Kevin Drum - 2013

The Conservative Fundraising Racket, Part 674

| Thu Oct. 17, 2013 10:09 AM EDT

This morning in my inbox I have a "personal appeal from Rand Paul." Nothing unusual about that, but check out the subject:

Dear Concerned American:

"I owe these unions."

President Barack Obama couldn't have stated it any more clearly.

And after spending an estimated BILLION dollars to re-elect Barack Obama and maintain control of the U.S. Senate, the union bosses couldn't agree more.

They're wasting no time demanding PAYBACK.

Top AFL-CIO union boss Richard Trumka has already made clear that he expects Big Labor's Card Check Forced Unionism Bill to be a top priority in Obama's second term.

....Since Barack Obama doesn't have to face the voters again for re-election, the union bosses understand this may be their last -- and best -- opportunity to make Card Check Forced Unionism the law of the land.

That's why it's vital you act today!

Vital indeed. And "VERY expensive," of course. So please make a generous contribution to the National Right to Work Committee.

The fact that Rand Paul opposes unions—and supports the NRWC—is no surprise, but this pitch is a sign of just how much of a racket conservative fundraising has become. There's no question that card check is something that both unions and Democrats support, but it couldn't even pass in 2009, when Democrats controlled the House and had a supermajority in the Senate. It has zero chance of passing now, and everyone knows it. Rand Paul certainly knows it, and the National Right to Work Committee knows it.

But there are frightened legions of Fox News viewers out there who don't know it, and Rand Paul wants a chunk of their Social Security checks. Right now. For a campaign against a nonexistent bill that he knows perfectly well isn't going to take place. Nice work.

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Top Ten Winners of the Budget Showdown Debacle

| Wed Oct. 16, 2013 11:50 PM EDT

Conventional wisdom has it that President Obama was a winner in the budget showdown, John Boehner was a loser, everyone hates Ted Cruz, blah blah blah. But that stuff will all blow over within days. Here's a top ten list of the real winners:

Wall Street: They didn't panic because they figured Congress would do the right thing at the last second, just like always. They were right.

Kathleen Sebelius: If not for the shutdown, the media would have focused its attention 24/7 on the disastrous rollout of Obamacare. By now, Sebelius would be in about the same mental shape as the House stenographer if Republicans hadn't helpfully covered for her.

Pandas: For two weeks, anyway, they got to grow up without millions of prying eyes following their every move and cooing about how cute they are.

Netflix: Furloughed federal workers had plenty of free time on their hands, and a lot of them turned to Netflix to fill all those empty hours.

Robert Costa: He was everyone's go-to reporter for the inside scoop on what Republicans were thinking at each step along the way. A new job and a big raise can't be too far off.

Iran: Benjamin Netanyahu wants everyone to be outraged over Iran's peace overtures, but no one is listening. For the moment, anyway, Obamacare is the only existential threat that American conservatives have time for.

China: They want to see a "de-Americanized world." After watching the know-nothing takeover of the American government by the tea party, horrified leaders across the globe are inclined to think that's not such a bad idea.

Random House: Following Ted Cruz's epic filibuster, Green Eggs and Ham is all set to become the Christmas present of choice for millions of devoted tea partiers this holiday season.

The World War II Memorial: I've been there, and it's really not a very good memorial. But now it's the infamous site of the Barrycade! Attendance should skyrocket.

Democrats: They actually stuck together! Can you believe it? Republican overreach was so egregious that it accomplished in two weeks what no one in history had managed to accomplish in over two centuries. Will Rogers is spinning in his grave.

Today I Fired a Gun For the First Time in my Life

| Wed Oct. 16, 2013 8:27 PM EDT

Since I write periodically about gun issues, I've long had a vague feeling that I should learn how to shoot a gun someday. Not to become an expert or anything, but just so I have some idea of what's involved in a tactile, rather than an academic, sense.

So today I did. A friend of mine hauled out his gun collection and showed it to me, and then we headed out to a small indoor range and shot a few rounds each. So how did I do? The first gun on our list was a .40 caliber Beretta semiautomatic. On my first try loading the clip, I put the rounds in backward, which didn't work so well. So I reloaded, popped the clip in, flipped off the safety, and did my best to hold the gun the way I had been told to. As you can see below, none of my seven rounds managed to hit inside the target area, but five of them did hit the paper. Not bad for a city boy!

So that's that: my first time ever firing a gun. I loaded another clip, and on my second try I started to get the hang of lining up the sight and adjusting for the recoil, and did a little better. One round even went into the black. Next, my friend got out a .22 caliber rifle, and we plinked away with that for a while. Those .22 clips are cute little things, aren't they? Here's a couple of clips worth in my next target:

The first set all landed to the left. Then I overcompensated and got the cluster on the right. Then I apparently got it about right, and the next five rounds all went into the black.

Finally, we fired a 1 ounce slug from a shotgun. That puppy has a bit of a kick, doesn't it? Oddly enough, though, I managed to fire it fairly straight anyway. We were using a silhouette target at that point, and my single round hit it in the shoulder.

So now I know what a gun feels like and how to handle one. That's about all I know, but I figure any day in which I learn something new is a pretty good day.

The Obamacare Website Might Finally Be Getting Better

| Wed Oct. 16, 2013 1:38 PM EDT

My timing, as always, is perfect. Last night I wrote a post wondering just how bad the problems with the Obamacare website really are. Today, Sarah Kliff reports that things are finally getting better. The site remains slow, but she was able to complete an application that included financial assistance in about 30 minutes. Her application is now "in progress," so she hasn't begun the actual process of choosing a plan, but this is still better than it was before. Kliff also reports that shopping for plans is fairly smooth and easy.

So....maybe the problems are more resolvable than we thought, and are in fact finally getting resolved. Stay tuned.

Reminder of the Day: When It Comes to Long-Term Spending, It's All Health Care, Baby

| Wed Oct. 16, 2013 1:22 PM EDT

With the budget crisis now on its way to resolution, it's worth reminding everyone that, in fact, the federal budget isn't really in bad shape. As Ryan Cooper of the Washington Monthly notes this morning, long-term predictions of doom are essentially based on one thing: the rising cost of health care:

The CBO's model has a factor which assumes that health care costs will continue to grow much faster than the economy forever—which means that if we get health care cost growth under control, our deficit "problem" will vanish entirely.

The conservative reply is that the way to get health care costs under control is to simply have less health care. We must "reform" entitlements; meaning raise the Medicare retirement age, cut Medicaid, etc. We can't afford to be generous, and some people are just going to have to go endure hardship or we're going to bankrupt the state.

But as the Monthly has long shown, this is nonsense. In fact, the United States' world-record health care costs are driven by a combination of policy factors, both on the private and the government side...."Centrist" elites don't seem to think that something counts as reform unless it's punishing a poor person somewhere, but the real action is in the policy design. Health care is expensive because of inefficiency, monopoly politics, lack of research, and interest group lobbying, not because Medicare is too generous. In fact, health care cost growth has slowed considerably since the passage of Obamacare, so if the administration manages to fix its IT disaster we could be in good shape already.

Yep. The chart below shows federal spending through 2008 in order to illustrate historical trends clearly without the spike of the Great Recession. As you can see, domestic spending ("Other") is declining; interest expense is declining; defense spending is declining; and Social Security spending is flat. It will increase a bit over the next few decades, but only by a point or two of GDP.

And then there's Medicare, which is increasing. But Medicare is increasing because (a) the population is aging, and (b) overall health care costs are rising. We can't do anything about aging, which means that essentially our entire long-term budget problem is caused by rising health care costs. That's it. If you're actually serious about this stuff, you'll spend essentially 100 percent of your time on policy proposals designed to reduce America's insanely high health care costs. Obamacare is a start, but there's still a lot more to be done.

Here's Why Your Asthma Inhaler Costs So Damn Much

| Wed Oct. 16, 2013 11:58 AM EDT

Dr. Russell Saunders is pissed off:

As I’m sure comes as no surprise, I prescribe a lot of medications....One medication I prescribe with great frequency is albuterol, a bronchodilator. Asthma is a very common childhood illness, and one that primary care providers can often manage without consulting subspecialists.

....So I prescribe a lot of albuterol [inhalers]. Or rather, I would if they existed. Unfortunately, albuterol inhalers per se are not currently on the market. What my patients really get are prescriptions for Proventil or Ventolin or Proair. There are, at this time, precisely zero generic albuterol [inhalers] on the market.

The reason why there are none on the market and thus patients (or their insurance companies, if they are blessed with good coverage) are forced to pay for the name brands is contained in this horrifying and infuriating article about pharmaceutical pricing in the New York Times. If it does not make your blood boil, then I congratulate you for having a more even temperament than I.

I'm pretty sure that I don't have a more even temperament than Saunders, but I do have one advantage over him: I already knew what was going on with asthma inhalers even before Elisabeth Rosenthal's piece—the latest in her series about the high cost of American health care—appeared a few days ago.

Here's the short version of the story: as Saunders says, albuterol is a cheap medication because it went off patent long ago. Then, a few years ago, as part of the campaign to eliminate CFCs and save the ozone layer, CFC-based inhalers were set to be banned. Pharmaceutical companies took advantage of this to design new delivery systems and surround them with a thicket of patents. As a result, even though albuterol itself might be off patent, only name-brand asthma inhalers are available—and since there's now no generic competition the big pharmaceutical companies are free to jack up prices to their heart's content. And they have. After all, as Rosenthal points out, this isn't like acne medicine that you can do without if it costs too much. If you have asthma, you need an inhaler, period.

Is your blood boiling? Well, wait a bit. The story is actually even worse than this. You're probably thinking that what happened here is (a) overzealous environmentalists insisted on banning CFC inhalers even though they don't really have much impact on the ozone layer, and (b) pharmaceutical companies cleverly took advantage of this to suck some extra money out of asthma sufferers.

Well, the ozone layer was the initial cause of all this, so feel free to place some of the blame on environmentalists if you like. But as it turns out, scientists raised some early concerns about the inhaler ban because the replacement for CFCs was a powerful greenhouse gas. So they suggested that maybe it was better just to make an exception for asthma inhalers and let well enough alone. At that point, the pharmaceutical companies that had been eagerly waiting for the old inhalers to be banned went on the offensive. Nick Baumann picks up the story from there:

The pharma consortium transformed from primarily an R&D outfit searching for substitutes for CFC-based inhalers into a lobbying group intent on eliminating the old inhalers. It set up shop in the K Street offices of Drinker Biddle, a major DC law firm. Between 2005 and 2010, it spent $520,000 on lobbying. (It probably spent even more; as a trade group, it's not required to disclose all of its advocacy spending.) Meanwhile, IPAC lobbied for other countries to enact similar bans, arguing that CFC-based inhalers should be eliminated for environmental reasons and replaced with the new, HFC-based inhalers.

The lobbying paid off. In 2005, the Food and Drug Administration (FDA) approved an outright ban on many CFC-based inhalers starting in 2009. This June, the agency's ban on Aerobid, an inhaler used for acute asthma, took effect. Combivent, another popular treatment, will be phased out by the end of 2013.

In other words, pharmaceutical companies didn't just take advantage of this situation, they actively worked to create this situation. Given the minuscule impact of CFC-based inhalers on the ozone layer, it's likely that an exception could have been agreed to if pharmaceutical companies hadn't lobbied so hard to get rid of them. The result is lower-quality inhalers and fantastically higher profits for Big Pharma.

Rosenthal has a lot more detail in her piece about how the vagaries of patent law make this all even worse, and it's worth reading. But she misses the biggest story of all: none of this would matter if drug companies hadn't worked hard to make sure the old, cheap inhalers were banned. How's your blood doing now, Dr. Saunders?

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Word of the Day: Brinkmanship

| Wed Oct. 16, 2013 11:01 AM EDT

Yesterday my copy editor objected to my use of the word brinksmanship, recommending that I replace it with brinkmanship. I prefer the version with the S, but I usually take his advice unless I have a pretty good reason not to. Since my dictionary lists both variants as acceptable, I did what I usually do next: I powered up the Google Ngram Viewer to see which version is in more common use. Here's the result:

The version without an S is plainly the most common by a wide margin, so I went ahead and made the change. But I was intrigued that the word apparently first appears in 1955 and then shoots up the charts quickly, suggesting that it's a child of the nuclear age. Sure enough, dictionary.com confirms that this is when it first appeared, coined by Adlai Stevenson during the 1956 presidential campaign:

Associated with the policies advocated by John Foster Dulles (1888-1959), U.S. Secretary of State 1953-1959. The word springs from Dulles' philosophy as outlined in a magazine interview with Time-Life Washington bureau chief James Shepley early 1956:

"The ability to get to the verge without getting into the war is the necessary art. If you cannot master it, you inevitably get into war. If you try to run away from it, if you are scared to go to the brink, you are lost."

The quote was widely criticized by the Eisenhower Administration's opponents, and the first attested use of brinkmanship seems to have been in such a context, a few weeks after the magazine appeared, by Democratic presidential candidate Adlai Stevenson criticizing Dulles for "boasting of his brinkmanship, ... the art of bringing us to the edge of the nuclear abyss."

This is news to me, and since we've been playing budget brinkmanship for the past few months, I thought a brief refresher on the nuclear origins of the word might be in order.

Also (according to dictionary.com once again), the S in the alternate spelling is a "parasitic S." What the heck is that? Can any linguists help out here?

Senate Budget Deal Close to Finished

| Wed Oct. 16, 2013 10:07 AM EDT

After last night's collapse of John Boehner's 87th attempt to forge some kind of plan to end the budget/debt ceiling crisis, the Senate is back in the driver's seat. And oddly enough, today's Senate plan is identical to yesterday's Senate plan except for one thing: the sole provision that Democrats wanted has been jettisoned. So now the deal is that Republicans get a small bone in return for extending the CR and the debt limit a couple of months. Matt Yglesias figures this is bad news:

I think there's a very strong chance we just do this all over again in the New Year. The conference committee will be at loggerheads over the question of tax increases. Hard-core conservatives will remain unreconciled to the idea of abandoning the struggle. Mainstream conservatives will continue to be loath to split the party. And the reality will be that the strategy of sticking with the majority-of-the-majority principle until the 11th hour and then passing bills with mostly Democratic votes is securing policy concessions from Democrats. So why not do it all over again?

I don't really disagree, especially given the fact that apparently no one in the Senate can really think of a good reason that they'll be able to meet their self-imposed December 13 deadline to come up with a permanent budget deal. But there is one reason to hold out a tiny ray of hope: midterm elections. The closer we get, the more likely it is that Republicans will be punished if they shut down the government yet again. Right now, the Senate deal extends the debt ceiling through February, and if you tack on another four or five months of "extraordinary measures," it means the next debt ceiling crisis will start to heat up in July. Do Republicans really want to go through yet another hostage-taking scenario that close to Election Day? Or would they rather spend the summer telling horror stories about the rollout of Obamacare?

I'd say the latter. They may be insane, but they're not stupid. So that leaves only the CR, and the odds are good that Republicans will basically win the CR battle by keeping sequester levels of spending in place. They won't be able to win agreement on a bigger plan, but they'll probably win the sequester battle—which, let's face it, is a pretty big win. And with that, they'll declare victory and go home.

Then, after next year's election, maybe it will be grand bargain time again. Or maybe it will be yet more gridlock as we begin the death march toward the 2016 primaries. I really have no idea.

BY THE WAY: Remember all those people who have been chastising Wall Street for not taking the threat of a debt ceiling breach seriously enough? Well, guess what? The financial folks were assuming that Congress, yet again, would make a deal, but not until the very last second. And right now, it looks like they were exactly right. Maybe they're not so out of touch after all.

Seeing the Debt Ceiling Fight From the Other Side

| Tue Oct. 15, 2013 8:55 PM EDT

As the debt ceiling fight drags on, we're seeing more and more reporting about just what it is that motivates tea partiers to be so frenzied on the subjects of Obamacare, the national debt, and government spending in general. Roughly speaking, the conclusion of these pieces of ethnography is that tea partiers have an almost panicky belief in several things:

  • The growth of the welfare state is sapping the strength of the country as more and more people are allowed to live off the taxes of others.
  • Obamacare is the tipping point: if it's allowed to stand, the fight against welfare entitlements is lost.
  • Likewise, the United States has reached the breaking point on its national debt. If it's allowed to keep growing, the country is doomed.
  • Refusing to raise the debt ceiling may be tough medicine, but it needs to be done in order to rein in spending right now.

If you believe these things, then you wouldn't care about polls or charges of hostage taking or any of that. You'd feel like you were literally fighting a war for the future of your country, and anything is worth the cost. Shut down the government. Breach the debt ceiling. Do anything. Just make sure to stop the spending, rein in welfare programs, and stop Obamacare. The fate of the United States literally depends on it.

But there's more to it. A lot of tea partiers just flatly don't believe that breaching the debt ceiling is the big deal that liberals are making it out to be. Not only does spending need to be cut anyway, but it's not even that hard. This is how you get interviews like this one, from Brett LoGiurato of Business Insider. He's talking to David Biddle, a GOP state committeeman who lives in Rep. Ted Yoho's Florida district:

"There's a scare tactic out there that if we breach the debt ceiling and default, there's just no more money coming in, and that's just not the case," Biddle said. "There's money to be allocated different ways. And maybe you have to make some cuts somewhere that might not make everybody happy, but at some point, you have to say, enough is enough."

So what can we cut? Social Security? Medicare? Those are the big, long-term problems on our docket.

"No one's going to cut Social Security or Medicare. That's another scare tactic," Biddle said.

So what can we cut now?

"You can start with foreign aid. Cut that out. You can cut, you know, federal arts ..." Biddle said.

"There are a lot of grants," adds Bob Clemons, a director of finance for the local school board.

"Grants. There's a lot of grants," Biddle confirms.

There's a pause for about 10 seconds.

"It's a big problem," Clemons said.

"It is. It is," Biddle said.

Like a lot of people, Biddle simply doesn't accept that refusing to raise the debt ceiling is a big deal. He thinks there's plenty of spending that can be cut if we have to. He doesn't know what, and apparently he doesn't want to start talking about welfare in front of a reporter from New York, but he knows it's there. Given all that, what's wrong with using the debt ceiling as a hostage to force spending cuts or the end of Obamacare? It's just ordinary leverage, not a threat of financial Armageddon.

For more, read the whole piece. It's worth a few minutes of your time.

Just How Bad Is the Obamacare Website, Anyway?

| Tue Oct. 15, 2013 5:44 PM EDT

I've been corresponding with a friend about the problems with the federal Obamacare website, and I have to admit that I'm having second thoughts about my initial reaction. Back on October 2, it looked to me like the problems were serious, but nothing all that out of the ordinary for a big software project. My conclusion: "Before long, the sites will all be working pretty well, with only the usual background rumble of small problems. By this time next month, no one will even remember that the first week was kind of rocky or that anyone was initially panicked."

That might still be the case, and certainly one of the lessons of big software rollouts is that you always reach a point when you're finally convinced that you really are well and truly doomed—and that's often the point when things start to get better. Maybe that's where we are now. But the reporting we've seen recently about the nature of the Obamacare problems certainly suggests otherwise. The bugs seem deep and profound. So why has this turned out to be so much worse than I thought it would be?

My guess is that I didn't take schedule slippage into account. I've worked on several projects that seemed disastrous at the time, but part of the disaster was the very fact that everything was late. It simply took much longer to build the product than we thought, so we ended up shipping months after we'd originally planned. Even at that there were still plenty of bugs, but they were mostly tractable. Bad, but tractable.

With Obamacare, however, they weren't allowed to slip the schedule. They had to ship on October 1. Period. And so now I find myself thinking back to some of those difficult projects. What would have happened if instead of slipping the schedule, I had been forced to ship on the original release date? Answer: the software flatly wouldn't have worked. It wouldn't just have been bad, it would have been an existential catastrophe. And it would have taken many months to fix, not many weeks.

So perhaps that's where we are with the Obamacare site. I hope not, but it's sure starting to look that way. And if things really are this bad, I really, really hope there a Plan B. Beefed up phone banks. Paper and pencil. Something.

Alternatively, maybe the reporting on this stuff has now swung around to being too pessimistic. Maybe the biggest problems will get sorted out in the next few weeks and everything will be OK. Stay tuned.

POSTSCRIPT: And while I'm at it, I have to add my voice to all those who are sort of agog over the missed chance on this from Republicans. Under normal circumstances, this stuff would be front-page news, with the Obama administration hunkered down and taking hailstorms of flak from all directions. Instead, the shutdown has sucked all the oxygen out of the room and has even provided a built-in excuse for all the website problems. For a party that has dedicated nearly its entire existence to trashing Obamacare, Republicans sure have scored an own goal here.