2013 - %3, June

Footnote of the Day: Ben Bernanke Plays With the Press

| Mon Jun. 3, 2013 1:16 PM EDT

From Ben Bernanke, appended to a Princeton commencement address that started out by noting that he "wrote recently to inquire about the status of my leave from the university":

Note to journalists: This is a joke. My leave from Princeton expired in 2005.

He's a sly one, that Ben. The part of his address that's getting the most attention, however, is this:

The concept of success leads me to consider so-called meritocracies and their implications. We have been taught that meritocratic institutions and societies are fair. Putting aside the reality that no system, including our own, is really entirely meritocratic, meritocracies may be fairer and more efficient than some alternatives. But fair in an absolute sense? Think about it. A meritocracy is a system in which the people who are the luckiest in their health and genetic endowment; luckiest in terms of family support, encouragement, and, probably, income; luckiest in their educational and career opportunities; and luckiest in so many other ways difficult to enumerate--these are the folks who reap the largest rewards. The only way for even a putative meritocracy to hope to pass ethical muster, to be considered fair, is if those who are the luckiest in all of those respects also have the greatest responsibility to work hard, to contribute to the betterment of the world, and to share their luck with others. As the Gospel of Luke says (and I am sure my rabbi will forgive me for quoting the New Testament in a good cause): "From everyone to whom much has been given, much will be required; and from the one to whom much has been entrusted, even more will be demanded."

There's nothing original about this, but it's interesting to hear from a guy who's still nominally a Republican. Of course, maybe this means he isn't anymore. It's been a very long time since I've heard anyone who's right of center acknowledge this obvious truth, and longer still since I've heard anyone who's right of center support policies that acknowledge this in any concrete kind of way. These days, being on the right means little more than cutting taxes on the rich and cutting spending on the poor. There's no place any longer for the Ben Bernankes of the world there.

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Supreme Court Okays Warrantless DNA Sampling

| Mon Jun. 3, 2013 1:01 PM EDT

Police can force suspects arrested for serious crimes to give DNA samples, a divided Supreme Court ruled, 5 votes to 4, on Monday (PDF). Law enforcement officials in 28 states already routinely collect DNA from alleged criminals, but privacy advocates had argued that taking suspects' DNA without a search warrant is a violation of the Fourth Amendment's protection against unreasonable searches and seizures. The high court's decision could lead to a massive national DNA database, conservative Justice Antonin Scalia warned in a dissent joined by three of the more liberal justices.

The case, Maryland v. King, originated from the arrest of Alonzo King, whose DNA was taken against his will after he was picked up for a gun-related assault charge. King was convicted of the gun charge, but officials also matched his DNA to evidence from an unsolved rape case. That, King argued, violated his Fourth Amendment rights. Maryland's Supreme Court agreed. (For more background on the case, read our report from February.)

The Supreme Court's five-justice majority struck down the Maryland court's ruling, noting that DNA sampling is routine police procedure. "Taking and analyzing a cheek swab of the arrestee DNA is, like fingerprinting and photographing, a legitimate police booking procedure that is reasonable under the Fourth Amendment," Justice Anthony Kennedy wrote for the majority.

The other four justices didn't take the decision so lightly. "Make no mistake about it: because of today’s decision, your DNA can be taken and entered into a national database if you are ever arrested, rightly or wrongly, and for whatever reason," wrote Scalia, who sometimes splits with his right-wing colleagues on civil liberties issues. Justices Ruth Bader Ginsberg, Elena Kagan, and Sonia Sotomayor joined Scalia's dissent.

Obamacare Will Be a Disaster, Part 176

| Mon Jun. 3, 2013 12:44 PM EDT

Avik Roy, I'm told, is one of the good conservatives. He may oppose liberal expansion of the welfare state, but he knows his brief and makes honest arguments.

As it happens, I haven't read much of Roy's stuff. But I've come across him twice in the past couple of months. First, he was on Chris Hayes' show, where he offered up a criticism of Social Security's disability program that was so misleading that Michael Astrue, a former commissioner of the Social Security Administration appointed by George Bush, nearly had a heart attack on the air. Roy eventually had to retreat to a criticism of Britain's disability program, which, as Astrue pointed out, had nothing to do with America's, which had long since dealt with the problems he was talking about.

Strike one. Then a few days ago, Roy wrote a piece about health insurance prices on California's Obamacare exchange. His headline charge was that rates in the individual market were going up 146 percent. How did he come up with this? By powering up his browser and getting a couple of teaser quotes from eHealthInsurance.com for the youngest, healthiest consumers buying a plan with enormous copays. This is so misleading that it's hard to believe it was offered in good faith.

But there's more: nothing about this is unexpected. Under Obamacare, insurance companies have to offer coverage to everyone at similar rates. This means that some people will see their rates go up and some will see them go down. In particular, the youngest, healthiest customers will probably pay more, while older, less healthy customers will pay less. You may think this is terrible (I don't), but it's the way social insurance works, and it's been acknowledged as part of Obamacare from the beginning.

So to recap: Roy pulled up some bogus quotes; didn't acknowledge that rates will go down for some people; and didn't bother mentioning that Obamacare's subsidies will lower rates further for those on limited incomes, including plenty of young people. The normally mild-mannered Jon Cohn was finally driven (almost) into shrillness by all this:

Roy never acknowledged that, even as young and healthy people would have to face higher premiums, older and sicker people would face lower premiums. He said absolutely nothing—not a single word!—about the federal subsidies available to people with incomes below 400 percent of the poverty line. (That's about $46,000 a year for a single adult, or $94,000 for a family of four.) This has been a pattern with his writing and, unfortunately, much of what I read on the right.

....While all of us are susceptible to hyperbole or selective intepretation from time to time, Roy's column was something else entirely. He plucked out two examples of people who would pay more in California, pretended they were emblematic of the system as a whole, then accused other writers of being irresponsible. His argument hasn't held up well to scrutiny, but it's part of the political conversation and, I'm sure, will remain so for a while.

In his follow-up post today, Roy says “we’re finally having the intellectually honest argument about Obamacare that we should have been having all along.” If only that were true.

Strike two. More here from Ezra Klein.

Rep. Darrell Issa: Tea Party-Targeting IRS Staffers Took Their Orders From Washington

| Mon Jun. 3, 2013 12:14 PM EDT
Rep. Darrell Issa (R-Calif.).

Despite the claims of Obama administration officials, the IRS scandal is not the fault of "rogue" staffers in Cincinnati, according to Rep. Darrell Issa (R-Calif.). No, the chairman of the House oversight committee charges—despite the paucity of evidence backing him up—that it leads all the way back to the agency's headquarters in Washington.

On CNN's State of the Union on Sunday, Issa made some of his strongest claims yet that top IRS brass knew of, if not directed, the targeting of right-leaning groups applying for tax-exempt status for special scrutiny. Issa also ripped Obama administration officials for denying that the IRS scandal reaches back to Washington.

"The administration is still trying to say there's a few rogue agents in Cincinnati, when in fact the indication is they were directly being ordered from Washington," Issa said.

He called White House Press Secretary Jay Carney the administration's "paid liar" while accusing him of dissembling about the extent of the IRS scandal. Carney, Issa said, is "still making up things about what happens and calling this a local rogue. The reason that [IRS director] Lois Lerner tried to take the Fifth [Amendment when asked to testify before Congress] is not because there's a rogue in Cincinnati. It's because this is a problem that was coordinated in all likelihood right out of Washington headquarters. And we're getting to proving it."

Issa also suggested—again, without evidence—that tea partiers' complaints about the agency's heavy-handed treatment were overlooked because it was an election year. "My gut tells me that too many people knew that this wrongdoing was going on before the election, and at least by some sort of convenient benign neglect allowed it to go on through the election, allowed these groups, these conservative groups, these, if you will, not friends of the president to be disenfranchised through an election," he said. "Now, I'm not making any allegations as to motive, that they set out to do it. But certainly, people knew it was happening."

There's been quite a bit of fallout since the IRS scandal erupted two weeks ago, when Lerner, who runs the IRS division that oversees politically active nonprofits, apologized for the singling out of conservative groups. Lerner is now on paid leave. Steven Miller, the acting commissioner of the IRS when the scandal broke, resigned his position; he was replaced by Danny Werfel, an Obama administration official. Members of the House and Senate have held numerous hearings on the issue, blasting Lerner, Miller, and the Treasury inspector general whose report found numerous examples of wrongdoing but no evidence of political bias. The release of an internal video showing IRS staffers learning a dance called the "Cupid Shuffle" at a 2010 conference has only added to the agency's woes.

Werfel, the current acting commissioner, will address the video and the IRS' targeting scandal at Congressional hearings this week.

Room Service Dying a Well-Deserved Death in New York

| Mon Jun. 3, 2013 11:01 AM EDT

The New York Hilton Midtown plans to stop offering room service in August. Why? It's a money loser:

The decision to jettison room service at the New York Hilton, reported by Crain’s New York Business, comes as other large hotels have cut back menus or reduced hours in recent years, and many newer boutique hotels have opened without offering it at all. Some hotels have even made arrangements with nearby restaurants to act as surrogate kitchens and deliver food to their hotel rooms.

John Fox, a consultant for the hotel industry, said nearly all hotels lost money on room service, which requires maintaining a staff of waiters and kitchen workers throughout the day, even though orders typically dwindle after breakfast and come in sporadically afterward. “Everybody’s doing what they can to engineer their properties to make more profit while still supplying the services their guests demand,” he said.

I guess if you work in the hotel biz, this is common knowledge. But I didn't know this. I figured big hotels with in-house restaurants already had kitchens, so offering room service didn't cost that much as an add-on. Not so, apparently. In any case, this explains the fact that a small breakfast will run you something like $40 all-in at a New York hotel. That always seemed kind of crazy to me, but it makes sense if room service is really such an expensive operation to maintain.

I rarely ever used room service myself, and certainly not in New York, where decent food is never more than a block or two away. I won't miss it when it goes away completely.

China Could Actually Improve US Pork. Here's How.

| Mon Jun. 3, 2013 6:00 AM EDT

China doesn't have the globe's most sterling food safety reputation, and its fast-growing pork industry provides an apt example of why. A few months ago, dead pigs were showing up by the thousands in a Chinese river—the result, apparently, of a scandal involving the slaughter of diseased pigs. In 2011, hundreds of people became ill after eating pork tainted with clenbuterol, a growth-enhancing chemical the Chinese government had banned from hog feed nearly a decade earlier.

All of which makes it odd that the decision of a massive Chinese meat processor called Shuanghui Group—the very company at the center of the clenbuterol fiasco—to buy US hog giant Smithfield might actually clean up one dirty aspect of our domestic pork industry.

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Enthralling: Camera Obscura's "Desire Lines"

| Mon Jun. 3, 2013 6:00 AM EDT
Camera Obscura

Camera Obscura
Desire Lines
4AD

Scotland's Tracyanne Campbell has a voice that could break your heart. Sad, sweet and serene at once, she's in peak form on the enthralling Desire Lines, Camera Obscura's fifth album and first in four years.

While her elegant pop melodies could be repurposed as '60s girl-group sounds or '50s doo-wop, Campbell's deceptively complex lyrics offer a more nuanced look at relationships than traditional mainstream melodramas usually provide. "You say honesty has made me cruel," she sings gently in the tender "William’s Heart," adding, "I say you're soft and made of wool." On "This Is Love (Feels Alright)" Campbell exclaims, "When I found your girlfriend crying / I could have slapped you in the face," in sharp contrast to the song's comforting textures.

For those who care about such things, Neko Case and My Morning Jacket's Jim James show support by adding backing vocals, but Desire Lines is its own nonguilty pleasure, soaked in romanticism—yet bracingly smart.

We Pay a Lot More for Health Care Than Other Countries

| Sun Jun. 2, 2013 1:58 PM EDT

The graphic on the right won't come as a surprise to anyone who's read this blog over the years. It comes from the New York Times today, and it illustrates the fact that medical procedures cost way, way more in the United States than in other countries. But why?

In the case of prescription drugs, the answer is supposedly that other countries are free riding off of us. If everyone paid $6 for Lipitor, then Pfizer never would have developed it in the first place. It wouldn't have been worth it. It's only the fact that Americans pay full market value for Lipitor that allows other countries to artificially force down the cost for their residents.

There may or may not be something to this, but at least it's an explanation. What about MRI scans, though? MRI machines cost the same in the Netherlands as they do here, and they're utilized just as heavily in both countries. So why the higher price in America? Some of the answer is in the cost of the personnel: we pay doctors and technicians more than most countries do, and that all goes into the price charged for diagnostic procedures. But does that explain a 4x price difference? Or the stunning 26x price difference in an angiogram between the U.S. and Canada?

Probably not. So Times reporter Elisabeth Rosenthal decided to dive into one particular procedure: colonoscopies. Why are they more expensive in the U.S. than elsewhere?

Largely an office procedure when widespread screening was first recommended, colonoscopies have moved into surgery centers — which were created as a step down from costly hospital care but are now often a lucrative step up from doctors’ examining rooms — where they are billed like a quasi operation. They are often prescribed and performed more frequently than medical guidelines recommend.

The high price paid for colonoscopies mostly results not from top-notch patient care, according to interviews with health care experts and economists, but from business plans seeking to maximize revenue; haggling between hospitals and insurers that have no relation to the actual costs of performing the procedure; and lobbying, marketing and turf battles among specialists that increase patient fees.

While several cheaper and less invasive tests to screen for colon cancer are recommended as equally effective by the federal government’s expert panel on preventive care — and are commonly used in other countries — colonoscopy has become the go-to procedure in the United States. “We’ve defaulted to by far the most expensive option, without much if any data to support it,” said Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice.

The "turf battles" mentioned above are about the routine use of anesthesiologists in colonoscopies, even though most aren't done under a general anesthetic. This drives the price way up:

In Austria, where colonoscopies are also used widely for cancer screening, the procedure is performed, with sedation, in the office by a doctor and a nurse and “is very safe that way,” said Dr. Monika Ferlitsch, a gastroenterologist and professor at the Medical University of Vienna, who directs the national program on quality assurance.

....Dr. Cesare Hassan, an Italian gastroenterologist who is the chairman of the Guidelines Committee of the European Society of Gastrointestinal Endoscopy, noted that studies in Europe had estimated that the procedure cost about $400 to $800 to perform, including biopsies and sedation. “The U.S. is paying way too much for too little — it leads to opportunistic colonoscopies,” done for profit rather than health, he said.

Bottom line: if a colonoscopy is performed in a doctor's office without an anesthesiologist, the price is cut in half—maybe more. Cut the number of colonoscopies and increase the use of other tests that are frequently just as good, and the average cost of colon cancer screening in America might drop by three-quarters.

But don't expect this to happen anytime soon. After all, one man's outrageous costs are another man's Mercedes Benz. Welcome to the best health care in the world, baby.

Liberals and Lightbulbs

| Sat Jun. 1, 2013 2:10 PM EDT

A few weeks ago, in a post that was mainly a response to Jonah Goldberg's dismissive attitude toward renewable energy, I mentioned a recent study showing that although liberals and conservatives were about equally likely to buy an energy efficient CFL lightbulb even if it cost more than an old-school bulb, conservatives were less likely to buy the bulb if the packaging included the message "Protect the Environment."

That's what the abstract of the article said, anyway: "Conservative individuals were less likely to purchase a more expensive energy-efficient light bulb when it was labeled with an environmental message than when it was unlabeled." But Tim Carney points out that there's a little more to it than that:

Most of the coverage of this made it sound like only conservatives were turned off by the label, and that it was clearly for petty reasons. While really, most people, including generally liberal people, became less likely to buy the bulbs with the label.

The green line in the chart shows how likely people are to buy the bulb with the environmental message. And Carney is right: It crosses below the gray line at an ideology score of -0.6, right in the middle of the liberal spectrum. Just about everyone was turned off by the message except hardcore liberals.

That's actually kind of interesting. And it also shows the danger of relying on a journal abstract when you don't have access to the full paper. It's not that the abstract was wrong—increased conservatism was associated with increased resistance to the message—but there's more to the story.