Kevin Drum - 2012

Angels Are Now Waltzing on the Edge of a Healthcare Plan

| Fri Feb. 10, 2012 2:11 PM EST

Well, we now have the details of the "accommodation" that President Obama has made over the contraception issue. Institutions affiliated with the Catholic church will be able to opt out of contraceptive coverage completely, so the bishops are said to be completely satisfied. The LA Times explains the rest:

The change essentially shifts the responsibility for providing and discussing contraception from the religious employer to the insurers. Any employer who has a religious objections to providing contraception will not have to provide that service to employees, but in those cases the insurer will be required to reach out directly to the employee and offer contraceptive care free of charge.

I've been laughing about this over email with a friend, who writes:

Further according to them, "Policy experts within the administration believe that there is effectively no cost to providing contraception, because use of it prevents much more expensive care they would otherwise have to provide."

Catholic bishops are reportedly thrilled. Insurance companies not heard from yet.

You think these things don't turn on the number of angels on the head of a pin? Apparently, they really do.

Not clear to me why they think there's "effectively no cost" and the insurance companies won't object, since if that were the case, they would have been offering this from the beginning of time.

If this gets everyone to sing Kumbaya, who am I to object? But really, this is just idiocy. If insurance companies are required to provide contraceptive coverage "free of charge," they will, of course, simply raise rates elsewhere to cover all these "free" contraceptives. And Catholic hospitals and universities will all pay these slightly higher rates, which means they're paying exactly as much for contraceptive coverage indirectly as they would be if their healthcare plans covered it directly — just as Catholic bishops who pay income taxes already pay indirectly for contraceptive care subsidized by tax dollars. (Which they do. That's life in a pluralistic democracy. We all pay for stuff we disapprove of.)

Still, I guess this accommodation means the bishops can convince themselves their money isn't going toward paying for the evils of contraception. Kumbaya!

POSTSCRIPT: I just want to add that it's possible that this is a cunningly brilliant move. Obama gets to show — again! — that he's always willing to meet his critics halfway, and if the insurance companies play along with the "free of charge" charade then the critics really don't have a leg left to stand on. If they continue to object, then they're exposed as simply opposed to birth control, not merely standing up for religious liberty.

On a broader note, I don't think there's a single person in the world who has a consistent opinion on the fungibility of money. And you know what? As silly as that is from a purely technical point of view, it's probably not a bad thing. We all need ways to fool ourselves into making compromises we otherwise wouldn't make, and in the grand scheme of things, inconsistency over the fungibility of money is a small price to pay for a better lubricated society.

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The Employment Picture Remains Murky and Hard to Parse

| Fri Feb. 10, 2012 1:50 PM EST

Paul Krugman says that although the employment picture is looking up, it still has a ways to go. To illustrate this, he displays a chart showing the employment-population ratio for prime age workers age 25-54:

I agree that this is a telling statistic. It really does indicate that we haven't made up much of the ground we've lost since 2007, so I don't have any argument with Krugman using it. At the same time, you get a different picture if you pull back and disaggregate the data a bit. Here's another view:

I don't want to make too much of this, especially since I'm not sure exactly what we should make of it. But the employment-population ratio among men has been declining steadily for over half a century, and right now we're only a point or two below the trendline for men. Conversely, participation among women plateaued starting in the mid-90s, which suggests that we're still a good four points or so below the trendline for women.

Maybe. The question is what the long-term trend really is. I'm not sure what to say about that, but it's been niggling at me for a very long time. Basically, I just want to caution everyone not to treat 2007 as a magic year. There's no question that employment is still in the doldrums, but the question of where the employment-population ratio "should" be is not easy to pinpoint.

Drone Attacks Are Popular Because They're Better Than the Alternative

| Fri Feb. 10, 2012 11:44 AM EST

As you may recall, I think one of the most important questions you should ask yourself when you ponder public policy is, "Compared to what?" Michael O'Hare asks this question regarding drone attacks:

I think our emotional reaction to stuff like this depends a lot on what alternatives we instinctively compare it to. Is the drone a cowardly analog to lying in wait for a bad guy and bushwacking him, a pusillanimous substitute for standing up and ‘fighting like a man’, putting your safety at immediate risk? Or is it just like launching a bullet from far away, or dropping a bomb from high in the air, or planting a mine that goes off when you’re in another county, except better because it’s more accurate and selective, can be called off right up to the last second, and even safer for the pilot/operator?

Here's a related point, prompted by the news that even a majority of liberals approve of drone attacks. Again, the key question is, "Compared to what?"

  • When you think of drone attacks, are you mentally comparing them to the invasions of Afghanistan and Iraq? If so, they'll seem like superior alternatives: more focused, less deadly, less costly, and less likely to spiral out of control.
  • Or, are you mentally comparing them to no war at all? If so, they'll obviously seem more deadly, more costly, and, as Mike points out, maybe even cowardly and pusillanimous too.

If liberals are implicitly choosing the first option, that might explain why so many approve of drone attacks: because they want us to withdraw troops from Afghanistan, and they think of drone attacks as a way of allowing that to happen. They may or may not approve of the attacks in a vacuum, but if that's what it takes to provide cover for a drawdown, then it's an acceptable compromise.

I'm not sure how you get inside people's heads to see if this is the lens they're using. But I suspect that something like this explains what's going on, just as "Compared to what?" explains a lot of other things that otherwise seem a little mysterious at first glance.

Compromise Due on Contraception?

| Fri Feb. 10, 2012 10:58 AM EST

I see that the Obama administration is expected to offer up a compromise on contraceptive coverage later this morning. Greg Sargent wisely tweets, "I see no reason not to wait for final proposal. The world won't be worse off if we yell 'cave' in an hour, instead of right now."

Fine. I'll wait. Politically, though, it sounds like a disaster no matter what the compromise is. All the folks who have had Obama's back on this are going to be wildly furious, and the Catholic bishops, having smelled blood already, will not be appeased. Not even slightly. They won't accept any compromise other than an absolute, ironclad exemption for any institution that's associated in any way with the church, putting a clear end to all the nonsense about this really being an issue of copays or some other secondary issue.

This has not been well played.

Why I'm Feeling So Hard-Nosed Over the Contraception Affair

| Fri Feb. 10, 2012 7:00 AM EST

Over the past week I've written a few posts expressing support for the Obama administration's decision to require health care plans to cover contraception, as well as for its decision to permit only a very narrow exemption for religious organizations. I haven't really laid out the whole case, though, and today I want to do that in telegraphic form. Then I want to tell you the real reason that my reaction to this has been stronger than you might have guessed it would be, especially considering that this isn't a subject I wade into frequently. But that won't come until the end of the post. First, the bullet point warm-up:

  • In any case like this, you have to look at two separate issues: (1) How important is the secular public purpose of the policy? And (2) how deeply held is the religious objection to it?
  • On the first issue, I'd say that the public purpose here is pretty strong. Health care in general is very clearly a matter of broad public concern; treating women's health care on a level playing field with men's is, today, a deep and widely-accepted principle; and contraception is quite clearly critical to women's health. Making it widely and easily available is a legitimate issue of public policy.
  • On the second issue, I simply don't believe that the religious objection here is nearly as strong as critics are making it out to be. As I've mentioned before, even the vast majority of Catholics don't believe that contraception is immoral. Only the formal church hierarchy does. What's more, as my colleague Nick Baumann points out, federal regulations have required religious hospitals and universities to offer health care plans that cover contraception for over a decade. (The fact that some such employers don't cover birth control is mostly the result of lax enforcement.) It's true that the Obama regulation tightens this requirement, but only modestly: it covers organizations with fewer than 15 employees and it bans copays. Dozens of states already have similar rules on the books. So when Kirsten Powers says, "One thing we can be sure of: the Catholic Church will shut down before it violates its faith," that's just wrong. They've been working under similar rules for a long time without turning it into Armageddon.
  • Some matters of conscience are worth respecting and some aren't. If, say, Catholic doctrine forbade white doctors from treating black patients, nobody would be defending them. The principle of racial nondiscrimination is simply too important to American culture and we'd insist that the church respect this. I think the same is true today of the principle of nondiscrimination against women, as well as the principle that women should have control of their own reproduction. Like racial discrimination laws, churches that operate major institutions in the public square have to respect this whether they like it or not.
  • This new policy doesn't apply to churches themselves or their devotional arms. It applies only to nominally religious enterprises like hospitals and universities that serve secular purposes, take taxpayer dollars, employ thousands of non-Catholic women, and are already required to obey a wide variety of secular regulations. At organizations like these, the money that pays for employee health care doesn't come from the church, it comes out of the income stream they get from their customers and clients.
  • What's more, this is hardly a unique matter of conscience. Anyone who pays taxes, including Catholic bishops, ends up financially supporting things they disapprove of. Public regulations often involve financial commitments too, and this one is no different. It's also pretty minuscule. This is an issue that's very clearly being blown up for partisan political reasons far beyond its actual impact on religious organizations or religious conscience.

Now, having said all that, it's also true that I'm normally fairly sympathetic to granting religious exemptions to public policy. You can make a case—not a great one, but a case—that allowing an exemption to the new contraceptive policy wouldn't actually work a huge hardship on the women affected. And the Catholic Church's objection to contraception, wrongheaded though I think it is, is plainly of long standing. This is no made-up issue.

So why am I really feeling so hard-nosed about this? The answer goes back a few years, to the controversy over pharmacists who refused to fill prescriptions for the morning-after pill. I was appalled: If you're a pharmacist, then you fill people's prescriptions. That's the job, full stop. If you object to filling prescriptions, then you need to find another occupation.

But of course, the entire right-wing outrage machine went into high gear over this. And it was at that point that my position shifted: if this was the direction things were going, then it was obvious that there would be no end to religious exemption arguments. The whole affair was, I thought, way over the top, and yet it got the the full-throated support of virtually every conservative pundit and talking head anyway. This was, in plain terms, simply a war on contraception.

So I changed my mind. Instead of believing as a default that we should take religious exemptions seriously and put the burden of proof on the rest of us to explain why they shouldn't be allowed, I now believe that neutral public policy comes first and the burden of proof should be on churches to provide convincing arguments that (a) An important matter of conscience is being violated, and (b) The public policy in question isn't important enough to be applied across the board. On the matter of contraception, I don't think they've made a convincing case for either one.

Contraceptives and Copays

| Thu Feb. 9, 2012 9:29 PM EST

I'm curious about something. Chris Matthews has been insisting for days now that the real issue in the Obama administration's new contraceptive rules is copays. That is, the problem isn't that the rules require Catholic hospitals and universities to provide healthcare coverage that includes contraceptives, it's that they're required to provide healthcare coverage that includes contraceptives with no copay.

Is there anything to this? I haven't heard a single critic of the new rules highlight this. Quite the contrary. Every one of them appears to believe that requiring contraceptive coverage from Catholic institutions is just flat-out wrong. Allowing copays wouldn't change this at all.

So where is this copay argument coming from? Does anyone know?

On a related topic, why was there (to my knowledge) no outburst last August, when these rules were first announced? The Catholic hierarchy certainly objected to them at the time, but aside from a few brief mentions it barely got any news coverage at all. My cynical view is that the only difference between then and now is that the Republican presidential primary is in high gear, but maybe there's more to this. Again, does anyone know?

UPDATE: In comments, Frank Parnell offers an answer to my second question:

According to NPR, the bishops were upset when the when the rules were announced in August, met with the White House, and (wink, wink, say no more) thought they received assurances from Obama that they would receive a broad exemption. Either someone badly misinterpreted the discussion, or someone is being less than truthful, or a bit of both.

And here's New York Times religion correspondent Laurie Goodstein a few days ago on NPR:

Well, I think part of the reason the bishops are so outraged is that they feel that they were given a signal by the administration and directly by President Obama. Archbishop Dolan met with President Obama. They talked about the work that the Catholic Church does, that the Catholic Church is not just parishes, but is also hospitals, is universities, charities and that all these institutions have a right to express their religious freedom and religious conscience.

So, Archbishop Dolan thought that he had gotten through to President Obama and thought he had a signal that this decision would go their way. So, when it didn't, they felt greatly betrayed by the president.

So there you go.

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Survey Says 24% of Kids Have Moved Back In With Their Parents

| Thu Feb. 9, 2012 4:13 PM EST

Pew Research has a new survey out about the effect of the lousy economy on young people, and it's chock full of interesting things. Go read it! But I think I was most surprised by this:

It's not all that surprising that lots of young people are taking crappy jobs or going back to school or even postponing having a baby. But a full quarter of them have moved back in with their parents? Yikes. I'm not sure how much this has changed over time, but it's a helluva lot regardless.

Quote of the Day: Ray LaHood Does Not Like the House Transportation Bill

| Thu Feb. 9, 2012 3:00 PM EST

From Ray LaHood, Secretary of Transportation and former Republican congressman, on the mind-bending stew of tea party crankery being stuffed into the transportation legislation currently being jammed through the House by its Republican leadership:

This is the most partisan transportation bill that I have ever seen. And it also is the most anti-safety bill I have ever seen. It hollows out our No. 1 priority, which is safety, and frankly, it hollows out the guts of the transportation efforts that we’ve been about for the last three years. It’s the worst transportation bill I’ve ever seen during 35 years of public service.

But other than that, Mrs. Lincoln, how did you like the play?

Chart of the Day: Unleaded Gasoline and Teen Pregnancy

| Thu Feb. 9, 2012 12:52 PM EST

Charles Murray is concerned about the moral collapse of the white working class and ascribes it to the breakdown of traditional values that began in the 60s. But Paul Krugman hauls out a couple of charts showing that violent crime and teen pregnancy have been dropping over the past few decades and makes a pointed observation: "So here’s a thought: maybe traditional social values are eroding in the white working class — but maybe those traditional social values aren’t as essential to a good society as conservatives like to imagine."

Maybe! But then again, maybe both Murray and Krugman are missing the boat. I've written before about Rick Nevin's research showing the startlingly strong correlation between the drop in childhood lead exposure (mostly thanks to the introduction of unleaded gasoline) and the drop in violent crime, but I've never mentioned the actual title of the original paper he wrote. Here it is:

How Lead Exposure Relates to Temporal Changes in IQ, Violent Crime, and Unwed Pregnancy

Guess what? The reduction in blood lead levels over the past few decades seems to be a very strong predictor of the drop in teen pregnancy levels. Here's Nevin:

Although other social trends and government policies are often cited to explain the rise and fall in unwed pregnancy and crime rates over recent decades, the role of childhood lead exposure seems to be especially apparent in the best-fit lag structures for gasoline lead regressions. In the case of the unwed pregnancy regressions, the best-fit lag for each bracket is consistent with changes in lead exposure in the first years of life....The fit between the temporal patterns, with lags consistent with the known risks of lead exposure in the first years of life, provide striking visual support for the association between lead exposure and undesirable social behaviors.

His "striking visual support" is below. Make of this what you will. Just keep in mind that sometimes neither "traditional moral values" nor economic stagnation provides all the answers. Sometimes you ought to be looking elsewhere.

Yet Another Last-Minute Step Away From the Cliff in Europe

| Thu Feb. 9, 2012 11:59 AM EST

The financial situation in Europe keeps looking dodgier and dodgier, and yet I continue to persevere in my belief that, at the very last moment, European leaders will end up doing more or less the right thing. ("Right thing" being very broadly defined, mind you, to be anything that prevents collapse and a euro crackup.) That seems to have happened yet again today:

After days of dramatic talks, Greek political leaders reached a deal on Thursday to support a package of harsh austerity measures demanded by Greece’s financial backers in return for the country’s latest bailout.

The deal is expected to unlock the €130 billion, or $172 billion, in new loans and save Greece from a potentially disastrous default.

Not everything is coming up roses, of course. The deal still has to be approved by a variety of folks in Greece, and there's always a chance of some last-minute theatrics. It's also true that the austerity measures agreed to will make Greece's economy spiral ever downward, so while the final implosion of the euro area has been delayed, it hasn't necessarily been prevented. That's going to depend a lot on Angela Merkel, the patience of the German populace, and the future actions of the European Central Bank.

But for now, collapse has been averted at the last minute. As usual. Whatever happens in the future, I think we can expect that this is when collapse is always going to be averted.