Kevin Drum

Canada Warns: "Goldfish the Size of Dinner Plates Are Multiplying Like Bunnies"

| Fri Jun. 26, 2015 12:29 PM EDT

A Fish Out of Water was one of my favorite childhood books. A boy buys a goldfish and is warned not to feed him too much. But he does, and the goldfish outgrows his tank. Then he outgrows a flower vase. Then he outgrows the bathtub. Then he outgrows the swimming pool. Finally, the owner of the shop comes to the rescue and gets the fish back to its normal size. The boy promises never to overfeed his fish again. Lesson learned: listen to your elders. The End.

Except....what if this was more than just a charming kids' book? Could it actually have been a premonition of 21st century ecological disaster? What if there really were gigantic goldfish out there rampaging through our lakes and ponds?

If you have a goldfish, and you are kind of over that goldfish, to the point where you are now wondering whether it might be best to set that goldfish free, please rethink that decision. That's the request from the Alberta government, which is trying to get Canadians to refrain from dumping out their fish tanks into ponds. Because those ponds are filling up with those discarded goldfish, which are getting really, really big in the wild.

Or, as the CBC notes: "Goldfish the size of dinner plates are multiplying like bunnies."

If it can happen in Canada, it can happen in America. You have been warned.

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Obamacare Still Isn't Safe, and Liberals Better Not Forget It

| Fri Jun. 26, 2015 12:07 PM EDT

Greg Sargent warns Democrats not to get complacent about Obamacare:

House Republicans are still forging ahead with a separate lawsuit against Obama over the law (though it may not be resolved for years). Conservatives like Ted Cruz are still calling for holding spending bills hostage to roll back the ACA. GOP presidential hopefuls Jeb Bush, Marco Rubio, Bobby Jindal, and Cruz are all pledging to keep up the fight to repeal Obamacare — “every single word,” as Cruz puts it.

....Democrats should take continued GOP opposition to Obamacare very seriously. It has serious real-world consequences. As long as states hold out against the Medicaid expansion, it could slow the law’s efforts to realize its goal of expanding coverage. One thing this means is that Democrats should redouble their efforts to regain electoral ground on the level of the states, where future decisions about the Medicaid expansion will be made.

When Obama won the 2012 election, I figured Obamacare was finally safe. Except....there was still the Supreme Court. But they mostly upheld Obamacare, and once again I thought it was finally safe. Whew. Still, Republicans kept fighting. And things remained dicey as long as Obamacare was still vaporware. Then it finally went into effect in 2014, and disastrous rollout or not, I figured that was it. Once it's actually helping millions of people, it's safe. But wait! Then there was another Supreme Court case. But that dropped this week, and Obamacare was once again upheld.

So now Obamacare is finally safe, right? You'd think so, wouldn't you? But Republicans are obsessed with Obamacare like no other law that's been passed in decades. It's kind of scary, the same way it was scary watching the unhinged Captain Ahab stumping around the Pequod. So no, Obamacare is still not safe. Not unless Democrats win at least the White House, and maybe both the White House and the Senate, in 2016. At that point, Republicans will finally have to give up. They'd have no plausible path to repeal, and by 2020 the law would have been in place for seven years; it would be covering upwards of 25 million people; and the health care industry would  be so plugged into Obamacare's rules that it would literally take years to extricate them if the law was repealed.

It sounds bizarre—not least of all to me, who badly underestimated how long Republicans could stay maniacally fixated on Obamacare—but it won't truly be safe until and unless Democrats win in 2016. I sure hope Democrats figure this out. If you want to know what we're up against, use Kevin's Quick Zeitgeist Test. Type "Obamacare" into Google and then go to image view. Here's the URL:

https://www.google.com/search?lr=&cr=&safe=images&gws_rd=ssl&um=1&ie=UTF-8&hl=en&tbm=isch&source=og&q=obamacare&sa=N&tab=wi&ei=-HSNVfnbNMLFggSu7YbIAw

Now do a quick count of pro vs. anti Obamacare images in, say, the top 50 results. Not counting neutral photos, I put it at about 10:1 for the haters. These guys aren't giving up. Those of us who support Obamacare had better show a similar level of passion for keeping it around.

Supreme Court: Gay Marriage Now Legal in all 50 States

| Fri Jun. 26, 2015 11:14 AM EDT

Jeez, sleep in a few minutes and you miss out. This has turned out to be lefty week at the Supreme Court:

In a long-sought victory for the gay rights movement, the Supreme Court ruled on Friday that the Constitution guarantees a nationwide right to same-sex marriage.

Justice Anthony M. Kennedy wrote the majority opinion in the 5 to 4 decision. He was joined by the court’s four more liberal justices.

No surprises here: it was the four liberal justices in the majority plus Anthony Kennedy, who has long been sympathetic to gay causes. And the timing was about right. It's one thing to say that marriage is quintessentially a state issue, but common sense dictates that states should (a) have roughly the same rules, and (b) should respect each other's marriages. Gay marriage has now been approved in enough states that it was time to set a nationwide standard. It's one thing for different states to have different waiting times or different medical requirements, but not fundamentally different rules on who can get married in the first place.

And for those who think the Supreme Court is locked away in a bubble, take a look at the chart on the right. 57 percent of all Americans now approve of same-sex marriage and 70 percent of those between the ages of 18 and 34. This was a freight train, and obviously Kennedy thought it was time to get off the tracks and get on board.

So hooray for the Supreme Court this week. They saved Obamacare; they saved non-discrimination requirements in low-income housing; they saved same-sex marriage; and they ruled that the government has to pay for any raisins it seizes. All in all, not a bad way to end their term.

Chart of the Day: Healthcare Industry Approves of Obamacare Decision

| Thu Jun. 25, 2015 9:14 PM EDT

They might not have said so very loudly, but the health care industry really didn't want to see Obamacare gutted by the Supreme Court. They've invested a lot of money into adapting to it, and to them it's not socialism run amok or looming tyranny. It's a positive development that's bringing American health care into the 21st century. As you can see in the chart below, Wall Street reflected this. When the Supreme Court's decision was announced, everyone breathed a sigh of relief and health care stocks soared.

Obamacare: Good for America, good for business.

President Obama Has Had a Pretty Good Week

| Thu Jun. 25, 2015 3:05 PM EDT

So....pretty good week for Obama, eh? He got fast-track passed; he won the Obamacare case in the Supreme Court; and Confederate flags are coming down all over America.

Not bad for a "very lame, lame duck."

John Roberts Now Officially the Fourth Conservative Sellout on the Supreme Court

| Thu Jun. 25, 2015 2:42 PM EDT

From Quin Hillyer at National Review:

With today’s Obamacare decision, John Roberts confirms that he has completely jettisoned all pretense of textualism. He is a results-oriented judge, period, ruling on big cases based on what he thinks the policy result should be or what the political stakes are for the court itself. He is a disgrace. That is all.

So there you have it. Roberts has now joined a long line of conservative sellouts, from Harry Blackmun to John Paul Stevens to David Souter. After Souter, Republicans swore this would never happen again and insisted on nominating only hardline conservatives with a long paper trail: Clarence Thomas, John Roberts, and Sam Alito. But now Roberts has let them down. It turns out that the ability to hold onto conservative principles while serving under Ronald Reagan is insignificant next to the power of the Washington DC cocktail party circuit.

Still, at least Republicans can now end their embarrassing charade of pretending to have a plan to fix things up if the court had ended Obamacare subsidies in states without their own exchanges. I think it's pretty safe to say that even the pretense of "working on" a plan to replace Obamacare will now be dumped quietly on the ash heap of history—until Republicans have a presidential nominee in hand, at which point the charade will have to start all over. But I think we already know what their bold new plan will contain. There are few surprises in the land of conservative ideas.

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The Wit and Wisdom of Antonin Scalia, the Supreme Court's Lovable Curmudgeon

| Thu Jun. 25, 2015 1:34 PM EDT

Here is Antonin Scalia's dissent in the Obamacare case. Although Scalia would not approve, I have arranged the excerpts out of order so they make more sense and are more amusing. I have also eliminated all the legal arguments and other boring parts. You can always read the full opinion here if you want. For now, though, tell us what you really think, Mr Scalia:

Words no longer have meaning if an Exchange that is not established by a State is “established by the State.”

Yet the opinion continues, with no semblance of shame, that “it is also possible that the phrase refers to all Exchanges—both State and Federal.”

But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved. [Scalia makes it clear throughout that he's still really pissed about losing the original Obamacare case in 2012. –ed.]

Contrivance, thy name is an opinion on the Affordable Care Act!

Faced with overwhelming confirmation that “Exchange established by the State” means what it looks like it means, the Court comes up with argument after feeble argument to support its contrary interpretation.

The Court’s next bit of interpretive jiggery-pokery involves other parts of the Act that purportedly presuppose the availability of tax credits on both federal and state Exchanges....Pure applesauce.

The somersaults of statutory interpretation they have performed...will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.

We should start calling this law SCOTUScare.

Greece Gives Europe What It Wants, Europe Says No Anyway

| Thu Jun. 25, 2015 12:11 PM EDT

European leaders were in final, last-ditch, eleventh-hour, crisis talks with their Greek counterparts today, which by my count is at least the third time we've held final, last-ditch, eleventh-hour, crisis talks in the past two weeks. This leaves me a little unsure of when the real "world will explode" deadline is anymore. But soon, I'm sure.

In any case, as Paul Krugman notes, the Europeans are no longer merely demanding concessions of a certain size from the Greeks, they now want final say over the exact makeup of the concessions:

The creditors keep rejecting Greek proposals on the grounds that they rely too much on taxes and not enough on spending cuts. So we’re still in the business of dictating domestic policy.

The supposed reason for the rejection of a tax-based response is that it will hurt growth. The obvious response is, are you kidding us? The people who utterly failed to see the damage austerity would do — see the chart, which compares the projections in the 2010 standby agreement with reality — are now lecturing others on growth? Furthermore, the growth concerns are all supply-side, in an economy surely operating at least 20 percent below capacity.

Basically, the Europeans just can't seem to say yes even when they get what they want. Besides, although tax increases probably will hurt Greek growth, so will spending cuts. There's just no way around it. The Greek economy is completely moribund, and any kind of austerity is going to make it worse. But the Europeans want austerity anyway, and they have the whip hand, so now they've decided they also want to dictate the exact nature of the concrete life preservers they're throwing to Greece.

The Greeks have little choice left, unless they're willing to leave the euro, which would cause massive short-term pain at home. Maybe they will, but it would take a backbone of steel to do it. Voters would probably cheer raucously the first night, but be in a mood to vote the entire team out of office after about the second day, when their savings and pensions were converted into New Drachmas and suddenly slashed in half. There is no happy ending to this.

Obamacare Survives Supreme Court to Fight Another Day

| Thu Jun. 25, 2015 11:30 AM EDT

Hey, I finally got one right! The Supreme Court decided to keep Obamacare subsidies intact, with both Roberts and Kennedy voting with the liberal judges in a 6-3 decision. And apparently they upheld the subsidies on the plainest possible grounds:

Chief Justice Roberts wrote that the words must be understood as part of a larger statutory plan. “In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he added. “If at all possible, we must interpret the act in a way that is consistent with the former, and avoids the latter.”

So this had nothing to do with the possibility that if Congress required states to build their own exchanges in order to get subsidies, that would be unconstitutional coercion on the states. That had been something a few of us speculated on in recent days. Instead it was a white bread ruling: laws have to be interpreted in their entirety, and the entirety of Obamacare very clearly demonstrated that Congress intended subsidies to go to all states, not just those who had set up their own exchanges.

So that's that. As far as I know, there are no further serious legal challenges to Obamacare. The only challenge left is legislative, if Republicans capture both the House and the Senate and manage to get a Republican elected president. So let's all hope that doesn't happen, m'kay?

Health Insurance for All Is About a Lot More Than Just Health

| Wed Jun. 24, 2015 6:28 PM EDT

Megan McArdle writes today that there's little consistent evidence showing that giving people health insurance actually does much to save lives. This is based largely on a couple of recent papers (plus a few other older ones), and she's basically right. She's also right when she says that health insurance does save people lots of money. I don't want to address this literature in detail right now, but if you want to know more about it you should read Ezra Klein's post about this and then McArdle's response.

However, I do have some quick comments I want to add to this conversation. Some of it echoes what the other posts say, while some of it is new. Here it is:

  • The single biggest piece of evidence about the effect of health insurance is a study of Medicaid in Oregon a few years ago. It showed that people who randomly got Medicaid coverage didn't show much improvement in their health, nor did they live any longer than those without Medicaid.
  • However, as important as it was, the Oregon study was small; the time frame was short; the population was drawn entirely from the poor; and the results were ambiguous. Nobody should ignore this study, which was unique in being a true controlled trial, but no one should think it's the final word either.
  • The results of the Oregon study would probably not scale up. One way or another, Oregon's health care system can absorb a few thousand uninsured people. Some of the cost gets absorbed by hospitals that don't get paid. Some gets absorbed by local programs. Some gets absorbed by free clinics. It's a strain, but the system can handle it without breaking completely.
  • But this isn't an argument against health insurance generally. If half the state were uninsured, the system would almost certainly break down. There would simply be too many people who either couldn't or wouldn't pay for their care, and not enough people left over to absorb that cost.
  • Also, as I like to point out ad nauseam, there's more to health care than mortality. A dental filling won't extend your life, but it will sure make you feel better. Ditto for a hip replacement or an antidepressant.
  • Health insurance is a financial lifeline, and in many cases prevents bankruptcy. But there's more. It's also a huge reliever of stress. Trying to cobble together care from a complicated, ad hoc network of clinics, ERs, doctors who don't want to see you, and friends who can loan you a few bucks is soul destroying—especially for people whose lives probably kind of suck to begin with.

In the end, I think this is what health insurance is mostly about: financial security and common decency. Yes, the uninsured can usually patch together health care in an emergency, and sometimes even when it's not. This is why access to health insurance probably has only a modest effect on health. (Though I don't believe it's zero. If we could do a bigger, better, longer-term study we'd almost certainly see a difference.) Still, is a constant, desperate search for health care really a decent thing to tolerate in the richest country in the world? Is relentless, gnawing worry about whether to buy food this week or take your child in for a checkup a decent thing for us to tolerate? Is an endless, threatening barrage of harassment from hospital bill collectors a decent thing for us to tolerate?

It kills me that some people think it's just fine to tolerate this—among the poor, anyway. It's true that there are lots of things that are inevitably going to afflict the lives of the poor. Compared to the better off, they'll have worse food, worse housing, worse cars, and worse clothes. But should they have worse health care? That's a moral question, not a scientific one. And my moral compass says that health care is one of the things all of us should have decent, regular access to. In fact, it makes me a little sick to my stomach every time I have to face up to the fact that a lot of moral compasses here in America apparently don't agree.