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Flint Probably Has Bigger Problems Than Lead Pipes

| Thu Feb. 4, 2016 12:38 PM EST

The latest from Flint:

Mayor Karen Weaver is calling for immediate removal of lead pipes from Flint's water distribution system, and is expected to detail her request at a news conference later Tuesday, Feb. 2....Replacing all of Flint's lead service lines has been estimated to cost more than $60 million.

The latest from New Jersey:

Eleven cities in New Jersey, and two counties, have a higher proportion of young children with dangerous lead levels than Flint, Mich., does, according to New Jersey and Michigan statistics cited by a community advocacy group....In New Jersey, children 6 years of age and younger have continued to ingest lead from paint in windows, doors and other woodwork found in older homes, particularly in older, poorer cities, said Elyse Pivnick, director of environmental health for Isles, Inc., a community development organization based in Trenton.

"In light of the Flint debacle, we wanted people to understand that water is not the only thing that's poisoning children," she said. "Most people think the lead problem was solved when we took lead out of gasoline and new homes in the 1970s, but that's not true."

I suppose it's inevitable that residents of Flint want to replace their lead pipes. But it's probably unfortunate. At this point, Flint's water pipes are almost certainly pretty safe, and will become even safer over the next few months as properly treated waters rebuilds the scale inside the pipes. A multi-year program to replace them will most likely have no effect at all on childhood lead levels.

So what would I spend $60 million on if I had the choice? Two things:

  • Lead paint abatement in older homes. The biggest danger points are window casings in old homes, because the friction from opening and closing windows eats through newer layers of paint and exposes old lead paint, which is then ground into lead dust.
  • Soil testing and cleanup. This is decidedly unsexy, but in modern cities this is where most of the lead is. Lead from gasoline spent decades settling into urban soil after we burned it in our cars, and every summer, when the weather dries up, it gets "resuspended" and becomes a source of lead poisoning all over again.

In both cases, the lead poisoning mechanism is the same: small children get lead dust on their fingers and then lick it off. This is one of the reasons that lead poisoning is a much smaller problem for adults than for children. Lead in small doses doesn't affect mature brains strongly, and even if it did, adults mostly don't play in the dirt and then lick their hands. Kids do.

The first step in soil abatement is mapping: figuring out which spots have the highest levels of lead contamination. The next step is cleaning it up. There are multiple ways of doing this, some cheap and some expensive, and only a professional evaluation can determine the best method in specific areas.

Anyway, that's that. The problem, of course, is that there's no chance at all that anyone is going to give Flint $60 million to clean up its soil and its old windows. But someone might give them $60 million to replace their lead pipes. It won't do nearly as much good, but at least it's something.

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Chris Christie: I May Be Old and Smelly, but at Least I'm Not Ted Cruz

| Thu Feb. 4, 2016 12:32 PM EST

New Jersey Gov. Chris Christie likes to think of himself as a guy who tells voters what he believes, and as he makes a last-gasp attempt to climb out of sixth place in the New Hampshire Republican primary, what he's telling people is this: He really can't believe he's losing to these idiots.

Speaking at a retirement community in Bow, New Hampshire, on Wednesday afternoon, Christie used an anecdote about the late actor James Gandolfini to rip into front-runner Donald Trump as a highly skilled magician deceiving the electorate with smoke and mirrors.

As he told the seniors, when he was a US attorney from New Jersey, Christie had gone with his daughter to a Broadway performance of Beauty and the Beast. Gandolfini, whose daughter on the show, Jamie-Lynn Discala, played the role of Belle, saw Christie in the line for refreshments and tapped him on the shoulder. "He said, 'Um, I'm Jimmy Gandolfini,' Christie recalled. "I said, 'I know.' And he said to me—he's a big guy, he had a very strong firm handshake, as you might imagine, and he wasn't letting go of my hand, so he's shaking and he pulled me towards him—and he says, 'You know it's all make-believe, right?'"

Christie paused for a moment, and then got to his point. "You know it's all make-believe, right?," he said, getting into it. "The guy who's running first in the polls right now—you know it's all make believe. You know that there's not really a board room he and Ivanka sit in, right? You know that when he says you're fired you're not really fired, right? Because it's not real! It is an all an act! It is all for TV!"

Trump, who leads in the polls by double digits, has perhaps overshadowed the notoriously blustery Christie by being even more blustery. But Christie wasn't simply trying to take Trump down a few notches; he also wanted to bring down Sens. Ted Cruz and Marco Rubio, the first- and third-place finishers in Iowa who are both now lapping him in the state where he's invested most of his energy. In the second truck-driving metaphor of his speech, he took aim at the two freshmen senators who don't know how to drive in the mud:

New is great—it's shiny and pretty. It looks great. I understand that. New is really good. Even on a day like today, right, you went and passed the car dealer and saw a new pickup truck, and you said, "Look at that pickup truck! It looks good." So you go and you buy the new truck and you park that truck right in front of your house. Let's say this rain keeps going, I don’t know what the forecast is, but if it keeps raining for a while you know what happens, rain turns everything into mud. And let's say you go outside to get your new car after a day or so in the rain. You get in that new truck the first time and start it up. You put it in gear and it's in the mud and the wheels start spinning. And you're thinking, why can't I get out of the mud? I gotta get out of the mud. You keep doing it, you're going back and forth, the wheels are spinning, and you're starting to get frustrated, and what's the only thing that's running through your mind? Where the heck is my old truck! My old truck always got me out of the mud. I never got stuck in the mud with my old truck. My old truck's banged up a little bit. It's scratched up a little bit. It doesn't smell nearly as good as it used to. It doesn't look as good as it used to, but I can't go anywhere in this new truck because it can't get out of the mud.

There's two different kinds of trucks in this race, man. The Marco Rubio–Ted Cruz truck is the new, shiny, smells-nice truck. And then there's the Chris Christie truck. It’s old. It's beat up. It's dinged up. It doesn't smell as good as it used to. But man, the Chris Christie truck knows how to get out of the mud. You know why? Because it's been in the mud before.

Chris Christie is a smelly old truck, and he wants your vote, New Hampshire. Except, that is, when he's a helicopter.

The Party Is Deciding....On Marco Rubio?

| Thu Feb. 4, 2016 11:39 AM EST

Over at FiveThirtyEight, they're taking The Party Decides out for a spin by tracking the most important sign of just how the party decides: endorsements. This is allegedly the key metric for predicting the nomination, and they report that young Marco Rubio is now solidly in the lead and moving ahead quickly:

Although four more endorsements and a slight lead in points do not make Rubio a lock as the choice of Republican elected officials, this bump is a sign that members of Congress could be starting to see him as the most acceptable option for the nomination....Some politicians had put early support behind Jeb Bush — he had led our list since August — but since January the only new endorsement he has received was from former presidential candidate Sen. Lindsey Graham.

....Iowa caucus winner Ted Cruz has slowly been picking up points as well — he’s added seven since the beginning of the year — though he has yet to receive an endorsement from a sitting senator or governor.

Poor Ted. Everyone hates him, so the only endorsements he can get are from a few backbench House members. I guess he'll show them when he's sitting pretty in the Oval Office next year.

Yes, Bernie Sanders Is Questioning Hillary Clinton's Integrity

| Thu Feb. 4, 2016 10:39 AM EST

Greg Sargent points us to this exchange yesterday on CNN:

WOLF BLITZER: Are you suggesting that Secretary Clinton is beholden to Wall Street and big money?

BERNIE SANDERS: No. What I’m simply saying is a fact. She recently reported that her Super PAC received $25 million. $15 million of that came from Wall Street. I will let the American people determine what all of that means.

And here is Sargent on what Sanders is doing:

He says our political economy is in the grip of an oligarchic elite, resulting in a massive upward redistribution of wealth in recent decades and rendering government paralyzed from doing anything about it....Sanders constantly points to the funding of her campaign — and her acceptance of speaking fees — as symptomatic of this problem. But Sanders does not want to take the final step and say that Clinton personally is making the policy choices she does precisely because she is beholden to the oligarchy, due to its funding of her campaign. The upshot is that Sanders is indicting the entire system, but doesn’t want to question the integrity of Clinton herself — or perhaps doesn’t want to be seen doing that. This is the central tension at the heart of Sanders’s whole argument.

Is it true that Sanders is just too nice a guy to name names? Maybe. But I'm a little less inclined to be generous about this kind of thing. To my ears, it sounds more like typical political smarm. "Hey, I'm not saying she's a crook. I'm just saying she drives a pretty nice car, amirite?" Contra Sargent, I'd say that Sanders is very much questioning the integrity of Clinton herself, and doing it in a pretty familiar way.

Study Shows Limiting Access to Planned Parenthood Hurts Poor Women Most

| Thu Feb. 4, 2016 7:29 AM EST

On Jan. 1, 2013, the state that has stood out in its assault on reproductive rights eliminated Planned Parenthood clinics from its Medicaid public family planning program for low-income women. The result? By the end of 2014, fewer claims for contraception were filed, and more low-income Texas women had babies.

According to a study published in the New England Journal of Medicine, when access to Planned Parenthood was taken away, women didn't find other options—they simply got less contraceptive care. The University of Texas at Austin study showed that prescriptions for long-acting reversible contraceptives (LARCs), such as IUDs and birth control implants, dropped by nearly 36 percent, and Depo Provera shots dropped by 31 percent.

Texas' public family planning program covers single women who earn less than $1,800 per month, or less than $2,426 if they have a child.

The study, which examined all pharmacy and medical claims from Jan. 1, 2011 through Dec. 31, 2014, filed under the public fee-for-service family planning insurance, also found adverse effects in the consistency of contraceptive care. In the 23 of 254 counties in Texas that have a Planned Parenthood-affiliated clinic, there was a nearly 20 percent decrease the number of women who returned to receive another injection of Depo Provera after they had previously relied on it for birth control. (The Depo Provera shot must be administered every three months to be effective.) According to Planned Parenthood's website, each individual shot can cost up to $100 without insurance, plus any applicable exam fees. An IUD can cost up to $1,000.

The study found no significant change for short-term contraception, such as the birth-control pill, in the wake of the coverage change. But it's important to note that IUD's and birth control implants are much more effective in preventing pregnancy than the pill or condoms, and contraceptive injections are also slightly more effective. The American College of Obstetricians and Gynecologists recommend LARCs as the most reliable form of birth control.

The rate of childbirth covered by Medicaid saw a relative increase of 27 percent within 18 months after the exclusion of Planned Parenthood from Medicaid programs in Texas counties with Planned Parenthood affiliates.

“The U.S. continues to have higher rates of unintended pregnancies than most rich nations, and we know that U.S. and Texas women face barriers as they try to access preventative services,” said Amanda Stevenson, lead author of the study. “It’s a public health issue that Texas women struggle to achieve their reproductive goals.”

Marco Rubio Is Very Upset That President Obama Went to a Mosque

| Wed Feb. 3, 2016 11:36 PM EST

On Wednesday, President Barack Obama visited a mosque for the first time as president, and offered perhaps the least controversial comment imaginable: "You're part of America too," he told his hosts. "You're not Muslim or American; you're Muslim and American."

Sen. Marco Rubio was not impressed, telling voters in New Hampshire:

I'm tired of being divided against each other for political reasons like this president's done. Always pitting people against each other. Always. Look at today—he gave a speech at a mosque. Oh, you know, basically implying that America is discriminating against Muslims. Of course there's going to be discrimination in America of every kind. But the bigger issue is radical Islam. And by the way, radical Islam poses a threat to Muslims themselves.

 

To be clear: America discriminates against Muslims.

In 2012, Wired reported that "[t]he FBI is teaching its counterterrorism agents that 'main stream" [sic] American Muslims are likely to be terrorist sympathizers; that the Prophet Mohammed was a 'cult leader'; and that the Islamic practice of giving charity is no more than a 'funding mechanism for combat." That investigative series on federal law enforcement's prejudices against Muslims won a National Magazine Award. In 2011, the Associated Press reported on how the NYPD, with the help of the CIA, spied on America mosques and even infiltrated Muslim student associations. That series won a Pulitzer. Last week, Buzzfeed reported on the intense pressure applied by the federal government on Muslim immigrants who apply for citizenship. My colleague Kristina Rizga has reported on the pervasiveness of anti-Muslim bullying in schools. One of the candidates who beat Rubio last week literally proposed banning Muslims from entering the country; the other limited his ban to people from predominantly Muslim countries.

This is all pretty easy to find online, but in Rubio's defense, the Internet is pretty spotty in New Hampshire.

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Marco Rubio Lashes Out Against Call For Religious Toleration

| Wed Feb. 3, 2016 7:36 PM EST

President Obama, during a speech today at a Baltimore mosque:

If we’re serious about freedom of religion — and I’m speaking now to my fellow Christians who remain the majority in this country — we have to understand an attack on one faith is an attack on all our faiths. And when any religious group is targeted, we all have a responsibility to speak up. And we have to reject a politics that seeks to manipulate prejudice or bias, and targets people because of religion.

Marco Rubio, commenting a couple of hours later on Obama's speech:

Always pitting people against each other. Always. Look at today: he gave a speech at a mosque. Oh, you know, basically implying that America is discriminating against Muslims....It's this constant pitting people against each other that I can't stand.

There you have it. Ask Christians to reject the politics of bigotry, and you're pitting people against each other. And Marco Rubio, for one, will have no part of that.

UPDATE: Revised to include exact quote from Rubio.

Yet Another Look at BernieCare

| Wed Feb. 3, 2016 5:35 PM EST

I hope you'll pardon a bit of real-time navel-gazing. It won't take long. A couple of weeks ago Bernie Sanders released an outline of his single-payer health plan, and I pronounced it "pretty good." A week later, Emory's Kenneth Thorpe took a detailed look at Sanders' plan and basically concluded that it was fantasy. Why the huge difference between us?

It has little to do with the details of the Sanders plan. We're both looking primarily at the financing. Here was my reasoning:

  • Total health care outlays in the United States come to about $3 trillion.
  • The federal government already spends $1 trillion.
  • Sanders would spend $1.4 trillion more. That comes to $2.4 trillion, which means Sanders is figuring his plan will save about $600 billion, or 20 percent of total outlays.
  • I doubt that. I'll buy the idea that a single-payer plan can cut costs, but not that much. I might find $1.7 or $1.8 trillion in extra revenue credible, which means that Sanders is probably lowballing by $300 billion or so—which, by the standards of most campaign promises, is actually not that bad. I'd be delighted if a single Republican were that honest about the revenue effects of whatever tax plan they're hawking at the moment.

But Thorpe says Sanders is off by a whopping $1.1 trillion. Yikes! Where does that come from? There are several places where Thorpe suggests the Sanders plan will cost more than Sanders thinks, but the main difference is shown in the table on the right. Thorpe, it turns out, thinks the Sanders plan would cost an additional $1.9 trillion in the first year. So he and I are roughly on the same page.

But I stopped there. I basically assumed that both costs and revenues would increase each year at about the same rate, and that was that. Thorpe, however, figures costs will increase substantially each year but tax revenues will increase hardly at all. So that means an increasing gap between revenue and spending, which averages out to $1.1 trillion over ten years.

Other details aside, then, this is the big difference. If Sanders' new taxes fall further and further behind each year as health care costs rise, then he's got a big funding gap that he would have to make up with higher tax rates. But if he can keep cost growth down to about the same level as his tax revenue growth, his plan is in decent shape.

So which is it? Beats me. This is the kind of thing where the devil really is in the details, and even a small difference in assumptions can add up to a lot over ten years. Still, I was curious to see why Thorpe and I seemed to diverge so strongly, and this is it. Take it for what it's worth.

And Now For a Short Dental Interlude

| Wed Feb. 3, 2016 2:21 PM EST

I'm off to the dentist. My teeth are actually in fine shape, but when you hit your 50s all the fillings you got in your 20s and 30s apparently start to go south, so they have to be removed and refilled. Or so my dentist says, anyway. Today I get two or three of them replaced. I don't remember exactly. Hopefully she does.

UPDATE: It was three. Two of them were old silver fillings, which she hates because of the mercury. So out they came.

The Republican Field Is Shrinking Rapidly

| Wed Feb. 3, 2016 1:06 PM EST

I know how easy it is to lose track of things. So just for the record, we're now down to seven real candidates on the Republican side of things:

  • Cruz
  • Rubio
  • Bush
  • Trump
  • Carson
  • Christie
  • Kasich

This doesn't count the three dead-enders who haven't officially quit yet: Jim Gilmore, Rick Santorum, and Carly Fiorina. By my figuring, New Hampshire should kill off Bush and Carson and get us down to five real candidates. Maybe even Kasich and Christie, too. For all practical purposes, by next Wednesday we might finally be down to our long-fabled three-man race.