A few days ago it was Spain. Now it's Italy. Prime Minister Mario Monti announced a new 3-year economic plan today that — surprise! — shows that austerity has been bad for Italy's economy:

The plan, which must be ratified by Parliament and sent to the European Commission in Brussels by the end of the month, forecasts that Italy's gross domestic product will contract by 1.2% this year, almost three times the forecast in December.

....Yet, Italy's fiscal policy is tightening, Deputy Economy Minister Vittorio Grilli said. Rome will post a budget surplus of 0.6% of GDP next year in structural, cyclically adjusted terms....The International Monetary Fund reached a similar conclusion, saying Tuesday that Italy won't balance its budget until 2017, but that next year it will achieve a structural balance—suggesting Italy wouldn't have a fiscal shortfall if the economy were performing at its full potential.

For those who argue that austerity is choking growth, the underlying rigor isn't something to boast about.

No, it's nothing to boast about. After all, lots of countries would have balanced budgets, or something close, if their economies were cranking along at full potential. But that's the whole point: austerity economics is stifling growth, which makes it hard to balance the actual, real-life budget. If the answer to that is even further austerity, you can expect even lower growth.

But austerity is the plan anyway. Hang on tight.

Yesterday I wrote a post about how expensive car batteries are. Today Brad Plumer has a post about clean energy subsidies and how they're fading out. These two things together reminded me about an energy factoid that's always struck me as slightly odd: virtually every form of energy seems to be almost as efficient as burning oil, but not quite.

For example, on either a power/weight basis or a cost basis, batteries are maybe 2x or 3x bigger and less efficient than an internal combustion engine. Not 50x or 100x. Just barely less efficient. And you see the same thing in electricity generation. Depending on how you do the accounting, nuclear power is maybe about as efficient as an oil-fired plant, or maybe 2x or 3x less efficient. Ditto for solar. And for wind. And geothermal. And tidal power.

I'm just noodling vaguely here. Maybe there's an obvious thermodynamic explanation that I'm missing. It's just that I wouldn't be surprised if there were lots of ways of generating energy that were all over the map efficiency-wise. But why are there lots of ways of generating energy that are all surprisingly similar efficiency-wise? In the great scheme of things, a difference of 2x or 3x is practically invisible.

It's tantalizing as hell, too. It doesn't seem like there ought to be a reason that during a century of looking we haven't been able to find a single energy source more efficient than either water wheels or burning oil, but we haven't. I think God is playing games with us.

A couple of weeks ago I published a chart showing that conservative trust in science has plummeted over the past few decades, while liberal and independent attitudes have remained fairly steady (liberals with high trust levels and indies with low trust levels). However, several commenters pointed out that this result was derived from GSS survey data, and the actual question was about institutions:

I am going to name some institutions in this country. As far as the people running these institutions are concerned, would you say you have a great deal of confidence, only some confidence, or hardly any confidence at all in them?

So conservatives were becoming less confident in the people who run the scientific community, which is not quite the same as becoming less confident in science as a discipline. This is fair up to a point, though I suspect that most people answering the question don't generally make distinctions quite that fine. What's more, in the aftermath of the 70s liberals had plenty of reason to lose confidence in some aspects of the scientific community too — this was a period in which corporate sponsorship of science was a growing flashpoint — but that didn't cause them to change their general level of trust. The Reagan-era decline was solely a conservative phenomenon.

All that said, though, the New York Times reported a couple of days ago that over the past decade or so there might well be reason for all of us to be a little more skeptical of scientific results than we have been. A couple of years ago, Dr. Ferric Fang, editor in chief of Infection and Immunity, discovered that one of his authors had doctored several papers:

Dr. Fang became curious how far the rot extended. To find out, he teamed up with a fellow editor at the journal, Dr. Arturo Casadevall of the Albert Einstein College of Medicine in New York. And before long they reached a troubling conclusion: not only that retractions were rising at an alarming rate, but that retractions were just a manifestation of a much more profound problem — “a symptom of a dysfunctional scientific climate,” as Dr. Fang put it.

....Last month, in a pair of editorials in Infection and Immunity, the two editors issued a plea for fundamental reforms. They also presented their concerns at the March 27 meeting of the National Academies of Sciences committee on science, technology and the law. Members of the committee agreed with their assessment. “I think this is really coming to a head,” said Dr. Roberta B. Ness, dean of the University of Texas School of Public Health. And Dr. David Korn of Harvard Medical School agreed that “there are problems all through the system.”

....Critics like Dr. Fang and Dr. Casadevall argue that science has changed in some worrying ways in recent decades — especially biomedical research, which consumes a larger and larger share of government science spending.

It's not clear how far this extends outside the biomedical community, and it's also not clear if this is genuinely new behavior, or if bad papers are simply more likely to get caught than in the past. Either way, though, the research community in general had better listen to Fang. Declining public trust in science may be primarily a conservative phenomenon right now, motivated by hostility toward evolution and climate science, but independents have had low trust levels ever since the 70s, and there are plenty of liberals who could probably be tipped into the anti-science camp pretty easily too. Time to clean house, folks.

Several years ago the Los Angeles Unified School District decided that every high school student should take and pass college prep classes in order to graduate. Most infamously this included an algebra requirement, but it was much broader than just that. Would this produce more dropouts? Sure, but everyone was told we'd just have to bite the bullet and accept that.

Well, it's now bullet-biting time as the new requirements finally take effect, and guess what? Bullets aren't really all that tasty:

On Tuesday, district officials backtracked, offering details of a proposal to reduce overall graduation requirements and allow students to pass those classes with a D grade. They must change course, Los Angeles Unified School District officials said, or they would open the doors to scores of dropouts and others who can't pass the more rigorous requirements. The new plan, which still must be approved by the board, would allow students to graduate with 25% fewer credits.

"If we don't do something, we have to be prepared to be pushing out kids as dropouts," said Deputy Supt. Jaime Aquino at a school-board committee meeting Tuesday. "We face a massive dropout rate in four years."

The idea, apparently, is that by requiring fewer credits, struggling kids will have more opportunity to repeat classes that they failed the first time around. That doesn't sound like much of a plan to make staying in high school more attractive.

I know this is an argument that's been played out thousands of times in hundreds of places already, but it just seems crazy to me. Encouraging everyone to take college prep classes is fine, but college prep just isn't the same thing as high school graduation. At least, it shouldn't be. There has to be some societal recognition of an achievement level in between "dropout," as traditionally conceived, and being prepared to attend college. We can pretend all we want, but not every 18-year-old is ready and able to attend even a community college, and effectively labeling all of these kids as dropouts is nuts. If politics weren't enough to make me think we've gone collectively crazy already, stuff like this would do the trick.

Karl Smith has an odd response to my post last night about Abbott Labs and its efforts to make sure that a generic version of TriCor would never see the light of day:

This is a part of a longer point but it's important to note that it's not clear that health care costs were raised as a part of this....Mostly it seems that at worst money was transferred from consumers and taxpayers to TriCor. This is not an economic cost. It is simply redistribution.

....However, as generally used the phrase “high health care costs” doesn’t refer to anything that makes any economic sense and so it's not clear what the appropriate remedy is. I would like to encourage people to be more explicit about the real problems that they perceive rather than extensive references to large scale accounting issues.

Just for the record, then: when I say "high healthcare costs," what I mean is "lots of money flowing to heathcare entities." I'm pretty sure that's what everyone else means too. I know that Karl likes to be contrarian, but calling this a mere large-scale accounting issue is surely a little bit too Olympian even for him, isn't it?

What follows is navel gazing of the worst kind, so there's no need to remind me of this in comments. But the chart below is sort of weirdly fascinating anyway. Based on data from Andy Baio, it represents the linking behavior of the Washington Monthly's Political Animal blog over time. Positive numbers indicate that a blog links mostly to stories favored by liberals, and my linking behavior, from January 2007 through August 2008, was moderately biased to the left (a value of .05 places you in about the leftmost 20%). Then Steve Benen took over, and the blog immediately began linking overwhelmingly to stories favored by liberals. But over time, Steve became more ecumenical, and by January of this year he was favoring liberal stories only slightly more than I had.

I have no conclusions to draw from this. It's just pure wankerific navel gazing. Do with it what you will.

Today, Aaron Carroll tells us the story of TriCor, aka fenofibrate, a cholesterol drug licensed by Abbott Labs in 1998. Unfortunately, TriCor's patent was due to run out in 2000 and a maker of generic drugs was all set to produce a generic version. So Abbott sued, which delayed the generic version by 30 months:

In the interim, Abbott sought and obtained FDA approval for Tricor-2. That drug was nothing more than a branded reformulation of Tricor-1. Tricor-1 came in 67-mg, 134-mg, and 200-mg capsules; Tricor-2 came in 54-mg and 160-mg tablets. No new trials involving Tricor-2 were submitted to the FDA. But Tricor-2 came out while the generic company was still waiting to make Tricor-1, and thus Tricor-2 began selling with no direct competition.

Six months later, Tricor-2 evidently accounted for 97% of all fenofibrate prescriptions. By the time the generic copies of Tricor-1 came out, no one was taking it anymore, and they couldn’t penetrate the market.

Wash, rinse, repeat. The generic companies petitioned to make generic Tricor-2. Abbott filed a patent infringement suit buying them a 30 month delay. They got to work on Tricor-3. That tablet came in 48-mg and 145-mg doses. No new studies. They got approval. Evidently, 70 days after Tricor-3 was introduced, 70% of users were switched to the new branded drug. By the time the other companies got generic Tricor-2 out, Tricor-3 had 96% of the market.

I swear I’m not making this up. Wash, rinse repeat.

The cost to American consumers of not having access to a generic version of TriCor is on the order of $700 million per year, money that (presumably) accrues to Abbott Labs instead. All of which goes to show that America's pharmaceutical companies are still the most innovative in the world, no matter what the naysayers claim. Unfortunately, their innovation seems to reside mostly in their legal and packaging departments, not their R&D departments.

POSTSCRIPT: Although Abbott Labs is the main culprit here, fairness dictates that blame be shared. Aaron abstracted this account from a journal article in Archives of Internal Medicine, and he notes that one of the authors of the article takes doctors to task too: "Why didn’t we prescribe the bioequivalent generics for our patients? What was the advantage to our patients of the more expensive proprietary drug? Did we let down our patients and society?" Fair enough. Abbott did everything it could to keep everyone confused, but generics were still available. So why didn't physicians prescribe them?

This is interesting:

One of the auto industry's most closely guarded secrets—the enormous cost of batteries for electric cars—has spilled out.

Speaking at a forum on green technology on Monday, Ford Motor Co. Chief Executive Alan Mulally indicated battery packs for the company's Focus electric car costs between $12,000 and $15,000 apiece. "When you move into an all-electric vehicle, the battery size moves up to around 23 kilowatt hours, [and] it weighs around 600 to 700 pounds," Mr. Mulally said at Fortune magazine's Brainstorm Green conference in California.

"They're around $12,000 to $15,000 [a battery]" for a type of car that normally sells for about $22,000, he continued, referring to the price of a gasoline-powered Focus. "So, you can see why the economics are what they are."

What's interesting isn't the fact that the batteries cost so much. What's interesting is that this was apparently such a closely guarded secret. I had no idea. And I still have no idea why this was such a closely guarded secret. It's hardly big news that batteries are a huge part of the cost of electric cars, is it?

Josh Barro says that government expenditures (federal + state + local) are going up, up, up. Just take a look at the top chart on the right:

This chart has a lot to teach us about what we can expect from the coming fiscal adjustment. For me, the most notable fact about this chart is that the growth of government spending has been remarkably steady. The trend over the last 83 years has been for government spending to rise by 0.24 percent of GDP per year, and the correlation is strong: a linear regression on this trend has an R-squared value of 0.72, meaning that time explains most of the movement in government spending.

But there's another way to look at this too. The chart on the bottom is my take: I've cut it off at 2007 so that the Great Recession doesn't obscure the real trend of the past few decades: government spending increased steadily until the mid-70s, but since then it's flattened out almost completely.

Now, I agree with Barro that entitlement spending is certain to go up over the next 20-30 years as the baby boomers retire. But what the bottom chart shows us is that government expenditures in general haven't been on an inexorable upward path over the past three decades, and there's no special reason to think they'll rise inexorably in the future. Generally speaking, domestic spending, defense spending, and Social Security are on extremely sustainable paths.

What's left is healthcare spending. That's it.

So this is basically just another excuse to repeat something that I and others have said over and over: We don't have a spending problem in America. We have a healthcare problem. The other three categories of government spending taken together will probably rise by a point or two over the next few decades, but that's not a big deal. We need to pay normal, prudential attention to them, but nothing more.

Bottom line: no one serious should spend an awful lot of time talking about "the deficit" or about "government spending." We should be talking about healthcare. Everything else is just a red herring.

Barney Frank says the only structural reform he cares about is getting rid of the filibuster in the Senate. Ed Kilgore comments:

I'm among those who really get upset when people sort of internalize the recent routine use of the filibuster by Republicans to create a de facto 60-vote requirement for doing business in the Senate, as though it came down from Mount Sinai on stone tablets. It didn't. It's a revolutionary development in the empowerment of congressional minorities, of special utility to those who wish to obstruct progress. And it has a huge ripple effect on what happens in the House (as Frank indicates), the White House, and the country. We should never get used to it until it's modified or gone.

Agreed. And yet, in a way, it seems to me that Ed is wrong: we have to internalize the recent routine use of the filibuster first in order to have any chance of getting rid of it. As long as the public continues to hear about "filibusters," they'll continue to think that this is just Mr. Smith Goes to Washington, something that happens now and again when the minority party opposes a bill especially strongly. It's only when everyone starts to realize that the Senate is a 60-vote body — not a place where filibusters take place periodically, but a 60-vote body — that we might finally get some public pushback on this.

Or maybe not. The sad truth is that no matter what we call it, filibusters will probably retain strong support pretty much forever. In general, fear of what your opponents could do in a majoritarian Congress seems to be a much stronger motivation than passion for what your own party could do. That's more true of conservatives than liberals, but it's true of a lot of liberals too. When you sit down and start to think about what, say, Paul Ryan might be able to do in a filibuster-less Senate, it makes your blood run cold. Suddenly 60 votes doesn't sound so bad, even if it does mean there's stuff of our own that will never see the light of day either.

Fear is stronger than hope. Every once in a great while that reverses, but not often and not for long. Most of the time, fear is stronger than hope.