Kevin Drum Feed | Mother Jones http://www.motherjones.com/Blogs/2013/01/%E2%80%9Dhttp%3A/www.businessinsider.com/legendary-harvard-law-professor-gives-the-ultimate-verdict-on-whether-the-trillion-dollar-platinum-coin-is-legal-2013-1 http://www.motherjones.com/files/motherjonesLogo_google_206X40.png Mother Jones logo http://www.motherjones.com en My Ten-Dollar Offer to the Halbig Truthers http://www.motherjones.com/kevin-drum/2014/07/my-ten-dollar-offer-halbig-truthers <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>There's no question that the statutory text of Obamacare contains a mistake. In one of its sections, it authorizes federal subsidies only for taxpayers who enroll through a state-based exchange, not for those who enroll through the federal <img align="right" alt="" class="image image-_original" src="/files/blog_ten_dollar_bill_again_again.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">exchange. But was it <em>really</em> a mistake? <a href="http://www.newrepublic.com/article/118880/halbig-gruber-video-gives-right-excuse-flip-aca-subsidies" target="_blank">Brian Beutler comments:</a></p> <blockquote> <p>Right-wing activists have spent the last several months fabricating a rival narrative<span class="em">&mdash;</span>a ludicrous theory of intent, in which leading Democrats meant to condition the subsidies, but decided to keep the inducement a secret from reporters, back bench members, governors, budget analysts, and health care reform advocates. This kind of deceptive argumentation is perhaps to be expected from activists. <strong>What's become incredibly frustrating to me about the <em>Halbig </em>brouhaha in the last few days is watching the conservative health care writers who were in the same trenches watching the same debate unfold<span class="em">&mdash;</span>attempting, from a very skeptical vantage point, to explain the bill correctly<span class="em">&mdash;</span>suddenly turn around and vouchsafe the Halbig Truthers.</strong></p> </blockquote> <p>That suggests something to me. As far as I know, not a single reporter who covered the Obamacare battle believes that Congress intended to restrict subsidies to state exchanges. As Beutler says, "To the extent that the question wasn&rsquo;t probed widely, if at all, it's because that would've been almost like asking whether the subsidies were intended to be denominated in Rubles." <a href="http://www.vox.com/2014/7/26/5937593/obamacare-halbig-gruber-tax-credits" target="_blank">Sarah Kliff agrees:</a> "It was never a question, during the five years I've spent writing about Obamacare, whether this would be case." Nobody in Congress questioned the universality of subsidies. Nobody in the executive branch questioned it. No governors questioned it. None of the bureaucrats tasked with building the exchanges questioned it. And nobody in the press questioned it.</p> <p>And that brings me to my suggestion: Is it really true that no one in the press questioned it? For the moment, let's forget about liberals. Hell, everyone knows we're in the bag for Obamacare, and by now we've probably scrubbed all our old posts of damning evidence. Ditto for the mainstream media. They're just shills for Obama anyway. But how about <em>conservatives</em>? They covered the Obamacare battle pretty obsessively too. Here's my guess: every single article written by conservatives between January 2009 and March 2010 (a) assumed that subsidies were universal and (b) never so much as mentioned the possibility that they weren't. In other words, they all believed in universal subsidies too because there was never any reason in their reporting to believe otherwise. Not one single reason.</p> <p>But maybe I'm wrong! So here's my offer: I will send a crisp, new ten-dollar bill to anyone who can point out a conservative who so much as suspected that subsidies were limited to state exchanges prior to March 2010. Surely that's incentive enough? Let's start digging up evidence, people.</p></body></html> Kevin Drum Health Care Wed, 30 Jul 2014 00:31:45 +0000 Kevin Drum 257286 at http://www.motherjones.com The Forgotten Murder Trial of the NRA's Top Lawyer http://www.motherjones.com/kevin-drum/2014/07/nras-murder-mystery <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Robert J. Dowlut is the NRA's top lawyer, a "human encyclopedia" on the subject of state gun laws and the man responsible for much of the gun lobby's success in a series of court cases that have steadily eroded restrictions on gun ownership in the United States. "He is a really <img align="right" alt="" class="image image-_original" src="/files/blog_nra_murder_mystery.jpg" style="border: 1px solid black; margin: 27px 0px 15px 30px;">reliable and exhaustive source for legal input on the issue," says one admirer.</p> <p>But 50 years ago, according to a pile of court documents MoJo's Dave Gilson uncovered for <a href="http://www.motherjones.com/politics/2014/07/robert-dowlut-nra-murder-mystery" target="_blank">"The NRA's Murder Mystery,"</a> a teenage Dowlut had a rather different relationship with guns:</p> <blockquote> <p>Shortly before dark on the evening of April 17, 1963, Robert J. Dowlut went looking for a gun inside the city cemetery in South Bend, Indiana. Making his way through the headstones, he stopped in front of the abandoned Studebaker family mausoleum. He knelt by the front right corner of the blocky gray monument and lifted a stone from the damp ground. Then, as one of the two police detectives accompanying him later testified, the 17-year-old "used his hands and did some digging." He unearthed a revolver and ammunition. As Dowlut would later tell a judge, the detectives then took the gun, "jammed it in my hand," and photographed him. "They were real happy."</p> <p>Two days earlier, a woman named Anna Marie Yocum had been murdered in her South Bend home. An autopsy determined she had been shot three times, once through the chest and twice in the back, likely at close range as she'd either fled or fallen down the stairs from her apartment. Two .45-caliber bullets had pierced her heart.</p> <p>....The following morning, Dowlut was charged with first-degree murder. A year and a half later, a jury found him guilty of second-degree murder. Before the judge handed down a life sentence, he asked the defendant if there was any reason why he shouldn't be put away. Dowlut replied, "I am not guilty." A day later, the Indiana State Prison in Michigan City registered Dowlut, now 19, as prisoner number 33848.</p> <p>Less than six years later, Robert Dowlut would be a free man&mdash;his murder conviction thrown out by the Indiana Supreme Court because of a flawed police investigation. The court ordered a new trial, but one never took place. Dowlut would return to the Army and go on to earn college and law degrees. Then he would embark on a career that put him at the epicenter of the movement to transform America's gun laws.</p> </blockquote> <p><a href="http://www.motherjones.com/politics/2014/07/robert-dowlut-nra-murder-mystery" target="_blank">Click the link</a> to read the whole story.</p></body></html> Kevin Drum Guns Tue, 29 Jul 2014 20:48:08 +0000 Kevin Drum 257221 at http://www.motherjones.com Guns and Doctors: A Follow-Up http://www.motherjones.com/kevin-drum/2014/07/guns-and-doctors-follow <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Aaron Carroll responds to my skeptical take on doctors asking patients about their gun ownership:</p> <blockquote> <p>I think you ask legitimate questions, but these are consensus things that pediatricians ask about. You&rsquo;re thinking like an adult, and not as a parent.</p> <p>I don&rsquo;t know if internists ask adults about guns. I doubt they do. But pediatricians do ask parents. They also ask if parents have talked about street safety. They ask if they keep chemicals out of reach of their children. They ask if they&rsquo;ve checked the temperature of the hot water heater. They ask about water safety, bathtubs, and talk about drowning. Fire safety. Bike safety. Car safety (including airbags). I could go on and on and on.</p> <p>This is what pediatricians do. You may be too far removed from that to remember, but it is! Read <a href="http://brightfutures.aap.org/pdfs/bf3%20pocket%20guide_final.pdf" target="_blank"><em>Bright Futures</em></a>. It&rsquo;s hundreds of pages long.</p> </blockquote> <p>In my post, I was mostly thinking about adult doctors, not pediatricians, though I suppose both were on my mind. In any case, this is an obvious distinction, and I thought it was worth passing along.</p></body></html> Kevin Drum Guns Health Care Tue, 29 Jul 2014 19:05:54 +0000 Kevin Drum 257201 at http://www.motherjones.com Quote of the Day: "The Press Loves to Cover Her Hard" http://www.motherjones.com/kevin-drum/2014/07/quote-day-press-loves-cover-her-hard <!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_hillary_clinton_speech.jpg" style="border: 1px solid black; margin: 8px 0px 15px 30px;">Dave Weigel notes that the media is <em>still</em> obsessed with Hillary Clinton's comment about being <a href="http://www.slate.com/blogs/weigel/2014/07/29/the_long_tail_of_dead_broke.html" target="_blank">"dead broke" when she and Bill left the White House:</a></p> <blockquote> <p>They've got to be sick of this by now. Maggie Haberman had it nailed three weeks ago: Hillary Clinton was "still raw over the partisan wars that hindered her husband&rsquo;s legacy and left the couple with millions of dollars in legal debt." Her answer, as she told Ramos, was accurate, and it's baffling to her that this became a "gaffe." As she continued her tour, HarperCollins was printing up copies of <em>Clinton, Inc.</em>, a tell-all by the <em>Weekly Standard's</em> Daniel Halper. <strong>On Page 18, Halper recalls that in 2001 "the Clintons were broke, owing a fortune in legal fees from the many investigations into their personal lives," and that they had to be loaned $1.3 by Terry McAuliffe.</strong> Until just a month ago, that was how even conservatives remembered the Clintons' departure from the White House.</p> </blockquote> <p>What's the deal with this? Sure, Hillary could have responded to questions about her wealth a little better. She's not the natural politician Bill is. But really, there's not much else here. So why does it continue to be news a full month later? Uber-insider Mark Halperin explains:</p> <blockquote> <p>She has a lot of positive attributes that are currently just being overwhelmed by all this negative coverage. And it&rsquo;s going to keep going. The momentum&mdash;there&rsquo;s, there&rsquo;s&mdash; <strong>The press loves to cover her hard.</strong></p> </blockquote> <p>This comes courtesy of Bob Somerby, who's been following this ever since the initial flood-the-zone coverage of Hillary's "gaffe" in the <em>Washington Post</em>. <a href="http://dailyhowler.blogspot.com/2014/07/destined-to-get-horrible-coverage-but.html?m=0" target="_blank">Somerby tells the rest of the story:</a></p> <blockquote> <p>Multimillionaire TV stars asked if voters would support a person as wealthy as Clinton. In response to Clinton&rsquo;s answers, some of the nation&rsquo;s most famous pundits launched their famous &ldquo;gaffe culture.&rdquo;</p> <p>The <em>Washington Post</em> even launched a front-page jihad concerning the size of Clinton&rsquo;s speaking fees. In the <em>New York Times</em>, Maureen Dowd assailed Clinton for her &ldquo;rapacious&rdquo; behavior and her &ldquo;wanton acquisitiveness,&rdquo; which she was said to be passing along to her daughter.</p> <p>....Halperin made a starting suggestion&mdash;he suggested the press corps&rsquo; coverage of a major candidate could determine the outcome of our next White House campaign.</p> <p>Plainly, that&rsquo;s what happened in Campaign 2000, when a twenty-month war against Candidate Gore let George Bush reach the White House. In the main, that war was conducted by the mainstream press corps, <em>not</em> by the RNC.</p> <p>The press corps&rsquo; poisonous war against Gore let Bush reach the White House. But it&rsquo;s a basic law of the guild: Major journalists <em>never</em> suggest that the behavior of their own guild could have such startling effects.</p> </blockquote> <p>The media's preoccupation with the Clintons' wealth won't last forever. Even for the Washington press corps, it's too transparently silly to pretend that it's somehow surprising that a presidential candidate is wealthy. But Somerby and Halperin are right: it's a sign of things to come. The press has never liked Hillary, and she's never liked them, and that's that. If she decides to run for president, this is going to be one of her biggest problems&mdash;or maybe her biggest, period. She's just never going to catch a break.</p></body></html> Kevin Drum Hillary Clinton Tue, 29 Jul 2014 18:49:09 +0000 Kevin Drum 257196 at http://www.motherjones.com Should Doctors Ask You About Your Guns? http://www.motherjones.com/kevin-drum/2014/07/should-doctors-ask-you-about-your-guns <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>In Florida, it's illegal for a physician to ask you if you own a gun. Pediatrician Aaron Carroll <a href="http://www.nytimes.com/2014/07/30/upshot/do-you-own-a-gun-in-florida-doctors-cant-ask-you-that.html" target="_blank">thinks this is ridiculous:</a></p> <blockquote> <p>When pediatricians ask you about using car seats, they&rsquo;re trying to prevent injuries. When they ask you about how your baby sleeps, they&rsquo;re trying to prevent injuries. When they ask you about using bike helmets, they&rsquo;re trying to <img align="right" alt="" class="image image-_original" src="/files/blog_gun_sale.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">prevent injuries. And when they ask you about guns, they&rsquo;re trying to prevent injuries, too.</p> <p>....When I ask patients and parents whether they own guns, if they tell me they do, I immediately follow up with questions about how they are stored. I want to make sure they&rsquo;re kept apart from ammunition. I want to make sure they&rsquo;re in a locked box, preferably in a place out of reach of children. Doing so minimizes the risks to children. That&rsquo;s my goal.</p> <p>When we, as physicians, ask you if you drink or smoke, it&rsquo;s not so that we can judge you. It&rsquo;s so we can discuss health risks with you. When we ask you about domestic violence, it&rsquo;s not to act like police detectives. It&rsquo;s so that we can help you make better choices for your health. When we ask you about what you eat or whether you exercise, it&rsquo;s so we can help you live better and longer. We&rsquo;re doctors; it&rsquo;s our job.</p> </blockquote> <p>I don't often disagree with Carroll, but I think I might here. Not about Florida's law: that really is ridiculous. The state may have an interest in making sure doctors don't give demonstrably bad advice, but it certainly doesn't have a legitimate interest in preventing them from asking simple, fact-oriented question. This represents prior restraint on non-commercial speech, and as such it's beyond the pale.</p> <p>That said, <em>should</em> physicians ask about gun ownership? I'm not so sure. Carroll says he only wants to discuss "health risks," and that's appropriate. Doctors have expertise in the area of human health: that is, the biology and physiology of the human body. But that's not the same thing as the <em>safety</em> of the human body.</p> <p>Not only do doctors have no special professional expertise in this area, but it's simply too wide open. Does your car have air bags? Do you ever jaywalk? Have you checked your electrical outlets lately? Is your house built to withstand an earthquake? Do you know how to work safely on your roof? Do you make sure to watch your kids in the pool? Are you planning any trips to eastern Ukraine?</p> <p>I could go on forever in this vein. These are things unrelated to human physiology. If you define them all as health risks, you're simply defining every aspect of life as a health risk, and therefore your doctor's concern. That goes too far, and I don't blame people for sometimes reacting badly to it. There are certainly gray areas here, but generally speaking, if I want advice about my health, I'll see a doctor. If I want advice about gun safety, I'll talk to a gun pro. I think it might be best to leave it this way.</p> <p><strong>FULL DISCLOSURE:</strong> My view is almost certainly colored by the fact that I'm all but phobic about doctors. I hate visiting them, I hate talking to them, and I hate the fact that they never seem to really, truly respond to what I tell them. I would be very annoyed if a doctor suddenly veered off and started quizzing me about general safety issues.</p> <p>I'm keenly aware that this is an obvious overreaction on my part, and I do my best to restrain it when I'm actually talking to a doctor. Nonetheless, it's there.</p></body></html> Kevin Drum Guns Health Tue, 29 Jul 2014 16:47:25 +0000 Kevin Drum 257156 at http://www.motherjones.com Color Me Skeptical About a Guaranteed Income for All http://www.motherjones.com/kevin-drum/2014/07/color-me-skeptical-about-guaranteed-income-all <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Should we have a guaranteed minimum income in the United States? Something nice and simple that would replace nearly our entire current alphabet soup of means-tested welfare programs?<sup>1</sup> Dylan Matthews posts about this frequently, and others <img align="right" alt="" class="image image-_original" src="/files/images/Blog_Uncle_Sam_Money.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">chime in occasionally as well. It even has some support among conservatives.</p> <p>I am not so sure, myself. Keith Humphreys makes a couple of good points <a href="http://www.samefacts.com/2014/07/domestic-politics/two-unknowns-of-a-guaranteed-minimum-income/" target="_blank">here,</a> but I want to step back a bit. At a bare minimum, I need answers to four questions:</p> <ol><li>How big would it be?</li> <li>Is it a family benefit or a personal benefit?</li> <li>Is it for adults only, or would children also qualify for a benefit?</li> <li>How would it phase out with income?</li> </ol><p>There are many more details to work out, all of them important, but I don't think you can even begin to talk about this without answers to these four basic questions.</p> <p>I'm skeptical about the whole thing because I don't think you can make the details work out. Nor do I think that it's politically feasible either now or in the future.<sup>2</sup> What's more, I'm always skeptical of ideas like this that haven't been adopted by any other country, even the ones with far more liberal welfare states than ours. I figure there must be a reason for this.</p> <p>But I'm happy to be proven wrong. Just give me a policy skeleton to work with. What exactly are we talking about here?</p> <p><sup>1</sup>Proponents usually (but not always) make exceptions for education and health care, which are too variable and too expensive to be handled by a simple minimum income.</p> <p><sup>2</sup>Perhaps it's feasible in our far-distant robot future. Maybe even necessary. For now, though, let's stick to the medium-term future.</p></body></html> Kevin Drum Economy Income Inequality Tue, 29 Jul 2014 15:50:42 +0000 257146 at http://www.motherjones.com America Should Get Out of the Peacekeeping Business in Israel http://www.motherjones.com/kevin-drum/2014/07/america-should-get-out-peacekeeping-business-israel <!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.washingtonpost.com/blogs/worldviews/wp/2014/07/28/the-one-thing-everyone-in-israel-seems-to-agree-on-john-kerry-blew-it/?hpid=z1" target="_blank">From the <em>Washington Post</em>:</a></p> <blockquote> <p>Anyone who has made even a passing glance at the Israeli media in the past few days will have noticed the incredible chorus of criticism being directed at John Kerry right now. The secretary of state has been lambasted by all sides for his apparent failure in attempts to negotiate a cease-fire between Israel and Hamas.</p> <p>[Examples follow]</p> </blockquote> <p>And it's not just Israelis. Elsewhere in the <em>Post</em>, David Ignatius <a href="http://www.washingtonpost.com/opinions/david-ignatius-john-kerrys-big-blunder-in-seeking-an-israel-gaza-cease-fire/2014/07/28/ab3fbfd2-1686-11e4-9349-84d4a85be981_story.html" target="_blank">takes Kerry to task too:</a></p> <blockquote> <p>Secretary of State John Kerry has made a significant mistake in how he&rsquo;s pursuing a Gaza cease-fire &mdash; and it&rsquo;s not surprising that he has upset both the Israelis and some moderate Palestinians.</p> <p>Kerry&rsquo;s error has been to....</p> </blockquote> <p>I think we should stop right there. Kerry has made only one mistake, and that was trying to negotiate a ceasefire in the first place. He didn't fail because of any personal shortcomings; he failed because there were no terms under which either side would ever have agreed to a ceasefire. The fighting will stop when both sides decide to stop, and not a minute before. It's long past time for everyone to acknowledge this.</p> <p>The United States has been trying to broker peace in the Middle East for the past 20 years. Maybe longer, depending on how you count. But 20 years at least, and every attempt has failed. Various Americans have tried, all with different approaches, and the result has been the same every time: not just failure, but a steady and inexorable deterioration of the situation. It's no longer credible to pretend that maybe a different person with a different approach and different sympathies might have made a difference in any particular situation. Blaming Kerry for this latest failure is just delusional.</p> <p>Quite famously, we all "know" what a deal between Israel and the Palestinians needs to look like. It's obvious. Everyone says so. The only wee obstacle is that neither side is willing to accept this obvious deal. They just aren't. The problem isn't agreeing on a line on a map, or a particular circumlocution in a particular document. The problem is much simpler than that, so simple that sophisticated people are embarrassed to say it outright: Two groups of people want the same piece of land. Both of them feel they have a right to it. Both of them are, for the time being, willing to fight for it. Neither is inclined to give up anything for a peace that neither side believes in.</p> <p>That's it. That's all there is. All the myriad details don't matter. Someday that may change, and when it does the United States may have a constructive role to play in brokering a peace deal. But that day is nowhere in the near future. For now, it's time for America to get out of the peacekeeping business. Our presence there does no good, and might very well be doing active harm. This doesn't mean withdrawing from the region, it just means getting out of the shuttle diplomacy business. Neither side is ready for it, and probably won't be for years. Let's end the charade.</p></body></html> Kevin Drum International Tue, 29 Jul 2014 14:58:55 +0000 Kevin Drum 257141 at http://www.motherjones.com Take Two: Just How Good Are Generic Meds Anyway? http://www.motherjones.com/kevin-drum/2014/07/take-two-just-how-good-are-generic-meds-anyway <!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.motherjones.com/kevin-drum/2014/07/doctors-arent-really-very-smart-about-buying-generics" target="_blank">A few days ago</a> I wrote a post about generic painkillers and the fact that doctors themselves&mdash;who should know better&mdash;often don't use them. "If physicians aren't really sold on generics in their own personal lives," I asked, "does this mean they're not really sold on them in their professional lives too?"</p> <p>Well, perhaps I got it backwards. A friend sent me a link to a <em>Forbes </em>article from last year about the FDA <a href="http://fortune.com/2013/01/10/are-generics-really-the-same-as-branded-drugs/" target="_blank">retracting its approval of a generic version of Wellbutrin:</a></p> <blockquote> <p>The episode is bringing momentum to a movement that has been quietly building among many doctors and medical societies that are increasingly willing to ask a question that borders on heresy: Are generics really identical to the branded products they are meant to replicate? To a surprising degree, they say, the answer is no.</p> <p>If you&rsquo;re a layperson, this is the way you probably think of generics: They&rsquo;re the exact same products in different packaging; generics companies can sell such medications for a fraction of the cost of the originals because they don&rsquo;t have to spend huge sums on drug development and marketing....But generic drugs diverge from the originals far more than most of us believe.</p> <p>....The FDA&rsquo;s rules effectively acknowledge that. The agency&rsquo;s definition of bioequivalence is surprisingly broad: A generic&rsquo;s maximum concentration of active ingredient in the blood must not fall more than 20% below or 25% above that of the brand name. This means a potential range of 45%, by that measure, among generics labeled as being the same.</p> </blockquote> <p>In other words, physicians are becoming increasingly concerned about the reliability of prescription generics, so maybe they're a little bit skeptical about over-the-counter generics too.</p> <p>Now, I doubt that anyone seriously thinks this applies to aspirin or ibuprofen. There's nothing proprietary about the formulas for these medications, and everyone knows how to make them just as well as the big guys. Still, I suppose it's possible that a generalized uncertainty about generic prescription meds could translate into a bit of uncertainty about OTC meds too. And that little bit might be enough to make lots of doctors shrug their shoulders and plunk down an extra dollar or two for a name brand.</p> <p>I'm just guessing here, of course. Mostly I just thought it was an interesting article and wanted to pass it along.</p></body></html> Kevin Drum Health Care Tue, 29 Jul 2014 05:04:28 +0000 Kevin Drum 257126 at http://www.motherjones.com Medicare Actuaries Are Big Fans of Obamacare's Cost Reduction Programs http://www.motherjones.com/kevin-drum/2014/07/medicare <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>As long as we're perusing the 2014 Medicare Trustees Report, here's another interesting chart. It shows just how much the Medicare actuaries expect to save thanks to all the cost-reduction measures included in Obamacare. It's a pretty speculative forecast, of course, but their estimate is that Obamacare will reduce federal spending a lot. By 2080, the savings add up to about 1.5 percent of GDP, which in today's dollars amounts to $250 billion per year.</p> <p>Now, don't take this too seriously on a pure policy basis. Projections that are extended 70 years out are pretty worthless. Trend lines don't stay the same that long, and government policies change every decade anyway. Nor does this mean that Obamacare is a free lunch. It still has a high net cost since it's insuring a whole lot of people who never had insurance before.</p> <p>Still, this shows that the Medicare actuaries take the efficiency measures in Obamacare pretty seriously. If we stick to them, they really are likely to cut the growth rate of Medicare spending. And remember: Medicare costs get reflected in overall health care costs too. If Republicans ever win their jihad against Obamacare, we lose not just the Medicare savings, but a lot of savings in private health care too. That's a lot to give up.</p> <p><img align="middle" alt="" class="image image-_original" src="/files/blog_medicare_obamacare_savings.jpg" style="margin: 15px 0px 5px 30px;"></p></body></html> Kevin Drum Economy Health Care Tue, 29 Jul 2014 00:42:01 +0000 Kevin Drum 257111 at http://www.motherjones.com Chart of the Day: The Great Medicare Spending Mystery http://www.motherjones.com/kevin-drum/2014/07/chart-day-great-medicare-spending-mystery <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Here it is: the biggest question mark in the entire federal budget. The <a href="http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/Downloads/TR2014.pdf" target="_blank">2014 Medicare Trustees Report</a> is out today, and it shows, rather remarkably, that the cost per person of Medicare in 2013 was absolutely flat compared to 2012. Even more remarkably, they expect the combined increase over the next two years to be zero as well. In other words, Medicare costs are growing considerably slower than the inflation rate.</p> <p>And now for the trillion-dollar question: How long will this slowdown last? The historical data in the report, along with future projections, suggests that between 2006 (when the prescription drug benefit began) and 2018, Medicare costs will have grown, on average, at exactly the rate of inflation. In real terms, that means zero growth over a 12-year period. But Medicare's actuaries don't expect that to last. Starting in 2017 they expect high growth rates again, leading to Medicare spending outpacing inflation.</p> <p>This is by far the biggest unknown going forward in the federal budget: Will Medicare spending continue to increase slowly, or will it revert to the higher growth rates of the early aughts? You can make a pretty good case either way. But no matter what anyone tells you&mdash;<a href="http://www.motherjones.com/kevin-drum/2013/08/medicare-costs-down-down-down" target="_blank">including me</a>&mdash;don't be fooled. The real answer is that We. Just. Don't. Know.</p> <p><img align="middle" alt="" class="image image-_original" src="/files/blog_medicare_spending_projection_2014.jpg" style="border: 1px solid black; margin: 15px 0px 5px 25px;"></p></body></html> Kevin Drum Health Care Mon, 28 Jul 2014 21:57:11 +0000 Kevin Drum 257101 at http://www.motherjones.com House Republicans Pass Bill to Lower Taxes on the Rich and Raise Taxes on the Poor http://www.motherjones.com/kevin-drum/2014/07/house-republicans-pass-bill-lower-taxes-rich-and-raise-taxes-poor <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>So what are Republicans in the House of Representatives up to these days? <a href="http://www.newrepublic.com/article/118866/house-republicans-vote-remove-marriage-penalty-child-tax-credit" target="_blank">According to Danny Vinik,</a> they just passed a bill that would reduce taxes on the rich and raise them on the poor.</p> <p>I know, I know: you're shocked. But in a way, I think this whole episode is even worse than Vinik makes it sound.</p> <p>Here's the background: The child tax credit reduces your income tax by $1,000 for each child you have. It phases out for upper middle-income folks, but&mdash;and this is the key point&mdash;it phases out differently for singles and couples. The way the numbers sort out, it treats singles better than couples. This is the dreaded "marriage penalty," which is bad because we want to encourage people to get married, not discourage them.</p> <p>So what did House Republicans do? Naturally, they raised the phase-out threshold for married couples so that well-off couples would get a higher benefit. They didn't have to do this, of course. They could have lowered the benefit for singles instead. Or they could have jiggled the numbers so that everyone got equal benefits but the overall result was revenue neutral.</p> <p>But they didn't. They chose the path that would increase the benefit&mdash;and thus lower taxes&mdash;for married couples making high incomes. The bill also indexes the credit to inflation, which helps only those with incomes high enough to claim the full credit. And it does nothing to make permanent a reduction in the earnings threshold that benefits poor working families. Here's the net result:</p> <blockquote> <p>If the House legislation became law, <a href="http://www.cbpp.org/cms/?fa=view&amp;id=4171" target="_blank">the Center for Budget and Policy Priorities estimated</a> that a couple making $160,000 a year would receive a new tax cut of $2,200. On the other hand, the expiring provisions of <img align="right" alt="" class="image image-_original" src="/files/blog_cbpp_child_tax_credit.jpg" style="margin: 20px 0px 15px 30px;">the CTC would cause a single mother with two kids making $14,500 to lose her full CTC, worth $1,725.</p> </blockquote> <p>So inflation indexing, which is verboten when the subject is the minimum wage, is A-OK when it comes to high-income taxpayers. And eliminating the marriage penalty is also a good idea&mdash;but again, only for high-income couples. Which is crazy. I don't really have a firm opinion on whether the government should be in the business of encouraging marriage, but if it is, surely it should focus its attention on the people who need encouragement in the first place. And that is very decidedly not the upper middle class, which continues to get married at the same rate as ever.</p> <p>So we have a deficit-busting tax cut. It's a cut only for the upper middle class. It's indexed for inflation, even though we're not allowed to index things like the minimum wage. And the poor are still scheduled for a tax increase in 2017 because this bill does nothing to stop it. It's a real quad-fecta. I wonder what Paul Ryan thinks of all this?</p></body></html> Kevin Drum Congress Income Inequality Mon, 28 Jul 2014 18:12:28 +0000 Kevin Drum 257071 at http://www.motherjones.com Why on Earth Are Argentine Bonds So Hot Right Now? http://www.motherjones.com/kevin-drum/2014/07/why-earth-are-argentine-bonds-so-hot-right-now <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>What's the hottest ticket in the global bond market right now? That's right: Argentine bonds. They're on a tear. But why? Didn't Argentina just <em>lose</em>&mdash;once and for all&mdash;its court case against vulture funds who own old Argentine bonds and are <img align="right" alt="" class="image image-_original" src="/files/blog_argentina_map.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">refusing to accept partial payment of the kind that everyone else accepted after Argentina's default a decade ago?</p> <p>Why yes, they did lose. Argentina now has to pay the vulture funds&mdash;which is politically unthinkable for any Argentine politician who wants to avoid being tarred and feathered&mdash;or else it has to default on <em>all</em> its bonds, including the restructured "exchange" bonds that it issued in 2005. So why are these exchange bonds becoming more valuable? Argentina has always been <em>willing</em> to pay those bonds, so it's not as if the court ruling has made default less likely. The risk of default was already close to nil. So what's up?</p> <p>Felix Salmon, having gotten tired of financial journalists offering up bizarre theories to explain this, tells us today that it's probably all simpler than it seems. In fact, the odds of default <em>have</em> gotten higher, just as logic dictates, but this might actually be a good thing for bondholders. Normally, he points out, there's no upside to bonds: you get the coupon payment, but you never get anything more. In Argentina's case, however, that might not be true.</p> <p>First off, there's something called a RUFO clause. This means that if Argentina does eventually settle with the vulture funds, it has to offer the same deal to all the other bondholders.</p> <blockquote> <p>Obviously, Argentina doesn&rsquo;t have the money to pay out the exchange bondholders in full according to that clause. But if Argentina is paying out billions of dollars to vultures who deserve much less than they&rsquo;re getting, and if those payments create a massive parallel legal obligation to the bondholders who cooperated with the country and did everything they asked, <strong>then it&rsquo;s not unreasonable to expect that Argentina might end up paying something to the exchange bondholders,</strong> if doing so would wipe out any RUFO obligations.</p> </blockquote> <p>Then there are interest payments:</p> <blockquote> <p>The second way that exchange bondholders could get more than 100 cents on the dollar is, paradoxically, if there is a default. The minute that Argentina goes into arrears on its coupon payments, the clock starts ticking. From that day onwards &mdash; and actually, that day has been and gone already &mdash; bondholders are owed not only those coupon payments but interest on those coupon payments. <strong>And the interest accrues at the standard statutory rate of 8% &mdash; a massive number, these days.</strong></p> </blockquote> <p>So there you have it: a paradoxical case in which bonds might be viewed as more valuable if the odds of default are higher. Salmon admits that he's just speculating here, since no one knows for sure why the market is so hot for Argentine bonds in the wake of Argentina <em>losing</em> its court case. But this is at least a reasonable guess. And a fascinating one.</p></body></html> Kevin Drum Economy International Mon, 28 Jul 2014 17:11:13 +0000 Kevin Drum 257056 at http://www.motherjones.com Congress Might Actually Pass a Bill to Address VA Problems http://www.motherjones.com/kevin-drum/2014/07/congress-might-actually-pass-bill-address-va-problems <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Since I've been griping for a long time about Congress being unable to pass so much as a Mother's Day resolution these days, it's only fair to highlight the possibility of <a href="http://www.washingtonpost.com/blogs/post-politics/wp/2014/07/27/house-senate-negotiators-reach-deal-on-veterans-bill/" target="_blank">actual progress on something:</a></p> <blockquote> <p>House and Senate negotiators have reached a tentative agreement to deal with the long-term needs of the struggling Department of Veterans Affairs and plan to unveil their proposal Monday.</p> <p>Sen. Bernie Sanders (I-Vt.) and Rep. Jeff Miller (R-Fla.), who lead the Senate and House Veterans' Affairs committees, continued negotiating over the weekend. Aides said they "made significant progress" on legislation to overhaul the VA and provide funding to hire more doctors, nurses and other health-care professionals. Sanders and Miller are scheduled to discuss their plan Monday afternoon.</p> </blockquote> <p>We don't have all the details yet, and the bill hasn't actually passed or anything. There's still plenty of time for tea partiers to throw their usual tantrum. And there's also plenty of time for the House GOP leadership to respond to the tantrum by crawling back into its cave and killing the whole thing. It'll be President Obama's fault, of course, probably for attending a fundraiser, or maybe for sneezing at the wrong time.</p> <p>But maybe not! Maybe they really will pass this thing. It would provide vets with more flexibility to see doctors outside the VA system, which is a bit of a Band-Aid&mdash;but probably a necessary one&mdash;and it provides additional funding for regions that have seen a big influx of veterans. On the flip side, I don't get the sense that the bill will really do much to fix the culture of the VA, which becomes a political cause c&eacute;l&egrave;bre every few years as we discover that all the same things we yelled about the time before are still true. But I guess that's inevitable in a political culture with the attention span of a newt.</p> <p>All things considered, it would be a good sign if this bill passed. The VA, after all, isn't an inherently partisan issue. Just the opposite, since both parties support vets about equally and both should, in theory, be more interested in helping vets than in prolonging chaos for political reasons.</p> <p>In other words, if there's anything that's amenable to a basically technocratic solution and bipartisan support, this is it. In a way, it's a test of whether our political system is completely broken or just mostly broken. "Mostly" would be something of a relief.</p></body></html> Kevin Drum Congress Mon, 28 Jul 2014 15:38:49 +0000 Kevin Drum 257051 at http://www.motherjones.com Friday Cat Blogging - 25 July 2014 http://www.motherjones.com/kevin-drum/2014/07/friday-cat-blogging-25-july-2014 <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Say hello to Mozart, the latest addition to the Drum family menagerie. One of my mother's neighbors found him wandering around, so naturally he ended up at my mother's house. He's a very sociable cat and appears to be very pleased with his choice of home. To celebrate his appearance, today you get two catblogging photos: one that shows his whole body and one that's a close-up of his face. Enjoy.</p> <p><img align="middle" alt="" class="image image-_original" src="/files/blog_mozart_body_2014_07_25.jpg" style="border: 1px solid black; margin: 20px 0px 5px 60px;"><img align="middle" alt="" class="image image-_original" src="/files/blog_mozart_face_2014_07_25.jpg" style="border: 1px solid black; margin: 10px 0px 5px 60px;"></p></body></html> Kevin Drum Fri, 25 Jul 2014 18:50:05 +0000 Kevin Drum 257001 at http://www.motherjones.com Doctors Aren't Really Very Smart About Buying Generics http://www.motherjones.com/kevin-drum/2014/07/doctors-arent-really-very-smart-about-buying-generics <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Sarah Kliff takes a look today at our use of generic drugs. Long story short, it's surprising how few of us save money by buying generic pain medicine instead of name brands (Advil, Tylenol, Bayer, etc.). Why? In most cases, I suppose it's just ignorance: people don't realize that the "store brand" is genuinely identical to the name brand. In other cases it might be something else. I buy generic ibuprofen, and it usually comes in the form of small brown pills. One day, however, I went to to a different drug store to stock up, and it turned out that their generic ibuprofen came in the form of small <em>orange</em> pills. Marian used these for a while, but really hated them. Eventually she cracked, and insisted on buying a new bottle from our usual drug store. Sometimes little things can make all the difference.</p> <p>Anyway. The main point of Kliff's post is that generics are good, and as evidence of this she puts up a chart showing what doctors themselves buy. <a href="http://www.vox.com/2014/7/25/5936739/shop-like-a-pharmacist-dont-buy-advil" target="_blank">Here's an excerpt from the chart:</a></p> <p><img align="middle" alt="" class="image image-_original" src="/files/blog_doctor_generics_1.jpg" style="border: 1px solid black; margin: 20px 0px 10px 5px;"></p> <p>It's true that doctors mostly favor generics when it comes to basic pain relievers. But frankly, what's amazing to me is how <em>little</em> they prefer them. For chrissake, they prefer generic <em>aspirin</em> by only ten percentage points. That means they buy the name brand about 45 percent of the time. Why would a doctor do this? Granted, the extra few dollars is probably no big deal to them, but why waste it anyway? Certainly not because of ignorance. Are their spouses doing the buying? Or what?</p> <p>And why the active preference for name-brand rubbing alcohol, of all things? It's hard to think of anything more generic than that. What's the deal here?</p> <p>As for Alka-Seltzer, the dislike of generics is so huge that there just has to be some real difference here. But what?</p> <p>In any case, I suspect this might have some real importance beyond the question of doctors spending a few dollars they don't have to. If physicians aren't really sold on generics in their own personal lives, does this mean they're not really sold on them in their professional lives too? Do they tend to prescribe name brands when they shouldn't? And how much does this cost all of us?</p></body></html> Kevin Drum Health Care Fri, 25 Jul 2014 18:05:56 +0000 Kevin Drum 256996 at http://www.motherjones.com Republicans Maybe Not as Inept as We Think http://www.motherjones.com/kevin-drum/2014/07/republicans-maybe-not-inept-we-think <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Paul Waldman thinks Republicans have become a <a href="http://prospect.org/article/how-did-gop-turn-such-bunch-clowns" target="_blank">bunch of bumblers and idiots:</a></p> <blockquote> <p>Think about it this way: Has there been a single instance in the last few years when you said, "Wow, the Republicans really played that one brilliantly"?</p> <p>In fact, before you'll find evidence of the ruthless Republican skillfulness so many of us had come to accept as the norm in a previous era, you'll need to go back an entire decade to the 2004 election. George W. Bush's second term was a disaster, Republicans lost both houses of Congress in 2006, they lost the White House in 2008, they decided to oppose health-care reform with everything they had and lost, they lost the 2012 election&mdash;and around it all they worked as hard as they could to alienate the <img align="right" alt="" class="image image-_original" src="/files/blog_gallup_republican_self_id.jpg" style="border: 1px solid black; margin: 25px 0px 15px 30px;">fastest growing minority group in the country and make themselves seem utterly unfit to govern.</p> <p>In fact, in the last ten years they've only had one major victory, the 2010 midterm election.</p> </blockquote> <p>Hmmm. It's true that the GOP has had a rough decade in a lot of ways. The number of self-IDed Republicans has <a href="http://www.gallup.com/poll/166763/record-high-americans-identify-independents.aspx" target="_blank">plummeted since 2004;</a> their standing among the fast-growing Hispanic population has cratered; and their intellectual core is now centered in a wing of the party that believes we should return to the gold standard. This isn't a promising starting point for a conservative renaissance.</p> <p>Still, let's not kid ourselves. If Republicans were really as woefully inept as Waldman says, then Democrats should be kicking some serious ass these days. I haven't especially noticed this. They won in the sixth year of Bush's presidency, when out parties always win, and then won in 2008, when an economic collapse pretty much guaranteed a victory for anyone with a D after their name. Then they had a single fairly good year&mdash;followed by an epic blunder that lost them a sure seat in Massachusetts, and with it control of the Senate. They got crushed in 2010. They won a squeaker in 2012 against an opponent who made a wedding cake figurine look good by comparison. For the last four years, they've basically gotten nothing done at all.</p> <p>And what about those Republicans? Well, they have a hammerlock on the House, and they might very well control the Senate after the 2014 election. They've won several notable Supreme Court victories (Heller, Citizens United, Hobby Lobby, etc.). They control a large majority of the states, and have passed a ton of conservative legislation in areas like voter ID and abortion restrictions. Their "Just Say No" strategy toward President Obama has tied Democrats in knots. They won an all but total victory on spending and deficits.</p> <p>Nor is it really true that today's GOP is notably more bumbling than it used to be. The myth of "ruthless Republican skillfulness" in the past is just that: a myth. George H.W. Bush screwed up on Supreme Court picks and tax hikes. Newt Gingrich&mdash;ahem&mdash;sure didn't turn out to be the world historical strategic genius everyone thought he was in 1994. George W. Bush&mdash;with the eager backing of every Republican in the country&mdash;figured that a war in Iraq would be just the ticket to party dominance for a decade. Ditto for Social Security reform. Republicans were just sure that would be a winner. By contrast, their simpleminded Obama-era strategy of obstructing Democrats at all times and on all things has actually worked out pretty well for them given the hand they were dealt.</p> <p>Make no mistake: It's not as if Republicans have been strategic geniuses. There's no question that they have some long-term issues that they're unable to address thanks to their capitulation to tea party madness. But if they're really so inept, how is it that in the past 15 years Democrats haven't managed to cobble together anything more than about 18 months of modest success between 2009-10?</p> <p>I dunno. Republicans keep getting crazier and crazier and more and more conservative, and liberals keep thinking that <em>this time</em> they've finally gone too far. I've thought this from time to time myself. And yet, moving steadily to the right has paid off pretty well for them over the past three decades, hasn't it?</p> <p>Maybe it will all come to tears in the near future as the lunatic wing of the party becomes even more lunatic, but we liberals have been thinking this for a long time. We haven't been right yet.</p></body></html> Kevin Drum The Right Fri, 25 Jul 2014 16:49:09 +0000 Kevin Drum 256991 at http://www.motherjones.com Gruber: "It Was Just a Mistake" http://www.motherjones.com/kevin-drum/2014/07/gruber-it-was-just-mistake <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Why did Jonathan Gruber tell an audience in 2012 that states which failed to set up Obamacare exchanges would be depriving their residents of federal subsidies? Jonathan Cohn caught up with Gruber this morning and <a href="http://www.newrepublic.com/article/118851/jonathan-gruber-halbig-says-quote-exchanges-was-mistake" target="_blank">got an answer:</a></p> <blockquote> <p>I honestly don&rsquo;t remember why I said that. I was speaking off-the-cuff. <strong>It was just a mistake.</strong></p> <p>....There are few people who worked as closely with Obama administration and Congress as I did, and at no point was it ever even implied that there&rsquo;d be differential tax credits based on whether the states set up their own exchange. <strong>And that was the basis of all the modeling I did,</strong> and that was the basis of any sensible analysis of this law that&rsquo;s been done by any expert, left and right.</p> <p>I didn&rsquo;t assume every state would set up its own exchanges but I assumed that subsidies would be available in every state. It was never contemplated by anybody who modeled or worked on this law that availability of subsides would be conditional of who ran the exchanges.</p> </blockquote> <p>So there you have it: Gruber screwed up. More importantly, as he points out, he's performed immense amounts of technical modeling of Obamacare, and all of his models assumed that everyone would get subsidies even though not every state would set up its own exchange. As Cohn says, this was pretty much the unanimous belief of everyone involved:</p> <blockquote> <p>As I&rsquo;ve written before, I had literally hundreds of conversations with the people writing health care legislation in 2009 and 2010, including quite a few with Gruber. Like other journalists who were following the process closely, <strong>I never heard any of them suggest subsidies would not be available in states where officials decided not to operate their own marketplaces</strong>&mdash;a big deal that, surely, would have come up in conversation.</p> </blockquote> <p>Kudos to Peter Suderman and his sleuths for uncovering this and getting everyone to talk about it for a day. It's a news cycle win for conservatives. But restricting subsidies to state exchanges just flatly wasn't part of Congress's intent. There's simply no way to rewrite history to make it seem like it was.</p></body></html> Kevin Drum Health Care Fri, 25 Jul 2014 15:17:30 +0000 Kevin Drum 256981 at http://www.motherjones.com 57 Percent of Republicans Want to Impeach Obama http://www.motherjones.com/kevin-drum/2014/07/57-republicans-want-impeach-obama <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>This is completely, barking <a href="http://i2.cdn.turner.com/cnn/2014/images/07/24/rel7e.pdf" target="_blank">insane:</a></p> <p><img align="middle" alt="" class="image image-_original" src="/files/blog_poll_obama_impeach.jpg" style="border: 1px solid black; margin: 15px 0px 15px 2px;"></p> <p>I don't even know how to react to this stuff anymore. A solid majority of Republicans wants to impeach President Obama for....what? An EPA regulation they don't like? Postponing Obamacare's employer mandate for a year? Not prosecuting some immigrant kids who have been in the country since they were three?</p> <p>This goes beyond politics as usual. It's nuts. Fox News is now officially in charge of one of America's two major political parties.</p></body></html> Kevin Drum Obama The Right Fri, 25 Jul 2014 14:38:18 +0000 Kevin Drum 256971 at http://www.motherjones.com Did Congress Actually Intend to Withhold Subsidies From Federal Exchanges? http://www.motherjones.com/kevin-drum/2014/07/did-congress-actually-intend-withhold-subsidies-federal-exchanges <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>In the <em>Halbig</em> case, the plaintiffs argued that the provision in Obamacare limiting subsidies to people enrolled through state exchanges was no typo. In fact, they claimed, Congress <em>intended</em> to limit subsidies to state exchanges as an incentive for states to set up their own exchanges instead of relying on the federal government. The problem with this theory is that <a href="https://twitter.com/ezraklein/status/492670708305391616" target="_blank">literally nobody</a> who was involved with the legislation or who covered it during its passage remembers anything of the sort, and the rest of the bill pretty clearly assumes that everyone gets subsidies regardless of whether they're enrolled via a state exchange or the federal exchange.</p> <p>Today, however, Peter Suderman presents some evidence that this was indeed Congress's intent. It's not evidence from 2009-10, when the bill was being debated. Nor is it from anyone involved in Congress. It's from Obamacare expert Jonathan Gruber <a href="http://reason.com/blog" target="_blank">speaking to an industry group in January 2012:</a></p> <blockquote> <p>What&rsquo;s important to remember politically about this is if you're a state and you don&rsquo;t set up an exchange, that means your citizens don't get their tax credits&mdash;but your citizens still pay the taxes that support this bill. So you&rsquo;re essentially saying [to] your citizens you&rsquo;re going to pay all the taxes to help all the other states in the country.</p> </blockquote> <p>I don't really know what to make of this. It's a very odd mistake for Gruber to make, because in January 2012 the IRS had already issued a preliminary ruling on this exact question and had already held a public hearing asking for comments. Gruber surely knew this, and therefore knew that (a) the final ruling hadn't been issued yet, but (b) the IRS had already signaled that it intended to rule that subsidies were allowed on federal exchanges. Maybe he misremembered the IRS's preliminary ruling, or maybe he was just mixing this up with something else. Who knows? Perhaps Gruber will tell us on Friday.</p> <p>In any case, I doubt this changes anything too much. Although Gruber was a consultant on the law and intimately familiar with its details, he was neither a legislator nor a congressional staffer. The fact that he bollixed an audience question two years after the law's passage doesn't mean much. It's a nice gotcha moment, but probably not much else.</p></body></html> Kevin Drum Health Care Fri, 25 Jul 2014 06:24:16 +0000 Kevin Drum 256956 at http://www.motherjones.com Power Outage Blogging http://www.motherjones.com/kevin-drum/2014/07/power-outage-blogging <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Hey, I'm back! It turned out that today was the day for our annual neighborhood power outage, and at first I thought I was sitting pretty. I've got a Windows tablet, which means it's compatible with MoJo's blogging software. I've got my Bluetooth keyboard. And my phone will act as a WiFi hotspot, so I can connect to the net. Who needs electricity?</p> <p>Well, apparently this year's blackout was so extensive that it took out the local T-Mobile cell tower. So that was that. No internet connection. I thought I had this thing wired, but apparently not.</p> <p>Anyway, at the time my computer died I think I was writing a brilliant post about Republicans and abortion, but I no longer remember just what brilliant point I was going to make. It probably amounted to an assertion that they've always been against it and nothing has really changed. Maybe I'll remember tomorrow.</p> <p>In the meantime, what happened this afternoon? Anything I need to get on top of?</p></body></html> Kevin Drum Fri, 25 Jul 2014 05:02:13 +0000 Kevin Drum 256951 at http://www.motherjones.com Help Us Solve the Rotisserie Chicken Mystery http://www.motherjones.com/kevin-drum/2014/07/help-us-solve-rotisserie-chicken-mystery <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Megan McArdle alerts me today to a story from a local TV station that answers a question I've vaguely wondered about for a while: Why is it cheaper to buy a cooked and seasoned rotisserie chicken than a raw chicken? <a href="http://www.kcet.org/living/food/the-nosh/grocery-store-rotisserie-chickens.html" target="_blank">Cat Vesko provides the straight dope:</a></p> <blockquote> <p>Right now, an uncooked chicken at Ralphs runs you $9.87, but a rotisserie chicken is $6.99; at Gelson's, you'll pay $8.99 for a cooked chicken or $12.67 for the raw version; and at that beloved emporium of insanity Whole Foods, a rotisserie chicken is $8.99, while a whole chicken from the butcher counter is $12.79 ... per pound.</p> <p>....In most cases, preparing meals from scratch is significantly cheaper than buying them pre-made. What makes rotisserie chickens the exception? The answer lies in the curious economics of the full-service supermarket....Much like hunters who strive to use every part of the animal, grocery stores attempt to sell every modicum of fresh food they stock. Produce past its prime is chopped up for the salad bar; meat that's overdue for sale is cooked up and sold hot. Some mega-grocers like Costco have dedicated rotisserie <img align="right" alt="" class="image image-_original" src="/files/blog_rotisserie_chicken.jpg" style="border: 1px solid black; margin: 20px 0px 15px 30px;">chicken programs, <strong>but employees report that standard supermarkets routinely pop unsold chickens from the butcher into the ol' rotisserie oven.</strong></p> </blockquote> <p>This is a curiously roundabout explanation, but it boils down to this: whole chickens that are about to reach their sell-by date&mdash;and be thrown out&mdash;are instead taken to the deli to be cooked up. The grocery store doesn't make as much money as it would selling the chicken fresh, but it makes more money than it would by throwing it out.</p> <p>I guess this makes sense. Except for one thing: the number of rotisserie chickens in your average supermarket is huge. As near as I can tell, the number being roasted in any single hour is greater than the total number of raw whole chickens in the entire poultry section. In other words, there's just no way that supermarkets toss out (or come close to tossing out) enough whole raw chickens to account for the vast pile of rotisserie chickens on offer. An awful lot of these chickens must have been purchased explicitly for the rotisserie. At least, that's what my informal eyeball estimate tells me.</p> <p>What's more, the availability of all those cheap rotisserie chickens is a conspicuous incentive to stop buying whole raw chickens in the first place, and supermarkets obviously know this. This is one of the reasons most supermarkets stock so few whole chickens these days.<sup>1</sup> So selling rotisserie chickens cheaply is just cutting their own throats. Why would they do that <em>and</em> lose money on the chicken?</p> <p>So there must be something else going on. I'm not sure what, but I suspect there's more to the story than just using up chickens that are approaching their sell-by date. Do I have any readers who work in supermarkets and can enlighten us?</p> <p><sup>1</sup>Not the only reason, or even the main reason, of course. The main reason is that most of us just don't want to bother cooking a whole chicken these days.</p> <p><strong>UPDATE:</strong> The most popular guess in comments is that rotisserie chickens are a loss leader. Sure, you lose a dollar or two on each one, but you make up for it with the cole slaw and 2-liter sodas and so forth that everyone buys to go with them.</p> <p>This is the most obvious explanation, and I'm totally willing to buy it. I just want to know if it's true. Not a guess, but a confirmation from someone who actually knows if this is what's going on. Anyone?</p></body></html> Kevin Drum Food and Ag Thu, 24 Jul 2014 18:18:07 +0000 Kevin Drum 256921 at http://www.motherjones.com A Question About Botched Executions http://www.motherjones.com/kevin-drum/2014/07/question-about-botched-executions <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>I'm reluctant to ask a question that may strike some people as too cavalier for a subject that deserves only serious treatment. But after yesterday's botched execution in Arizona&mdash;the latest of several&mdash;I continue to wonder: why is it so damn hard to execute people?</p> <p>For starters, there are plenty of time-tested approaches: guillotines, firing squads, hanging, electrocution, gas chambers, etc. Did those really fall out of favor because people found them too grisly? Personally, I find the sterile, Mengele-like method of lethal injection considerably more disturbing than any of the others. And anyway, if you're bound and determined to kill people, maybe you <em>ought</em> to face up to a little bit of grisly.</p> <p>Beyond that, is it really so hard to find a lethal injection that works? Obviously I'm not a doctor, but I do know that there are plenty of meds that will very reliably knock you unconscious. And once you've done that, surely there are plenty of poisons to choose from? Or even asphyxiation: place a helium mask over the unconscious prisoner and he'll be painlessly dead in about ten minutes or less.</p> <p>Can anyone point me to a readable but fairly comprehensive history of executions over the past few decades? When and why did lethal injection become the method of choice? Why does there seem to be only one particular cocktail that works effectively? Lots of people have asked the same questions I'm asking, but nothing I've ever read really seems to explain it adequately.</p></body></html> Kevin Drum Crime and Justice Thu, 24 Jul 2014 16:45:42 +0000 Kevin Drum 256911 at http://www.motherjones.com Quote of the Day: John Boehner Invites Obama to Ignore Congress on Immigration http://www.motherjones.com/kevin-drum/2014/07/john-boehner-invites-obama-ignore-congress-immigration <!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.msnbc.com/rachel-maddow-show/boehner-wants-obama-act-his-own-border-crisis" target="_blank">From House Speaker John Boehner,</a> who is currently beavering away on a plan to sue President Obama for dealing with too many problems on his own:</p> <blockquote> <p>We&rsquo;ve got a humanitarian crisis on the border, and that has to be dealt with. But the president clearly isn&rsquo;t going to deal with it on his own, even though he has the authority to deal with it on his own.</p> </blockquote> <p>Man, this begs for a follow-up, doesn't it? What exactly does Obama have the authority to do on his own, Mr. Speaker? What unilateral actions would you like him to take without congressional authorization? Which particular law would you like him to reinterpret? Inquiring minds want to know.</p></body></html> Kevin Drum Congress Immigration Obama Thu, 24 Jul 2014 15:49:14 +0000 Kevin Drum 256896 at http://www.motherjones.com A Quick First Look at Paul Ryan's Anti-Poverty Plan http://www.motherjones.com/kevin-drum/2014/07/quick-first-look-paul-ryans-anti-poverty-plan <!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_ryan_anti_poverty.jpg" style="margin: 8px 0px 15px 30px;">Paul Ryan is out today with his anti-poverty proposal, and my first reaction after a quick skim is that I'm surprised at how limited it is. Maybe that's fine. There's no law that says every white paper has to offer a comprehensive solution to every federal program ever invented. In any case, Ryan is offering ideas <a href="http://budget.house.gov/uploadedfiles/embargoed_expanding_opportunity_in_america___7232014.pdf" target="_blank">primarily in three areas:</a></p> <blockquote> <p><strong>Experimentation.</strong> In a few select states, he wants to consolidate a number of federal poverty programs and then allow states to use the money to test different approaches to fighting poverty. It would be revenue neutral ("this is not a budget-cutting proposal&mdash;this is a reform proposal") and states would have to agree to a rigorous program of testing and research to evaluate how well their plans work.</p> <p><strong>EITC.</strong> Ryan wants to expand the Earned Income Tax Credit. This would be paid for by unspecified cuts in other anti-poverty programs.</p> <p><strong>Education.</strong> This is a bit of a hodgepodge and requires some reading between the lines. Mostly, he seems to want to block grant spending on early childhood programs; increase federal support for K-12 vouchers; "modernize and reform" tuition assistance for colleges; and block grant job training programs.</p> </blockquote> <p>Ryan also has some ideas about prison reform and loosening occupational licensing standards. I'll try to have more on this later after I've read his paper more thoroughly. Overall, my initial reaction is that I like the idea of more rigorously testing different anti-poverty approaches, but I'm pretty skeptical of Ryan's obvious preference for eventually eliminating most federal anti-poverty programs and simply sending the money to the states as block grants. This is a longtime conservative hobbyhorse, and not because states are models of efficiency. They like it because it restricts spending, especially during recessions when federal entitlement programs automatically increase but block grants don't. That may please the tea party set, but it's bad for poor people and it's bad for the economy, which benefits from countercyclical spending during economic downturns.</p> <p>This is just a quickie reaction. More later.</p></body></html> Kevin Drum Economy Thu, 24 Jul 2014 14:34:41 +0000 Kevin Drum 256891 at http://www.motherjones.com For Lower Back Pain, You Can Skip the Tylenol http://www.motherjones.com/kevin-drum/2014/07/lower-back-pain-you-can-skip-tylenol <!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><p>Here's the latest from the <a href="http://well.blogs.nytimes.com/2014/07/23/acetaminophen-no-better-than-placebo-for-back-pain/?hp&amp;action=click&amp;pgtype=Homepage&amp;version=HpSum&amp;module=second-column-region&amp;region=top-news&amp;WT.nav=top-news" target="_blank">frontiers of medical research:</a></p> <blockquote> <p>About two-thirds of adults have lower back pain at some point in their lives, and most are told to take acetaminophen, sold under brand names like Tylenol, Anacin and Panadol. Medical guidelines around the world recommend acetaminophen as a first-line treatment.</p> <p>But there has never been much research to support the recommendation, and now a large, rigorous trial has found that acetaminophen works no better than a placebo.</p> </blockquote> <p>The good folks at Johnson &amp; Johnson will no doubt disagree with extreme prejudice, but I'm not surprised. I suppose different people respond differently, but I've basically never responded other than minimally to Tylenol. It might dull a bit of headache pain slightly, but that's about it. However, there's more:</p> <blockquote> <p>Dr. Williams said that acetaminophen had been shown to be effective for <strong>headache, toothache and pain after surgery</strong>, but the mechanism of back pain is different and poorly understood. Doctors should not initially recommend acetaminophen to patients with acute low back pain, he said.</p> </blockquote> <p>Hey! That's right. I had some mild toothache recently thanks to a filling that involved a fair amount of work beneath the gum line. It acted up whenever I chewed food on that side of my mouth, and I found that Tylenol made it go away within 20 minutes. I was pretty amazed, since Tylenol had never really worked for anything else. But it was great for toothache.</p> <p>Anyway, everyone is different, and Tylenol might work for you better than it does for me. It might even work for back pain. It doesn't <em>on average</em>, but that doesn't mean it's ineffective for everybody. In the meantime, maybe the medical research profession could hurry up a bit on that business of understanding what lower back pain is all about, OK? It so happens that I could use some answers on that score.</p></body></html> Kevin Drum Health Thu, 24 Jul 2014 00:24:57 +0000 Kevin Drum 256866 at http://www.motherjones.com