Kevin Drum

Eating Their Own Dog Food

| Sun Nov. 22, 2009 6:53 PM EST

Last week I found myself talking about healthcare for a few minutes with a friend I hadn't seen in a while, and at one point she remarked sarcastically that if healthcare reform was such a great idea, why didn't Congress give itself whatever deal it was foisting on the rest of us?  I mumbled some kind of lame reply, but little did I know that the Senate bill actually does this.  Joe Klein explains:

My favorite provision requires that all members of Congress give up their federally-funded health care benefits and join the health care exchanges that will be set up by this bill. This is brilliant politics, addressing the tide of populist anger and fears of incipient socialism. But it also makes an important substantive point. The future of health care reform in this country will depend on how effectively the exchanges — health insurance super-stores — are working. If members of Congress have to participate in this system, you can bet they'll insist on a array of choices, similar to the system they currently use, the Federal Employees Health Benefits Plan.

There are actually a couple of ways you can look at this, and the pessimistic way is that if you make Congress buy insurance from the exchange then we'll never get any cost controls in place — because members of congress will never approve of anything that might infringe on their own perks of office.

But even I'm not quite that pessimistic.  I think Klein is right: if this survives the conference report, and gets the publicity it deserves (why is this the first time I'm hearing about it?), it will actually go a long way toward assuaging public cynicism about both Congress and healthcare reform.

(And hey — why is this the first time I've heard about this?  It's not as if I don't follow this stuff pretty closely.  Was it added in by Harry Reid at the last second?  Or what?)

UPDATE: Answer here!

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Tricked Out

| Sun Nov. 22, 2009 2:46 PM EST

Compare and contrast.  Here is a math teacher describing a technique in algebra:

The trick to deriving the quadratic equation is remembering to complete the square.

You probably remember that from junior high school.  Now, here is climate scientist Phil Jones describing a statistical technique in an email to another climate scientist that was recently hacked and stolen from the University of East Anglia webmail server:

I've just completed Mike's Nature trick of adding in the real temps to each series for the last 20 years (ie from 1981 onwards) and from 1961 for Keith's to hide the decline.

Climate skeptics have gone gaga over this, of course, insisting that the word "trick" means something nefarious designed to pull the wool over the eyes of the world.  But it's not.  RealClimate explains:

The paper in question is the Mann, Bradley and Hughes (1998) Nature paper on the original multiproxy temperature reconstruction, and the ‘trick’ is just to plot the instrumental records along with reconstruction so that the context of the recent warming is clear. Scientists often use the term “trick” to refer to a “a good way to deal with a problem”, rather than something that is “secret”, and so there is nothing problematic in this at all. As for the ‘decline’, it is well known that Keith Briffa’s maximum latewood tree ring density proxy diverges from the temperature records after 1960 (this is more commonly known as the “divergence problem”–see e.g. the recent discussion in this paper) and has been discussed in the literature since Briffa et al in Nature in 1998 (Nature, 391, 678-682). Those authors have always recommend not using the post 1960 part of their reconstruction, and so while ‘hiding’ is probably a poor choice of words (since it is ‘hidden’ in plain sight), not using the data in the plot is completely appropriate, as is further research to understand why this happens.

This won't slow down the skeptics for a millisecond, of course, but there you have it.  The rest of the email stash contains plenty of examples of scientists being annoyed with skeptics and wishing them ill, but that's about it.  For the record, though, I also find skeptics annoying and wish them ill, so the only surprise to me is that the scientists managed to restrain themselves so well even in private.  I don't think I could have kept things so civil.

Dissent of the Day

| Sat Nov. 21, 2009 6:26 PM EST

A regular reader emails to tell me to wake up and smell the mooseburgers:

It's easy as hell to laugh at Palin but I think Democrats are making a big mistake if they don't start taking her much more seriously as a credible challenger to Obama. People are in a sour-as-hell mood and if the economy doesn't pick up dramatically by 2012, Obama is going to be toast. Heaven help our Congressional majority next year.

Yes, Palin speaks in trite, childish platitudes but so do most Americans. Face it, the vast majority of our voters are not exactly rocket scientists and for many of them she will be a perfectly fine alternative to Obama.

Listen, I'm the guy who was convinced the American people would never choose the "amiable dunce" Reagan or the stupendously stupid Bush over Democrats who had IQ scores that couldn't possibly be any less than 30 or 40 points above their opponents'.

Given the state of today's Republican Party, I'd say Palin has an excellent shot at the nomination and if our economy still sucks in 2012 she'll have an excellent shot at beating Obama. So, let's take her for the more serious threat that she actually is and not as some poor joke. Remember, the dullest knife in the drawer is often the quickest to cut us.

I'm pretty sure I disagree.  But let's open up the floor for discussion.  Sarah Palin: joke or serious threat?  Vote in comments.

Reining in Healthcare Costs

| Sat Nov. 21, 2009 4:22 PM EST

Ronald Brownstein on the cost-control measures in the Senate healthcare reform bill:

[Jonathan] Gruber is a leading health economist at the Massachusetts Institute of Technology who is consulted by politicians in both parties. He was one of almost two dozen top economists who sent President Obama a letter earlier this month insisting that reform won't succeed unless it "bends the curve" in the long-term growth of health care costs. And, on that front, Gruber likes what he sees in the Reid proposal. Actually he likes it a lot.

"I'm sort of a known skeptic on this stuff," Gruber told me. "My summary is it's really hard to figure out how to bend the cost curve, but I can't think of a thing to try that they didn't try. They really make the best effort anyone has ever made. Everything is in here....I can't think of anything I'd do that they are not doing in the bill. You couldn't have done better than they are doing."

....In their November 17 letter to Obama, the group of economists led by Dr. Alan Garber of Stanford University, identified four pillars of fiscally-responsible health care reform....[Mark] McClellan, the former Bush official and current director of the Engleberg Center for Health Care Reform at the Brookings Institution, was one of the economists who signed the November letter. McClellan has some very practical ideas for improving the Reid bill (more on those below), but generally he echoes Orszag's assessment of it. "It has got all four of those elements in it," McClellan said in an interview. "They kept a lot of the key elements of the Finance bill that I like. It would be good if more could be done, but this is the right direction to go."

McClellan is being honest here: it would be nice if more could be done to rein in costs (it would always be nice if more could be done, wouldn't it?), but the Senate bill is still pretty good.  It includes all the primary elements of healthcare cost control and gets us moving in the right direction.

It's noteworthy how much support healthcare reform has from retired Republicans compared to the zero support it has from active Republicans.  The Senate measure is basically a pretty good bill considering the political environment it's being built in, and lots of Republicans who aren't running for office see that.  But Republicans who are running for office aren't allowed to admit any of this.  Not because the bill is bad, but because their political careers would be ruined by taking any of this stuff seriously.  Sad.

Via Ezra.  As he says, it's a very good, detailed column.  Worth a full read if you want to understand more about how the Senate bill gets the ball rolling on healthcare cost control.

Quote of the Day

| Sat Nov. 21, 2009 1:32 PM EST

From Sarah Palin, after Bill O'Reilly asked her if she thinks she's qualified to handle "the most powerful job in the world":

I believe that I am because I have common sense, and I have, I believe, the values that are reflective of so many other American values. And I believe that what Americans are seeking is not the elitism, the kind of a spinelessness that perhaps is made up for that with some kind of elite Ivy League education and a fact resume that's based on anything but hard work and private sector, free enterprise principles. Americans could be seeking something like that in positive change in their leadership. I'm not saying that has to be me.

I've been waiting for this transcript to appear ever since I heard this segment last night.  I started laughing halfway through and couldn't stop, which probably just proves that I'm one of those sneering coastal libertines Palin is talking about.  But there you have it: Palin is qualified to be president because she's got American values and she isn't a spineless elitist.

And yes, I know that I should probably pay less attention to Palin.  Sorry.  I can't help myself.  Her word-salad-straight-from-the-limbic-system approach to life is just too fascinating.  But as long as we're on the subject of elitist condescension toward Palin, check out this part of the O'Reilly interview about Iran:

PALIN: Let's start considering the sanctions that we should have been applying already, especially in this past year. Let's start looking at cutting off their imports of refined petroleum products.

O'REILLY: Does that mean a blockade, a naval blockade?

PALIN: We need to at least be willing to do such a thing and discuss it with our allies. And we need to be working closely with France and Britain, or other allies whom we can count on even.

O'REILLY: But they're already onboard. The primary...

PALIN: They're on board with what though? What were...

O'REILLY: They're onboard with economic sanctions against Iran. Do you know the country that isn't onboard, that's causing all the trouble here?

PALIN: Well, we have to question Russia's commitment to all this also.

O'REILLY: Excellent. Russia is the problem.

Palin was apparently unaware that Britain and France are already on board within beefing up sanctions on Iran, but that's par for the course with her.  Hardly worth mentioning.  But notice O'Reilly's reaction: he starts quizzing her like a big brother.  When she manages to pluck the right answer out her mental note file, he beams and almost pats her on the knee.  "Excellent.  Russia is the problem."

If Charlie Gibson or Katie Couric had pulled something like that, the conservosphere would be apoplectic with rage over their patronizing, elitist treatment of Palin.  Do you think O'Reilly will get the same treatment?  Me neither.

(BTW, I actually give O'Reilly some points for the way he conducted the interview.  Sure, it was basically friendly, but it wasn't fawning, and he did ask some tough questions and then fight back a bit when she delivered mangled platitudes instead of answers.  Overall, pretty good for a Fox host.)

Blame Democrats

| Sat Nov. 21, 2009 12:54 PM EST

Via Matt Yglesias, here is Gillian Tett arguing that a populist backlash against bankers could be headed our way when we have to start getting serious about cutting deficits in 2011-13:

Perhaps that will occur when income taxes are hiked above 50 per cent. Or maybe when hospital budgets are cut, or military spending slashed....“Don’t the bankers realise what could be coming?” I heard one senior western finance official tell a room full of bankers this week, as he argued — with passion and a sense of desperation — that it would be a mistake for banks to pay big bonuses.

Well, stranger things have happened, I suppose, but here's my guess about who will get the blame if we raise taxes or slash spending a couple of years from now: Democrats.  End of story.  By then, bankers will be yesterday's news, but Republicans and the media will still be eager to haul out the liberal-tax-and-spend narrative and lay into it with gusto.  The fact that the financial meltdown happened under a GOP president, the bank bailout was championed by a GOP treasury secretary, and monetary policy was controlled by a GOP Fed chairman won't matter a whit.  Democrats will be in power and Democrats will get the blame.

Does anyone seriously want to argue that this isn't how things will play out?

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Friday Cat Blogging - 20 November 2009

| Fri Nov. 20, 2009 3:49 PM EST

We have a winner in our cat cover contest!  Though actually it was a tie.  There were two cats who received the same number of votes, but one of them turned out to be an internet cat while the other one is (I hope) a real live cat belonging to a real live MoJo reader.  It was also my favorite cat cover of the bunch.  So by the awesome tiebreaking power vested in me as final coverblogging judge, I declare the winner of our cat cover contest to be Ginger, possibly the smuggest looking cat I've ever seen.  All hail Ginger!

The dynamic duo will be back next week.  In the meantime, if you're Ginger's owner, email me to claim your prize.  Have a good weekend, all.

The Fall of Greg Craig

| Fri Nov. 20, 2009 2:42 PM EST

Time has an interesting tick-tock this week about Greg Craig, the White House lawyer tasked with dismantling Bush-era interrogation and detention policies.  At first, Obama was on board with Craig's plans.  Then, reality set in.  Here he is deciding whether to release a set of "torture memos" last spring:

Obama arrived at [Rahm] Emanuel's office a few minutes later, took off his windbreaker and sat down at a table lined with about a dozen national-security and political advisers. He asked each to state a position and then convened an impromptu debate, selecting Craig and McDonough to argue opposing sides. Craig deployed one of Obama's own moral arguments: that releasing the memos "was consistent with taking a high road" and was "sensitive to our values and our traditions as well as the rule of law." Obama paused, then decided in favor of Craig, dictating a detailed statement explaining his position that would be released the next day.

But for Craig, it turned out to be a Pyrrhic victory. Four days later, former Vice President Dick Cheney attacked Obama on Fox News Channel for dismantling the policies he and Bush had put in place to keep the country safe. More significant was the reaction within Obama's camp. Democratic pollsters charted a disturbing trend: a drop in Obama's support among independents, driven in part by national-security issues. Emanuel quietly delegated his aides to get more deeply involved in the process. Damaged by the episode, Craig was about to suffer his first big setback.

Obama repeatedly promised during the presidential campaign to close the prison at Guantánamo Bay, but Guantánamo proved much easier to say than to do....But inside the White House, the mood had changed amid the furor over the release of the torture memos in April. McDonough and other NSC advisers assembled in the Oval Office to discuss it. Obama raised questions about security — were the FBI and the Department of Homeland Security on board? Separately, his legislative-affairs staff warned of stiff congressional resistance — and Republicans responded on cue. Word of the plan leaked on April 24, and Senate minority leader Mitch McConnell launched three weeks of near daily attacks on the idea of letting the Uighurs loose in the U.S. Dick Durbin, Obama's mentor and the Democrats' No. 2 in the Senate, called the White House asking for ammunition to fight back against McConnell and the Republicans. "What's our plan?" Durbin asked.

....Obama needed to regain control quickly, and he started by jettisoning liberal positions he had been prepared to accept — and had even okayed — just weeks earlier. First to go was the release of the pictures of detainee abuse. Days later, Obama sided against Craig again, ending the suspension of Bush's extrajudicial military commissions. The following week, Obama pre-empted an ongoing debate among his national-security team and embraced one of the most controversial of Bush's positions: the holding of detainees without charges or trial, something he had promised during the campaign to reject.

The whole piece is worth a read.

More Obama Narratives

| Fri Nov. 20, 2009 2:17 PM EST

A couple of days ago I griped about the media's insistence on imposing its preferred one-size-fits-all narrative on Obama's trip to China.  The narrative I had in mind was the one about China's huge dollar holdings driving major changes in policy when the evidence for that was pretty thin, but over at CJR Greg Marx picks up on another one:

As media narratives go, this whole “Barack Obama is a popular individual and a gifted speaker with a compelling personal story, but doesn’t automatically get everything he wants!” thing is getting awfully old, awfully fast.

The theme popped up months ago, when the press began to notice that though America had elected a “change” president, the world was—surprise!—not changing overnight. It cropped up again around the time of the off-year elections, when the media noticed that Obama’s personal appeal is not a magical amulet that can be transferred to unpopular Democrats. And it has framed much of the coverage of Obama’s recently completed trip to Asia.

[Several examples follow.]

If it were clear that Obama is pursuing a “biography-as-diplomacy” approach, this question might be pressing. And, if he were pursuing a strategy that rested primarily on his public appeal or his silver tongue, the observations from the NYT and LAT would be more significant, too. But, since evidence that he’s doing so is slight, this sort of frame comes off as more trite than trenchant.

Narratives will always be with us, but it would be nice if they could at least be tenuously based on reality.  The narrative about China's increasing leverage due to its dollar holdings has at least a little bit of that going for it, even if it gets overplayed, but the "silver tongued orator" narrative has really been plucked out of nowhere.  Yes, Obama is a good speaker, but there's zero evidence that his administration or his governing style is based on this in any significant way.  Just the opposite, in fact.  So knock it off, folks.

Passionate Minorities

| Fri Nov. 20, 2009 1:46 PM EST

Ezra Klein on the new recommendations suggesting women should start getting mammograms at age 50, not age 40:

You could hardly imagine a better example of why cost control is so hard: This was a recommendation from an institution with no actual power that was based entirely on accepted medical evidence. Cost was not a component in the analysis. This is simply the data on whether mammograms make sense for most women between 40 and 50, not whether they're "worth" doing as opposed to other expenditures.

And the political outcry has been deafening.

Beyond the purely scientific aspect of the debate, one of the notable things about the reaction to the new mammography guidelines is the way it highlights how passionate minorities drive so many public debates.  The USPSTF recommendation is based on large-scale costs vs. large-scale benefits, but the conversation that followed has been based mostly on personal stories.  And you'll never hear any personal stories about the costs.  Only the benefits.  Virtually all of the personal testimony over the past few days has been from women who either contracted breast cancer in their 40s and were saved by a mammogram, or who have unusual conditions that require unusual monitoring.  Obviously, if you fall into one of these categories you're going to feel very, very strongly about the benefits of early mammography.

And the millions of women who (if the USPSTF is to be believed) got mammograms in their 40s and suffered ill effects of one kind of another?  For the most part those effects were relatively minor, so nobody feels motivated to write op-eds about them.  But they're surprisingly widespread: the report suggests that the cumulative risk of a false positive result is over 50% for women who get annual mammograms between 40-49.  That's a lot of false positives, a lot of extra biopsies, and a lot of unnecessary panic.

It's a close call, and annual testing may still be worth it.  (The USPSTF continues to recommend it for women with a family history, genetic prediliction, or environmental risks.)  That's a largely personal choice.  But as with most political arguments, the public debate on this is being driven mostly not by dispassionate science, but by a passionate minority.  That's democracy for you.

UPDATE: Via comments, it turns out that women who get false positives are occasionally motivated to write op-eds about the experience after all.  Here's one from Andrea Stone.