Yesterday I posted a chart from a group called Medical Billing and Coding Certification that featured an astonishing statistic: in the U.S., one out of seven hospital-acquired infections (HAIs) leads to death. That's 14%. In Europe the number is only 1 out 122, or a mere 0.8%.

I guess it was too good to check, so I didn't check it. But a reader emailed this morning to suggest that this was preposterous, and he seems to be right. I checked the references at the bottom of the MBCC chart, and none of them seemed to back up their numbers. What's more, a few years ago the CDC estimated 99,000 deaths per year out of 1.7 million HAIs, a mortality rate of 5.8%. For the EU, the European Centre for Disease Prevention and Control estimates 146,000 deaths per year out of 4.5 million HAIs (see p. 27), a mortality rate of 3.3%.

That's a modest difference, and it gets even more modest when you read more about these estimates, which are very, very rough and depend strongly on exactly how you count infections and how you attribute deaths. You can read much more about it in this WHO report if you're interested. The chart below, from the WHO report (with U.S. figures added from here), shows HAI prevalence rates in various high-income countries, and on this score the U.S. does pretty well. Most likely, the U.S. is about average both in prevalence of HAI and in mortality rates from HAI. Apologies for the error.

I almost forgot about this, but Ari Berman has a terrific piece in Rolling Stone this week about one of my pet topics: the relentless Republican drive to pass laws designed to reduce voting rates among traditional Democratic constituencies:

All told, a dozen states have approved new obstacles to voting. Kansas and Alabama now require would-be voters to provide proof of citizenship before registering. Florida and Texas made it harder for groups like the League of Women Voters to register new voters. Maine repealed Election Day voter registration, which had been on the books since 1973. Five states — Florida, Georgia, Ohio, Tennessee and West Virginia — cut short their early voting periods.

Florida and Iowa barred all ex-felons from the polls, disenfranchising thousands of previously eligible voters. And six states controlled by Republican governors and legislatures — Alabama, Kansas, South Carolina, Tennessee, Texas and Wisconsin — will require voters to produce a government-issued ID before casting ballots. More than 10 percent of U.S. citizens lack such identification, and the numbers are even higher among constituencies that traditionally lean Democratic — including 18 percent of young voters and 25 percent of African-Americans.

Here's my favorite passage:

After the recount debacle in Florida in 2000, allowing voters to cast their ballots early emerged as a popular bipartisan reform. Early voting not only meant shorter lines on Election Day, it has helped boost turnout in a number of states — the true measure of a successful democracy. "I think it's great," Jeb Bush said in 2004....But Republican support for early voting vanished after Obama utilized it as a key part of his strategy in 2008.

....That may explain why both Florida and Ohio — which now have conservative Republican governors — have dramatically curtailed early voting for 2012. Next year, early voting will be cut from 14 to eight days in Florida and from 35 to 11 days in Ohio, with limited hours on weekends. In addition, both states banned voting on the Sunday before the election — a day when black churches historically mobilize their constituents.

If this weren't so loathsome, you'd almost have to admire it. I mean, would it ever even occur to you to specifically ban voting on the Sunday before election? It wouldn't to me. But that's because I don't have quite the reptilian mind it takes to figure out that this might affect black churches disproportionately compared to white churches, and therefore provide a small advantage for Republicans.

But Republican strategy gurus have exactly that kind of mind. Thus we get laws like this one, plus many, many more designed for exactly the same purpose. Berman runs them all down for you, so read his whole piece. This is revolting far beyond anything we should accept as normal politics, and it's a disgrace that the Supreme Court allows it to continue.

Our Eternal Senate

While I was writing the previous post, I happened to look up the process for amending the Constitution, and I noticed something I hadn't registered before. Here's Article V:

The Congress, whenever two thirds of both Houses shall deem it necessary, [blah blah blah] Provided that no Amendment which may be made prior to the Year One thousand eight hundred and eight shall in any Manner affect the first and fourth Clauses in the Ninth Section of the first Article; and that no State, without its Consent, shall be deprived of its equal Suffrage in the Senate.

Huh. If that says what I think it says, it means the Senate in its current form is eternal. Not even a constitutional amendment can eliminate it or reform it unless literally every state agrees. Since 1808 has long since come and gone, that means this is the only absolutely immutable part of our national machinery, the one and only thing that can never be touched. Sort of an odd choice to be given such lofty distinction, no?

Rick Perry thinks Supreme Court justices should serve 18-year terms instead of having lifetime appointments. Jon Chait says this is a rare example of a smart Perry policy:

The current system of lifetime tenure creates real problems. Huge policy swings hinge on the simple health and longevity of Supreme Court justices. This results in very old justices clinging to their seats until a sufficiently friendly president can take office. It also gives presidents an incentive to nominate the youngest possible justice who can be confirmed, as opposed to the most qualified possible justice. And eliminating some element of the sheer randomness by which each party gets to appoint justices would tend to reduce the chances of the court swinging too far one way or another from the mainstream of legal thought.

It's hard to imagine the incentive structure for any president to propose such a reform — why volunteer to the the first president whose judicial nominees don't get lifetime tenure? But it is slightly reassuring to see glimmers of sense in Perry's platform.

Why be the first president to volunteer for this? That would depend on how it was implemented. It would require a constitutional amendment, and I imagine a constitutional amendment could affect sitting justices. So a president might agree to this as long as the amendment limited the terms not just of new justices, but also of sitting justices, starting with the longest-serving ones. That could end up working out fairly favorably.

More to the point, though, the president wouldn't get a chance to volunteer in the first place. Presidents have no role in the constitutional amendment process. Still, the same logic applies to the president's party in Congress, so that's a nit. So who knows? Maybe it could be done with the proper amount of fiddling around the edges.

But this brings up another question: why is Perry in favor of this? Is it just part of the general movement conservative outrage over "activist judges"? Perry seems to believe that term limits would "restrict the unlimited power of the courts to rule over us with no accountability," but I don't really see that. It's equally hard to see how you'd conclude that this would be institutionally favorable toward either liberals or conservatives unless you're really, really sure that your side is going to control the White House more often than the other.

Meh. It's probably a mug's game to try and dig too deep into Perry's mind here. My guess is that "judges bad, term limits good" is about as far as he's considered things. Still, for the usual goo goo liberal reasons that Chait lists, I'd support him on this. Let's hear it for term limits on Supreme Court justices.

WikiLeaks still hasn't published the full cache of diplomatic cables that it began releasing last year. So should they? The Guardian reports:

WikiLeaks is conducting an online poll of its Twitter followers to decide whether the whistleblowing site should publish in full its unredacted cache of US diplomatic cables.

Hmmm. A Twitter poll. I wonder how that's going to turn out?

WikiLeaks appeared likely to use the Twitter responses, which it said favoured disclosure at a ratio of 100 to one, to pave the way for imminent disclosure of the remaining material from its cable archive.

Consider me non-shocked. Anyway, if you read the whole story it turns out this is apparently all part of the ongoing war between Julian Assange and the Guardian. One way or another, though, it looks as if we're all going to have access to the entire cache of cables soon enough.

UPDATE: This chart appears to be completely wrong. Apologies. More details here.

Via Chris Bodenner, this graphic compares fatal hospital infections in the U.S. to those in Europe. This might disturb you at first, but remember: the free market is always right, so clearly we've collectively made a rational choice here. We've decided that although our healthcare costs are far higher than in Europe, this is worth it in return for far higher death rates from hospital infections. Best healthcare in the world, baby!

More graphic at the link.

I'm curious about something. Conservatives are forever reminding us liberals that the New Deal didn't get us out of the Great Depression. It was World War II that got us out of the Great Depression. And roughly speaking, that's true enough.

So why, then, isn't that a good model for getting us out of our current slump? WWII featured five years with federal deficits above 10% of GDP, three of which were above 20% of GDP. And although WWII might have been a good thing for global freedom, all that spending was for war materiel that was completely useless to the U.S. economy. If we repeated this today, we could do better than that even if half the stimulus spending was meaningless makework.

So what's the deal? Did WWII rescue the American economy or not? And if it did, what's the argument for not trying it again, but without the war?

My position on the proposed merger between AT&T and T-Mobile (which the Justice Department has decided to fight) is aggressively wishy-washy. On the one hand, maybe the mobile phone market is sort of a natural duopoly given the huge capital costs of building out a good nationwide network. Then again, maybe having three or four companies really does provide more competition, stronger price pressure, and increased innovation. I just haven't studied this enough to know. Still, Felix Salmon makes an interesting point here:

One thing which fascinates me is the way in which neither the complaint nor the press release makes any mention of the fact that the proposed deal would give the merged company substantially all of the market in GSM cellphones — the only ones which work in most of the rest of the world. Americans who travel internationally pretty much have to get their cellphone service from one of these two providers — and they’re highly sensitive to exorbitant international roaming fees. Which would almost certainly go up in the event of this merger.

Now, you could argue that this is actually a pretty small segment of the market. Maybe Felix cares about it, but the number of Americans who travel abroad frequently and need a universal phone isn't that large. So it's not something the Justice Department should be worrying about.

Still, it's an interesting observation — though I'd note that dual-mode phones are available from Verizon and others who use CDMA networks in the U.S., and current international roaming fees are so outrageously high from all U.S. carriers that it's hard to imagine them going up much more with or without a merger. But maybe that just shows a lack of imagination on my part. Those of you who travel overseas frequently and know more about this should feel free to school me in comments.

Rick Perry would like to repeal the 16th and 17th Amendments, hates the New Deal, thinks Social Security is a Ponzi scheme and global warming is a gigantic hoax, and would pretty much like to roll back America's entire social-welfare edifice "from housing to public television, from the environment to art, from education to medical care, from public transportation to food, and beyond." Ruth Marcus is appalled:

Whoa! These are not mainstream Republican views—at least, not any Republican mainstream post-Goldwater and pre-Tea Party. Even Ronald Reagan, who had once criticized Social Security and Medicare, was backing away from those positions by the 1980 presidential campaign.

…Perry’s ideas range from wrongheaded to terrifying.…The subtitle of Perry’s book is "Our Fight to Save America from Washington." Reading it summons the image of another, urgent fight: saving America from Rick Perry.

Here's what gets me. Perry's views are getting denounced by all the usual lefty suspects but not much by anyone else. And the reason for this is something very odd: In modern America, conservatives are largely given a pass for saying crazy things. They're just not taken seriously, in a boys-will-be-boys kind of way. It's almost like everyone accepts this kind of stuff as a kind of religious liturgy, repeated regularly with no real meaning behind it. They're just the words you use to prove to the base that you're really one of them.

Why is this? I'm not quite sure what the left-wing equivalent of this would be, but it would be something along the lines of Hillary Clinton writing a book that proposed repealing the 2nd Amendment and adding one that banned hate speech; limiting defense spending to 2 percent of GDP; raising the top marginal tax rate back to 90 percent on millionaires and 100 percent on anything above, say, $10 million; instituting British-style national health care; and spending half a trillion dollars on new programs for universal preschool, two-year paid leaves for new parents, and an increase in the minimum wage to $15 per hour. But in real life, Dennis Kucinich wouldn't support a platform like this, let alone a front-runner for the presidential nomination. And if one did, he or she would be instantly tarred as an insane nutball and would never see the business end of a TV camera again.

But when Republicans say the mirror image of stuff like this, it just gets a shrug. Sure, Perry apparently wants to roll things back to about 1900 or so. But hey—it's just a way of firing up the troops. Nothing to be taken seriously.

But why not?

I'm pretty sure I've posted this before in one form or another, and I'm not sure what prompted me to do it again, but every once in a while I feel the urge to present some raw data about how our kids are doing in school. The charts below are taken directly from the most recent NAEP report card, generally viewed as the "gold standard" among measures of student achievement. Here are the results among eighth-graders over the past 20 years in reading:

  • Overall scores are up.
  • White scores are up.
  • Black scores are up.
  • Hispanic scores are up.

And for math:

  • Overall scores are way up.
  • White scores are way up.
  • Black scores are way up.
  • Hispanic scores are way up.

Obviously it would be nice to be doing even better. It would be nice if black and Hispanic scores were catching up faster. We still have plenty of lousy schools that we should be working hard to improve. And achievement results among twelfth-graders are more ambiguous. School reform is an important topic and worth spending a lot of time on.

Still, keep these basic results in the back of your minds. Contrary to widespread opinion, our children are doing better today than they were 20 years ago. We're making progress, not falling ever further behind.