Kevin Drum Feed | Mother Jones http://www.motherjones.com/Blogs/2009/05 http://www.motherjones.com/files/motherjonesLogo_google_206X40.png Mother Jones logo http://www.motherjones.com en Net Neutrality Finally Dies at Ripe Old Age of 45 http://www.motherjones.com/kevin-drum/2014/04/net-neutrality-finally-dies-ripe-old-age-45 <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Apparently net neutrality is officially dead. The <em>Wall Street Journal</em> reports today that the FCC has given up on finding a legal avenue to enforce equal access and will instead propose rules that explicitly allow <img align="right" alt="" class="image image-_original" src="/files/images/Blog_Net_Neutrality_Shirt.jpg" style="margin: 20px 0px 15px 30px;">broadband suppliers to <a href="http://online.wsj.com/news/articles/SB10001424052702304518704579519963416350296?mod=WSJ_hp_LEFTTopStories&amp;mg=reno64-wsj" target="_blank">favor companies that pay them for faster pipes:</a></p> <blockquote> <p>The Federal Communications Commission plans to propose new open Internet rules on Thursday that would allow content companies to pay Internet service providers for special access to consumers, according to a person familiar with the proposal.</p> <p>The proposed rules would prevent the service providers from blocking or discriminating against specific websites, <strong>but would allow broadband providers to give some traffic preferential treatment,</strong> so long as such arrangements are available on "commercially reasonable" terms for all interested content companies. Whether the terms are commercially reasonable would be decided by the FCC on a case-by-case basis.</p> <p>....The FCC's proposal would allow some forms of discrimination while preventing companies from slowing down or blocking specific websites, which likely won't satisfy all proponents of net neutrality, the concept that all Internet traffic should be treated equally. The Commission has also decided for now against reclassifying broadband as a public utility, which would subject ISPs to much greater regulation. However, the Commission has left the reclassification option on the table at present.</p> </blockquote> <p>So Google and Microsoft and Netflix and other large, well-capitalized incumbents will pay for speedy service. Smaller companies that can't&mdash;or that ISPs just aren't interested in dealing with&mdash;will get whatever plodding service is left for everyone else. ISPs won't be allowed to deliberately slow down traffic from specific sites, but that's about all that's left of net neutrality. Once you've approved the notion of two-tier service, it hardly matters whether you're speeding up some of the sites or slowing down others.</p> <p>This might have been inevitable, for both legal and commercial reasons. But that doesn't mean we have to like it.</p> </body></html> Kevin Drum Regulatory Affairs Tech Wed, 23 Apr 2014 22:38:15 +0000 Kevin Drum 250476 at http://www.motherjones.com The Fourth Amendment Takes Yet Another Body Blow http://www.motherjones.com/kevin-drum/2014/04/fourth-amendment-takes-yet-another-body-blow <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>This week the Supreme Court has handed down decisions on affirmative action and child porn that have gotten a lot of press. But the affirmative action decision was probably inevitable, and the child porn case is an oddball example of statutory interpretation that probably has no greater significance.</p> <p>More important is <em>Navarette vs. California</em>, which has real potential to do some long-term damage. In this case, a 911 caller reported an erratic driver, who was then pulled over and eventually convicted of transporting four bags of marijuana. The police had no probable cause to stop the driver except for that one anonymous phone call, but <img align="right" alt="" class="image image-_original" src="/files/images/Blog_Constitution_0.jpg" style="border: 1px solid black; margin: 20px 20px 15px 30px;">the Court upheld the conviction anyway. Justice Scalia is typically apoplectic in his dissent, <a href="http://www.lawyersgunsmoneyblog.com/2014/04/today-war-classes-people-use-drugs-v-fourth-amendment" target="_blank">but nonetheless makes some good points:</a></p> <blockquote> <p>It gets worse. Not only, it turns out, did the police have no good reason at first to believe that Lorenzo was driving drunk, they had very good reason at last to know that he was not. The Court concludes that the tip, plus confirmation of the truck&rsquo;s location, produced reasonable suspicion that the truck not only had been but still was barreling dangerously and drunkenly down Highway 1. In fact, alas, it was not, and the officers knew it. They followed the truck for five minutes, presumably to see if it was being operated recklessly. And that was good police work. While the anonymous tip was not enough to support a stop for drunken driving under <em>Terry v. Ohio</em>, it was surely enough to counsel observation of the truck to see if it was driven by a drunken driver.</p> <p>But the pesky little detail left out of the Court&rsquo;s reasonable-suspicion equation is that, for the five minutes that the truck was being followed (five minutes is a long time), Lorenzo&rsquo;s driving was irreproachable. Had the officers witnessed the petitioners violate a single traffic law, they would have had cause to stop the truck, and this case would not be before us. And not only was the driving irreproachable, but the State offers no evidence to suggest that the petitioners even did anything suspicious, such as suddenly slowing down, pulling off to the side of the road, or turning somewhere to see whether they were being followed. Consequently, the tip&rsquo;s suggestion of ongoing drunken driving (if it could be deemed to suggest that) not only went uncorroborated; it was affirmatively undermined.</p> </blockquote> <p>The problem here is obvious: the Court has basically said that an anonymous 911 call is sufficient <em>all by itself</em> to justify a police stop and subsequent search of a vehicle.</p> <p>In this particular case, it's likely that the 911 caller was entirely sincere. But that's surely not always the case, and this decision gives police far greater discretion stop pretty much anyone they like for any reason. You don't even need to roll your front bumper a foot over the limit line in an intersection to give them a pretext.</p> <p>If we're lucky, this case will become a footnote, with the precise nature of its facts giving it little value as precedent. But if we're not so lucky, it's yet another step in the Supreme Court's decades-long project to chip away at the Fourth Amendment. When an unknown caller is all it takes to trigger a search, the entire notion of "probable cause" is pretty much consigned to the ash heap of history.</p> </body></html> Kevin Drum Courts Crime and Justice Wed, 23 Apr 2014 18:21:55 +0000 Kevin Drum 250441 at http://www.motherjones.com Rand Paul Apparently Thinks Republicans Controlled Congress in 1978 http://www.motherjones.com/kevin-drum/2014/04/rand-paul-apparently-thinks-republicans-controlled-congress-1978 <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Over at the mother ship, David Corn has assembled a bunch of clips of Rand Paul being less than reverential toward Ronald Reagan. <a href="http://www.motherjones.com/politics/2014/04/rand-paul-jimmy-carter-was-better-budget-ronald-reagan" target="_blank">Here's an example from 2009:</a></p> <blockquote> <p>People want to like Reagan. He's very likable. And what he had to say most of the time was a great message. But the deficits exploded under Reagan....The reason the deficits exploded is they ignored spending. Domestic spending went up at a greater clip under Reagan than it did under Carter.</p> </blockquote> <p>Ouch! That's not just a hit on Reagan, it's a direct suggestion that his fiscal policy was worse than Jimmy Carter's. Jimmy Carter's!</p> <p>David has a bunch more along these lines. But here's my favorite part:</p> <blockquote> <p>After this article was posted, Paul's office sent this statement from the senator: "I have always been and continue to be a great supporter of Ronald Reagan's tax cuts and the millions of jobs they created. Clearly spending during his tenure did not lessen, but he also had to contend with Democrat majorities in Congress."</p> </blockquote> <p>Um, didn't Jimmy Carter also have to contend with Democratic majorities in Congress? Bigger ones, in both houses? Or am I thinking about a different Jimmy Carter?</p> </body></html> Kevin Drum 2016 Elections Congress Economy Rand Paul Wed, 23 Apr 2014 17:14:11 +0000 Kevin Drum 250436 at http://www.motherjones.com Medicaid Expansion Now an Even Better Deal For States http://www.motherjones.com/kevin-drum/2014/04/medicaid-expansion-now-even-better-deal-states <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p><img align="right" alt="" class="image image-_original" src="/files/blog_cbpp_medicaid_expansion.jpg" style="margin: 8px 20px 15px 30px;">Need some more good news on Obamacare? How about some mixed news instead? <a href="http://www.cbpp.org/cms/index.cfm?fa=view&amp;id=4131" target="_blank">Here it is:</a></p> <blockquote> <p>Congressional Budget Office (CBO) estimates released last week show that health reform&rsquo;s Medicaid expansion, which many opponents wrongly claim will cripple state budgets, is an even better deal for states than previously thought....CBO now estimates that the federal government will, on average, pick up more than 95 percent of the total cost of the Medicaid expansion and other health reform-related costs in Medicaid and the Children&rsquo;s Health Insurance Program (CHIP) over the next ten years (2015-2024).</p> </blockquote> <p>The good news is obvious: the Medicaid expansion is an even better deal for states than we thought. The federal government will pick up nearly the entire cost of expansion, and when you account for money that states will save from reduced amounts of indigent care and greater help with mental health costs, the net cost of expansion gets very close to zero.</p> <p>The mixed nature of this seemingly good news comes from the reason for CBO's more optimistic budget projection: it's because they think the program will cover fewer people than they previously projected. There had always been a fear among states that lots of people who were already eligible for Medicaid&mdash;but had never bothered applying for it&mdash;would hear the Obamacare hoopla and "come out of the woodwork" to claim benefits. Since these folks weren't technically part of the expansion, states would be on the hook to cover the bulk of their costs.</p> <p>CBO now believes this fear was overblown. Apparently most people who didn't bother with Medicaid before Obamacare took effect aren't going to bother with it now either. That's good for state budgets, but obviously not so good for all the people who could be getting medical care but aren't.</p> <p>For what it's worth, this is a tradeoff we're going to see a lot of. Unless the actual cost of medical care comes down, the budget impact of Obamacare is always going to depend on how many people benefit from it. If lots of people sign up, that's good for public health but costly for taxpayers. If fewer people sign up, then government spending goes down but fewer people receive medical care. There aren't very many ways around this iron law.</p> </body></html> Kevin Drum Health Care Wed, 23 Apr 2014 16:10:00 +0000 Kevin Drum 250421 at http://www.motherjones.com Running Away From Obamacare Is a Fool's Errand http://www.motherjones.com/kevin-drum/2014/04/running-away-obamacare-fools-errand <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Are red-state Democrat senators certain losers to Republican challengers in this year's midterm election? According to recent polling, no. The races are all pretty close. But <img align="right" alt="" class="image image-_original" src="/files/blog_obamacare_site_new.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">Greg Sargent points out that these Democrats <a href="http://www.washingtonpost.com/blogs/plum-line/wp/2014/04/23/morning-plum-conventional-wisdom-about-2014-takes-another-hit/" target="_blank">do indeed have an Obamacare problem:</a></p> <blockquote> <p>In Arkansas, 52 percent would not vote for a candidate who disagrees on Obamacare, versus 35 percent who are open to doing that. In Louisiana: 58-28. In North Carolina: 53-35. It seems plausible the intensity remains on the side of those who oppose the law. This would again suggest that the real problem Dems face with Obamacare is that it revs up GOP partisans far more than Dem ones &mdash; exacerbating the Dems&rsquo; already existing &ldquo;midterm dropoff&rdquo; problem.</p> <p>However, in Kentucky, the numbers are a bit different: 46 percent would not vote for a candidate who disagrees with them on the law, while 39 percent say the opposite &mdash; much closer than in other states. Meanwhile, Kentucky Governor Steve Beshear &mdash; the most outspoken defender of Obamacare in the south &mdash; has an approval rating of 56-29.</p> </blockquote> <p>I'm keenly aware that I've never run for dogcatcher, let alone had any experience in a big-time Senate race. So my political advice is worth zero. And yet, polls like this make me more, not less, invested in the idea that running away from Obamacare is a losing proposition. Electorates in red states know that these Democrats voted for Obamacare. Their opponents are going to hammer away at it relentlessly. It's just impossible to run away away from it, and doing so only makes them look craven and unprincipled.</p> <p>The only way to turn this around is not to distance yourself from Obamacare, but to try and convince a piece of the electorate that Obamacare isn't such a bad deal after all. You won't convince everyone, but you don't need to. You just need to persuade the 5 or 10 percent who are mildly opposed to Obamacare that it's working better than they think. That might get the number of voters who would "never" vote for an Obamacare supporter down from the low 50s (Arkansas, Louisiana, North Carolina) to the mid 40s (Kentucky). And that might be enough to eke out a victory.</p> <p>Needless to say, this works best if everyone is pitching in. And surely this is the time to start. The early website problems have been resolved and the initial signup period has been a success. Conservative kvetching has taken on something of a desperate truther tone, endlessly trying to "deskew" the facts and figures that increasingly make Obamacare look like a pretty successful program. There are lots of feel-good stories to tout, and there are going to be more as time goes by. What's more, the economy is improving a bit, which always makes people a little more sympathetic toward programs that help others.</p> <p>Obamacare isn't likely to be a net positive in red states anytime soon. But it's not necessarily a deal breaker either. It just has to be sold&mdash;and the sellers need to show some real passion about it. After all, if they don't believe in it, why should anyone else?</p> </body></html> Kevin Drum Elections Health Care Wed, 23 Apr 2014 15:24:22 +0000 Kevin Drum 250411 at http://www.motherjones.com Why Does Everyone Think Lolita Is a Teenager? http://www.motherjones.com/kevin-drum/2014/04/why-does-everyone-think-lolita-teenager <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>This is way off my usual beaten path, but <a href="http://www.newrepublic.com/article/117471/sexy-lolita-book-covers-vladimir-nabokov" target="_blank">here is Hillary Kelly in the <em>New Republic</em>:</a></p> <blockquote> <p>People have the wrong idea about <em>Lolita</em>, and Lolita. Today, the name is widely used as a synonym for a sexually precocious young girl. But the most important fact of the novel is that Lolita is a 12-year-old girl....This makes the oversexed, hyper-titillating cover art that has been repeatedly slapped on Lolita incredibly bizarre&mdash;not to mention disturbing. We aren't meant to find Lolita sexy. We shouldn't find Lolita sexy. Nabokov himself said that readers were "misled" by the book's repuation "into assuming this was going to be a lewd book." I'm not so na&iuml;ve as to imagine book covers always faithfully replicate the literary intentions of their authors. But <em>Lolita</em> covers aren't simply exaggerated or oversimplified representations. They're downright creepy.</p> </blockquote> <p>Huh. I didn't know that. But there's a good reason for this: I've never read the book. Like a lot of people, however, I <em>have</em> seen the movie. And in the movie, Sue Lyon plays a teenage Lolita. So I always figured Lolita was indeed a high-school age girl. I don't know if Stanley Kubrick made this decision for artistic reasons or&mdash;ah, wait. Sure enough, the ever-helpful Wikipedia <a href="http://en.wikipedia.org/wiki/Lolita_%281962_film%29" target="_blank">informs me that</a> "Lolita's age was raised from twelve to early teens in the film to meet the MPAA standards. As such, Sue Lyon was chosen for the title role partly due to her more mature appearance."</p> <p>Anyway, I wonder if this is the wellspring of much of the common confusion? I'll bet a whole lot more people have seen the movie than ever read the book.</p> </body></html> Kevin Drum Books Film and TV Wed, 23 Apr 2014 14:20:29 +0000 Kevin Drum 250401 at http://www.motherjones.com Most Independent Voters Aren't, Really http://www.motherjones.com/kevin-drum/2014/04/most-independent-voters-arent-really <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>I write from time to time about the myth of the independent voter, which goes something like this: there aren't any. Oh, lots of people <em>say</em> they're independent, but it turns out that most of them lean in one direction or another, and when Election Day rolls around the leaners vote just as reliably as stone partisans. <em>True</em> independents&mdash;the ones who switch between parties from election to election&mdash;make up only about 10 percent of the electorate.</p> <p>Still, 10 percent is 10 percent. It's not quite <em>nothing</em>. But it turns out that it really is. Today, Lynne Vavreck breaks things down a bit further and explains <a href="http://www.nytimes.com/2014/04/23/upshot/the-myth-of-swing-voters-in-midterm-elections.html?rref=upshot" target="_blank">just how these folks vote:</a></p> <blockquote> <p>Only a small percentage of voters actually switched sides between 2008 and 2010. Moreover, there were almost as many John McCain voters who voted for a Democratic House candidate in 2010 as there were Obama voters who shifted the other <img align="right" alt="" class="image image-_original" src="/files/blog_independent_voter.jpg" style="border: 1px solid black; margin: 20px 20px 15px 30px;">way....On average, across districts, roughly 6 percent of Obama voters switched and just under 6 percent of McCain voters switched.</p> </blockquote> <p>So, yes, there are some true switchers. But mostly they're going to cancel each other out. The net result from a huge push for swing voters is likely to be no more than 2 or 3 percentage points. In a few high-stakes states in a presidential election, that might make them worth going after. But in your average congressional election, it's a waste of time and money. So what does make the difference?</p> <blockquote> <p>On turnout, the numbers were not evenly balanced for Democrats and Republicans. Only 65 percent of Obama&rsquo;s 2008 supporters stuck with the party in 2010 and voted for a Democrat in the House. <strong>The remaining 28 percent of Mr. Obama&rsquo;s voters took the midterm election off. By comparison, only 17 percent of McCain&rsquo;s voters from 2008 sat out the midterms.</strong></p> <p>....It may seem hard to believe that the [2010] shellacking was more about who turned up than about who changed their minds between 2008 and 2010, but it lines up with a lot of other evidence about voters&rsquo; behavior. Most identify with the same political party their entire adult lives, even if they do not formally register with it. They almost always vote for the presidential candidate from that party, and they rarely vote for one party for president and the other one for Congress. And most voters are also much less likely to vote in midterm elections than in presidential contests.</p> </blockquote> <p>The problem is that going after turnout is every bit as hard as picking up the crumbs of the swing voters. Traditional Democratic constituencies&mdash;minorities, low-income voters, and the young&mdash;simply don't turn out for midterm elections at high rates. They never have, despite Herculean party efforts and biannual promises that this time will be different. But it never is. They'll vote for president, but a big chunk of them just aren't interested in the broader party.</p> <p>So what's the answer? Beats me.</p> </body></html> Kevin Drum Elections Wed, 23 Apr 2014 00:31:06 +0000 Kevin Drum 250391 at http://www.motherjones.com Male Doctors Bill Medicare for More Services Than Female Doctors http://www.motherjones.com/kevin-drum/2014/04/male-doctors-bill-medicare-more-services-female-doctors <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p><a href="http://www.vox.com/2014/4/22/5639500/medicare-pays-women-less-than-men" target="_blank">Via German Lopez,</a> today brings us an interesting study from Andrew Fitch of NerdWallet. Long story short, he finds that male doctors get paid a lot more by Medicare than female doctors.</p> <p>Obviously there are several reasons for this. Chief among them: Higher paid specialties tend to be dominated by men, and men see more Medicare patients than women. <a href="http://www.nerdwallet.com/blog/health/2014/04/22/doctor-salary-gender-pay-gap/" target="_blank">But here's the most interesting bit:</a></p> <ul> <li> <img align="right" alt="" class="image image-_original" src="/files/blog_medicare_services_male_female_doctors.jpg" style="border: 1px solid black; margin: 8px 20px 15px 30px;"><strong>Male doctors perform more services per patient treated.</strong>&nbsp; To explore this, NerdWallet Health devised a metric to calculate a physician&rsquo;s average &ldquo;service volume&rdquo; per patient. We found that male doctors billed Medicare, on average, for one more procedure per patient than female physicians (5.7 services performed per patient by male doctors vs. 4.7 services per patient by female doctors).</li> <li> <strong>This gap in service volume is true across specialties.</strong> Male doctors performed more services per patient than female doctors across nearly all specialties. In a specialty like pathology&nbsp;&mdash; where doctors infrequently provide services directly to patients&nbsp;&mdash; we found no variation in average service volume.</li> </ul> <p>On average, male doctors bill 5.7 services per patient vs. 4.7 for women! That's a huge gap. And it's not just that cardiologists tend to bill for more services than, say, pulmonologists. Even within specialties, men bill for more services than women.</p> <p>But why? Are they just generally more aggressive? Are they gaming the system? Do sicker patients prefer male doctors for some reason? If this analysis turns out to be true, it would sure be fascinating for someone to follow up and try to figure out what's going on.</p> </body></html> Kevin Drum Health Care Sex and Gender Tue, 22 Apr 2014 18:45:12 +0000 Kevin Drum 250351 at http://www.motherjones.com Chart of the Day: Wind Turbines Don't Kill Very Many Birds http://www.motherjones.com/kevin-drum/2014/04/chart-day-wind-turbines-dont-kill-very-many-birds <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p><img align="right" alt="" class="image image-_original" src="/files/blog_bird_fatalities.jpg" style="border: 1px solid black; margin: 8px 20px 15px 30px;">Tom Randall is fed up with hysteria over wind turbines being responsible for bird genocide. <a href="http://www.bloomberg.com/news/2014-04-21/beware-the-blades-of-death-world-s-top-serial-bird-killers-.html" target="_blank">The numbers just don't support it:</a></p> <blockquote> <p>The estimates above are used in <a href="http://worldofwind.vestas.com/en/impact-on-wildlife" target="_blank">promotional videos</a> by Vestas Wind Systems, the world's biggest turbine maker. However, they originally came from a study by the U.S. Forest Service and are similar to numbers used by the U.S. Fish and Wildlife Service and the Wildlife Society&nbsp;&mdash; earnest defenders of birds and bats.</p> <p>....It&rsquo;s nice for wind-farm planners to take migration patterns and endangered habitats into account. But even if wind turbines were to double in size and provide 100 percent of our energy needs (both of which defy the laws of physics as we currently understand them), they still wouldn&rsquo;t compare to the modern scourges of high-tension power lines or buildings with glass windows. Not even close.</p> </blockquote> <p>Wind turbines can be noisy and they periodically kill some birds. We should be careful with them. But the damage they do sure strikes me as routinely overblown. It's bad enough that we have to fight conservatives on this stuff, all of whom seem to believe that America is doomed to decay unless every toaster in the country is powered with virile, manly fossil fuels. But when environmentalists join the cause with trumped-up wildlife fears, it just makes things worse. Enough.</p> </body></html> Kevin Drum Energy Tue, 22 Apr 2014 16:22:53 +0000 Kevin Drum 250341 at http://www.motherjones.com America's Middle Class is Losing Out http://www.motherjones.com/kevin-drum/2014/04/americas-middle-class-losing-out <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>First, there was Wonkblog. Then came 538. Then Vox. And now we have <a href="http://www.nytimes.com/upshot/" target="_blank">The Upshot,</a> a new venture from the <em>New York Times</em> that aims to present wonky subjects in more depth than you normally find them on the front page. Today, David Leonhardt and Kevin Quealy kick off the wonkiness with an interesting analysis of median income in several rich countries. Their aim is to estimate the gains of the middle class, and their conclusion is that America's middle class is losing out.</p> <p>Their basic chart is below. As you can see, in many countries the US showed a sizeable gap in 1990. Our middle class was much richer than most. By 2010, however, that gap had closed completely compared to Canada, and become much smaller in most other countries. Their middle classes are becoming more prosperous, but lately ours hasn't been:</p> <p><img align="middle" alt="" class="image image-_original" src="/files/blog_income_gap.jpg" style="border: 1px solid black; margin: 15px 0px 15px 0px;"></p> <p>Germany and France show the same low-growth pattern for the middle class that we see in the United States, but countries like Norway, Ireland, the Netherlands, and Britain have shown much faster growth. <a href="http://www.nytimes.com/2014/04/23/upshot/the-american-middle-class-is-no-longer-the-worlds-richest.html?rref=upshot&amp;_r=0" target="_blank">What's going on?</a></p> <blockquote> <p>[The data] suggest that most American families are paying a steep price for high and rising income inequality. Although economic growth in the United States continues to be as strong as in many other countries, or stronger, a small percentage of American households is fully benefiting from it.</p> <p>....The struggles of the poor in the United States are even starker than those of the middle class. A family at the 20th percentile of the income distribution in this country makes significantly less money than a similar family in Canada, Sweden, Norway, Finland or the Netherlands. Thirty-five years ago, the reverse was true.</p> </blockquote> <p>Note that these figures are for after-tax income. Since middle-income taxes have been flat or a bit down in the United States, this isn't likely to have had much effect on the numbers.</p> </body></html> Kevin Drum Economy International Tue, 22 Apr 2014 14:20:23 +0000 Kevin Drum 250326 at http://www.motherjones.com Quote of the Day: Here's How the GOP Shows Its Enviro Cred http://www.motherjones.com/kevin-drum/2014/04/quote-day-heres-how-gop-shows-its-enviro-cred <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Jonah Goldberg says it's unfair that environmental groups are <a href="http://www.latimes.com/opinion/commentary/la-oe-goldberg-keystone-democrats-20140422,0,7790783.column#axzz2zch3TzR5" target="_blank">almost uniformly anti-Republican:</a></p> <blockquote> <p>Contrary to what you may have heard, GOP politicians still care about the environment, but they take their cues from public opinion, not from the green lobby. This often means that when the green lobby denounces Republicans (or centrist Democrats) for supporting drilling or fracking, the greens are at odds with the majority of Americans.</p> </blockquote> <p>So there you go. Conservatives care deeply about the environment, and they demonstrate this commitment by ignoring "global warming hysteria" and instead pandering to public opinion polls at every turn. I'm glad we got that straightened out.</p> </body></html> Kevin Drum Tue, 22 Apr 2014 13:58:22 +0000 Kevin Drum 250316 at http://www.motherjones.com In America, Spending Cuts Are Driven by the Rich http://www.motherjones.com/kevin-drum/2014/04/america-spending-cuts-are-driven-rich <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Over at the Monkey Cage, Larry Bartels presents the remarkable chart on the right. Its message is simple: In most affluent countries, there's net support for government spending cuts, but it doesn't depend much on income. Not only is the level of <img align="right" alt="" class="image image-_original" src="/files/blog_spending_cuts_rich_poor.jpg" style="border: 1px solid black; margin: 20px 20px 15px 30px;">support modest, but it's the same among rich and poor.</p> <p>But not in America. Here, demand for spending cuts is driven <a href="http://www.washingtonpost.com/blogs/monkey-cage/wp/2014/04/21/u-s-is-a-world-leader-in-class-conflict-over-government-spending/" target="_blank">almost entirely by the well-off:</a></p> <blockquote> <p>What accounts for the remarkable enthusiasm for government budget-cutting among affluent Americans? Presumably not the sheer magnitude of redistribution in the United States, which is modest by world standards. And presumably not a traditional aversion to government in American political culture, since less affluent Americans are exposed to the same political culture as those who are more prosperous. A more likely suspect is the entanglement of class and race in America, which magnifies aversion to redistribution among many affluent white Americans.</p> <p>....The U.S. tax system is also quite different from most affluent countries&rsquo; in its heavy reliance on progressive income taxes. The political implications of this difference are magnified by the remarkable salience of income taxes in Americans&rsquo; thinking about taxes and government....Income taxes seem to dominate public discussion of taxes and tax policy. For example, years of dramatic political confrontation culminated in a grudging agreement to shave a few percentage points off the Bush tax cuts for incomes over $400,000 per year; meanwhile, a major reduction in the payroll taxes paid by millions of ordinary working Americans expired with barely a whimper.</p> </blockquote> <p>It's no surprise that spending cuts are popular in other countries: most of them spend a lot of money, and they fund it with high tax rates on just about everyone. But that's decidedly not the case in the United States. Our government spending is relatively low and so are our tax rates. But none of that matters. Rich Americans don't like paying taxes, and as we know from <a href="http://www.motherjones.com/kevin-drum/2014/04/nobody-cares-what-you-think-unless-youre-rich" target="_blank">multiple lines of research</a>&mdash;in addition to plain old common sense&mdash;the opinions of the rich are what drive public policy in America. Add in longstanding grievances against providing benefits to people with darker skins, and you've got a big chunk of the middle class on your side too. This works great for the rich. For the rest of us, not so much.</p> </body></html> Kevin Drum Economy Race and Ethnicity Mon, 21 Apr 2014 20:15:04 +0000 Kevin Drum 250286 at http://www.motherjones.com A Criminologist Takes On the Lead-Crime Hypothesis http://www.motherjones.com/kevin-drum/2014/04/criminologist-takes-lead-crime-hypothesis <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Dominic Casciani of the BBC has a good piece up today about the hypothesis linking lead exposure in small children to violent crime rates later in life. <a href="http://www.bbc.com/news/magazine-27067615" target="_blank">Here's my favorite part:</a></p> <blockquote> <p>So why isn't this theory universally accepted?</p> <p>Well, it remains a theory because nobody could ever deliberately poison thousands of children to see whether they became criminals later in life. <strong>Lead theorists says that doesn't matter because the big problem is mainstream criminologists and policymakers who can't think outside the box.</strong></p> <p>But Roger Matthews, professor of criminology at the University of Kent, rejects that. He says biological criminologists completely miss the point. <strong>"I don't see the link," he says. "If this causes some sort of effect, why should those effects be criminal?</strong></p> <p>"The things that push people into crime are very different kinds of phenomena, not in the nature of their brain tissue. The problem about the theory is that a lot of these [researchers] are not remotely interested or cued into the kinds of things in the mainstream.</p> <p>"There has been a long history of people trying to link biology to crime&nbsp;&mdash; that some people have their eyes too close together, or an extra chromosome, or whatever. This stuff gets <img align="right" alt="" class="image image-_original" src="/files/blog_crime_baseline_lead.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">disproved and disproved. But it keeps popping up. It's like a bad penny."</p> </blockquote> <p>If Matthews didn't exist, someone would have to invent him. He plays the role of closed-minded scientist to perfection here. He obviously hasn't read any of the literature about lead and crime; doesn't care about the evidence; and is interested only in sociological explanations of crime because he's ideologically committed to a particular sociological school of criminology. Beyond that, he apparently figures that because phrenology got debunked a century ago, there's no real point in reading up on anything more recent in the field of neuroscience. All this despite the fact that mainstream criminology is famously unable to reasonably account for either the epic crime wave of the 60s through the 80s or the equally epic decline since then.</p> <p>In any case, if anyone really wants to know why the lead theory isn't universally accepted, the answer is easy: it's not universally accepted because it's new and unproven. Nor does it pretend to be a monocausal explanation for all crime. However, there's pretty good reason to think that neurology might indeed mediate violent behavior, and there's <a href="http://www.motherjones.com/kevin-drum/2013/01/lead-and-crime-linkfest" target="_blank">pretty good reason</a> to think that massive postwar exposure to lead may have been a very particular neurological agent mediating a large rise in violent crime starting in the mid-60s. The evidence isn't bulletproof, but it's pretty strong. It deserves more than cavalier dismissal.</p> </body></html> Kevin Drum Crime and Justice Science Mon, 21 Apr 2014 17:25:04 +0000 Kevin Drum 250221 at http://www.motherjones.com Quote of the Day: Will Obamacare Deliver More Votes Than Medicare? http://www.motherjones.com/kevin-drum/2014/04/quote-day-will-obamacare-deliver-more-votes-medicare <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p><a href="http://www.bloombergview.com/articles/2014-04-21/no-obamacare-won-t-win-elections-for-democrats" target="_blank">From Jonathan Bernstein,</a> questioning whether Obamacare will ever be a vote winner for Democrats:</p> <blockquote> <p>After Medicare passed in 1965, voters &ldquo;rewarded&rdquo; Democrats for Medicare with big midterm losses in 1966 and then by putting Republicans in the White House in five of the next six presidential elections.</p> </blockquote> <p>Actually, that's....true, isn't it? Even granting that there was a lot of other stuff going on in 1966, let's hope that history doesn't repeat itself.</p> </body></html> Kevin Drum Health Care Mon, 21 Apr 2014 16:35:49 +0000 Kevin Drum 250266 at http://www.motherjones.com Paul Ryan Goes Small on Medicare Reform http://www.motherjones.com/kevin-drum/2014/04/paul-ryan-goes-small-medicare-reform <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>If you have a good memory, you may recall that a couple of years ago I had an <a href="http://www.motherjones.com/kevin-drum/2012/08/programming-note-ryan-2013-not-ryan-2012" target="_blank">unexpectedly positive reaction</a> to Paul Ryan's latest Medicare reform plan. His 2013 edition was still based on premium support (i.e., vouchers), but he'd made some changes. Instead of simply capping the vouchers at the rate of overall inflation, which wouldn't come close to keeping up with medical costs, Ryan proposed that insurers would bid for Medicare business. Vouchers would be set at the cost of the second-lowest bid, and seniors could use their vouchers to buy into traditional Medicare if they preferred.</p> <p>Not bad. In fact, it was basically Obamacare with a public option. But there were still problems. Ryan kept his inflation-based cap, which suggested he didn't really believe in the power of competition after all, and seniors would still end up paying more under his plan than they do now.</p> <p>But over at TPM, <a href="http://talkingpointsmemo.com/dc/paul-ryan-huge-medicare-shift" target="_blank">Sahil Kapur points out something I missed:</a> Ryan's 2014 Medicare plan is different still. The voucher is now based on the average bid, not the second-lowest bid, and the inflation cap is gone. <img align="right" alt="" class="image image-_original" src="/files/blog_cbo_ryan_medicare_2014_savings.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">The market will either produce savings or it won't.</p> <p>That's good news. But it also goes to show the difficulty of truly reforming Medicare, especially if you don't tackle the broader problems of health care costs at the same time. The CBO has <a href="http://cbo.gov/sites/default/files/cbofiles/attachments/09-18-PremiumSupport.pdf" target="_blank">analyzed the effect of Ryan's 2014 changes,</a> and they conclude that by 2020 the Ryan plan would save a grand total of $15 billion per year. That's 2 percent of net Medicare spending.</p> <p>Now, this is nothing to sneeze at. Savings are savings. However, like the cost containment proposals that are part of Obamacare, this represents a highly speculative estimate. We might get the 2 percent, we might get nothing.</p> <p>The bottom line is this: Without root-and-branch changes to our health care system, you're simply not going to get big cost savings. If you make radical changes, as Ryan originally tried to do, it comes out of the pockets of seniors. If you keep seniors whole, you're going to get small savings at best. Ryan's 2014 plan might be a good one, but is it worth the experiment for such a small and questionable payback? Hard to say.</p> </body></html> Kevin Drum Health Care Mon, 21 Apr 2014 16:11:24 +0000 Kevin Drum 250216 at http://www.motherjones.com The Right Wing Trains Its Hysterical Eye on Renewable Energy http://www.motherjones.com/kevin-drum/2014/04/right-wing-trains-its-hysterical-eye-renewable-energy <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Evan Halper of the <em>LA Times</em> filed a story this weekend about new conservative efforts to fight America's biggest energy scourge: solar power. <a href="http://www.latimes.com/nation/la-na-solar-kochs-20140420,0,2718030,full.story#axzz2zRPWf8ks" target="_blank">And they're dead serious:</a></p> <blockquote> <p>The Koch brothers, anti-tax activist Grover Norquist and some of the nation's largest power companies have backed efforts in recent months to roll back state policies that favor green energy. The <img align="right" alt="" class="image image-_original" src="/files/images/blog_solar_installation.jpg" style="border: 1px solid black; margin: 20px 20px 15px 30px;">conservative luminaries have pushed campaigns in Kansas, North Carolina and Arizona, with the battle rapidly spreading to other states.</p> <p>....At the nub of the dispute are two policies found in dozens of states. One requires utilities to get a certain share of power from renewable sources. The other, known as net metering, guarantees homeowners or businesses with solar panels on their roofs the right to sell any excess electricity back into the power grid at attractive rates.</p> <p>....The American Legislative Exchange Council, or ALEC, a membership group for conservative state lawmakers, recently drafted model legislation that targeted net metering. The group also helped launch efforts by conservative lawmakers in more than half a dozen states to repeal green energy mandates.</p> <p>"State governments are starting to wake up," Christine Harbin Hanson, a spokeswoman for Americans for Prosperity, the advocacy group backed by billionaire industrialists Charles and David Koch, said in an email. The organization has led the effort to overturn the mandate in Kansas, which requires that 20% of the state's electricity come from renewable sources.</p> </blockquote> <p>There are, technically speaking, some colorable objections to the way net metering (or feed-in tariffs, a similar concept) operate. Sometimes the incentive schemes go awry, and sometimes the pricing goes awry. It's reasonable to insist that these programs be evaluated regularly and rigorously, and modified where necessary. Mandates need to be designed properly too, though in practice they tend to have fewer problems since they allow a lot of flexibility in implementation.</p> <p>But does anyone think this is what's going on here? A calm, technocratic effort to make sure these programs work better? Of course not. We've now entered an era in which affinity politics has gotten so toxic that even motherhood and apple pie are fair targets if it turns out that liberals happen to like apple pie. There are dozens of good reasons that we should be building out solar as fast as we possibly can&mdash;plummeting prices, overdependence on foreign oil, poisonous petrostate politics, clean air&mdash;but yes, global warming is one of those reasons too. And since global warming has now entered the conservative pantheon of conspiratorial hoaxes designed to allow liberals to quietly enslave the economy, it means that conservatives are instinctively opposed to anything even vaguely related to stopping it. As a result, fracking has become practically the holy grail of conservative energy policy, while solar, which improves by leaps and bounds every year, is a sign of decay and creeping socialism.</p> <p>Does it help that the Koch brothers happen to be oil barons who don't want to see the oil industry lose any of the massive government support it's gotten for decades? It sure doesn't hurt, does it?</p> <p>If there's anything that liberals and conservatives ought to be able to agree on, it's the benefit of renewable power. It's as close to a no-brainer as you can get. But President Obama made green programs part of his stimulus package, and that was that. When tea-party hysteria took over the conservative movement, renewable energy became one of its pariahs. Griping about Solyndra is ancient history. Today's conservatives oppose renewable energy for the same reason they've gone nuts over Benghazi and the IRS and Syrian rebels: to show solidarity to the cause. Welcome to modern American politics.</p> </body></html> Kevin Drum Energy The Right Mon, 21 Apr 2014 15:10:43 +0000 Kevin Drum 250256 at http://www.motherjones.com Nope, There Are No Russians in Eastern Ukraine. Why Do You Ask? http://www.motherjones.com/kevin-drum/2014/04/nope-there-are-no-russians-eastern-ukraine-why-do-you-ask <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p><a href="http://www.nytimes.com/2014/04/21/world/europe/photos-link-masked-men-in-east-ukraine-to-russia.html?hp" target="_blank">Imagine my surprise:</a></p> <blockquote> <p>For two weeks, the mysteriously well-armed, professional gunmen known as &ldquo;green men&rdquo; have seized Ukrainian government sites in town after town, igniting a brush fire of separatist unrest across eastern Ukraine. Strenuous denials from the Kremlin have closely followed each accusation by Ukrainian officials that the world was witnessing a stealthy invasion by Russian forces.</p> <p>Now, photographs and descriptions from eastern Ukraine endorsed by the Obama administration on Sunday suggest that many of the green men are indeed Russian military and intelligence forces....More direct evidence of a Russian hand in eastern Ukraine is contained in a dossier of photographs provided by Ukraine to the Organization for Security and Cooperation in Europe, a Vienna-based organization now monitoring the situation in Donetsk and other parts of the country. It features pictures taken in eastern Ukraine of unidentified gunmen and an earlier photograph of what looks like the same men appearing in a group shot of a Russian military unit in Russia.</p> </blockquote> <p>Nope, nobody here but us surprisingly disciplined, well-trained, and Russian-armed guys in masks taking over government buildings. Anybody got a problem with that?</p> </body></html> Kevin Drum International Mon, 21 Apr 2014 05:59:00 +0000 Kevin Drum 250226 at http://www.motherjones.com Housekeeping Notes http://www.motherjones.com/kevin-drum/2014/04/housekeeping-notes <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>These are <em>real</em> housekeeping notes. That is, notes about stuff around my house. First topic: LED light bulbs.</p> <p>I've purchased several LED floods that are can-mounted in my ceiling. They're great. The quality of the light is good; they turn on instantly; they don't flicker; and they use hardly any electricity. There's only one problem: they seem to last less than a year. The LEDs themselves last for decades, of course, but the circuitry that drives the bulb doesn't. As <img align="right" alt="" class="image image-_original" src="/files/blog_led_flood.jpg" style="border: 1px solid black; margin: 20px 20px 15px 30px;">near as I can tell, there's eventually enough heat buildup in the can to burn out the chip that controls the whole thing, and when the chip burns out, no more bulb.</p> <p>I'm just guessing here, but this has now happened three times out of five bulbs I've purchased, and in all three cases the case of the bulb was hot to the touch when I unscrewed it from the base. So here's my question: Does anyone know for sure what's going on here? Is my guess that a chip is burning out probably correct? Am I just buying cheap bulbs? Can anyone recommend a can-mounted flood that's reliable and will actually last for the 25 years that manufacturers so cheerfully promise?</p> <p>Second: a cell phone update. In last weekend's thread, the Google Nexus 5 got a lot of love, but so did the Motorola Moto X. I had actually made up my mind on the Nexus 5, but the T-Mobile store only sold it in a 16GB version, so I decided to go home and buy one online. But then I started dithering because of all the nice things people had said about the Moto X. Eventually, after far more dithering than makes sense for someone who doesn't use a cell phone much, I decided the slightly smaller Moto X was the better choice. So: thanks, folks! I don't think this would have come across my radar otherwise.</p> </body></html> Kevin Drum Sat, 19 Apr 2014 15:50:28 +0000 Kevin Drum 250191 at http://www.motherjones.com Friday Cat Blogging - 18 April 2014 http://www.motherjones.com/kevin-drum/2014/04/friday-cat-blogging-18-april-2014 <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>I have to leave early today for yet another pulmonary checkup, so Friday catblogging comes a little ahead of schedule this week. Here is Domino pretending she doesn't notice the fabulous feline shadow she's casting in the late afternoon sun. But it <em>is</em> fabulous, no?</p> <p><img align="middle" alt="" class="image image-_original" src="/files/blog_domino_2014_04_18.jpg" style="border: 1px solid black; margin: 15px 0px 5px 105px;"></p> </body></html> Kevin Drum Fri, 18 Apr 2014 17:50:04 +0000 Kevin Drum 250126 at http://www.motherjones.com Krauthammer Lights the Way for Tidal Waves of Secret Campaign Cash http://www.motherjones.com/kevin-drum/2014/04/krauthammer-lights-way-tidal-waves-secret-campaign-cash <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Charles Krauthammer writes today that he used to think there was a simple and elegant solution to the fight over campaign finance reform: "For a long time, a simple finesse offered a rather elegant solution: no limits on giving &mdash; but with full disclosure." <a href="http://www.washingtonpost.com/opinions/charles-krauthammer-the-zealots-win-again/2014/04/17/ac0b6466-c654-11e3-8b9a-8e0977a24aeb_story.html" target="_blank">But now he's changed his mind:</a></p> <blockquote> <p>This used to be my position. No longer. I had not foreseen how donor lists would be used not to ferret out corruption but to pursue and persecute citizens with contrary views. Which corrupts the very idea of full disclosure.</p> <p>It is now an invitation to the creation of enemies lists. Containing, for example, Brendan Eich, forced to resign as Mozilla CEO when it was disclosed that six years earlier he&rsquo;d given $1,000 to support a referendum banning gay marriage. He was hardly the first. Activists compiled blacklists of donors to Proposition 8 and went after them. Indeed, shortly after the referendum passed, both the artistic director of the California Musical Theatre in Sacramento and the president of the Los Angeles Film Festival were hounded out of office.</p> <p>....The ultimate victim here is full disclosure itself. If revealing your views opens you to the politics of personal destruction, then transparency, however valuable, must give way to the ultimate core political good, free expression.</p> <p>Our collective loss. Coupling unlimited donations and full disclosure was a reasonable way to reconcile the irreconcilables of campaign finance. Like so much else in our politics, however, it has been ruined by zealots. What a pity.</p> </blockquote> <p>I wonder if Krauthammer feels the same way about free speech? Or gun rights. Or fair trials. The scope of zealots to abuse the system in those cases is infinitely greater than the sparse, weak-tea "harassment" he points to in the case of campaign finance disclosure.</p> <p>On a larger scale, I realize that the Koch brothers think they've suffered abuse akin to the Holocaust at the hands of Harry Reid, but that's what happens when you enter the political arena in a big way. You take your lumps. That's no reason to allow billions of dollars to influence the political system with not even the slightest shred of accountability for where it's coming from. With allies as weak as Krauthammer, ready to cave at the slightest provocation, campaign finance disclosure is now just the latest victim of conservative goal post moving.</p> </body></html> Kevin Drum Money in Politics Fri, 18 Apr 2014 17:03:55 +0000 Kevin Drum 250141 at http://www.motherjones.com How Will We Know If Obamacare Is a Success? http://www.motherjones.com/kevin-drum/2014/04/how-will-we-know-if-obamacare-success <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Will Obamacare be a success? Ross Douthat thinks we should all lay down some firm guidelines and hold ourselves to them. <a href="http://douthat.blogs.nytimes.com/2014/04/16/for-obamacare-what-counts-as-success/" target="_blank">Here are his:</a></p> <blockquote> <p>For my own part, I&rsquo;ll lay down this marker for the future: If, in 2023, the uninsured rate is where the C.B.O. currently projects or lower, health inflation&rsquo;s five-year average is running below the post-World War II norm, and the trend in the age-adjusted mortality rate shows a positive alteration starting right about now, I will write a post (or send out a Singularity-wide <img align="right" alt="" class="image image-_original" src="/files/blog_obamacare_site_new.jpg" style="border: 1px solid black; margin: 20px 20px 15px 30px;">transmission, maybe) entitled &ldquo;I Was Wrong About Obamacare&rdquo; &mdash; or, if he prefers, just &ldquo;Ezra Klein Was Right.&rdquo;</p> </blockquote> <p>Let's take these one by one. I'd say a reduction in the uninsured of 25 million is a pretty good metric. If, by 2023, the number is substantially below that, it would be a big hit to the law's success. Getting people covered, after all, has always been the law's primary goal. What's more, I'd be surprised if more states don't expand Medicaid and get more aggressive about setting up their own exchanges by 2023. At some point, after all, Republican hysteria about Obamacare just has to burn out. (Doesn't it?)</p> <p>On health inflation, I think running <em>below</em> the post-WWII average is a pretty aggressive standard. That would require health care inflation of about 1 percent above overall inflation. If we manage to keep it to around 2 percent, I'd call that a reasonable result.</p> <p>But my biggest issue is with the age-adjusted mortality rate. I know this is a widely popular metric to point to on both left and right, but I think it's a terrible one. Obamacare exclusively affects those under 65, and mortality just isn't that high in this age group. Reduced mortality is a tiny signal buried in a huge amount of noise, and I very much doubt that we'll see any kind of clear inflection point over the next few years.</p> <p>So what to replace it with? I'm less sure about that. Maybe the TIE guys would like to weigh in. But this is a longtime hobbyhorse of mine. Medical care does people a ton of good even if it doesn't save their lives. Being able to afford your asthma inhaler, or getting a hip replacement, or finding an antidepressant that works&mdash;these all make a huge difference in people's lives. And that's not even accounting for reduced financial strain (and bankruptcies) and lower stress levels that come from the mere knowledge that a doctor is available if you need one&mdash;even if you don't have a life-threatening emergency that requires a trip to the ER.</p> <p>In addition, I'd probably add a few things. Douthat doesn't include any negative metrics, but critics have put forward a whole bunch of disaster scenarios they think Obamacare will be responsible for. It will get harder to see doctors. Pharmaceutical companies will stop innovating. Insurance companies will drop out of the exchanges. Premiums will skyrocket. Etc. Without diving into the weeds on all these possible apocalypses, they count as predictions. If, in 2023, we all have to wait months for a routine appointment, or we can't get the meds we need because drug companies have gone out of business, then Obamacare is a failure regardless of what else it does. I don't think these things will happen, but they're surely on my list of metrics for judging the law's success.</p> <p><strong>UPDATE:</strong> Whoops. It turns out that one of the TIE guys, Austin Frakt, has already weighed in on this. You can read his comments <a href="http://theincidentaleconomist.com/wordpress/were-all-a-little-awrong-about-obamacare/" target="_blank">here.</a></p> </body></html> Kevin Drum Health Care Fri, 18 Apr 2014 16:26:12 +0000 Kevin Drum 250131 at http://www.motherjones.com It's Spring, So California Refineries Are Suddenly Having a Few Problems http://www.motherjones.com/kevin-drum/2014/04/its-spring-so-california-refineries-are-suddenly-having-few-problems <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>The swallows may no longer return to Capistrano, but don't worry. We still have an <a href="http://www.latimes.com/business/la-fi-gas-prices-20140418,0,3834291.story#axzz2zFaPt1xO" target="_blank">annual rite of spring here in California:</a></p> <blockquote> <p>A gallon of regular gasoline hit a statewide average of $4.196 on Thursday, up about 13 cents in a week, according to AAA. That's the highest price since March 2013....Problems at a few refineries in the Golden State undergoing routine spring maintenance have squeezed inventory and boosted prices, analysts said. And only a handful of refineries outside the state are capable of making the ultra-clean type of gasoline mandated in California.</p> <p>"A couple of refinery issues have started to flare up, which is fairly normal this time of the year," said Patrick DeHaan, senior petroleum analyst at GasBuddy.com, a fuel price tracking website.</p> </blockquote> <p>I used to keep a file of clippings of this exact same story running each spring and summer. I mean, literally the exact same story. Every year, right at the point where the winter/summer switch squeezes supplies from out of state, there would suddenly be a bunch of "glitches" that took some local refinery capacity offline and prices would spike.</p> <p>I haven't bothered with that for a while, but seeing this story today brought back memories, so I just thought I'd share. It's an amazing annual coincidence, isn't it?</p> </body></html> Kevin Drum Energy Fri, 18 Apr 2014 15:11:54 +0000 Kevin Drum 250121 at http://www.motherjones.com Doctors Begin to Notice That Health Care Is Really Expensive http://www.motherjones.com/kevin-drum/2014/04/doctors-begin-notice-health-care-really-expensive <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>Andrew Pollack reports that some doctors are starting to notice that the health care they provide can be <a href="http://www.nytimes.com/2014/04/18/business/treatment-cost-could-influence-doctors-advice.html?hp&amp;_r=0" target="_blank">really, really expensive:</a></p> <blockquote> <p>Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care....Traditionally, guidelines have heavily influenced <img align="right" alt="" class="image image-_original" src="/files/blog_drug_cost.jpg" style="border: 1px solid black; margin: 20px 20px 15px 30px;">the practice of medicine, and the latest ones are expected to make doctors more conscious of the economic consequences of their decisions &mdash; even though there is no obligation to follow them.</p> <p>....Some doctors see a potential conflict in trying to be both providers of patient care and financial overseers. &ldquo;There should be forces in society who should be concerned about the budget, about how many M.R.I.s we do, but they shouldn&rsquo;t be functioning simultaneously as doctors,&rdquo; said Dr. Martin A. Samuels, the chairman of the neurology department at Brigham and Women&rsquo;s Hospital in Boston. He said doctors risked losing the trust of patients if they told patients, &ldquo;I&rsquo;m not going to do what I think is best for you because I think it&rsquo;s bad for the health care budget in Massachusetts.&rdquo;</p> </blockquote> <p>Generally speaking, this is overdue. Some doctors are highly sensitive to patient costs, but some aren't. I'm often surprised at how little doctors know about how much their treatment recommendations cost or how they're delivered. Even if you have the presence of mind to ask, sometimes they simply don't know their own systems well enough to find out.</p> <p>That said, I'd recommend baby steps. First, plenty of doctors are already very cost conscious&mdash;but in the wrong direction, pushing lucrative, highly expensive treatments because it's good for their own bottom line. Sometimes it's because they have a part ownership in a diagnostic facility. Other times they're just gaming the system, as some high-volume ophthalmologists do by routinely prescribing Lucentis ($120 reimbursement from Medicare) vs. Avastin ($3 reimbursement from Medicare) for treatment of macular degeneration. Guidelines that rein in this kind of behavior are an obvious target.</p> <p>Second, Congress could allow Medicare more discretion about how much it pays for various drugs. It's flatly crazy that taxpayers are the only people in the entire medical system who, by law, have virtually no leverage to negotiate pricing with pharmaceutical manufacturers.</p> <p>Third, doctors should be more proactive about simply being aware of costs and sharing this information with patients. Some patients care more than others, depending on their incomes and quality of insurance coverage. But every doctor should have at least a basic idea of what different treatment options cost their patients, and they should have it quickly available right in the exam room. Nobody should get stuck with a huge bill&mdash;or even just a large bill&mdash;simply because they got sent to an out-of-network specialist or got prescribed a drug that turned out to be off their provider's formulary.</p> <p>I suspect this is harder than I think. It could only be done by computer, and the software would have to have access to a ton of information. Doctors alone couldn't get it done. But electronic medical records are already taking over the profession, and with some help from the federal government I'll bet this kind of thing could be done. One way or another, cost transparency is the first step toward cost reduction.</p> </body></html> Kevin Drum Health Care Fri, 18 Apr 2014 14:46:23 +0000 Kevin Drum 250111 at http://www.motherjones.com Please Donate to Our Fundraiser http://www.motherjones.com/kevin-drum/2014/04/please-donate-our-fundraiser <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>For those of you who missed it in last week's catblogging post, we haven't yet reached our $100,000 goal, so how about donating a few bucks to our investigative reporting fundraiser? We're a reader-supported nonprofit, which means those dollars aren't going to come from big corporations or super-rich political donors. They'll be small contributions from regular people who read <em>Mother Jones</em>. If you value our reporting&mdash;or even if you only value our catblogging&mdash;please donate $5 to the Mother Jones Investigative Fund. If you can afford it, make it $10. We'll put it to good use. Here's how to make a contribution:</p> <ul> <li>Credit card donations: <a href="https://secure.motherjones.com/fnp/?action=SUBSCRIPTION&amp;list_source=7Z44DRU&amp;extra_don=1" target="_blank">Click here</a> </li> <li>PayPal donations: <a href="https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&amp;hosted_button_id=DA2WBARE3WZDG" target="_blank">Click here</a> </li> </ul> <p>Thanks!</p> </body></html> Kevin Drum Fri, 18 Apr 2014 13:00:05 +0000 Kevin Drum 250096 at http://www.motherjones.com The Economy Is Improving, But Not for Everyone http://www.motherjones.com/kevin-drum/2014/04/economy-improving-not-everyone <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body> <p>The BLS <a href="http://www.bls.gov/news.release/wkyeng.nr0.htm" target="_blank">reported today</a> that weekly earnings for full-time wage and salary workers rose 3 percent in the first quarter of 2014 compared to a year ago. Since inflation is running at 1.4 percent, <img align="right" alt="" class="image image-_original" src="/files/blog_earnings_production_2014_q1.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">that's good news. Earnings are going up.</p> <p>But wage gains are pretty unevenly distributed. Jeffrey Sparshott passes along a recent Labor Department note which concludes that <em>all</em> of the wage gains since 2009 have <a href="http://blogs.wsj.com/economics/2014/04/17/wealthiest-households-accounted-for-80-of-rise-in-incomes-in-recessions-aftermath/" target="_blank">gone to the top 40 percent.</a> The poor, the working class, and the middle class have seen no gains at all. This is reflected in the chart on the right, which shows weekly earnings for production and nonsupervisory workers. Weekly earnings for this group have been rising at a rate slightly above inflation for the past year, but not by much. Nor is that number getting better: In the first quarter of 2014, weekly earnings rose only 1.8 percent.</p> <p>There are some positive signs that the labor market is tightening a bit&mdash;decent job creation rates, fewer unemployment claims, rising earnings for full-time workers&mdash;but not everyone is benefiting. This remains a pretty uneven recovery.</p> </body></html> Kevin Drum Economy Fri, 18 Apr 2014 05:08:30 +0000 Kevin Drum 250101 at http://www.motherjones.com