2013 - %3, June

Chart of the Day: The Immense Power of Naming a Thing

| Thu Jun. 27, 2013 9:00 PM EDT

Via Bill Gardner, we learn today that infant diagnoses of GERD—gastroesophageal reflux disease—have skyrocketed in recent years. This is good news for the makers of Prilosec and other proton pump inhibitors, and as you might expect, the increased rate of diagnosis of infant GERD is largely because they've been aggressively marketing their pills for just this purpose. But guess what? It turns out that an awful lot of doctors are diagnosing GERD for any baby who's spitting up and just generally crying a lot. However, for those babies—ones who don't have objective evidence of GERD—randomized trials show that Prilosec and its cousins have no effect.

So what's the answer? Well, how about if we tell parents that these drugs are ineffective? Amazingly enough, that doesn't work. As the chart below shows, parent interest in the medication goes down only if you tell them it doesn't work and you refrain from diagnosing GERD in the first place:

Gardner ruminates on the underlying cause of this: "Getting a diagnosis, I speculate, activated a mental schema that 'my baby has reflux disease, therefore she needs an acid-reducing medicine,' and this neutralized the information that 'PPIs don’t work.' So simply getting a diagnosis can have a harmful side effect on parents' understanding of physician communication."

So there you have it: once you put a label on an illness, people are more likely to want medication for it even if they're explicitly told the medication doesn't work. And this is even more important than it appears at first glance, since diagnoses of GERD vary from hospital to hospital by a factor of 13x. This may be a small example by itself, but those hospitals at the high end of the GERD curve are a perfect illustration of one of the reasons that healthcare in America costs so much.

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Virginia Gov. Candidate Cuccinelli Asks Supreme Court to Revive Ban on Oral, Anal Sex

| Thu Jun. 27, 2013 5:54 PM EDT

Virginia Attorney General Ken Cuccinelli, the GOP's nominee for governor, filed an appeal on Tuesday asking the Supreme Court to revive the state's law banning oral and anal sex. In a statement, Cuccinelli claimed that the law, which the US Court of Appeals for the 4th Circuit ruled unconstitutional earlier this year, is "an important tool that prosecutors use to put child molesters in jail." Cuccinelli warned that the appeals court's decision to strike down the statute "threatens to undo convictions of child predators that were obtained under this law" since 2003, when the Supreme Court ruled in Lawrence v. Texas that laws criminalizing oral and anal sex—sometimes referred to as sodomy bans—are unconstitutional.

As the Huffington Post reported:

Cuccinelli wants the court to reconsider a March 2013 decision by the U.S. Court of Appeals for the 4th Circuit striking down the state's "crimes against nature" statute. The 4th Circuit ruled that the law did not pass muster in light of the Supreme Court's 2003 Lawrence v. Texas decision, which struck down the latter state's anti-sodomy law as an unconstitutional criminalization of Americans' sexual conduct. The Virginia law, however, remained on the books.

The 4th Circuit ruled in favor of William Scott McDonald, who was convicted in 2005 at age 47 under the Virginia statute for soliciting a 17-year-old girl to commit sodomy. That law broadly makes oral and anal sex a Class 6 felony. While such laws historically targeted gay men, they have also been used against heterosexual activity.

The three-judge panel ruled that an unconstitutional law could not be used to convict McDonald. It added that the Virginia Legislature could pass another law to criminalize sexual conduct specifically between a minor and an adult. The Lawrence ruling applied only to consensual adult conduct.

Virginia has a notably low age of consent, which means, in effect, that vaginal sex between a 47-year-old and a 17-year-old is legal, but oral and anal sex between the same two people is not. Cuccinelli claims he will only use the sodomy law to bring cases involving minors or sexual assault, and argues that Virginians need not worry about him prosecuting "consenting adults," because the part of the law that would enable him to do so was defanged by the Supreme Court's Lawrence decision. But in 2004, when a bipartisan group of state Senators was trying to fix the sodomy law so that it would only apply to cases involving minors and non-consensual sex, Cuccinelli, then a state Senator, blocked the effort. And in 2009, as my colleague Andy Kroll has noted, Cuccinelli made clear that he objected to oral and anal sex (at least between gay people) on principle, telling the Virginian-Pilot, "My view is that homosexual acts—not homosexuality, but homosexual acts—are wrong. They're intrinsically wrong. And I think in a natural law-based country it's appropriate to have policies that reflect that...They don't comport with natural law."

As Mother Jones noted, some 90 percent of Americans would be felons if the Virginia law were to be applied nationally. Cuccinelli has remained mute as to whether he's one of them.

Here Are the 14 Republicans Who Voted for Immigration Reform

| Thu Jun. 27, 2013 5:52 PM EDT

After two weeks of debate on the floor and the addition of beefed-up border security measures backed by Sens. Bob Corker (R-Tenn.) and John Hoeven (R-N.D.), the Senate passed a comprehensive immigration reform bill on Thursday by a 68-32 vote. The bill, which House Speaker John Boehner (R-Ohio) has repeatedly said he won't bring for a vote in the House, would offer a path to citizenship for the nation's estimated 11 million undocumented immigrants after the border measures are implemented.

Here's how all 100 senators voted (no Democrats voted against the bill):

Republicans who voted for the bill (14)

  • Lamar Alexander (R-Tenn.)
  • Kelly Ayotte (R-N.H.)
  • Jeff Chiesa (R-N.J.)
  • Susan Collins (R-Maine)
  • Bob Corker (R-Tenn.)
  • Jeff Flake (R-Ariz.)
  • Lindsey Graham (R-S.C.)
  • Orrin Hatch (R-Utah)
  • Dean Heller (R-Nev.)
  • John Hoeven (R-N.D.)
  • Mark Kirk (R-Ill.)
  • John McCain (R-Ariz.)
  • Lisa Murkowski (R-Alaska)
  • Marco Rubio (R-Fla.)

Democrats and Independents who voted for the bill (54)

  • Tammy Baldwin (D-Wis.)
  • Max Baucus (D-Mont.)
  • Mark Begich (D-Alaska)
  • Michael Bennett (D-Colo.)
  • Richard Blumenthal (D-Conn.)
  • Barbara Boxer (D-Calif.)
  • Sherrod Brown (D-Ohio)
  • Maria Cantwell (D-Wash.)
  • Ben Cardin (D-Md.)
  • Carper Thomas (D-Del.)
  • Bob Casey (D-Pa.)
  • Christopher Coons (D-Del.)
  • Mo Cowan (D-Mass.)
  • Joe Donnelly (D-Ind.)
  • Richard Durbin (D-Ill.)
  • Dianne Feinstein (D-Calif.)
  • Al Franken (D-Minn.)
  • Kirsten Gillibrand (D-N.Y.)
  • Kay Hagan (D-N.C.)
  • Tom Harkin (D-Iowa)
  • Martin Heinrich (D-N.M.)
  • Heidi Heitkamp (D-N.D.)
  • Mazie Hirono (D-Hawaii)
  • Tim Johnson (D-S.D.)
  • Timothy Kaine (D-Va.)
  • Angus King (I-Maine)
  • Amy Klobuchar (D-Minn.)
  • Mary Landrieu (D-La.)
  • Patrick Leahy (D-Vt.)
  • Carl Levin (D-Mich.)
  • Joe Manchin (D-W.Va.)
  • Claire McCaskill (D-Mo.)
  • Robert Menendez (D-N.J.)
  • Jeff Merkley (D-Ore.)
  • Barbara Mikulski (D-Md.)
  • Christopher Murphy (D-Conn.)
  • Patty Murray (D-Wash.)
  • Bill Nelson (D-Fla.)
  • Mark Pryor (D-Ark.)
  • John Reed (D-R.I.)
  • Harry Reid (D-Nev.)
  • Jay Rockefeller (D-W.Va.)
  • Bernie Sanders (I-Vt.)
  • Brian Schatz (D-Hawaii)
  • Charles Schumer (D-N.Y.)
  • Jeanne Shaheen (D-N.H.)
  • Debbie Stabenow (D-Mich.)
  • Jon Tester (D-Mont.)
  • Mark Udall (D-Colo.)
  • Tom Udall (D-N.M.)
  • Mark Warner (D-Va.)
  • Elizabeth Warren (D-Mass.)
  • Sheldon Whitehouse (D-R.I.)
  • Ron Wyden (D-Ore.)

Republicans who voted against the bill (32)

  • John Barrasso (R-Wyo.)
  • Roy Blunt (R-Mo.)
  • John Boozman (R-Ark.)
  • Richard Burr (R-N.C.)
  • Saxby Chambliss (R-Ga.)
  • Dan Coats (R-Ind.)
  • Tom Coburn (R-Okla.)
  • Thad Cochran (R-Miss.)
  • John Cornyn (R-Texas)
  • Mike Crapo (R-Idaho)
  • Ted Cruz (R-Texas)
  • Michael Enzi (R-Wyo.)
  • Deb Fischer (R-Neb.)
  • Chuck Grassley (R-Iowa)
  • Jim Inhofe (R-Okla.)
  • Johnny Isakson (R-Ga.)
  • Mike Johanns (R-Neb.)
  • Ron Johnson (R-Wis.)
  • Mike Lee (R-Utah)
  • Mitch McConnell (R-Ky.)
  • Jerry Moran (R-Kansas)
  • Rand Paul (R-Ky.)
  • Rob Portman (R-Ohio)
  • James Risch (R-Idaho)
  • Pat Roberts (R-Kansas)
  • Timothy Scott (R-S.C.)
  • Jeff Sessions (R-Ala.)
  • Richard Shelby (R-Ala.)
  • John Thune (R-S.D.)
  • Pat Toomey (R-Penn.)
  • David Vitter (R-La.)
  • Roger Wicker (R-Miss.)

A Wee Bit of Immigration Reform Arithmetic

| Thu Jun. 27, 2013 5:46 PM EDT

Today the Senate passed its immigration reform bill. It passed by a huge bipartisan majority, which is supposed to bode well for its future. But here's a little bit of bipartisan math to ponder over:

  • It received 14 Republican votes.
  • That's 30 percent of the Senate Republican caucus.
  • If the eventual House bill does as well—not likely, but let's be optimistic—it will receive 71 Republican votes.
  • To pass, it will then need 147 Democratic votes.

This is pretty much a best-case scenario. So ask yourself: Is John Boehner willing to let immigration reform pass with a 2:1 Democratic majority? Or, more likely, something like a 3:1 Democratic majority? I guess you never know, but it doesn't seem very likely.

NSA Claims That It Has Stopped Collecting Bulk Domestic Email Records

| Thu Jun. 27, 2013 3:36 PM EDT

The NSA revelations of the past few weeks have focused heavily on telephone metadata, records of telephone calls made both domestically and internationally. But under George Bush, NSA also collected records of domestic email traffic. This was supposedly a temporary program started in the wake of 9/11, but it continued for years and eventually led to the now-famous hospital room rebellion led by James Comey in 2004.

Because of the DOJ rebellion, the program was shut down for a while, but was then restarted under FISA authority. So is this metadata still being collected? According to a secret inspector general's report obtained by Glenn Greenwald and Spencer Ackerman, it continued throughout the Bush administration and then for a couple of years into the Obama administration. But it's since been halted:

"The internet metadata collection program authorized by the Fisa court was discontinued in 2011 for operational and resource reasons and has not been restarted," Shawn Turner, the Obama administration's director of communications for National Intelligence, said in a statement to the Guardian.

"The program was discontinued by the executive branch as the result of an interagency review," Turner continued. He would not elaborate further.

Needless to say, an official denial like this should be taken with a grain of salt. Turner says here that "the program authorized by the FISA court" has been discontinued, but that doesn't necessarily mean that internet metadata on U.S. persons is no longer being collected. Maybe it's simply being collected via a different program. Turner was carefully noncommital about that.

And even if domestic email records aren't being collected any longer, it would be nice to know why. "Operational and resource reasons" doesn't tell us much. Was it really too expensive? Was it ineffective? Did the president become disturbed by it? We don't know.

The IG report is here. Marcy Wheeler has some notes about the report here.

Rick Perry's 3 Dumbest Comments on Teen Pregnancy

| Thu Jun. 27, 2013 2:35 PM EDT

Texas Gov. Rick Perry isn't happy about Democratic state Sen. Wendy Davis' 11-hour (11th hour) filibuster of a strict anti-abortion bill that would ban pregnancies after 20 weeks and close all but five abortion providers in the nation's second-largest state. On Wednesday, he announced plans to convene a special session of the Legislature next month so Republicans can reintroduce the legislation. On Thursday, he took a more personal shot at Davis. Referring to the fact that Davis was herself a teen mom (she had her first child at 19, before going on to Texas Christian University and Harvard Law), Perry mused: "It is just unfortunate that she hasn't learned from her own example that every life must be given a chance to realize its full potential and that every life matters."

This isn't the first time Perry has wandered into uncomfortable territory when talking about teen pregnancy, though. He sort of has a knack for it.

In February, he blamed rising teen pregnancy rates on the fact that America had strayed from the core values exemplified by the Boy Scouts—something he feared would be exacerbated if the organization drifted from its morals and embraced openly gay members. The Boy Scouts advocate abstinence before marriage. Then again, so does the state of Texas—and all it has to show for it is the third-highest teen pregnancy rate in the nation.

Speaking of that, in a 2010 interview that went viral during his presidential campaign, Perry was asked by Texas Tribune editor Evan Smith to explain the disconnect between Texas' high teen pregnancy rate and its policy of abstinence-only sex education. "Abstinence works," Perry said, to laughter from the audience. He continued:

It works. Maybe it's the way that it's being taught or the way that it's being applied out there, but the fact of the matter is it is the best form to teach our children. I'm just gonna tell you from my own personal life abstinence works. And the point is if we're not teaching it and if we're not impressing it upon them, no, but if the point is we're gonna go stand up here and say, "Listen, y'all go have sex and go have whatever is going on and we'll worry with that and here's the ways to have safe sex," I'm sorry, call me old-fashioned if you want, but that is not what I'm gonna stand up in front of the people of Texas and say that's the way we need to go and forget about abstinence.

It is just unfortunate that the governor of Texas hasn't learned from his own example that nothing good ever happens when he talks about teen pregnancy.

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The Exciting Return of Zero-Based Tax Reform

| Thu Jun. 27, 2013 1:26 PM EDT

This is from the Washington Post today in a story about congressional efforts to write a tax reform bill:

Aides in both parties acknowledged that a tax bill cannot pass unless President Obama and congressional Republicans resolve their long-standing dispute over the national debt. Obama wants a tax overhaul to generate additional revenue to rein in borrowing; Republicans say they will agree to fresh revenue only if Democrats agree to restrain spending on expensive health and retirement benefits.

Wait. What? Did I miss something? Which Republicans have said they'd agree to new revenue if Democrats rein in entitlement spending? I can think of two or three who have kinda sorta said this was a possibility, but it's the same two or three who have been saying this for a long time. For the party as a whole, this is still a complete nonstarter. No new revenues, no how, no way.

Right? Does anyone know where this came from?

Anyway, moving on, the gist of the story is something we started to hear about a few days ago: Max Baucus's plan to do tax reform starting with a "blank slate." That is, wipe out every tax credit, deduction, subsidy, or tax expenditure, and only include it in the final bill if someone can affirmatively justify it:

The Senate’s chief tax writers plan to scrap the entire code and start from scratch in their push for tax reform, and on Thursday they gave lawmakers a month to make a case for preserving some of the $1.3 trillion in breaks on the books.

....“We plan to operate from an assumption that all special provisions are out unless there is clear evidence that they: (1) help grow the economy, (2) make the tax code fairer, or (3) effectively promote other important policy objectives.”

I guess this sounds bold and innovative—it got top billing from the Post, anyway—but color me unimpressed. It's possible that this approach will end up eliminating some of the hundreds of small tax loopholes out there, but the top twenty account for something like 80 or 90 percent of the revenue, and no one will have the slightest trouble justifying those. What really matters isn't forcing a few lobbyists to write term papers, it's whether Congress has the political will to stand up to them. So far, I've seen zero evidence of that.

Nor have I seen any evidence that the Republican Party will accede to any significant new revenues—and by this I mean actual revenue, not sham revenue based on dynamic scoring fairy tales. Hope springs eternal, I suppose, but the stars sure don't seem aligned for any real progress on this issue. Is there anyone out there who wants to try to persuade me I'm wrong?

The Worm Turns in the IRS Scandal

| Thu Jun. 27, 2013 12:28 PM EDT

Steve Benen reports today that the IRS scandal might be changing gears. In the beginning, it was supposedly about a lawless agency targeting conservative groups at the behest of a thuggish Democratic president. That charge has pretty much crumbled away. But now the worm is turning, and the scandal is about a lawless inspector general, appointed by a hyperpartisan Republican president, who has deliberately misled Congress about IRS activities.

Wouldn't it be sweet if things turned out that way? And it couldn't happen to a more deserving guy than Darrell Issa. Keep your fingers crossed.

Immigration Reform Is Driving Republicans Insane

| Thu Jun. 27, 2013 11:51 AM EDT

Today, Dave Weigel passes along the non-news that House Republicans don't care—at all—about the Senate immigration reform bill. Rep. Peter Roskam, the Republican deputy whip, outlined the reasons for reporters this morning, and it was mostly the same stuff we've been hearing about forever. But then there was this:

But the no-go reason Roskam kept returning to was all about electoral politics. "If you're the White House right now," he theorized, "and you have a signature law — that is, Obamacare — that is completely a legacy issue for the president, and it's looking like implementation is going to be a disaster, and if you're on your heels in terms of these scandals, and you're flummoxed by the NSA, there's one issue out there that's good for the White House. That's immigration. The question is: How much energy does the White House actually put into getting the legislation, or do they want to keep the issue for 2014?"

It's a paradoxical theory with a little whiff of projection. Roskam (like many Republicans) was saying that a desperate White House would rather run against Republicans in 2014 on the immigration issue than pass a bill and remove the issue. With that in mind Roskam was saying Republicans would probably kill the bill, thus keeping the issue alive. How far has Obama crawled inside their heads?

Well, either Obama is way inside their heads, or else Roskam is desperately flailing around to figure out a way to avoid having Republicans take the blame for the failure of immigration reform. Maybe a bit of both.

Here in the real world, we know perfectly well why Obama is keeping a low profile: because everyone on both sides of the aisle wants him to. Obama Derangement Syndrome is so virulent on the right that speaking in favor of the bill would almost certainly doom the whole enterprise. That's the reality of the Republican base these days, and Roskam knows it. We've already got Obamacare, Obamaphones, and Obamacars, and this would just add ObamaMexicans to the list.

Of course, the conundrum for House Republicans is that Roskam is right: Killing the bill probably would be good for Democrats in the short run. It would gin up lots of Latino resentment against Republicans and probably help Democratic turnout in 2014. Conversely, passing the bill would be good for Republicans. They wouldn't get a ton of credit for it right away, but at least it would blunt Democratic efforts to rally the Latino community to the polls. Relatively speaking, that's a win for the GOP, which would then have a freer hand to set the terms of debate for next year's midterms.

So we're faced with a peculiar prospect here. Democrats are fighting to pass a bill because it's the right thing to do, even though they'll probably take an electoral hit from it. Republicans are fighting to kill a bill, even though it would be an electoral winner, because a small part of their base hates it. It's basically electoral suicide because they simply can't get out from under the tea party elephant that's strangling the life out of them. They built a monster, and now it's turned on them.

America's Place in the World is Basically Just Fine, Thanks Very Much for Asking

| Thu Jun. 27, 2013 11:10 AM EDT

Dan Drezner suggests that America's foreign policy community needs to take a very deep breath:

I suggest a community-wide vacation because, right now, a lot of them are writing a lot of nonsense. The combination of perceived U.S. inaction on Syria and Snowden is leading to a lot of silly talk about how Russia is back and China is back and the U.S. can't do anything anymore and everything is going to hell in a handbasket.

I don't mean to go on a rant here, but this is just so much bulls**t.

OK, it's not all that. Advocates of humanitarian intervention are justifiably upset about inaction on Syria — and they should be even more upset if the administration is actually doing what I think they're doing in Syria.

That said, there's not much that's new in these laments. China and Russia are opposing U.S. interests? Well, blow me down!! I haven't seen that kind of activity since... since... every year for the last decade. There's nothing new here.

This is truth. The Middle East has been a festering trouble spot for, oh, about the last five or six decades. Our relations with China and Russia have been tetchy (or worse) for about as long, and are likely to continue that way pretty much forever. Hell, our relations with France are kinda tetchy sometimes. As for all the Snowden hysteria, President Obama has roughly the right attitude: "No, I'm not going to be scrambling jets to get a 29-year-old hacker."

Our current problems are, in historical context, fairly modest, and America's place in the world is basically fine. Relatively speaking, it's almost certain to improve in the medium-term future, not decline. And Obama's foreign policy, though it's had the usual share of missteps, has been pretty solid. Dan is right: we need to chill, people.