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ARPA-H awards Columbia researchers nearly $39M to develop a living knee replacement

A team of researchers from Columbia University Irving Medical Center (CUIMC) and Columbia Engineering has been awarded up to a $38.95 million contract…

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A team of researchers from Columbia University Irving Medical Center (CUIMC) and Columbia Engineering has been awarded up to a $38.95 million contract from the Advanced Research Projects Agency for Health (ARPA-H) to build a living knee replacement from biomaterials and human stem cells, including a patient’s own cells. ARPA-H is a federal funding agency that funds transformative biomedical and health research breakthroughs, rapidly translating research from the lab to applications in the marketplace. 

Credit: ARPA-H

A team of researchers from Columbia University Irving Medical Center (CUIMC) and Columbia Engineering has been awarded up to a $38.95 million contract from the Advanced Research Projects Agency for Health (ARPA-H) to build a living knee replacement from biomaterials and human stem cells, including a patient’s own cells. ARPA-H is a federal funding agency that funds transformative biomedical and health research breakthroughs, rapidly translating research from the lab to applications in the marketplace. 

The Award

The award, part of the ARPA-H’s Novel Innovations for Tissue Regeneration in Osteoarthritis (NITRO) program, will support the development of NOVAJoint, a revolutionary biocompatible, low-cost, patient-specific knee joint replacement. This high-risk project builds upon more than two decades of collaborative musculoskeletal research at Columbia in engineering and medicine, and promises to offer a transformative solution for the more than thirty million people in the U.S. who suffer from osteoarthritis. NITRO is the first Health Science Futures specific program under the new ARPA-H agency, established by the Biden Administration.

The project is led by Clark T. Hung, Professor and Vice Chair of the Department of Biomedical Engineering and Professor of Orthopedic Science (in Orthopedic Surgery) at Columbia Engineering, and Nadeen O. Chahine, Associate Professor of Biomedical Engineering in the Department of Orthopedic Surgery at Columbia University Vagelos College of Physicians and Surgeons, leaders in tissue regeneration and orthopedic research.

“ARPA-H is a hugely important endeavor that could bring about a breakthrough in personalized and patient-specific solutions,” said Shih-Fu Chang, Dean of Columbia Engineering. “As society seeks to address the challenge of population aging, such collaborative approaches combining engineering and medicine will help improve conditions for those with osteoarthritis and many other musculoskeletal conditions.”

“We saw during the COVID pandemic just how fast science can move when teams of researchers are given the support and resources to work together,” said Katrina Armstrong, Dean of the Faculties of Health Sciences and the Vagelos College of Physicians and Surgeons, and Executive Vice President for Health and Biomedical Sciences, Columbia University. “By focusing Columbia’s expertise in biomedical engineering and orthopedic surgery onto a single goal, this funding from ARPA-H has the potential to rapidly revolutionize the way we treat osteoarthritis and the way we do biomedical research in the future.” 

Impact of Osteoarthritis

Osteoarthritis is a degenerative joint disease that is the most common type of arthritis. It gradually worsens over time as cartilage, the specialized connective tissue that covers the ends of bones, wears down, leading to pain, stiffness, and loss of mobility. Osteoarthritis is already the third most common type of disability and has an estimated economic burden of more than $136 billion per year. It disproportionately affects women, the elderly, certain racial/ethnic minorities, and those with lower socioeconomic status. The prevalence of knee osteoarthritis has been rising due to aging of the population, increasing rates of joint injury, and, significantly, obesity.

The clinical gold standard treatment for knee joints ravaged by pervasive OA or traumatic injury is a total joint replacement using prosthetic implants made of metal and plastic. Although knee replacement is widely successful, there are some major drawbacks to these conventional materials. There can be life-changing complications and limitations of current artificial knee replacements, including infection, loosening, hardware failure, stiffness, abnormal kinematics (i.e., the way a knee moves), instability, and persistent pain. Historically, knee replacements have had a limited lifespan with a portion failing at 15 to 20 years due to plastic wear or implant loosening. This means that younger patients may need one or even two revision implants. The demand for total knee replacements is projected to grow by 673% — 3.48 million procedures from 2005 to 2030 — with total knee revisions projected to grow 601% between 2005 to 2030. 

NOVAJoint — a living solution to ravaged knees

With the ARPA-H award, the researchers propose to design NOVAJoint to address the urgent, unmet clinical need for a permanent solution for patients with advanced OA where a conventional knee replacement is indicated. The project’s goal is to develop a replacement knee of regenerated living cartilage and bone that integrates seamlessly with the native bone and restores pain-free joint function. Since cells are required to regenerate and maintain this living implant, the team will create two versions of NOVAJoint: a version that uses patient’s own cells and one that uses donor cells. The researchers expect NOVAJoint to substantially extend the implant life, reducing complications, and to become a permanent and final procedure for the treatment of osteoarthritis of the knee.  With an aggressive timeline, in the first two years, the team will create the first prototypes before moving into preclinical and clinical studies in the final three years, including a Phase 1 safety clinical trial in the final year.

Though the first NOVAJoint is still in development, many of the technologies and scientific discoveries necessary to create the joint have already been developed and validated by Columbia researchers through funding from the National Institutes of Health, National Science Foundation, Department of Defense, and institutional support.

“The ARPA-H NITRO program has enabled us to leverage our innovative technologies and expertise to solve one of the most difficult challenges in biomedical engineering,” said Hung, a groundbreaking researcher in musculoskeletal regeneration.

The Collaborators

The NOVAJoint team will fabricate a living knee replacement using modern manufacturing techniques and capitalizes on the critical mass of musculoskeletal researchers at Columbia with collective expertise in biomechanics, biomaterials, stem cells, and orthopedic surgery from across the School of Engineering and Applied Science, Vagelos College of Physicians and Surgeons and College of Dental Medicine, building on a decades-long history of collaboration between the Departments of Orthopedic Surgery and Biomedical Engineering. The project team is multidisciplinary, with scientific leadership from faculty in the Departments of Biomedical Engineering, Mechanical Engineering, Orthopedic Surgery, and Dental Medicine. Co-PIs and Task Leads include Treena Arinzeh, Professor of Biomedical Engineering; Gerard Ateshian, Andrew Walz Professor of Mechanical Engineering and Professor of Biomedical Engineering;  Alice Huang, Associate Professor of Bioengineering (in Orthopedic Surgery); and Roshan Shah, Russell A. Hibbs Associate Professor of Orthopedics (in Orthopedic Surgery) and Director of Complex Reconstruction; Chang Lee, Associate Professor of Craniofacial Engineering (in Dental Medicine).

Working with the Columbia team is James L. Cook, William & Kathryn Allen Distinguished Chair in Orthopaedic Surgery, University of Missouri, who will lead preclinical testing. Drs. Cook and Shah will also lead the clinical trial, which will be recruiting patients at both universities. The team is partnering with New York Stem Cell Foundation and New York Blood Center for GMP manufacturing of NOVAJoint.

“This is a big challenge, but by creating a large and experienced team that works well together and can be focused on one goal, we expect to succeed,” said Chahine, a leader in orthopedic research. “NOVAJoint will mark a major milestone in the field of regenerative medicine and orthopedic surgery, and has the potential to revolutionize musculoskeletal treatments of the many joints that degenerate with age or injury.”

Equity and Commercialization

In addition to the advancement in science, equity and commercialization are key pillars to the programmatic success of this project. Part of NITRO’s vision is to establish a clear path to commercialization, which is a prerequisite for successful clinical translation and impact of disruptive technologies such as NOVAJoint. ARPA-H has a firm commitment to equitable healthcare access for all, irrespective of race, ethnicity, gender/gender identity, sexual orientation, disability, geography, employment, insurance, and socioeconomic status.

“Our goal is to push knee replacement to its next stage of evolution and to create a better solution to osteoarthritis for all Americans. Every day patients ask me about new advancements in knee replacement surgery, hoping for validation of their years of suffering before seeking care,” says Dr. Shah.  “Now I have something to tell them. I think the big orthopedic companies will be watching this project closely, and will be vying for the chance to commercialize NOVAJoint nationally.”

In order to meet these programmatic goals, the team will also be leveraging the expertise and resources of the Irving Institute for Clinical and Translational Research and Columbia Technology Ventures. The NOVAJoint team will include a full-time Equity Officer who will help develop key equity performance indicators. The equity officer will work closely with Rachel C. Shelton, Associate Professor of Sociomedical Sciences at Mailman School of Public Health and co-director of the Irving Institute’s Community Engagement Core Resource (CECR) and Lisa Royse, Department of Orthopedic Surgery, University of Missouri, to foster research conducted in partnership with community stakeholders to better inform the application of scientific findings to clinical and community settings.

The Research Team

The scientific and clinical faculty at Columbia include:

  • Clark Hung, Professor of Biomedical Engineering and Orthopedic Sciences (in Orthopedic Surgery)
  • Gerard Ateshian, Andrew Walz Professor of Mechanical Engineering and Professor of Biomedical Engineering
  • Nadeen Chahine, Associate Professor of Biomedical Engineering (in Orthopedic Surgery)
  • Alice Huang, Associate Professor of Bioengineering (in Orthopedic Surgery)
  • Treena Arinzeh, Professor of Biomedical Engineering
  • Chang Lee, Associate Professor of Craniofacial Engineering (in Dental Medicine) 
  • Roshan Shah, Russell A. Hibbs Associate Professor and Director of Complex Reconstruction at Columbia University
  • Kam Leong, Samuel Y. Sheng Professor of Biomedical Engineering (in Systems Biology)
  • Helen Lu, Percy K. and Vida L.W. Hudson Professor of Biomedical Engineering and Senior Vice Dean of Faculty Affairs and Advancement 
  • X. Edward Guo, Stanley Dicker Professor of Biomedical Engineering and Professor of Medical Sciences (in Medicine)
  • José McFaline-Figueroa, Assistant Professor of Biomedical Engineering
  • Samuel Sia, Professor of Biomedical Engineering, Vice Provost for the Fourth Purpose and Strategic Impact
  • Steve Thomopoulos, Robert E. Carroll and Jane Chace Carroll Laboratories Professor of Biomechanics (in Orthopaedic Surgery and Biomedical Engineering) 
  • Elan Goldwaser, Assistant Professor of Sports Medicine (in the Center for Family and Community Medicine, in Medicine and Orthopedic Surgery) at CUIMC
  • Mildred Embree, Dr. Edwin S. Robinson Associate Professor of Dental Medicine
  • Joanna Smeeton, H.K. Corning Assistant Professor Rehabilitation and Regenerative Medicine Research (in Rehabilitation and Regenerative Medicine) (in Genetics and Development)

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Government

The Canaries In America’s Coal Mine

The Canaries In America’s Coal Mine

Authored by J.Peder Zane via RealClearPolitics.com,

Joe Biden vs. Donald Trump is not the race America…

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The Canaries In America's Coal Mine

Authored by J.Peder Zane via RealClearPolitics.com,

Joe Biden vs. Donald Trump is not the race America needs, but it is the one we deserve.

A political system that has spit out a race few voters want is the perfect symbol of a nation – and a people – bent to the point of breaking.

Biden vs. Trump appears to be a welcome diversion in a country whose government seems unequipped to face its biggest challenges and whose people are increasingly unwilling to take responsibility for their own problems. Eight months arguing about two angry old men – hearing our own side praise us to the hilt while blaming every woe on the other – is time we don’t have to spend confronting our own difficulties.

Historic declines in life expectancy, jaw-dropping rates of obesity, and rising truancy among students are just a few of the ways we the people are running off the rails.

A few others include:

  • In a Wall Street Journal commentary about post-COVID America, Yale University’s Nicholas Christakis observes how “reckless behavior” is becoming epidemic. “Americans gambled a record $66.5 billion in 2023. Compared with 2019, there has been an 18% increase in fatal accidents involving alcohol and a 17% increase in those involving speeding. Over 500 Americans are dying every day from alcohol-related deaths, a 30% increase. Sexually transmitted diseases are rising across the nation, too.”

  • Jonathan Haidt reports in the Atlantic that “rates of depression and anxiety in the United States – fairly stable in the 2000s – rose by more than 50 percent in many studies from 2010 to 2019. The suicide rate rose 48 percent for adolescents ages 10 to 19. For girls ages 10 to 14, it rose 131 percent.” A CNN and Kaiser Family Foundation poll published in 2022 found that more than 20% of adults described their mental health as “fair” or “poor,” and about one-third of adult respondents said they feel anxious much of the time.

  • A 2021 study by the Survey on American Life found that 49% of Americans said they had fewer than three close friends – in 1990 the figure was 27%. That same year 33% of respondents said they had 10 or more close friends; in 2021 that number fell to 13%. The birth rate and rates of marriage – which, when done in tandem, producer happier and more stable parents and children – have long been in decline.

  • Unable to meet its recruitment goals, the Pentagon has repeatedly lowered its standards for physical fitness, mental health, and academic achievement to meet its numbers. “America’s youth are less qualified for service than ever before,” Army Brig. Gen. Patrick Michaelis, commander at Fort Jackson, S.C., was quoted as saying in a Stars and Stripes article published last year. Added Gen. James McConville, the Army’s chief of staff, “We have a lot of young men and women who want to serve – and they can’t pass the academic requirements or they can’t pass the physical requirements.”

  • The New York Sun reports that many citizens are no longer part of the workforce. “Jobs held by native-born Americans decreased by nearly half a million between January and February of this year, while jobs held by foreign-bornAmericans (both legal and illegal immigrants) spiked to 1.16 million. Looking further back, since January 2020 — just before the pandemic — there has been no growth in native-held jobs, while jobs for foreign-born employees have skyrocketed by more than 3.9 million. … The native-born workforce participation rate of 6 percent is also less than the foreign-born participation rate of 66.6 percent.”

  • The liberal Vera Institute has reported that “the number of women incarcerated in the United States has skyrocketed in the last four decades, increasing 475 percent in 40 years. In 2019, there were more than 231,000 women and girls held in prisons and jails across the country. … 50 years ago, almost 75 percent of counties held not a single woman in jail.” In a similar vein, news reports now routinely carry articles about female teachers accused of molesting students.

These are just some of the canaries in the American coal mine. Together they suggest how – despite the many strengths our nation still possesses – we are unraveling. The government cannot fix most of these problems, which may be why politicians largely ignore them. Such issues must be addressed at that most local of levels – the individual and the family.

It may feel good to complain about the other guy for the next eight months – and heaven knows we have plenty of reason to. But after the November election, all of our problems will remain. It’s long past time we recognized that much of the fault for our deep-rooted challenges lies not in our political stars but in ourselves.

Tyler Durden Tue, 03/26/2024 - 15:25

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International

Lockdown’s Fourth Birthday

Lockdown’s Fourth Birthday

Authored by Kit Knightly via Off-Guardian.org,

Last weekend marked four years to the day since the UK went into…

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Lockdown's Fourth Birthday

Authored by Kit Knightly via Off-Guardian.org,

Last weekend marked four years to the day since the UK went into “lockdown” for the first time.

What an exciting time that was, right? With the pan-banging and the curve-flattening and the Spirit of the Blitz living on. Good times.

UK Prime Minister Rishi Sunak’s team decided to honour the occasion by slapping themselves on the back:

Needless to say, this is revisionism of the highest order. To quote my favourite reply, it’s the “gaslightiest gaslight I’ve ever been gaslit by”.

The furlough system did not “save the economy”. The economy was not saved. Rather, it was laid out on a stone table and slowly flayed with a sharpened flint.

We are all still living with the consequences of lockdown, not just in the UK but globally. The world over, hundreds of millions of people have been plunged into extreme poverty by so-called “anti-Covid measures”.

Billions more are worse off, paying more for almost every product and service, and struggling in general.

It’s important to remember this was the point.

As we wrote in our piece addressing Covid revisionism last year:

The poverty, the depression, despair. The shuttered stores and closed hospitals and bankrupt businesses. They were all predictable, and all deliberate. They knew that’s what would happen…that’s what it was for. That’s why “Covid” was invented. Lockdown was not a policy mistake, it was a policy success.

Lockdowns killed more people than they saved. Lockdowns doubled global child poverty.

Lockdown doesn’t work, it never worked and it wasn’t supposed to work.

And the only thing more nauseating than the anti-human trolls pushing it at the time, are the same anti-human trolls re-writing history since, claiming lockdowns were a mistake or a panic reaction, or that no one could have known how much damage they would do.

As we wrote in our piece marking Lockdown’s first birthday:

Too often soft language in the media talks about “misjudgments” or “mistakes” or “incompetence”. Supposed critics claim the government “panicked” or “over-reacted”. That is nonsense. The easiest, cheesiest excuse that has ever existed.

“Whoops”, they say, with an emphatic shrug and shit-eating grin “I guess we done messed up!”. Unflattering, but better than the truth.

Because the truth is that the government isn’t mistaken or scared or stupid…they are malign. And dishonest. And cruel.

All the suffering of lockdown was entirely predictable and deliberately imposed. For reasons that have nothing to do with helping people and everything to do with controlling them.

It’s been more than apparent for most of the last fifty-two weeks that the agenda of lockdown was not public health, but laying the groundwork for the “new normal” and “the great reset”.

A series of programmes designed to completely undercut civil liberties all across the world, reversing decades (if not centuries) of social progress. A re-feudalisation of society, with the 99% cheerfully taking up their peasant smocks “to protect the vulnerable”, whilst the elite proselytise about the worth of rules they happily admit do not apply to them.

Lockdown was not a policy mistake it was murder.

This revisionism isn’t just about protecting reputations or saving face, of course, but about establishing a couple of important new “truths”:

  1. Lockdowns are responsible for post-Covid excess deaths, NOT the experimental “vaccines”.

  2. Lockdowns were so bad that we need to do anything we can to avoid using them for the next pandemic, including vaccine mandates and quarantine camps.

In the future we may see another lockdown – for terrorism or climate or “disease X” – but we might not. It might be we never see another lockdown again.

Either way, it’s a policy which realised its goal.

Massive unemployment. Massive misery. Massive state-overreach. Normalizing Orwellian police raids for private actions on private property, increasing snitch culture, and promoting fear and resentment of your neighbours.

Drugs, depression, suicide up. Prosperity happiness and freedom down.

And most importantly, they now know they can get away with it. They wanted to see what we would do, and for the most part the answer was “nothing”.

It was a test, and most people failed.

As I wrote two days before lockdown was announced in 2020:

“Special powers” don’t go away. They are not temporary, they won’t be surrendered. Everything we give the government our permission to do, they will do. For the foreseeable.

And now CBDCs and edible insects and 15 minute cities are on the way. They will continue to do what they want, because they think we’ll continue to let them.

Hopefully, next time, we’ll prove them wrong.

Tyler Durden Tue, 03/26/2024 - 05:00

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Government

Capital Confusion at the New York Times

In a recent guest essay for The New York Times, Aaron Klein of the Brookings Institution claims that the merger between Capital One and Discover would…

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In a recent guest essay for The New York Times, Aaron Klein of the Brookings Institution claims that the merger between Capital One and Discover would “keep intact the broken and predatory system in which credit card companies profit handsomely by rewarding our richest Americans and advantaging the biggest corporations.”

That’s quite an indictment! Fortunately, Klein also offers solutions. Phew!

But really, it’s difficult to understand how someone could describe the highly innovative, dynamic, and efficient U.S. credit-card system as “broken.” If it were, why would U.S. credit-card networks like Visa, Mastercard, American Express, and Discover be the world leaders, accounting for more than 60% of global market share?

And far from being “predatory,” credit cards have been hugely valuable to American families at all income levels. During the pandemic, they literally saved lives by enabling people in lockdown to buy food online and have it delivered to their homes. As Klein himself notes:

The pandemic changed how we buy things, significantly increasing the share of transactions put on credit cards rather than conducted in cash.

Klein tries to turn this positive into a negative, noting that the increase in card use added “to the swipe fees merchants pay.”  What he fails to mention is that the switch from cash to credit has, in general, reduced merchants total costs because the costs of handling cash are so much higher. When a customer pays in cash, checkout takes longer than paying with a card (especially where the transaction is contactless). For larger stores, that means more cash-register operators must be hired. For smaller stores, it means there are less resources available to perform other tasks, such as taking inventory or restocking shelves.

Cash also presents a greater risk of theft, which means merchants must invest in security systems both in-store and for moving cash to the bank. And cash must be counted and deposited, both of which take time.

Study after study has shown that, when all relevant costs are taken into account, cash costs merchants more than payment cards. A 2018 study by the IHL Group, for example, found that the cost of accepting cash averaged about 9% and ranged from 4.7% for larger grocery stores to 15.5% for bars and restaurants. By contrast, the all-in cost of processing credit-card payments is typically less than 3%.

Klein’s sources don’t inspire much confidence. The link in his opening paragraph is not to an academic study, but to a video on the Times’ own website that spins an elaborate tale of how a frying pan bought using credit-card rewards was actually paid for by MJ, the owner of a local convenience store. In essence, the video asserts that, by using a rewards credit card to buy $100 of goods every week for a year at MJ’s store, enough rewards were accrued to pay for the frying pan.

Let’s suppose that the bank that issued the rewards card charged the maximum interchange fee on the transactions at MJ’s store, which in 2023 was 3.15%. Further assume that MJ’s merchant-account provider charges her on an “interchange-plus” basis. If MJ used Helcim, she would pay the interchange fee plus 0.4%, plus $0.08 per transaction.

So, of the $5,200 spent over the course of the year by the customer using a rewards card, $163.80 would go to the issuing bank and $28.80 to Helcim, leaving MJ with a net of $5,007.40. By contrast, if MJ had been paid in cash, she would have a net of $4,768.4 (based on the average costs identified by IHL for convenience stores of 8.3%).

While the Times video wants our hearts to bleed for MJ having to pay for a customer’s All-Clad D5 12” frying pan, had the customer paid her in cash instead, she would have made $239 less. And the customer would have been less happy, because he would have effectively paid about $250 more (the cost of the pan). In other words, paying with cash would make the merchant and the consumer worse off to the tune of nearly $500.

Credit cards also have other benefits that Klein ignores in his simplistic story. By providing credit—including up to 45 days interest free for cardholders who pay off their balance each month—credit cards enable people to smooth their spending so that they can buy items even when they don’t have money in the bank. They also provide fraud and theft protection for the cardholder, making it far less risky to carry a card than a bundle of cash. Many cards also include payment-protection insurance, rental-car insurance, and travel insurance.

Finally, credit cards make it far easier to trace payments, because the card issuer knows the identity and address of the legitimate user. This makes it more difficult to make illegal purchases using credit cards (compared to relatively untraceable cash) and easier to enforce sales taxes.

This highlights a fundamental problem with Klein’s analysis: he counts the costs of paying with credit cards but fails to explain for what would happen in the alternative. He wants us to believe that:

the rest of us, whether we pay with cash, a debit-card or a middle-of-the-road credit card, wind up paying more—because we are subsidizing these rewards cards for whom only the wealthiest qualify.

Except that’s just not true.

First, as noted, in most cases, cash purchases are more costly for store owners, so credit-card users are subsidizing cash users. Second, as Todd Zywicki, Ben Sperry, and I have noted, and as can be seen in the figure below from the most recent Consumer Financial Protection Bureau (CFPB) report on the consumer credit-card market, access to rewards credit cards is less a function of income and more a function of the cardholder’s credit score. Third, as the figure also shows, more than 90% of all credit-card transactions are made using rewards cards.

Fourth, as can be seen in the chart below, and as the CFPB noted in the accompanying text: “Earning rates are about the same across credit score tiers for those with rewards cards, except for consumers with scores above 800.” Perhaps Mr. Klein does not have access to those higher-value rewards cards, but if so, he is the exception, not the rule.

These data suggest that, for all the critics’ bluster, the value of rewards per dollar spent varies relatively little from card to card; what differs is the types of rewards and other associated benefits. Innovations along these lines have been important drivers in the shift from cash and checks to credit cards, with attendant benefits for consumers, merchants, and society as a whole.

Nonetheless, Klein is correct that the fees charged for different cards can vary significantly. In fact, importantly, the story is rather more complicated than Klein makes out. Interchange fees typically vary not only by card, but also by type of merchant. This is, at least in part, because different merchants pose different risks of fraud and chargeback.

Moreover, in contrast to Klein’s assertion that low-dollar sales typically have high fees, networks often discount the fees on small-ticket items in order to encourage adoption. For transactions of $15 or less, Visa’s small-ticket interchange fee for credit cards carries no fixed-fee component. For transactions of $5 or less, Mastercard’s fixed fee is only $0.04. And in some cases, such as for gasoline purchases, they cap the total amount (for example, Mastercard charges a maximum of $0.95 and Visa a maximum of $1.10 for gas).

Nonetheless, Klein offers the anecdote that, one year, his “oldest friend’s small coffee shop paid more in card processing costs than for coffee beans.” In fairness, the coffee shop in question, Bump n Grind in Maryland, roasts its own beans, and therefore buys green beans that are considerably less expensive than pre-roasted beans. It also sells much more than just coffee, including vinyl records. So it probably has many costs that are higher than the amount it pays for beans, including: rent, equipment, utilities, and staff.

It may also use a merchant acquirer or a payment gateway (such as Square or Stripe) that offers blended rates (that is, a single rate for all transactions regardless of the type of card or size of transaction), which would mean that it is unable to take advantage of the small-ticket discount available on “interchange-plus” plans.

‘Solutions’ Far Worse Than the ‘Problem’

Klein lays much of the blame on the U.S. Supreme Court for the alleged problem of consumers being charged different swipe fees for different cards issued on the same payment network. He claims that “a 2018 Supreme Court ruling effectively forces merchants to accept either every type of card – from, say, a basic Green Card to the Platinum Card – from an issuer like Amex or none of them.” And he goes on to assert that “the ruling also barred merchants from incentivizing consumers to use cheaper ones.”

There’s just one problem with these claims: they’re not true.

What the Supreme Court did in Ohio v. Amex was to prevent the state from overriding the contractual “anti-steering” provisions that had long been established by credit-card networks in their agreements with merchants (either directly, in the case of three-party cards such as Amex and Discover, or via agreements with issuers, in the case of four-party cards like Visa and Mastercard). The Court explained its rationale clearly:

Respondent… Amex… operate[s] what economists call a “two-sided platform,” providing services to two different groups (cardholders and merchants) who depend on the platform to intermediate between them. Because the interaction between the two groups is a transaction, credit-card networks are a special type of two-sided platform known as a “transaction” platform. The key feature of transaction platforms is that they cannot make a sale to one side of the platform without simultaneously making a sale to the other. Unlike traditional markets, two-sided platforms exhibit “indirect network effects,” which exist where the value of the platform to one group depends on how many members of another group participate. Two-sided platforms must take these effects into account before making a change in price on either side, or they risk creating a feedback loop of declining demand. Thus, striking the optimal balance of the prices charged on each side of the platform is essential for two-sided platforms to maximize the value of their services and to compete with their rivals.

Visa and MasterCard—two of the major players in the credit-card market—have significant structural advantages over Amex.  Amex competes with them by using a different business model, which focuses on cardholder spending rather than cardholder lending. To encourage cardholder spending, Amex provides better rewards than the other credit-card companies.  Amex must continually invest in its cardholder rewards program to maintain its cardholders’ loyalty.  But to fund those investments, it must charge merchants higher fees than its rivals.  Although this business model has stimulated competitive innovations in the credit-card market, it sometimes causes friction with merchants. To avoid higher fees, merchants sometimes attempt to dissuade cardholders from using Amex cards at the point of sale—a practice known as “steering.” Amex places antisteering provisions in its contracts with merchants to combat this.

While these anti-steering provisions are important, they are not the provisions to which Klein refers, which are known as “honor-all-cards” provisions and which prevent merchants from discriminating against cards bearing the network’s brand. Nonetheless, honor-all-cards provisions are likewise important to the functioning of two-sided payment networks (as Nobel laurate economist Jean Tirole has noted) because they enable card networks to create a range of offerings, thereby facilitating innovation by and competition among issuers.

Without the honor-all-cards provisions, merchants might refuse to accept cards with higher interchange fees. Klein seems to think this is a good idea. He proposes that:

Congress should legislatively correct the Supreme Court’s mistake. For starters, give merchants the power to reject the priciest credit cards, and let’s see if their users are willing to pay the true cost of their rewards.

But this would result in a race to the bottom in which card issuers were unable to offer rewards or otherwise differentiate their products, leading to a decline in the use of cards. This, in turn, would reduce spending, harming both consumers and merchants.

Klein supports his argument that Congress could override the honor-all-cards provision by citing the Durbin amendment, which imposed price controls on debit-interchange fees. A recent study by Vladimir Mukharlyamov of Georgetown University and Natasha Sarin of the University of Pennsylvania found that this had the effect of reducing covered banks’ annual revenues by about $5.5 billion. Seeking to recoup some of the lost revenue, banks on average doubled their monthly fees on checking accounts; increased the minimum deposit required for “free” checking by 21%; and reduced the availability of accounts with no-minimum free checking by about half.

Likely as a direct consequence, hundreds of thousands of the poorest Americans left the banking system altogether. Meanwhile, merchants passed through little, if any, of the savings resulting from the reduced debit-interchange fees, so those on low incomes who kept their accounts but paid monthly fees were measurably worse off.

To make matters worse, Klein wants “brave policymakers” to “start taxing reward points.” At least he is clear that this is really just about taxing the rich:

The richer you are, the more likely you qualify for bigger rewards. Progressive taxation rates mean that exempting rewards from taxation makes them nearly four times as valuable to those in the top tax bracket as the bottom.

As it happens, some credit-card rewards probably are taxable; it depends on their function. But if policymakers were to make all rewards taxable, it would harm those that function primarily as rebates and loyalty incentives—such as airline miles received on co-branded cards. And that, in turn, would harm the co-brand partners, such as airlines and hotels.

Klein’s final proposal is more troubling. He suggests that “we could require all merchants have access to the same swipe-fee pricing, regardless of size.” His concern here is that some larger merchants  leverage their bargaining power to obtain lower interchange fees. In part, larger merchants benefit from economies of scale and can implement transaction monitoring and security systems that smaller merchants simply can’t afford.

Meanwhile, a few large merchants (such as Costco) operate membership-based systems that enable them to forego customer convenience and strike exclusive deals with specific card issuers and networks, thereby obtaining lower swipe fees. Neither of these apply to individual smaller merchants, so the suggestion that swipe fees could be reduced by mandate to the levels negotiated by larger merchants is totally unrealistic.

In his last few paragraphs, Klein returns to the merger between Capital One and Discover, the hook around which he has hung a series of shibboleths about credit cards that he uses as the premise for his terrible policy proposals. And here again, he repeats those shibboleths, moaning that:

Capital One already seems to be competing with American Express for wealthy customers who like elite airport lounges and bit travel perks …

And in the next paragraph:

As the economy continues to digitize with more micropayments, the credit card burden will keep growing, particularly on smaller businesses.

And in the final paragraph:

Until legislators are willing to change the system that showers tax-free rewards on the upper middle class, the cash register will continue to exacerbate the wealth gap.

What utter tosh.

The post Capital Confusion at the New York Times appeared first on Truth on the Market.

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