Kevin Drum

Quote of the Day: "I Have to Thank Obamacare for Saving My Life"

| Fri Mar. 28, 2014 9:58 AM PDT

From Kathy Bentzoni of Slatington, Pennsylvania, who signed up for Obamacare after giving up her "useless" old coverage because it was too expensive and denied all her claims. A few weeks ago, knowing she could afford it, she went to the ER complaining about numbness in her fingers:

Where would I be without Obamacare? ER, 3 units of blood, multiple tests in the hospital and a 5-day inpatient stay without insurance? Probably dead.

I have to thank Obamacare for saving my life.

Bentzoni would have been treated in the ER regardless of her insurance status. Without insurance, though, she might not have gone. Or she might have waited too long. But on March 1, knowing that it wouldn't bankrupt her, she went in time to avoid the worst. And thanks to Obamacare, she can afford the ongoing care she'll need to treat her rare blood disorder.

This is from a piece at CNN highlighting five Obamacare success stories. More like this, please.

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Pre-K Can Make You Healthier and More Talkative

| Fri Mar. 28, 2014 9:27 AM PDT

I'm a fan of pre-K and early childhood interventions in general. For the most part, this isn't because these programs boost IQ or increase academic performance. They may do a bit of that, but the evidence so far suggests that direct academic effects are modest. Rather, the benefits are mostly indirect: fewer behavioral problems; less teenage drug use; better impulse control; lower arrest rates; and so forth. Today, Aaron Carroll suggests yet another benefit: these programs produce healthier adults. That's the conclusion of a long-term follow-up in the Carolina Abecedarian Project (ABC):

Males who were randomized to the ABC program had significantly lower blood pressure (systolic 143 vs 126). That’s a massive difference. They had significantly lower levels of hypertension. They had lower levels of metabolic syndrome and lower Framingham risk scores. To get a sense of the magnitude of the difference, one in 4 males in the control group had metabolic syndrome; none in the ABC group did. Women also had improvements, although not as dramatic.

Males in the intervention group were significantly more likely to have health insurance at age 30, and to have bought it. They were more likely to get care when they were sick at age 30, too. They were at lower risk for overweight throughout their childhood. Women in the intervention group were less likely to start drinking alcohol before age 17. They were more likely to be active and to eat more healthily.

The cost of this program was about $16,000 per child in 2010 dollars.

This isn't a smoking gun. The sample size is small and the program was run a long time ago. But as Carroll says, that's inevitable in long-term longitudinal studies: "Anytime you do a follow-up of 30+ years, by definition the intervention will be old by the time you get results. There's no other way to do it. It's such a silly attack."

Along similar lines, Bob Somerby lavishes rare praise on a New York Times report by Motoko Rich about a program in Providence, RI, that intervenes with kids even before pre-K. The goal is a simple one. Researchers just want to get parents to talk to their children:

Recent research shows that brain development is buoyed by continuous interaction with parents and caregivers from birth, and that even before age 2, the children of the wealthy know more words than do those of the poor....Educators say that many parents, especially among the poor and immigrants, do not know that talking, as well as reading, singing and playing with their young children, is important. “I’ve had young moms say, ‘I didn’t know I was supposed to talk to my baby until they could say words and talk to me,’ ” said Susan Landry, director of the Children’s Learning Institute at the University of Texas in Houston, which has developed a home visiting program similar to the one here in Providence.

....As in Providence, several groups around the country — some of longstanding tenure — are building home visiting programs and workshops to help parents learn not only that they should talk, but how to do so.

“Every parent can talk,” said Dr. Dana Suskind, a pediatric surgeon at the University of Chicago who founded the Thirty Million Words Initiative, which oversees home visiting programs and public information campaigns. “It’s the most empowering thing,” said Dr. Suskind, who is securing funding for a randomized trial of a home-based curriculum intended to teach parents how they should talk with their children and why.

One of the most frustrating things about the education gap between rich and poor is that it shows up so early, and vocabulary appears to be one of the reasons. Even by the time they're two or three, children of middle-class parents have vocabularies that are substantially larger than those of poor children. Even if poor kids get into a good-quality pre-K program, they're behind from the beginning and they never catch up.

And plonking kids in front of the TV doesn't do the trick. Vocabulary isn't built by listening, but by interacting. It requires parents who talk to their children continuously. It barely even matters what they're talking about.

The goal of programs like the one in Providence is to make sure that low-income parents know this. They may not have the time or money to do all the things for their kids that better-off parents can do, but they can talk to them. Doing that on a regular basis, starting very early in life, may turn out to be a critical component of any pre-K intervention program. Hopefully Suskind's RCT will get funded and we'll have firmer knowledge about this in the future.

Condi Rice In Running For 2014 Chutzpah Award

| Fri Mar. 28, 2014 8:29 AM PDT

Condi Rice has joined the tut tutting brigade against Americans who aren't crazy about fighting yet another war:

“I fully understand the sense of weariness," she told a GOP fundraiser Wednesday, according to reports. "I fully understand that we must think: ‘Us, again?’ I know that we’ve been through two wars. I know that we’ve been vigilant against terrorism. I know that it’s hard. But leaders can’t afford to get tired. Leaders can’t afford to be weary.”

....Rice said the United States has taken a step back in conflicts including Syria, Ukraine and others. “When America steps back and there is a vacuum, trouble will fill that vacuum," Rice said.

That's precious, isn't it? Maybe Rice should give some thought to the possibility that Americans aren't weary of war, but weary of dumb, poorly fought wars. Maybe if the administration she served for eight years hadn't launched two of the dumbest, most mismanaged wars in American history, we wouldn't all be so weary.

As an aside, I'd point out that her administration took no military action against Iran and mounted no serious international sanctions against the regime. Her administration also did nothing when Russia invaded South Ossetia. Obama, by contrast, has doubled down in Afghanistan to try and clean up the mess left over from the Bush administration; he's forced Iran to the negotiating table by crippling its economy; he's participated in an invasion and regime change in Libya; he's crippled al-Qaeda via massive drone attacks; and he's spearheaded a growing backlash against Russia's invasion of Crimea. And when he tried to mount an attack against Syria in retaliation for its use of chemical weapons, he was shot down not just by members of his own party, but by members of Rice's Republican Party too.

Whatever else you can say about Obama, he's hardly a peacemonger. His foreign policy might not be quite as blindly bellicose and unfocused as George Bush's, but he sure isn't shy about using or threatening military force when he thinks it's in America's interest. Rice should pay more attention. She might learn something.

California Bullet Train Fails Yet Another Test

| Thu Mar. 27, 2014 10:55 PM PDT

Here is today's round of non-shocking news:

Regularly scheduled service on California's bullet train system will not meet anticipated trip times of two hours and 40 minutes between Los Angeles and San Francisco, and are likely to take nearly a half-hour longer, a state Senate committee was told Thursday.

....Louis Thompson, chairman of the High-Speed Rail Peer Review Group, a state-sanctioned panel of outside experts, testified that "real world engineering issues" will cause schedules for regular service to exceed the target of two hours and 40 minutes. The state might be able to demonstrate a train that could make the trip that fast, but not on scheduled service, he told lawmakers.

And remember: not a single mile of track has been laid yet. In the space of a few years, based solely on planning documents that are almost certainly still too rosy, the cost of the project has already doubled; travel times have blown past the statutory goal; ridership estimates have been halved; and every plausible funding source has disappeared. Just imagine what will happen once they start building this thing and begin running into real-world problems.

Somebody put a stake through this project. Please. LA to San Francisco is just not a good showcase for high-speed rail. Even the true believers have to be getting cold feet by now.

John Boehner vs. the Tea Party, Part XVII

| Thu Mar. 27, 2014 4:28 PM PDT

It's hard not to laugh at this. The House Republican leadership needed to pass the annual Medicare doc fix, but they didn't want to raise taxes or cut other spending to pay for it. Nor did they want anyone to be forced to go on record voting for a bill that wasn't paid for. What to do? Answer:

  • Call a recess.
  • Huddle up with Democratic leaders and get their buy-in for a quick voice vote.
  • Do not—repeat: do not—tell tea party types about this.
  • Get back out on the floor pronto and call up a bill that doesn't pay for the doc fix at all. Just put it on the ol' deficit spending credit card.
  • Pass it fast before conservative Republicans realize what's going on and demand a roll-call vote.
  • Hightail it out of Dodge.

Martin Longman has the whole story here. It's pretty hilarious.

UPDATE: Just to make this even better, the C-SPAN video of the proceedings makes it pretty clear that the voice vote didn't even go in favor of the bill. At least, not by the two-thirds margin required to suspend the rules and pass the bill pronto. Truly banana republic territory.

When Housing Prices Become Fish Stories, the Economy Suffers

| Thu Mar. 27, 2014 1:30 PM PDT

Over at Wonkblog, Christopher Ingraham points us to new research from Ireland suggesting that an awful lot of people don't know how much they paid for their houses. I've adapted the main chart from the study on the right. As you can see, most people who get this wrong underestimate how much they paid—sometimes by gigantic amounts. Very few people overestimate how much they paid, and virtually no one overestimates by more than a quarter or so.

What accounts for this? As it happens, the authors are mostly concerned with how this poor recall affects estimates of the wealth effect—which I admit I didn't really understand.1 Because of this focus, they don't spend a lot of time speculating on the underlying causes. But they do mention that the older the loan, the less accurate people are; that younger people remember better than older people; and that errors are smaller among the well-educated.

But none of this explains why the bad recall is overwhelmingly on the low side. So here's my guess: people lie. Or, more charitably, they're in denial. They don't want to admit to themselves or their friends how much they lost during the housing crash. Or, when prices are rising, they like to brag about how much they've made. Everyone else claims to have made a killing, so they slice a little bit off their buying price to make it seem like they made a killing too. No one wants to be a sucker, after all. Do this enough times, and eventually you come to believe it yourself.2

1The authors say that "An increasing number of micro based estimates of the housing wealth effect use the recall house price as an indicator of housing wealth." So if recall prices are systematically lower than the actual prices paid, this would lead to estimates of the wealth effect that are too low.

That's fine, and it's a reasonable topic for a research paper. It's important to know just how the wealth effect works. But why would anyone use the recall price for this in the first place? Shouldn't wealth effect estimates be based on how much people think their houses are worth right now? Or on how much equity people think they have, which would actually be higher if they underestimate the original price of their house? I'm a little stumped by this.

2Here's another guess: people tend to remember loan amounts more than the actual price of the house. If they put 10 percent down on a $300,000 house, the amount of the loan is $270,000, and that's what they remember. I'm not sure I buy this, but it's a possibility.

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How Big Is the National Debt?

| Thu Mar. 27, 2014 11:22 AM PDT

As a public service, I would like to present this FAQ from the Treasury Department explaining the national debt. Here it is, complete and unedited:

What is the National Debt?

The term national debt refers to direct liabilities of the United States Government. There are several different concepts of debt that are at various times used to refer to the national debt:

  • Public debt is defined as public debt securities issued by the U.S. Treasury. U. S. Treasury securities primarily consist of marketable Treasury securities (i.e., bills, notes and bonds), savings bonds and special securities issued to state and local governments. A portion is debt held by the public and a portion is debt held by government accounts.
  • Debt held by the public excludes the portion of the debt that is held by government accounts.
  • Gross federal debt is made up of public debt securities and a small amount of securities issued by government agencies.

Debt held by the public is the most meaningful of these concepts and measures the cumulative amount outstanding that the government has borrowed to finance deficits.

As of yesterday, total public debt amounted to $17.555 trillion. Debt held by the public amounted to $12.579 trillion. The term "national debt" can refer to either one. Just make sure it's clear which one you're talking about.

Sponsored Content Really Not a Big Deal, Folks

| Thu Mar. 27, 2014 10:35 AM PDT

Earlier today Josh Marshall announced that TPM had launched a new section called "IdeaLab: Impact," sponsored by PhRMA, the famously ubiquitous pharmaceutical industry lobby. Henry Farrell was distinctly unimpressed by the news:

In that spirit, I’d like to introduce a very cool new non-sponsored section myself, “Bullshit Lab: Impact,” focused on the very cool ways in which PhRMA lobbying is affecting real human lives and impacting people and communities living on the margins of global wealth and on the margins of the technological transformations. Except losing the “impacting,” since it isn’t a verb ever seen outside corporate press releases. How, for example, is PhRMA lobbying advancing the ball on shoving insanely demanding requirements into international trade agreements? What are the impactful ways in which PhRMA is impacting high drug prices? What are the cutting edge techniques in which PhRMA is pushing back on patent reform for AIDS drugs in South Africa....Feel free to treat this post’s comments sections as an opportunity to provide further examples, and unleash the real world impacts of innovative lobbying innovations!!

Sponsored content is all the rage these days, so this was probably inevitable. In fact, I was just reading about it the other day on my Dell Venue 11 tablet. I had just gotten back from Target, which was having a sale on DiGiorno frozen pizzas, and hopped onto Internet Explorer while I waited for the pizza to heat up in my Breville toaster oven. I wanted to read about NYT Now, a "compelling new iPhone® app with quick summaries and updates of top stories from our editors" that the Times announced a couple of weeks ago at South By Southwest Interactive. I found a few blurbs via Google News, but I still want to know more. It sounds exciting! I wonder if I'll be able to read it on the HTC One Android phone I'm planning to buy from T-Mobile?

Anyway, like I said, the whole sponsored content thing is probably inevitable, but I doubt it has much actual effect on what journalists choose to write about. Nothing to get worked up about, Henry.

Christie Lawyers Engage in Special Pleading For Their Client

| Thu Mar. 27, 2014 9:40 AM PDT

A couple of months ago, Chris Christie hired a legal firm to investigate whether Chris Christie knew about the September 9-12 lane closures on the George Washington Bridge. So they went off and investigated. Among other things, they investigated the charge from David Wildstein that he had mentioned the lane closures to Christie during a September 11 memorial ceremony. Check out the way Christie's legal firm dealt with this:

There is, however, no evidence we have seen that the Governor and Wildstein actually had any substantive discussion of the Fort Lee lane realignment at that public event.

To begin with, it seems incredible that, in a public setting leading up to a 9/11 Memorial event, surrounded by other government officials and scores of constituents seeking photographs and handshakes, anything substantive or inculpatory would have been discussed.

Moreover, the context of Wildstein’s counsel’s claim that “evidence exists” of the Governor’s alleged knowledge of the lane realignment is critically important....Wildstein’s counsel’s letter was a not-too-subtle attempt to press the Port Authority into granting Wildstein indemnification while, at the same time, to induce federal authorities to grant Wildstein immunity in exchange for Wildstein’s information here.

....In any event, even if credited, any passing reference by Wildstein—made in a social, public setting at the time of a public 9/11 Memorial event—to a traffic issue in Fort Lee would not have been meaningful or memorable to the Governor. Indeed, it seems highly unlikely such a brief mention, even if made by Wildstein to the Governor, would have registered with the Governor at all. Only a more substantive conversation about the ulterior motive behind the Port Authority’s traffic study would have registered, and in that public setting, any claim that such a conversation occurred would lack credibility. In any event, the Governor recalls no such exchange.

Tell me: does this sound like a dispassionate review of the evidence? Or does it sound like the closing arguments to a jury on behalf of a client accused of corruption?

I have no real opinion about whether Christie knew about the lane closures. My guess is that he didn't, though that's mainly because I credit him with not being a complete moron. At this point, my guess remains that Christie set up a nakedly political operation in his office; made it clear what he expected of them; and then let them freewheel without much supervision. The result was a bunch of eager beavers who eventually decided they were invulnerable and started doing really stupid things.

But those are just guesses. My real interest in this passage is the tone of voice. And that tone is plain: these guys are going out of their way to spin the evidence to exonerate Christie. I suspect the entire report should be read with that in mind.

Was Crimea Mainly a Diversion From Putin's Burgeoning Olympic Scandal?

| Thu Mar. 27, 2014 8:29 AM PDT

Kimberly Marten suggests that the main reason for Vladimir Putin's invasion of Crimea was entirely domestic. He needed something to divert public attention from a huge unfolding scandal:

Putin’s scandal was the corruption surrounding the Sochi Olympics. As we all know by now, the construction costs associated with Sochi facilities and infrastructure exceeded $50 billion.

....Putin has stayed in power for so long because he has been able to control the snake-pit of competing informal political networks that surround the halls of power in Russia....Members of that network told some Americans privately in 2013 that they believed some kind of reckoning over corruption in Sochi would happen this spring, perhaps when it became clear that tens of billions of dollars in state loans could not be repaid....The public might never have known or understood what was happening, but Putin would have lost face where it matters most—inside Kremlin walls, where he is supposed to be the great informal network balancer. Putin’s Crimean adventure neatly shifted the conversation to other topics, and no one is likely to bring it up again anytime soon.

....Diversion could not have been Putin’s only motive. There are certainly deep nationalist, historical, and triumphalist reasons for Putin’s actions, as Joshua Tucker wrote about here in The Monkey Cage last week. But it is striking how little Putin gained in Crimea. The region was subsidized by the rest of Ukraine, and he will now have to fund those subsidies out of the Russian state budget. Russian generators are now keeping the Crimean capital of Simferopol lit, as Ukraine turns off the electricity flowing in from the mainland. Crimea does have a crucial Russian naval base, but Putin already controlled that base without needing to occupy Crimea, because of a treaty that lasted through 2042.

The only thing that surprises me about this is that it's presented as a novel thesis. I thought this was widely taken for granted. Obviously there were international triggers for Putin's actions—the EU association agreement, the downfall of Yanukovich, the expansion of NATO, etc.—but it's still striking that Putin was willing to give up so much on the international stage for something that, as Marten says, gets him almost nothing in return. By nearly any measure, Crimea simply isn't much of a plum. If this was his idea of reasserting the Russian empire, Putin has a mighty cramped view of empire.

But it was massively popular domestically. Whatever else you can say about it, it's certainly gotten the Russian public firmly on Putin's side for the time being. I don't know if anyone can say for sure that this was his primary motive—frankly, I'm not sure Putin himself even knows what his primary motive was—but it seems almost certain that it was a significant one. After all, Putin would hardly be the first world leader to shore up his public standing with a lovely little war abroad.