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China's Future, Take 2

| Tue May 12, 2015 7:51 PM EDT

After writing my post this morning about China's economic future, I got an email response from an American who lived there for nearly two decades and had a different perspective on what China's biggest problem might be going forward. Obviously this is just one person's opinion, and I can't independently vouch for it, but I thought it was interesting enough to share. Here it is:

I read with interest your musings on the future of China. As it happens, I lived for 17 years in Beijing, married, and started a family there.

I believe the macro-level statistics and phenomena you discuss are all trailing indicators. I left China with my family almost five years ago as a large number of interrelated quality-of-life issues became increasingly unbearable. Those factors have continued to worsen since then at an accelerating rate, to the point where the economy is now largely driven by people trying to earn or steal enough money to leave.

The once-thriving expat community in Beijing has shriveled to nearly nothing. The cost of living is approaching world-capital (NY, London, Tokyo, etc.) levels for a miserable existence. The local culture has become increasingly desperate and cutthroat. And Beijing is one of the more attractive places in China to live, work, and raise a family.

People, generally, and Chinese especially, will tolerate all sorts of deprivation in service of a better future for their children. And that is largely what has driven the rapid pace of Chinese development since the end of the Cultural Revolution and the beginning of Deng Xiaoping's opening and reform policies. My feeling is that biggest challenge ahead for China is when the population at large concludes that a better future for their children is no longer in the cards.

When it happens, it will happen gradually, then suddenly. And what happens after that, no one can say, but a continuation of the policies driving hyper-accelerated GDP growth over all else probably isn't it.

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Obama Just Called Out Fox News For Making the Poor Out to Be "Leeches"

| Tue May 12, 2015 3:50 PM EDT

Via Politico, oh snap:

President Barack Obama criticized Fox News on Tuesday, accusing the network of portraying poor people as "leeches."

In a discussion at Georgetown University, Obama said the media made an effort to “suggest the poor are sponges, leeches, don't want to work, are lazy, are undeserving," and he then singled out Fox News for special rebuke.

From the White House transcript:

There’s always been a strain in American politics where you’ve got the middle class, and the question has been, who are you mad at, if you’re struggling; if you’re working, but you don’t seem to be getting ahead. And over the last 40 years, sadly, I think there’s been an effort to either make folks mad at folks at the top, or to be mad at folks at the bottom. And I think the effort to suggest that the poor are sponges, leaches, don’t want to work, are lazy, are undeserving, got traction. And, look, it's still being propagated.
I mean, I have to say that if you watch Fox News on a regular basis, it is a constant menu—they will find folks who make me mad. I don’t know where they find them. They’re like, "I don’t want to work, I just want a free Obama phone"—or whatever. And that becomes an entire narrative, right? That gets worked up. And very rarely do you hear an interview of a waitress—which is much more typical—who’s raising a couple of kids and is doing everything right but still can’t pay the bills.
And so if we’re going to change how John Boehner and Mitch McConnell think, we’re going to have to change how our body politic thinks, which means we’re going to have to change how the media reports on these issues and how people’s impressions of what it's like to struggle in this economy looks like, and how budgets connect to that. And that’s a hard process because that requires a much broader conversation than typically we have on the nightly news.
Amen.
 
Here's the video, courtesy of Media Matters:

BOOM. President Obama just called out Fox News by name for their awful coverage of poverty in America and for regularly pushing false stereotypes about poor people. Watch:

Posted by Media Matters for America on Tuesday, May 12, 2015

More Americans Ditching Organized Religion

| Tue May 12, 2015 3:36 PM EDT

According to a new study published by the Pew Research Center today, the largest shift in religious demographics over the past seven years is in the number of Americans who don't affiliate with any religion at all. The study, which started in 2007 and surveyed more than 35,000 people, saw this group jump from 16.1 to 22.8 percentage points—with young, college-educated Americans being the most religiously unaffiliated:

While many U.S. religious groups are aging, the unaffiliated are comparatively young – and getting younger, on average, over time. As a rising cohort of highly unaffiliated Millennials reaches adulthood, the median age of unaffiliated adults has dropped to 36, down from 38 in 2007 and far lower than the general (adult) population’s median age of 46.4 By contrast, the median age of mainline Protestant adults in the new survey is 52 (up from 50 in 2007), and the median age of Catholic adults is 49 (up from 45 seven years earlier).

The findings had some disappointing news for Christians. While the number of people who identify with the religion has been waning for decades, the drop in the Christian population has been the sharpest of all in recent years with fewer Americans than ever before identifying themselves as Christians.

Pew

Other interesting details include: Religious intermarriage is up. Christians are getting more diverse. And Muslims and Hindus are seeing significant increases in their numbers. For more, head over to the Pew Research Center here.

Apparently Jeb Bush Needs a Hearing Aid, Stat

| Tue May 12, 2015 2:24 PM EDT

Yesterday's quote of the day:

Megyn Kelly: Knowing what we know now, would you have authorized the [Iraq] invasion?

Jeb Bush: I would have.

Really? As Byron York points out, even George W. Bush himself has some qualms about the war knowing what we know now—namely that the intel about Saddam's WMD was all 100 percent fiction derived from phony sources and wishful thinking. So how is ol' Jeb going to clean up this steaming pile of gaffe-osity? Like this, according to former Bush aide Ana Navarro:

I emailed him this morning and I said to him, 'Hey, I'm a little confused by this answer so I'm genuinely wondering did you mishear the question?'" Navarro said. "And he said, 'Yes, I misheard the question.'"

....On Tuesday morning, Navarro she wasn't sure whether he would clarify the answer.

Hoo boy. That's his story? Good luck with that.

The Pentagon Gave How Much Taxpayer Cash to the NFL?

| Tue May 12, 2015 1:32 PM EDT

For the last three years, the Department of Defense has forked over $5.4 million to 14 NFL teams to pay respect to service members during games. And while that's a small line in the behemoth Pentagon budget, at least one GOP senator isn't thrilled about it.

Sen. Jeff Flake (R-Ariz.) criticized the "egregious and unnecessary waste of taxpayer dollars" on Monday after a weekend report by NJ.com found the Defense Department and the New Jersey National Guard paid the New York Jets $377,000 for in-game salutes and promotional activities at professional football games. The Atlanta Falcons received more than $1 million during that time, while the Baltimore Ravens raked in $885,000.  

"While it may be appropriate for the National Guard or other service branches to spend taxpayer funds on activities directly related to recruiting," Flake said, "giving taxpayer funds to professional sports teams for activities that are portrayed to the public as paying homage to US military personnel would seem inappropriate."

What did the National Guard get in return? From NJ.com's Christopher Baxter and Jonathan Salant:

The agreement includes the Hometown Hero segment, in which the Jets feature a soldier or two on the big screen, announce their names and ask the crowd to thank them for their service. The soldiers and three friends also get seats in the Coaches Club for the game.

[…]

Aside from the Hometown Heroes segment, the agreements also included advertising and marketing services, including a kickoff video message from the Guard, digital advertising on stadium screens, online advertising and meeting space for a meeting or events.

Also, soldiers attended the annual kickoff lunch in New York City to meet and take pictures with the players for promotional use, and the Jets allowed soldiers to participate in a charity event in which coaches and players build or rebuild a playground or park.

The Jets also provided game access passes.

Flake, who first highlighted the National Guard's spending as part of his #PorkChops campaign on wasteful spending, said his office had found "a number of advertising and promotion contracts between the Pentagon and professional sports teams in the MLB, NBA, NASCAR, Major League Soccer and the NCAA," according to the Hill.

Here's the full list of NFL teams that received DOD money, via NJ.com:

Property Bubble, Tech Bubble, What's Next For China?

| Tue May 12, 2015 11:47 AM EDT

I've long been conflicted about China's prospects for the future. On the one hand, their growth rate has been impressive over the past few decades, and their long-term growth seems to be reasonably well assured too. But there are clouds on the horizon. Demographics are one: China is getting older, and by 2030 nearly a quarter of the country will be elderly. There's also a problem that's inherent to growth: As China gets richer and more middle class, their labor costs will rise, eliminating one of their key attractions to Western manufacturers.

But what about the short term? That's starting to look problematic too. China's stock markets have been on a massive, bubblicious tear recently, none more so than the exchanges that specialize in tech companies. Matt O'Brien speculates about the underlying cause of this mania:

Why are China's stock markets partying like it's 1999? Well, part of it is that China's housing bubble might be bursting—new home prices fell 5.1 percent in January—and the only other place people can put their money is in stocks. Another part is that China's state-owned media companies have been saying for months that stocks look cheap, and people are listening. Especially people who haven't graduated from high school. Indeed, 67 percent of China's new stock investors don't have a high school diploma. And now that China has cut interest rates so much—and looks like it will keep doing so—they can borrow money to buy as many stocks as they want. And that's a lot. So-called margin accounts, which let people do this, more than doubled in 2014, and, even though brokerages have tightened their terms a bit, they're still growing.

So whether you want to call this a boom, a bull market, or a mania doesn't really matter. A bubble by any other name will pop just as much.

The best-case scenario is probably that China's central bank manages to engineer a fairly normal cyclical recession, which will be mild and short-lived. The worst-case scenario is that borrowing is fueling more of this boom than we think, and China will shortly experience a bursting property and stock bubble that will look an awful lot like the one we went through in 2008.

Still, I will say one thing in China's favor: a lot of analysts have been predicting a crash for a long time, and somehow China's economy just keeps rolling along. On the other hand, to paraphrase Keynes, bubbles can last a helluva lot longer than you'd think. But eventually they all burst anyway.

So color me nervous about China. At the same time, keep in mind that all I know is what I read in the papers. I might be totally off base with my concerns.

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Why Do We Give Medical Treatment That Increases Patients' Chances of Dying?

| Tue May 12, 2015 9:00 AM EDT

While Kevin Drum is focused on getting better, we've invited some of the remarkable writers and thinkers who have traded links and ideas with him from Blogosphere 1.0 to this day to contribute posts and keep the conversation going. Today we're honored to present a post from Aaron E. Carroll.

I saw this study a few weeks ago on blood pressure treatment for nursing home residents, and I almost ignored it. There are so many like it. But it's just ridiculous that this kind of stuff continues, and that we can't seem to do anything about it.

We know that in many people, high blood pressure is bad. We therefore try and do things to lower it. But then we go ahead and decide that if lowering blood pressure in some people is good, it must be good for everyone. In frail, elderly people, however, there's no evidence for this—and there may be evidence that lowering blood pressure is a bad idea. But that runs counter to what we've always been told, so many ignore it.

Getting doctors to change their behavior is hard, and getting them to stop doing something may be even harder.

This was a longitudinal study of elderly people living in nursing homes, meaning that the authors recruited people there and then followed them for about two years. They were interested in seeing how different aspects of care were related to the subjects' chance of dying. Almost 80 percent of them were being treated for high blood pressure (in spite of the above). A previous analysis of this study had shown that blood pressure was inversely related to all-cause mortality "even after adjusting for several confounders, such as age, sex, history of previous cardiovascular (CV) disease, Charlson Comorbidity Index score, cognitive function (Mini-Mental State Examination), and autonomy status (activities of daily living)." This study went further, to look at whether being on lots of drugs for high blood pressure was bad—even after controlling for the blood pressure relationship.

Patients in this study were on an average of seven drugs and were on at least two drugs for high blood pressure.

What the study found, to no one's real surprise, is that the people on two or more blood pressure medications who had a systolic blood pressure of less than 130 mm Hg had a significantly higher all-cause mortality. This held true even after additionally adjusting for propensity score–matched subsets, other cardiovascular issues, and the exclusion of patients without a history of hypertension who were receiving BP-lowering agents.

We know that there’s evidence that keeping blood pressure lower in this population might be bad. Yet, many of these patients were not only being treated for "high" blood pressure—many were on multiple medications for it. Those on more medications (i.e. more treatment) were more likely to die.

Here's the kicker: This wasn't a study done in the United States. It was done in France and Italy—so this isn't me bashing on the US health care system. It's a problem that's writ large. We find something that is bad. We find that lessening it is better. We then start to lessen it even more. Soon we're trying to lessen it for everyone. We're saying it's too high in all populations, even when we don't have evidence that's true. We say it even as evidence builds that less is bad for lots of people.

Better clinical decision support might help, but we can't seem to get that in electronic health records, and doctors hate those anyway. Many are still unaware that guidelines even exist.

And then when things get really bad, we act as if we weren't to blame. From an editorial in JAMA:

It is surprising that among frail elderly patients with a systolic blood pressure less than 130 mm Hg (20 percent of the studied group), the use of multiple antihypertensive drugs was continued, because few evidence-based data support this approach.

Really? It's surprising?

Getting doctors to change their behavior is hard, and getting them to stop doing something may be even harder. But all of this is important, and it's part of why health services research is so critical.

A final note: Even when I'm upset about some aspects of medicine, I'm grateful for so many others—like the ones helping Kevin right now. I'm crazy about health care. I'll keep poking it with a stick. That's how I show my love.

This Marble Race Is the Greatest Thing I've Ever Seen In my Entire Life

| Tue May 12, 2015 3:17 AM EDT

Here is the most amazing marble race ever.

Here is that same amazing marble race with the theme song to Chariots of Fire.

 

This amazing marble race was on DIgg so I took the time to add the Chariots of Fire theme song to it. You're welcome.

Posted by Ben Dreyfuss on Tuesday, May 12, 2015

You're welcome.

(via Digg)

West Virginia Democrats' Best Hope Might Be This Billionaire Coal Magnate

| Mon May 11, 2015 6:21 PM EDT

Over the last six years, West Virginia Democrats have seen their grip on state politics slip away in no small part due to their alleged collaboration with President Barack Obama's "War on Coal." The solution: put a coal kingpin on the ballot.

On Monday, Jim Justice, owner of Southern Coal Corp., announced he would run for governor as a Democrat in 2016, to replace the retiring incumbent Gov. Earl Ray Tomblin. Justice, the state's richest citizen with an estimated net worth of $1.6 billion, is a political novice but a state icon. In 2009, he purchased the Greenbrier, a historic mountain resort that had fallen on hard times, and restored it into a first-class resort. During his gubernatorial campaign kickoff event, Justice drew a parallel between his state's lackluster reputation, and the derelict condition of the White Sulphur Springs retreat. "[Times] were tough at the Greenbrier, too," he said.

In Justice, Democrats have found a walking counterpoint to the war-on-coal attacks. (The attacks are also largely unfounded—under Tomblin the state has rolled back mine safety regulations.) In contrast to, say, frequent Greenbrier guest Don Blankenship, who as CEO of Massey Energy famously re-designed his property so he wouldn't have to use his town's polluted drinking water and is currently awaiting trial on conspiracy to violate mine-safety laws, Justice has always styled himself as a man of the people. A 2011 Washington Post profile began with a surprise sighting of Justice at an Applebee's near his hometown. The richest man in the state, it turned out, was grabbing a late snack after coaching his hometown's high school girls basketball team.

But Southern Coal Corp. isn't without its issues. An NPR investigation last fall found that the company owed nearly $2 million in delinquent fines for federal mine safety violations. (After the report was published, Justice agreed to work out a payment plan.) And he may not have the Democratic field to himself, either; senate minority leader Jeff Kessler (D) filed his pre-candidacy papers in March. No Republicans have thrown their hats into the ring yet.

Cheater Punished

| Mon May 11, 2015 5:53 PM EDT

Don't do the crime if you can't...well, maybe just don't do the crime?

The NFL has suspended New England Patriots quarterback Tom Brady four games for his role in deflating football for the AFC Championship Game, the league said in a statement Monday.

The Patriots will also lose a first-round pick in 2016 and a fourth-round pick in 2017 and have been fined $1 million.

(via ESPN)