The overriding theme of President Obama's last few months has been "We Can't Wait." Translated, this means that we can no longer wait for congressional Republicans, who are plainly unwilling to address the nation's problems, so we're going to do everything we possibly can by executive action alone.

But as Ezra Klein points out today, that theme suddenly disappeared when the subject turned to relief for homeowners. Instead of proposing a limited program that he could enact on his own, Obama has deliberately chosen an approach that requires congressional approval:

In choosing to expand the program beyond Fannie and Freddie, the administration has also expanded the program beyond what it has the executive authority to do on its own. If they just wanted to further streamline the HARP program, they could recess appoint a new director for Fannie and Freddie and get to work. Creating the new program through the FHFA -- and paying for it through a new tax on banks -- requires congressional approval, and few think House Republicans are likely to sign onto a new tax.

The administration argues that there has been bipartisan support for refinancing initiatives in Congress. In the Senate, for instance, Republican Johnny Isakson (Ga.) has cosponsored legislation with Democrat Barbara Boxer (Calif.). And there’s no doubt that legislation produced with Congress’s cooperation can do much more to extend refinancing help than executive actions. But the question remains: If Congress ignores this bill, as they have ignored so many of the Obama administration’s other initiatives, is the White House sufficiently committed to leave Congress behind and use Fannie and Freddie to go their own way?

If this were any other program, I'm not sure this question would come up. But Obama's attitude toward homeowner relief has been so weak and so plainly inadequate for so long that his credibility on this subject is close to nonexistent. It's hard not to think that his latest proposal is meant more to score political points when Republicans vote it down than it is to actually help homeowners.

The High Cost of Bad Handwriting

One of my longtime medical pet peeves has been jokes about doctors' bad handwriting. Ha ha. But it's no joke. If you have sloppy handwriting, then prescriptions and procedures get mixed up and patients suffer. (Or maybe even die.)

Today Sarah Kliff points us to an Australian study that quantifies this. In two different hospitals, researchers replaced handwritten records with electronic records in some wards but not in others. Then they measured prescribing errors per 100 patient days. Here are the results:

  • Hospital A: Errors reduced from 51 ---> 17
  • Hospital B1: Errors reduced from 39 ---> 10
  • Hospital B2: Errors reduced from 48 ---> 17

Three control groups saw only slight drops in their error rates. Replacing handwriting with electronic records has a huge impact. So the moral of the story is: Switch to electronic records! These systems not only catch medication and dosage errors algorithmically, but they reduce the chance of errors from illegible written scripts. In the meantime, start taking handwriting as seriously as you do washing your hands.

Public Money and Public Policy

Yesterday, writing about the Obama administration's refusal to grant Catholic-run organizations an exemption from their rule requiring insurance plans to cover contraceptives, I said that if these organizations take public money then they need to follow public rules. Megan McArdle disagrees:

As Ross Douthat points out, the regulations seem to have nothing to do with whether the Catholic hospitals or other charities take public money; rather, it's the fact that they provide services to the public, rather than having an explicitly religious mission.

I've seen several versions of Kevin's complaint on the interwebs, and everyone who makes it seems to assume that we're doing the Catholic Church a big old favor by allowing them to provide health care and other social services to a needy public....In the universe where I live, some of the best charity care is provided by religious groups.

…In this world, I had been under the impression that we were providing Catholic charities with federal funds mostly because this was the most cost-effective way of delivering services to needy groups. Thus it's not obvious to me that we will be better off encouraging Catholic hospitals and other groups to provide services exclusively to their own flock, while exclusively employing members of their own flock. And I'm fairly certain that if I wanted to stage a confrontation with Catholic charities, it would not be over something as trivial as forcing them to provide birth control coverage to their employees.

I don't know if the Obama administration based its new regulations on the notion that taking public money obliges you to follow public rules. However, that's my belief, so that's why I used it as part of my argument.

But I want to make a broader point. I'm unhappy with the creeping growth of religious conscience exemptions to public policy, and this affects my belief that such exemptions ought to be pretty limited. I can live with exceptions for abortion, for example, but not contraception.

Here's an analogy. A century ago, if a Catholic hospital had refused to admit blacks, that would have been permissible. This isn't because no one thought such a policy was wrong. Plenty of people did, even then. But in that time and place it was a genuinely controversial question, and that's why the government didn't get involved.

But that changed. As the public came overwhelmingly to believe that racial discrimination was unsupportable, public policy changed and hospitals were required to admit all comers. If you claimed a religious exemption, too bad. You had to follow the rules.

The same thing has happened to contraception. Unlike abortion, which remains a genuine hot button, contraception simply isn't. Poll after poll shows that the public almost unanimously has no moral objection to contraception, and, by margins of 3- or 4-to-1, believes that insurance ought to cover contraception. This is true even among Catholics. It's almost literally the case that the only remaining objection to contraception in modern American society comes from the tiny, exclusively male group that makes up the church's leadership.

If the Catholic hierarchy wants to maintain its barbaric position that contraception is immoral, there's nothing I can do to stop it. But it's a position that maims and kills and immiserates millions throughout the world, and there's simply no reason that a secular government needs to—or should—humor them over this. I don't think the church will stop providing charity care because they object to the contraception rule, but if they do then we'll just have to find others to step in. We're living in the 21st century, and in the 21st century contraception is almost unanimously viewed as morally benign and practically effective. It's a boon, not a curse, and there's simply no reason that a secular government supported by taxpayer dollars should continue to indulge the pretense that it's not.

Shooting the Messenger, Greek Style

Say what you will about technocrats, but if there's one place where you really do want one it's in your statistical agency. But that hasn't worked out so well for Andreas Georgiou, who was appointed to run the newly established Hellenic Statistical Authority in 2010 after years of egregious misreporting of Greece's official economic figures:

Greece has won strong endorsements in the past year for shoring up its economic statistics after years of fudging data to conceal its deficits and financial mismanagement, but the man who's responsible for restoring the country's reputation is now the target of possible prosecution. He's been accused of exaggerating Greece's deficits in a conspiracy to strengthen the hand of the European Union and the International Monetary Fund.

....A Greek government official called the case "outrageous." Visiting European Union officials are said to be "speechless" over the dispute. But to an outside observer, the most disconcerting aspect of the case is that Georgiou couldn't name a top political figure who's publicly thrown his support behind him.

....A Greek government official, who said he wasn't authorized to be quoted by name, called the notion of a conspiracy outlandish. "It's as if ELSTAT, Eurostat" — the Luxembourg-based Statistical Office of the European Communities — "the Department of State and the planet Mars conspired to change the deficit numbers so that Greece would have to turn to the IMF for more help," the official said. "It's crazy. It's even crazier that we are devoting part of our time" to responding to the charges.

No good deed goes unpunished, I guess. More here from Felix Salmon on why Greece is doomed.

Planned Parenthood has been thrown under the bus by an unexpected group:

The nation's leading breast-cancer charity, Susan G. Komen for the Cure, is halting its partnerships with Planned Parenthood affiliates — creating a bitter rift, linked to the abortion debate, between two iconic organizations that have assisted millions of women. The change will mean a cutoff of hundreds of thousands of dollars in grants, mainly for breast exams.

....Komen spokeswoman Leslie Aun said the cutoff results from the charity's newly adopted criteria barring grants to organizations that are under investigation by local, state or federal authorities. According to Komen, this applies to Planned Parenthood because it's the focus of an inquiry launched by Rep. Cliff Stearns, R-Fla., seeking to determine whether public money was improperly spent on abortions.

Seriously? That's their story? They're planning to respond to every politically-motivated witch hunt led by some two-bit state legislator or grandstanding county commissioner by cutting off funding to the target of the investigation? If you believe that, I've got a bridge to sell you.

This was a craven political decision, pure and simple. Joan Walsh said this: "The Komen Foundation just destroyed its brand, and it's going to be very, very sorry." Yep. What a loathsome move.

Are Eyes Really a Window Into the Soul?

Here's something to take our minds off politics for the next few hours as we await word from Florida about just how badly Mitt Romney and his George-Soros-Goldman-Sachs-New-York-Washington-establishment-money-power have crushed Newt Gingrich's people power in today's primary. It comes from a biography of Frances Perkins, FDR's secretary of labor, and it's a reporter's description of her eyes:

It is her eyes that tell her story. Large and dark and vivid, they take their expression from her mood. If she is amused, they scintillate with little points of light. If moved to sympathy or compassion, they cloud over. At the slightest suspicion of insincerity or injustice, they can become keen and searching.

I'm pretty much oblivious to people's eyes. I could sit across from you for an hour in deep conversation and come away not even knowing the color of your eyes, let alone whether they scintillate or cloud over from time to time. So I am, sort of literally, a blind man when it comes to stuff like this.

So I turn to you, my faithful readers. Are descriptions like this for real? It's part of the whole "eyes are the window to the soul" schtick, which has always seemed more poetic than verifiably factual to me, but what do I know? And another thing: if this is real, how does it happen? That is, what physiological mechanism makes eyes scintillate or cloud over?

Help me out, those of you with normal human perceptions. What's the deal here?

POSTSCRIPT: And here's a fascinating historical tidbit that I learned today. In 1938, suspecting that Perkins, the first female cabinet member, was a communist sympathizer, conservatives concocted a story that she wasn't really American at all. Instead, she was supposedly a Russian Jewish immigrant who had lied about her real identity. Perkins eventually set the record straight in a letter outlining her genealogy, but there's no mention of whether she also had to release a copy of her long-form birth certificate to quell the rumors.

It's remarkable how history repeats itself, isn't it?

Reining in Super PACs Won't Be Easy

Adam Skaggs writes that Congress needs to do something about the tsunami of money coming into campaigns via supposedly independent Super PACs:

Super PACs make a mockery of the idea of independence. As Elizabeth Drew wrote recently in the New York Review of Books, today, the “connections between . . . candidates and the Super PACs supporting them aren’t very well hidden.”....The candidate Super PACs were all established by former campaign advisors to the candidates. They are funded by friends and associates with close ties to the candidates (or, in the case of former candidate Jon Huntsman, by the candidate’s father). As election law expert Rick Hasen explained, Super PACs can do a lot that sure sounds like coordination, including soliciting funds, attending fundraisers, appearing in ads, and using the same lawyers — all without coordinating, and still legally claiming to be independent.

....There are countless ways the existing system of campaign finance should be reformed, but cleaning up Super PACs is an obvious first step. Congress should adopt common-sense rules that make terms like independence and coordination mean something. Super PACs that function as adjunct campaigns should be treated like what they are — and they should be subject to the same contribution limits as candidates. Putting candidates in charge of their own campaigns is the first step toward putting the public back in charge of democracy.

I would really like to hear more about this from someone steeped in — something. I'm not sure what, actually. Election law? Insider trading law? Maybe both. In any case, I'd like to hear in some detail how, exactly, rules could be written that would guarantee genuine independence. Even if some of the most obvious loopholes were closed, it still sounds close to impossible to do this without creating a lot of unintended consequences that could end up being worse than the disease we're trying to cure. Here's Drew, for example, on various proposals to cure the plague of Super PACs:

Another route would be through new legislation to assure the independence of the Super PACs. But even if this could be achieved another serious problem would arise: political consultants could be making their own decisions about what would help their candidates, who could lose control of their own campaigns.

Would true independence be better or worse than what we have now? That's as unclear to me as it is to Drew. And it's unclear to me if we could really police independence effectively anyway. After all, how many successful prosecutions for insider trading have we seen recently? Not many. It's a similar principle, and it's really, really hard to prove even though financial records often make a prima facie case that's even stronger than suspicions of collusion in electioneering.

So: suggestions welcome. But I suspect this is a very, very hard problem.

Apropos of my post this morning suggesting that Republicans unhappy with the current presidential field will come around, here is Rick Perlstein:

I've never been impressed with the argument that Mitt Romney makes for a weak Republican nominee because conservatives don't like him. That's not how that party works. Like they say, "Democrats fall in love, Republicans fall in line." Don't believe me? Think back four years. When the race was still up in the air, the venom aimed at McCain was ten times worse than anything being suffered by Mitt. I collected the stuff back then: Rush Limbaugh said McCain threatened "the American way of life as we've always known it"; Ann Coulter said he was actually "a Democrat" (oof!); an article in the conservative magazine Human Events called him "the new Axis of Evil"; and Michael Reagan, talk radio host and the 40th president's son, said "he has contempt for conservatives, who he thinks can be duped into thinking he's one of them."

Then McCain wrapped up the nomination, and Mike Reagan suddenly said, "You can bet my father would be itching to get out on the campaign trail working to elect him." One thing Republicans understand: In American elections you have to choose from among only two people — not between the perfect and the good.

Roger that. However, Rick then goes on to argue that Romney's Mormon faith won't hurt him among evangelicals. After all, evangelicals hated Catholics 50 years ago ("Mother of Harlots," "Whore of Babylon," etc.) but they eventually came around when they decided they needed to make common cause to fight abortion. "When the siren song of cobelligerency beckons," he says, "theological qualms tend to fall away. That's the way it's always been."

I'll buy that. But the real question is: When? Rick suggests that conservatives usually abandon their cultural prejudices "in the fullness of time," but Romney doesn't have the fullness of time. He's got nine months. And it's not clear to me that evangelical suspicion of Mormonism as a cult is going to disappear in nine months.

This won't hurt Romney a lot. The alternative is our current Muslim president, after all, so most evangelicals will come around. But if even a few percent don't, and if a larger number vote but don't actively campaign, that could be enough to sink him. In a 50-50 nation, even a few percent can spell the difference between victory and defeat.

Steve Benen, posting from his new home at Rachel Maddow's online presence, suggests that at this point in the primary process Republican voters ought to be getting happier with their candidates:

And yet, as the Pew Research Center found, rank-and-file Republicans are finding themselves less satisfied with their presidential choices, not more. As the Pew report, released yesterday, explained, "In fact, more Republican and Republican-leaning registered voters say the GOP field is only fair or poor (52%) than did so in early January (44%)."

In other words, this field of candidates isn't just unappealing to the party's own voters; it's increasingly unappealing.

But how unusual is this, really? Maybe someone with a vast collection of past polling data can weigh in on this, but I'm not sure that we're seeing anything all that out of the ordinary. Campaigns usually get nastier as they get closer to their endgames, and that nastiness often translates into increased voter dissatisfaction. This year's Republican primary only entered its nuclear phase after New Hampshire, and it's not too surprising that this has driven up everyone's negatives.

Now, this is the point at which I'd normally remind everyone that it's only January (hard to believe, I know, after the debate marathon of the past five months) and there's plenty of time for everyone to cool down before summer. And I think that's exactly what's going to happen. Still, there's that little niggling voice in my head saying "Newt, Newt, Newt....." Will Newt Gingrich, even after he's obviously lost, continue his scorched-earth campaign against Romney? Will Sheldon Adelson fund this doomed effort? I'd guess no. But it's a soft, unconvincing no. He just might, after all.

Coming Apart, Coming Together

David Brooks glosses Charles Murray's new book, Coming Apart:

His story starts in 1963. There was a gap between rich and poor then, but it wasn’t that big. A house in an upper-crust suburb cost only twice as much as the average new American home. The tippy-top luxury car, the Cadillac Eldorado Biarritz, cost about $47,000 in 2010 dollars. That’s pricy, but nowhere near the price of the top luxury cars today.

More important, the income gaps did not lead to big behavior gaps. Roughly 98 percent of men between the ages of 30 and 49 were in the labor force, upper class and lower class alike. Only about 3 percent of white kids were born outside of marriage. The rates were similar, upper class and lower class.

Since then, America has polarized. The word “class” doesn’t even capture the divide Murray describes. You might say the country has bifurcated into different social tribes, with a tenuous common culture linking them.

....Roughly 7 percent of the white kids in the upper tribe are born out of wedlock, compared with roughly 45 percent of the kids in the lower tribe. In the upper tribe, nearly every man aged 30 to 49 is in the labor force. In the lower tribe, men in their prime working ages have been steadily dropping out of the labor force, in good times and bad.

People in the lower tribe are much less likely to get married, less likely to go to church, less likely to be active in their communities, more likely to watch TV excessively, more likely to be obese.

I haven't read Murray's book, and probably won't. But I'm not unwilling to take his thesis seriously. The part that keeps pushing back at me, though, is the idea that this is something new. I don't doubt that Murray can show that there's a much larger group of very well-off people today than there was in 1963: these are the folks buying the McMansions and the $100,000 cars. That's not news. And the behavioral changes in the bottom third are real too.

But is it really true that back in 1963 the "upper tribe" and the "lower tribe" were more similar than they are today? It might seem that way in retrospect, but it sure didn't at the time. It didn't seem that way to Gunnar Myrdal or Michael Harrington, anyway. Overall, I can pretty easily buy the "Apart" piece of the title, but I'm a lot less sure about the "Coming" piece. For every example of a way in which top and bottom have diverged over the past 50 years, I suspect that you could also find an example of ways in which they've converged. It's just that Murray wasn't looking for any of those.

But as I said, I haven't read the book. Perhaps someone over at Crooked Timber, or someplace like that, would like to read it and do us all the public service of commenting on it? Thanks.