Kevin Drum

The Lies of August

| Fri Aug. 7, 2009 12:37 PM EDT

Hey, I thought MSM columnists weren't allowed to use the word "lie"?  Either (a) Steven Pearlstein didn't get the memo, (b) the rules are different for Pulitzer Prize winners, or (c) Republican lies about healthcare reform have caused his brain to explode:

There is no credible way to look at what has been proposed by the president or any congressional committee and conclude that these will result in a government takeover of the health-care system. That is a flat-out lie

....Health reform will cost taxpayers at least a trillion dollars. Another lie.

....The Republican lies about the economics of health reform are also heavily laced with hypocrisy. While holding themselves out as paragons of fiscal rectitude, Republicans grandstand against just about every idea to reduce the amount of health care people consume or the prices paid to health-care providers.

And he didn't even get around to mentioning the "Democrats want to kill granny" meme or the "Obama wants you to snitch on your neighbor" meme or the "liberals want to provide spa vacations to illegal immigrants" meme.  I guess his column wasn't long enough.

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Crime and Punishment

| Fri Aug. 7, 2009 12:08 PM EDT

Good news, Californians!  Our state may be a shambles, debt-ridden and stuck in an endless political quagmire, but Arnold Schwarzenegger has just signed a bill that makes it safe to organize March Madness pools in your workplace:

The new law changes the penalty for participation in a non-commercial or an office "sports betting pool" from a misdemeanor, punishable by fines up to $1,000, to an infraction, punishable by a fine not to exceed $250.

Since we're so fond of naming laws after people, I think we should call this one Margaret's Law, after Margaret Hamblin, the 76-year-old grandmother who was busted in 2006 for running a $50 football pool at an Elks Lodge.  She was fined $130 and had her fingerprints and mug shot taken after she was cited for running a betting pool.

But no longer!  We're free of the jackbooted tyranny of the office pool gestapo!  Surely marijuana legalization can't be far behind?

No More Coups in Pakistan?

| Fri Aug. 7, 2009 11:31 AM EDT

Juan Cole says the possible death of Baitullah Mahsud, leader of Pakistan's Taliban Movement and likely mastermind of the assassination of former prime minister Benazir Bhutto in 2007, is only the second most important news out of Pakistan:

The really big news out of Pakistan in the last week was the  finding of the restored Supreme Court that Gen. Pervez Musharraf's emergency decree of November, 2007, was unconstitutional. The ruling has larger implications, in perhaps suggesting that all of Pakistan's military coups have been unconstitutional. This is the first time that the Pakistani Supreme Court has so forcefully stood up to the military.

If the American press and political establishment was serious about supporting democracy in Pakistan and the Muslim World, we'd have seen an avalanche of comment praising the Supreme Court ruling as a victory for democracy. I did a keyword search at Lexis under television transcripts and could not find any evidence that anyone in national television or radio except Julie McCarthy at NPR even mentioned the epochal Pakistani Supreme Court ruling!

Consider it reported.  I confess to some skepticism about how seriously to take a court decree that military coups are unconstitutional, since military coup leaders don't generally pay a lot of attention to the niceties of judicial review in the first place.  But Prof. Cole calls it "a bigger turning point in Pakistani history than any we have seen since 1947," so it's worth knowing about.

Vive La Healthcare

| Fri Aug. 7, 2009 2:01 AM EDT

David Gauthier-Villars has a piece about France's healthcare system in the Wall Street Journal today that's worth a read.  Like everyone, the French have been fighting a rearguard action against financing problems in their system for as long as I've been reading about it, but that means something a little different there than it does here:

Despite the structural differences between the U.S. and French systems, both face similar root problems: rising drug costs, aging populations and growing unemployment, albeit for slightly different reasons. In the U.S., being unemployed means you might lose your coverage; in France, it means less tax money flowing into Assurance Maladie's coffers.

....Today, Assurance Maladie covers about 88% of France's population of 65 million. The remaining 12%, mainly farmers and shop owners, get coverage through other mandatory insurance plans, some of which are heavily government-subsidized. About 90% of the population subscribes to supplemental private health-care plans.

Italics mine.  Despite the story's focus on France's "financing woes" — a problem shared by every healthcare system in the world — the chart on the right tells the real story.  The French spend a third less than we do per person and have a growth rate about a third lower than ours.  We should be so lucky as to have woes like that.  Their healthcare costs may be rising, but their tax-funded system reins in costs better than ours and still remains among the best in the world.

No system is perfect, but the French do pretty well.  Service is top notch, costs are reasonable, everyone is covered, administrative costs are low, the private sector is substantial, and supplemental insurance is common for people who want more than the standard level of care.  It is, ironically, a very American approach to universal care.  If we had our heads screwed on straight, we could do a lot worse than to adopt it wholesale.

Starkman on Taibbi

| Thu Aug. 6, 2009 9:42 PM EDT

Over at CJR today, Dean Starkman has an almost pitch perfect review of Matt Taibbi's famous (or, depending on your point of view, infamous) evisceration of Goldman Sachs in last month's Rolling StoneGo read it.  Both his praise and his criticism match mine nearly perfectly.  There's hardly a word I disagree with.

Hoisted From Comments

| Thu Aug. 6, 2009 7:21 PM EDT

Is the mainstream media giving a lot of attention to the "Democrats want to kill granny" meme?  Commenter majun says, "My impression has been that FOX covers it as the unvarnished truth, MSNBC tends to make fun of it and debunk it a lot and CNN falls in the middle."  Sounds about right.  And then there's this exchange:

g.powell: But the right-wing crazies really believe this stuff about "kill granny". My father is one of them. He moved up the schedule of some elective surgeries at the VA because he is convinced Obama is out to kill him.

Anonymous: Wow g. powell. Now that's what I call irony! Moving up surgery within a govt run health care system (the VA) because govt-run health care is so scary.

g.powell: It's worse than that, my dad hates the idea of socialized medicine — it would be a disaster for the country — but loves the VA. Don't ask me to explain. I have thousand of these stories. The laws of physics and logic behave differently in Crazyland.

That's from the land of the email chain letter.  Just thought I'd share.

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Disrupting the Disruptors

| Thu Aug. 6, 2009 6:42 PM EDT

Rotwang says that whining about right-wing mobilization over healthcare reform just makes liberals look weak.  We're bigger and have a better case and we should just make it:

The numbing details of health care reform are important and worth discussing, but the argument against the [teabaggers] is pretty simple. If you hate socialized medicine, do you want to abolish Medicare? Why not? If not, why not have more Medicare, rather than less? Why not have wider access to health insurance that resembles what Members of Congress have? Medicare is their soft underbelly. It's socialized medicine that people already have, are used to, and support. More, not less. Once that is established, you can have a civil discussion about all the details.

That's exactly what my mother was saying to me on the phone last night.  And it's very logical.  I don't think it will work with these folks, but it's very logical.  I'm not sure Rotwang thinks it will work either, considering his ultimate advice:

Anybody who is unwilling to throw people out of their meetings should not be organizing them.

Yeah, but that has to be done very, very carefully indeed.  One small slip and you'll end up on a 24/7 loop on Glenn Beck's show.  Videotape of your goons dragging some 70-year-old grandma out of the room by her hair will not play well at all in the fabled heartland.

I guess I'd propose the following for members of congress speaking at town hall events: (1) Announce beforehand that there have been organized efforts to disrupt constituent meetings and it might happen here too, (2) ask everyone to please stay calm even in the face of provocation, (3) have your own cameras there to record the lunatics, and (4) rely on the fact that organized screaming doesn't wear well with the American public.  And then turn up the volume on your sound system.

Either that or you can get on the stage and announce that some there are some shaggy punks outside burning an American flag and you want some volunteers to go teach them a lesson.  That should get the riff raff out of the room.

Gog, Magog, and George Bush

| Thu Aug. 6, 2009 5:13 PM EDT

I may regret posting this, but here's an account of how George Bush tried to talk French president Jacques Chirac into supporting the invasion of Iraq:

Chirac recounts that the American leader appealed to their “common faith” (Christianity) and told him: “Gog and Magog are at work in the Middle East.... The biblical prophecies are being fulfilled.... This confrontation is willed by God, who wants to use this conflict to erase his people’s enemies before a New Age begins.”

This bizarre episode occurred while the White House was assembling its “coalition of the willing” to unleash the Iraq invasion. Chirac says he was boggled by Bush’s call and “wondered how someone could be so superficial and fanatical in their beliefs.”

After the 2003 call, the puzzled French leader didn’t comply with Bush’s request. Instead, his staff asked Thomas Romer, a theologian at the University of Lausanne, to analyze the weird appeal.

....In 2007, Dr. Romer recounted Bush’s strange behavior in Lausanne University’s review, Allez Savoir....Subsequently, ex-President Chirac confirmed the nutty event in a long interview with French journalist Jean-Claude Maurice, who tells the tale in his new book, Si Vous le Répétez, Je Démentirai (If You Repeat it, I Will Deny), released in March by the publisher Plon.

This isn't brand new: the Toronto Star wrote about it a couple of months ago, though it's gotten very little attention since.  In any case, consider it your weirdness of the day.  Not that we've exactly been lacking for that lately.....

(Via Andrew Sullivan.)

Stimulus Around the World

| Thu Aug. 6, 2009 2:45 PM EDT

Does fiscal stimulus work when the economy is in a deep recession?  There's no way to definitively "prove" that it does, but we can certainly amass evidence for it.  Via Tim Fernholz, here's a chart from a talk CEA chair Christina Romer gave today.  The question she's addressing is whether countries that applied bigger stimulus packages have recovered more quickly:

To get evidence about this, we started with a set of forecasts of growth in the second quarter of this year that were made last November — after the crisis had hit, but before countries had formulated their policy response. We then collected analysts’ recent best guesses for what second-quarter growth will be in those countries. This figure shows the relationship between how countries’ second-quarter growth prospects have changed from what was expected back in November, and the countries’ discretionary fiscal stimulus in 2009.

The fact that the observations lie along an upward-sloping line shows that, on average, things have improved more in countries that adopted bigger stimulus packages. And, the relationship is sizable: on average, a country with stimulus that’s larger by 1% of GDP has expected real GDP growth in the second quarter that’s about 2 percentage points higher relative to the November forecast.

Italics mine. This is, obviously, hardly ironclad proof about how well fiscal stimulus works.  For one thing it's based on estimates, not final data, and if those November forecasts were systematically overoptimistic they might also have been systematically useless.  What's more, eyeballing that line doesn't suggest to me that Romer's correlation is very strong — especially since it mostly seems to rely on three Asian outliers.

Still, it's up and to the right, and that's a data point in favor of using fiscal stimulus during an economic crisis.  There's more evidence in the talk too, all of which is suggestive though not conclusive.

Of course, you wouldn't expect anything conclusive at this point.  Overall, though, I expect data from 2008-2011 to become a rich field for economists to study in the future.  We haven't had a worldwide recession like this since the Great Depression, and it presents a unique opportunity to study what worked and what didn't.  There are enough variables that drawing firm conclusions will always be hard, but it's nonetheless the best chance we've had in decades to get meaningful comparative data on macroeconomic policy responses to an economic crisis.  This paper is a start.

Restless Pharmaceutical Companies

| Thu Aug. 6, 2009 1:30 PM EDT

Megan McArdle asks:

Why is restless leg syndrome always the poster child for people who hate pharma advertising?  Both my fiance and I clearly have it, and you know what?  It's really not very much fun not being able to sleep, nor are the cramp-like sensations that accompany the uncontrollable urge to kick your legs.

I've wondered about this too.  Is it just because it's kind of funny sounding?  I don't have it myself, but I have a friend with RLS and he tells me he can barely sleep in the same bed with his wife when it's acting up because it's so violent.

Actually, though, the answer doesn't seem to have much to do with whether RLS really exists.  It's more about whether pharmaceutical companies are vastly overestimating its incidence in order to sell more drugs.  In Britain, for example, GlaxoSmithKline got in trouble for promoting an off-label use of one of their products for RLS:

Dr Des Spence, the Glasgow GP who raised the complaint, said the case was an example of the way pharmaceutical companies used patient groups to promote a new condition, and then supplied drugs to treat it.

“The Ekbom Support Group was hijacked by GSK to promote restless legs syndrome and the GSK drug ropinirole,” he said. “I am not saying some people do not experience pain and restless legs but claims on the website that it is a widespread and serious condition are disproportionate.”

The Ekbom Support Group says 5% of the population suffer from the condition. Doctors say fewer than 3% experience symptoms on a regular basis and, of them, only a minority require any treatment.

This is the great gray area of pharmaceutical advertising, of course.  On the one hand, letting people know about a condition and a possible new way to treat it is perfectly fine.  On the other hand, we're all natural hypochondriacs, and it's all too easy to convince millions of people whose legs twitch a bit that they have a serious disease.  In fact, most of them just have legs that twitch a bit.

Anyway, the lesson here seems to be (a) RLS is real but (b) you probably don't have it.  What the policy response to this should be I'm less sure of.