted in 2033. Part of the reason is that premiums paid by Medicare enrollees cover only about 14% of the program’s cost. If the rest of the country could join by paying only 14 cents on the dollar, Medicare would go bankrupt overnight.

Although most of what is being said about Medicare for All borders on being silly, Nobel prize-winning economist Paul Krugman has a proposal that is worth serious attention.

Krugman would let everybody voluntarily enroll in Medicare. But, they (and their employers) would have to pay actuarially fair premiums, equal to the average expected cost of their health care. So, there is no free lunch here and no need for additional taxes.

Why would people choose this option? Because Medicare is less costly than private alternatives for the same services. According to the RAND Corporation, private payers (employers and commercial insurers) are paying about 2½ times what Medicare pays for inpatient hospital care. For outpatient care the difference is nearly three times greater. So, in theory, the Medicare premiums people would pay would be substantially lower than what they’re now paying for private health insurance.

Krugman implies that we could all get the same health care for a lot less money. But would we?

Right now, Medicare accounts for 25% of hospital revenues and private insurance and private payers account for 38%, according to the Centers for Medicare & Medicaid Services’ National Health Expenditure Data.

Suppose all the people currently in private sector plans joined Medicare and got their care at Medicare rates. What would happen?

Krugman admits he doesn’t know a lot about health-care economics. But any run-of-the-mill economist, much less a Nobel laureate, should know that if you take 38% of an organization’s revenues and reduce it by as much as two thirds, something is going to change.

Studies show that when hospitals suffer large reductions in their revenues they reduce staff, halt capital spending, provide fewer services and even close down altogether. As a result, we would experience less hospital care and rationing by waiting—perhaps as bad as what we see in Britain and Canada.

There also are other likely changes.

In principle, hospitals compete on three dimensions: price, quality and amenities. In India, which has the freest hospital marketplace in the world, hospitals compete on all three. According to a study published in the journal, Health Policy and Planning, patients know the price of procedures for nonurgent care in advance. Apollo Hospitals (a large hospital chain) publishes their quality measures: mortality rates, readmission rates, and infection rates, for example.

As I showed in Health Affairs, in our highly regulated, bureaucratic system, hospitals do not compete on price or on quality. That leaves amenities.  If you cut American hospital revenues, there will be fewer of them.

When Americans enter a hospital, they normally expect a private room. By contrast, in a typical hospital in the British National Health Service (where the government pays all the costs), most beds are in multi-bed bays, commonly 4–6 patients per bay. Moreover, the few private rooms that are available are normally allocated for medical reasons (such as avoiding infections) and not out of respect for patient privacy.

Canada has a two-tier system, in which patients have to pay out of pocket for privacy. For example, London Health Sciences Centre in Ontario describes its standard accommodation as a four-bed room. A patient can request a semi-private or private room if they pay extra.

Another amenity is food. In Britain and in Canada hospital patients receive what Americans would regard as traditional “hospital food,” delivered on a rigid schedule.

Many American hospitals, by contrast, offer made-to-order meals, served at the patient’s request (hotel-style ordering) and even gourmet menus. Overall, American hospitals spend six times as much on food service as Canadian hospitals ($129.65 per patient day versus $21.38).

Under Krugman’s proposal people might pay less. But they also would get less."