Kevin Drum - February 2009

Comparative Effectiveness

| Wed Feb. 18, 2009 12:33 PM EST
Via Ezra, medblogger KevinMD writes in favor of federal funding for comparative effectiveness research:

Physicians need an authoritative source of unbiased data, untainted by the influence of drug companies and device manufacturers....The only way to tackle such a huge project is with money, and indeed, the Obama administration recognizes this fact by including $1.1 billion in comparative effectiveness research in the economic stimulus package.

Clearly, the pharmaceutical and device industry would like both the public and physicians to continue to assume that "newer means better." Not asking these questions allows them to continue promoting profit-making brand-name treatments.

Their motives in attempting to quash comparative effectiveness research could not be more obvious.

Indeed, their motives are obvious: They know perfectly well that a lot of their newest and priciest treatments aren't any better than the stuff going off patent next year, and they'd just as soon no one knew that fact.  But I'd like to know, and I'm positively delighted to kick in my share of that $1.1 billion to find out.  Anyone who's not a pharmaceutical executive ought to be pretty happy about it too.  Ezra has more on how the whole scam works.

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GOP Meltdown Watch

| Wed Feb. 18, 2009 12:15 PM EST
The Republican leader in the California state senate is one of only two GOP senators who's agreed to back a budget compromise that includes both spending cuts and tax increases.  Last night, Sen. Mark Leno (D-San Francisco) taunted the holdouts, telling them, "You ought to follow your leader or choose a new one."  It turns out they agreed:

Around 11 p.m., a group of GOP senators, unhappy with the higher taxes that Senate leader Dave Cogdill of Modesto agreed to as part of a deal with the governor and Democrats, voted to replace him in a private caucus meeting in Cogdill's office.

They chose Sen. Dennis Hollingsworth, a staunchly antitax lawmaker from Murrieta, as their new leader.

....Hollingsworth said he does not want to see a tax increase passed, but he offered no plan for resolving the budget crisis.

So it's back to square one with the flat earthers determined to wreck the state.  A friend of mine emailed to say that my post the other day comparing California Republicans to lemmings and neanderthals was unfair to both lemmings and neanderthals, and I guess he had a point.  So what do we compare them to now?

Homeowner Bailout

| Wed Feb. 18, 2009 12:03 PM EST
President Obama unveiled his homeowner bailout plan today.  The first provision is aimed at motivating mortgage servicers to offer underwater homeowners improved loan terms:

Servicers can receive an up-front payment of $1,000 for each eligible loan modification that meets certain criteria. The government said it would pay servicers $500 and mortgage investors $1,500 if at-risk loans are modified before borrowers fall behind. The government said it would also help pay down the principal of certain mortgages by up to $1,000 a year for up to five years if the borrower doesn't miss any payments.

Hmmm.  Loan servicers already have an incentive to rework loans that would otherwise go into default, and for the most part they aren't doing it.  Will a couple thousand dollars change their internal calculus?  Offhand, it doesn't sound like enough to really make a difference — though another provision of Obama's plan adds a stick to the carrot, by allowing bankruptcy judges to unilaterally alter mortgage terms.  So it's possible that the carrot and the stick together will have a noticeable impact.

The second major part of the program is aimed at lowering interest rates on underwater loans:

Finance companies cannot currently refinance a loan if the homeowner owes more than 80 percent of the home's value. But under the plan, Fannie and Freddie — which were taken over by the government last year — would be able to refinance a mortgage if it does not exceed 105 percent of the current value of the property. For example, if the value of the borrower's property is $200,000, but the homeowner owes $210,000, he or she could still qualify for the program.

This sounds promising.  If the interest rate reductions are significant, it could provide some serious help to homeowners.  It will also help arrest the slide in home prices, which might be a worthwhile goal at this point.  It's true that house prices are still too high and need to fall further, but Obama's program most likely won't have a serious effect for another six months at least, and by that time we might be at risk of house prices overshooting on their way down.  A program that pushes against that tide could end up being a good countercyclical tool.

Bailing Out Detroit

| Wed Feb. 18, 2009 12:46 AM EST
The latest from Detroit:

The price tag for bailing out General Motors and Chrysler jumped by another $14 billion Tuesday, to $39 billion, with the two automakers saying they would need the additional aid from the federal government to remain solvent.

....The deteriorating finances of the two companies present the Obama administration with two options, neither of them appealing  It can provide the money in the hopes that the companies will stabilize, and no longer have to keep pushing workers into a growing pool of people without jobs....But if the federal government balks at the automakers’ requests, that would mean the two companies probably would have no choice but to file for bankruptcy protection, because they are losing hundreds of millions of dollars each month.

Hell's bells.  What to do?  I mean, does anyone believe this is the end of the bailout requests?  I certainly don't, and I doubt anyone else does either.  On the other hand, the alternative is allowing GM and Chrysler to fail in the middle of a recession.  Nobody wants that.  But on the third hand, even if we bail them out, what are the odds that they can survive in the long term anyway?

In the end, I suppose we'll continue bailing.  But this whole process shows up one of the big pitfalls of government action like this.  My own guess — and this is obviously just a personal hunch — is that while GM is at least arguably salvagable, Chrysler is a hopeless basket case.  So if we're going to do anything, we should probably bail out GM but let Chrysler go under.  That would save the taxpayers some money and reduce overcapacity in the auto industry at the same time. Unfortunately, politics being what it is, the Obama administration probably feels like they can't pick winners and losers and needs to treat them both equally.

This is almost certainly dumb, but it's what's most likely going to happen.  So the American public will end up pumping $10 or $20 billion into Chrysler in order to help it become, basically, the North American subsidiary of Fiat — a partnership that does the U.S. auto industry little good and will itself almost certainly crumble and fail before long in any case.  What a mess.

Performance Bleg

| Tue Feb. 17, 2009 7:23 PM EST
A question for y'all: how's the performance of our site these days?  I use Firefox and Windows XP and my performance is sort of sluggish, but not wildly so.  Maybe 10 seconds to load the first few posts on the blog and another 10 or 15 seconds to finish loading the whole thing.  How about you?  Better?  Worse?  Is load time consistent or does it bounce around a lot?

Vitamins

| Tue Feb. 17, 2009 5:16 PM EST
Everyone needs vitamins.  Too little Vitamin C and you get scurvy.  Not enough B1 and you come down with beriberi.  But even a halfway balanced diet provides you with enough essential nutrients to avoid vitamin deficiency diseases, so scurvy and beriberi aren't things for most of us to worry about. A more important question for us developed world types is, Can large doses of vitamins help prevent other chronic conditions, like cancer and heart disease?  The New York Times says no:

The latest news came last week after researchers in the Women’s Health Initiative study tracked eight years of multivitamin use among more than 161,000 older women. Despite earlier findings suggesting that multivitamins might lower the risk for heart disease and certain cancers, the study, published in The Archives of Internal Medicine, found no such benefit.

Last year, a study that tracked almost 15,000 male physicians for a decade reported no differences in cancer or heart disease rates among those using vitamins E and C compared with those taking a placebo. And in October, a study of 35,000 men dashed hopes that high doses of vitamin E and selenium could lower the risk of prostate cancer.

....“I’m puzzled why the public in general ignores the results of well-done trials,” said Dr. Eric Klein, national study coordinator for the prostate cancer trial and chairman of the Cleveland Clinic’s Glickman Urological and Kidney Institute. “The public’s belief in the benefits of vitamins and nutrients is not supported by the available scientific data.”

Eating leafy greens is good for you, but apparently getting megadoses of the same vitamins in pill form doesn't do squat.  In fact, they even have some negative side effects.  Bottom line: have a salad tonight and skip the multivitamins.

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Quote of the Day - 02.17.09

| Tue Feb. 17, 2009 4:09 PM EST
QUOTE OF THE DAY....From James Joyner, musing on how the blogosphere has changed in the past six years:

The rise of RSS readers and aggregators like Memeorandum mean that fewer of us are using our blogrolls or just keeping a log of interesting things we’re finding on the Web; instead, we’re much more apt to write about what everyone else is writing about.

I'm not quite sure I'd agree that RSS and Memeorandum are to blame for this, but there's not much question that the blogosphere is more herdlike than it used to be.  Not a change for the better, I'd say.

Preventive Detention

| Tue Feb. 17, 2009 2:33 PM EST
PREVENTIVE DETENTION....Jane Mayer writes in the New Yorker this week about how the Obama administration plans to handle the enemy combatants currently held at Guantanamo Bay and elsewhere.  Greg Craig, Obama's White House counsel, says that some disturbing options are being considered:

The Obama Administration has indicated that it hopes to return the majority of the detainees to other countries, or to try them in civilian and military courts. The looming question, however, is whether there is a category of terror suspect whose status precludes such options. It’s unclear whether some home countries can provide fair trials or secure prisons. More important, the high standard of evidence required in U.S. courts—guilt must be proved “beyond a reasonable doubt” — might result in dangerous individuals being set free.

....Depending upon how many such “hard cases” exist, Craig says, the Administration will decide whether new laws, including possibly those enabling some sort of preventive detention, are necessary....“It’s possible but hard to imagine Barack Obama as the first President of the United States to introduce a preventive-detention law,” Craig said. “Our presumption is that there is no need to create a whole new system. Our system is very capable.” Then again, the idea is not being ruled out, which may be surprising to some constituents, given Obama’s past support for civil liberties and Craig’s own record — in the early nineties, he served as the chairman of the board of the International Human Rights Law Group, an advocacy organization now known as Global Rights.

There are lots of genuinely tough questions here, so I sympathize with Craig's position, but still: preventive detention?  Is he talking about indefinite preventive detention?  That's hard to believe, but temporary preventive detention (i.e., holding a prisoner without bail while awaiting trial) is already a standard part of our judicial system — and it's hard to believe that the government is truly afraid that a judge presented with even minimal evidence of danger and flight risk would allow a terrorism suspect out on bail.

Hopefully I'm just confused here.  In the meantime, though, read the whole thing.  It's a good summary of where we stand right now.

Job Creation!

| Tue Feb. 17, 2009 1:37 PM EST
JOB CREATION....So how many jobs will the stimulus package create for my hometown?  Luckily, the White House has a fact sheet to tell me exactly that.  Lessee....California....48th district....ah, here it is: 8,000 jobs.

Suspiciously, this just happens to be exactly the number you get if you divide 3.5 million jobs by 435 congressional districts plus DC.  Which makes me think that this is not exactly a fine-grained exercise in employment econometrics.  Still, there are differences: Delaware supposedly gets 11,000 jobs, for example, while my mother's district just north of here only gets 6,500 jobs.  That's less than I get, which seems a shame since she has a Democratic congresswoman who voted for the stimulus and I have a Republican critter who voted against it, but them's the breaks.  That's our brave new postpartisan world for you.

Who's Afraid of the Filibuster?

| Tue Feb. 17, 2009 1:04 PM EST
WHO'S AFRAID OF THE FILIBUSTER?....Steve Benen explains why there's support for the filibuster in both parties:

The status quo is a mess. The American electorate can give a party the White House and sizable majorities in both chambers, but that party will still struggle badly to pass its agenda. A 41-member minority party can block legislation — controversial or not — by abusing an obscure procedural tactic that was never intended to be used to necessitate supermajorities on literally every piece of legislation.

....Those who approve of keeping the filibuster around as a "check" — despite the fact that it was never intended to block congressional majorities from passing legislation — envision a cyclical dynamic: Republicans win voter approval, but are limited by the Senate minority. Democrats win voter approval, but are limited by the same obscure legislative tactic. Government through obstructionism. Everyone has a credible excuse for failing to deliver on a policy agenda.

I'd put this a little bit differently.  I think it's fear that's kept the filibuster around for so long.  Republicans could have gotten rid of it in 1983 if they'd wanted to.  Democrats could have axed it in 1993.  Republicans could have killed it in 2003.  Democrats could do it again today.  So why is it still around?

Tradition and custom are part of the answer, but mostly it's fear.  Fear of what the other guys will do when they eventually come back into power.  Both parties are so afraid of what their opposite numbers could do with simple majority rule that they've lost sight of what they could do with it.

This is especially short-sighted coming from liberals.  I got several emails after my last filibuster post suggesting that I should think twice.  What if the GOP had been able to get all their judicial nominees through during the past eight years?  What if Bush had passed Social Security reform?  What if, what if, what if.

But look: only a handful of Bush's judges were successfully filibustered.  Social Security reform never even came up for a vote.  But even conceding that, yes, there would be some short-term pain from conservative rule in a filibuster-less world, in the long run the filibuster is bad for liberalism because liberals are fundamentally in favor of change and the filibuster is fundamentally obstructive.  It's well suited for a movement that wants to stand athwart history and yell "Stop!" but less well suited to a movement that has a positive agenda revolving around the enactment of ambitious new social programs.

This makes it unsurprising that conservatives want to keep the filibuster around.  They know perfectly well that once liberal social programs are enacted, they become very popular and very hard to get rid of.  They can't count on the swing of the pendulum to eventually turn the public against Social Security or Medicare or national healthcare, so their only alternative is to stop programs like this in the first place.  For them, the filibuster is a key tool.

But not for us.  Sure, if we get rid of the filibuster we'll pay a price when Republicans get back into power.  But overturning conservative programs isn't that hard.  And in return we'll make a lot of progress during out own time in office, progress that's largely permanent.  But only if we have the courage of our convictions.  If we truly think that our programs will work and become popular, then we shouldn't worry about what will happen when the opposition eventually returns to power.  We should be more concerned about what we can do while we're in power.  And the answer is: a lot more.  Throughout history, the filibuster has been a tool that makes America a more conservative place, and any liberal who's afraid to get rid of it is crazy.