• Health Update

    Good news! I got my latest lab results today, and my M-protein level has increased only slightly since last month:

    It’s hard to see in the chart, but this is an increase of only 0.05, half of the 0.1 increase in each of the past two months. This suggests (knock wood) that the Darzalex on its own is working adequately and the rise in my cancer load is starting to flatten out. If it does end up flattening in the 0.5-6 range, everything will be fine and I won’t have to start up the Evil Dex again.

    On a related note, I have this number today because I’ve been in the infusion center all morning. I asked one of the nurses if she could change the date for my next set of tests, but she misheard me and thought I wanted my current test results. When she gave them to me, they included the M-protein number.

    Normally it takes me a while to get that. My first oncologist said it was impossible for the online system to deliver M-protein test results, but this was just a straight-up lie. My current oncologist, in what passes for candor among doctors, admits that he has to release it before I can see it, but says it’s because the IT folks have set it up this way. This is also a lie, of course, since IT would never want or be given that authority. It’s obvious that the doctors themselves have decided to withhold certain test results until they’ve seen them, but they don’t want to admit that. I sort of understand why, but it still grates. I paid for the tests, after all.

    But enough griping. These test results are pretty good, and I hope for more good news next month.

  • Lunchtime Photo

    Here’s my favorite picture from my trip along the Blue Ridge Parkway: a cloudless sulphur butterfly. There’s nothing special about the butterfly itself, but I was lucky enough to catch it in flight, perfectly focused with the wings frozen by a shutter speed of 1/5000th of a second. The curlicue antenna and the gorgeous flame azaleas top it all off. I love this picture.

    The second picture was taken a tenth of a second and half a wing-beat later. In this one, the butterfly looks a bit like a queen in a huge robe, mysterious and imperial. I like it too.

    UPDATE: In comments, Joel Hanes tells me that the curlicue is a feeding tube, not an antenna. I sort of figured something like this had to be the case, since the butterfly already had the regulation two antennae.

    May 8, 2019 — Near Milepost 170, Blue Ridge Parkway, Virginia
    May 8, 2019 — Near Milepost 170, Blue Ridge Parkway, Virginia
  • What Happened in 2013 to Cripple California’s Anti-Vaxxers?

    In a new paper, a team of researchers asks whether stricter state rules about exemptions for vaccinations leads to higher vaccination rates. Their test bed is California, which passed a law in 2016 that made it much harder to get a nonmedical exemption for vaccinations.

    Their basic conclusion is simple: nonmedical exemptions did indeed plummet, but most anti-vax parents were able to find doctors to give them a medical exemption instead. In the end, the exemption rate dropped by only one percentage point.

    Interesting. But check out this chart, which is presented without comment:

    Vaccination rates went up in 2016, but only by a little bit. Why? Because in 2014 and 2015 vaccination rates skyrocketed. By the time the law had passed, vaccination rates had already recovered two-thirds of their losses since 2000, and the trendline suggests that vaccination rates might have made up the rest of their losses in 2016 even without the law. (But the law seems to have helped: by 2017 vaccination rates had surpassed their previous high point.)

    So what happened in 2013 that killed off the anti-vax trend? Whatever it was, that seems like the thing we should be studying.

    UPDATE: Reader LR provides the likely answer:

    AB2109 was enacted in 2013 and led to the rise in rates you commented about in your post. AB2109 required people to get signoff from an MD/DO that they had been advised of the risks of not vaccinating. It made it requisite to at least go see a doctor before not vaccinated.

    ….Washington State enacted a similar policy a few years earlier, and we knew from watching them that there would be a significant gain the first year or two but that it would plateau. Colorado also did the same. So when measles started spreading in 2014/15, and vax rates were not above the threshold to prevent outbreaks from taking hold and spreading, we got rid of non-medical exemptions altogether (SB277). And now that we’ve seen a few doctors undermine community immunity through unjustified exemptions, we are pushing for a new law to ensure proper oversight over medical exemptions (SB276).

    So merely forcing people to see a doctor leads to a rise in vaccinations, probably due partly to laziness and partly to the advice the doctor is certain to give. Banning nonmedical exemptions improved things further, and regulating medical exemptions will probably improve things even more.

  • Donald Trump Admits He Doesn’t Really Want to Stop Illegal Immigration

    John Westberg/Modesto Bee via ZUMA

    E-Verify is a system that employers can use to make sure they hire only people who are legally allowed to work in the United States. It’s pretty easy to use and pretty accurate—though it could still stand to be improved on that score. So should it be made mandatory for all employers? President Trump isn’t sure:

    In an interview with Fox News Channel conducted last week, Trump said a new White House plan to overhaul portions of the legal immigration system could “possibly” include the use of E-Verify. But he also said that the verification system could be overly onerous on certain employers, such as farmers, who Trump said were “not equipped” to use it.

    “I used it when I built the hotel down the road on Pennsylvania Avenue,” he said, referring to the Trump International Hotel in Washington. “I use a very strong E-Verify system. And we would go through 28 people — 29, 30 people — before we found one that qualified.

    He continued: “So it’s a very tough thing to ask a farmer to go through that. So in a certain way, I speak against myself, but you also have to have a world of some practicality.”

    As usual, it’s not clear what Trump is talking about here. Is he seriously suggesting that when they hired workers for his DC hotel, 29 out of 30 applicants were undocumented? That’s ridiculous.

    Nor does it make any sense to say that farmers are “not equipped” to use E-Verify. All you need is a smartphone or a computer with an internet connection. It’s insulting to suggest that farmers aren’t up to this.

    Needless to say, what Trump really means is that farmers would be seriously pissed off if he tried to make them hire only legal workers. E-Verify would do that. Unspoken—but obvious—is the corollary to this: Trump’s wall doesn’t piss off farmers because they know it won’t accomplish anything. It’s just something that sounds good to his base.

    Trump’s tariffs have already hurt farmers, and the last thing he wants to do is lose their votes for good by making it hard to hire undocumented workers. That’s why he’s for a wall but against mandatory E-Verify. It’s all about practicality.

  • Even the Best Charter Schools Haven’t Closed the Black-White Achievement Gap Yet

    Over the weekend I wrote a post about segregation in modern American schools, and it probably seemed like it came out of nowhere. What, if anything, was I responding to?

    Nothing, really. It was just a detour from an entirely different post that was originally inspired by Bernie Sanders’ recent speech about charter schools. Long story short, he doesn’t like them. Jon Chait does, and had this to say:

    Sanders frames his opposition to charter schools as a blow against segregation. But…neither traditional neighborhood schools nor charters do anything to reduce segregation. What charters do instead is offer poor urban children a better education. And the results at the best models are remarkable. No-excuses charter schools eliminate the achievement gap between white and black children. This is a staggering triumph of progressive social policy that should be spread and emulated.

    A new paper by Sarah Cohodes, Elizabeth Setren, and Christopher R. Walters studies the charter sector in Boston, which is one of the most successful in the country. The Boston charter system, like many successful charters, presents a clear example for studies, because it has a hard cap on attendance that requires students be admitted by lottery. The lottery gives researchers a chance to measure the difference in results between students who win and get to enroll in a charter, and those who don’t. The charters do a far better job than the neighborhood Boston schools.

    The link in Chait’s piece goes to a post about Success Academy, a famous system of charter schools in New York City run by Eva Moskowitz. (Which, by the way, isn’t a “no-excuses” charter.) And it’s true that Success Academy has been, well, very successful. Their kids score far better than similar kids on standardized tests, and the line of applicants to get in goes around the block three or four times.

    Now, I’m a semi-fan of charters. The best of them seem to work pretty well, and I like the idea of allowing schools to experiment with different methods to see what works best. On the other hand, I’m also a longtime skeptic of whether they can scale up, since nearly all of them seem to depend on a steady supply of young teachers willing to work 70-hour weeks. There aren’t enough teachers like that to fill all the schools in America. There are also questions about whether they hound out students with behavior problems, traumatize students with Victorian-era discipline, and teach so rigorously to standardized tests that students are helpless when they leave school and have to start thinking independently. It’s also worth wondering if the gains from charter schools—which are mostly elementary and middle schools—wash out by the end of high school. These are all legitimate questions, and there are no simple answers to them.

    But put all that aside. On some level, the best charters really do work, for almost any definition of “work” that makes sense. But do they “eliminate the achievement gap” between black and white children?

    The effect of charters on this gap is tricky. Here’s the thing: the lottery that Chait mentions makes charters a dream for researchers. The usual problem when you’re testing different educational systems is that you can never be sure that two different groups of students really are the same. Maybe one group does better than the other for reasons having nothing to do with school. Maybe it’s income or geography or the amount of TV they watch.

    But with charters we have a lottery. You take a group of, say, a thousand parents, and then you randomly—literally randomly—divide them up. Some get their kids into the charter school and others don’t. Almost by definition, these two groups are likely to be the same to two decimal places,¹ which means that if one does better than the other it’s almost certainly due to differences in schooling. And this, in turn, means that if low-income black kids at Success Academy do as well as (or better than) low-income whites who end up in public schools, the black-white gap has been closed.

    But it hasn’t been. That’s because there is a difference between the charter kids and public school kids in general: the charter kids probably aren’t the very lowest performers, and at the very least they have parents who care enough about education to go through the whole process of applying to the charter. If the black charter winners do better than white charter losers, the most you can say is that the school has closed the black-white gap among kids who are at least moderately motivated.

    That’s not nothing, not by a long stretch. It’s a huge accomplishment. But it tells us nothing about how well charters do among kids who are at the bottom scholastically and have parents who don’t really care much. My guess is that this is a very large group indeed, and nobody is much interested in them. And even if you are, it’s not as if you can force parents to give a damn.

    When somebody invents an educational intervention that closes the black-white gap among all black and white children, then we will have closed the black-white gap. Until then, we should be careful about how much we promise. The best charter schools have done great work, but they haven’t closed the racial achievement gap yet.

    ¹As an aside, I’ll mention that there actually is at least one difference: the losing group of students is likely to be disappointed and may be more likely to give up just because they lost. I don’t think this is a huge issue, but it probably has at least some impact.

  • Rape, Incest, and Abortion

    I’ve never had much interest in arguing over the metaphysics of abortion. Either you believe that a fetus is a human life that deserves legal protection, or you don’t. It’s not the kind of thing amenable to reason or evidence.

    But I confess that I’m curious about the whole rape/incest issue. Donald Trump, like many Republicans, has responded to Alabama’s absolute ban on abortion by saying he thinks it goes too far. He supports exceptions for rape, incest, and the life of the mother.

    But my understanding is that anti-abortion activism among Protestants is, today, based on the Catholic conception of the fetus as a full and complete human life from the moment of conception. If that’s true, how can you make exceptions for rape and incest? This has never made any sense.

    I get that it’s politically useful, since even a lot of people who oppose abortion are queasy about forcing a victim of rape or incest to bear a child. But is there a more substantive defense of this position? What is it?

  • The Mystery of the California Gasoline Premium Deepens

    This is the price of gasoline at my local Chevron station. Up in Los Angeles you can find prices of $5 or more if you're lucky.Kevin Drum

    My vacation along the Blue Ridge Parkway has rekindled my interest in a question I first asked a couple of years ago: why is gasoline so expensive in California? Near me, a gallon of regular costs about four bucks right now. But in Virginia and North Carolina, it’s closer to $2.65. That’s a huge difference, and it can’t be accounted for solely by the higher taxes and environmental requirements here in the Golden State. Here’s a chart showing the difference in price between gasoline in California and gasoline in “PADD 1C,” the federal government’s adorable abbreviation for the region of the East Coast from Virginia down to Florida:

    Up until 2015, the California premium bounced up and down a little bit but mostly stayed in the range of 30-40 cents. This made sense. California gasoline taxes were about 25 cents higher than in PADD 1C, and because of special smog rules our gasoline costs an extra 10-15 cents to produce. Then, in early 2015, a refinery fire in Torrance took a bunch of production offline and caused a big spike in the premium. This also made sense.

    But it took nearly two years for the premium due to the fire to finally wash out. And once it did—long before California raised its gasoline tax—the premium started to shoot up for no apparent reason. It’s continued to increase for more than two years now. This week the premium reached $1.33.

    This is nuts. If you put everything together—taxes, smog rules, cap-and-trade, etc.—gasoline in California should cost maybe 40-50 cents more than it does in Virginia and North Carolina. Why is it nearly a dollar more than that?

    What makes this even weirder is that it’s not just some irritable blogger asking. This was first highlighted by Severin Borenstein, a genuine expert who’s a former member of the California Energy Commission’s Petroleum Market Advisory Committee. He wrote about it in 2017 and then again in 2018. Even back then he figured the mystery premium was costing California $3 billion per year, and it’s probably doubled since then. Nevertheless, the response was . . . crickets. Everyone just shrugged and went about their business.

    I’ve noted several times that every year, around the time we switch to summer formulations of gasoline, a number of refineries in California seem to mysteriously shut down due to “maintenance” or “accidents” or “labor issues” or some other reason. Outside sources usually can’t replace the lost production quickly, which results in shortages and price spikes even though the volume of gasoline sold in California is pretty predictable:

    So not only does the mystery remain, it’s gotten even more mysterious over the past year. However, Governor Gavin Newsom has recently taken an interest, which means that yet another study will be produced. If it’s like the last one, it will conclude that the whole issue is really complicated, and really, who knows? But at least this time they’re starting off with the idea that market manipulation might—just might—be part of the problem. And why not? After all, Californians proved long ago that we were suckers for market manipulation by energy companies. Why not go to the well a second time?

  • Corruption and Bubbles in New York: How the Taxi Medallion Scam Ruined Thousands

    The New York Times has a good piece today about the price of taxi medallions, which act as permission to operate a yellow cab in the city. Here’s what prices look like over the past few decades:

    The crash starting in 2014 is almost universally described as the “Uber effect,” and it certainly makes sense that the growth of Uber would make the value of a yellow cab decline. But if you look more closely, the real question is different: why did prices for medallions go up in the first place? Between 2002 and 2014 the population of New York City didn’t grow much; the number of medallions didn’t change appreciably; and the average income from driving a cab didn’t go up. So why would the price of a medallion quintuple? According to the Times, the answer is corruption:¹

    Much of the devastation can be traced to a handful of powerful industry leaders who steadily and artificially drove up the price of taxi medallions, creating a bubble that eventually burst. Over more than a decade, they channeled thousands of drivers into reckless loans and extracted hundreds of millions of dollars before the market collapsed.

    ….The practices were strikingly similar to those behind the housing market crash that led to the 2008 global economic meltdown: Banks and loosely regulated private lenders wrote risky loans and encouraged frequent refinancing; drivers took on debt they could not afford, under terms they often did not understand….Some industry leaders fed the frenzy by purposefully overpaying for medallions in order to inflate prices, The Times found.

    ….As in the housing crash, government officials ignored warning signs and exempted lenders from regulations. The city Taxi and Limousine Commission went the furthest of all, turning into a cheerleader for medallion sales. It was tasked with regulating the industry, but as prices skyrocketed, it sold new medallions and began declaring they were “better than the stock market.”…At the market’s height, medallion buyers were typically earning about $5,000 a month and paying about $4,500 to their loans, according to an analysis by The Times of city data and loan documents.

    The victims of this scam were largely low-income, of course, and also largely immigrants. They were sold on medallions as an entry to the middle class: hard work, sure, but it would pay off. After all, medallions always increased in value.

    But that was never true, something which had nothing to do with Uber. It’s true that after Uber and Lyft entered the New York market the average income of taxi drivers declined. By about 10 percent. That’s a lot for a low-income immigrant family, but obviously not enough to account for a price drop for medallions from $1 million back to $200,000. Mostly that happened because lenders and fleet owners engineered a massive, artificial bubble that was never sustainable.

    In the end, then, we have an old story: basically a Ponzi scheme enabled by lots of money sloshing around and a lack of regulation from the people who should have been protecting the victims. The story about Uber and Lyft is mostly just a fairy tale invented to hide what really happened.

    ¹Corruption comes in all forms and sizes. This scam was small and local, but otherwise it was much the same as the housing bubble that wrecked the global economy in 2008. That’s why it’s important to root it out, no matter where it happens. If you want to donate to our Corruption Project, just click here.

  • Why Are American Schools So Segregated?

    You’ll often read or hear that American schools are more segregated today than they were 50 or 60 years ago. The technical measure used to demonstrate this is usually something like the number of schools in which non-white students make up, say, 90 percent or more of the total enrollment. But why has this increased? Bob Somerby provides part of the answer:

    Why are so many more schools now so heavily non-white? There are several parts to the answer, but the answer must start with this….White kids were 68.8% of the student population in 1988. That number had dropped to 48.4% by 2016….To add more meat to the bones of a partial explanation, consider the recent demographics of the Detroit Public Schools, according to Stanford’s Sean Reardon….White kids: 3 percent.

    And Jon Chait provides another part:

    The deep cause of segregation is residential living patterns driven by decades of racist housing policy. Neighborhood schools reflect those patterns of racial segregation.

    Both of these explanations have some truth to them, but I think they miss the biggest part of what happened. The real root of the answer can be found in a simple chart. I’m using the Los Angeles Unified School District as an example, but it’s pretty representative of what happened all over the country:

    An overall drop in the share of white kids from 68 percent to 48 percent can’t explain an 80 percent drop in the number of white kids in the LAUSD. Nor can housing policy, which has gotten less racist over the past 50 years.

    And it wasn’t just Los Angeles, of course. The same thing happened in city after city: steady white flight to the suburbs during the 50s and 60s, followed by a short but more panicked white flight during the busing era. By the time it was all over, (a) the white population of big cities had dropped dramatically and (b) the white population of big city public schools had dropped even more dramatically. At the same time, enrollment in non-religious private schools doubled among high-income families:

    Exact figures are slippery, but if you put all this together, along with some other data, it suggests that in Los Angeles virtually all affluent whites have either moved out of the LAUSD or else decamped to private schools. The small number of whites still left are almost exclusively working and middle class. Much the same thing has happened in other big cities.

    I don’t mean to pick on anyone here. I just want to make it clear that what happened wasn’t really due to cold-blooded forces of either demographics or housing policy. Rather, it was due to the very deliberate, very conscious choice of whites to abandon big city school districts when they became too black and too Hispanic. The middle class did it mostly by moving away, while the affluent did it by moving their kids into private schools.

    A lot of things in American life are driven by institutional racism, but this isn’t one of them. This was driven by racism that’s as hot-blooded and as individual as you can get. Over the course of 30 years, millions of whites all over the country made a personal decision that they didn’t want their kids in the same schools as blacks and Hispanics. That’s why big city school districts today are more segregated than they were half a century ago.

  • Quote of the Day: Sure, Trump Can Visit Ireland. If He Insists.

    Artur Widak/NurPhoto via ZUMA

    From Leo Varadkar, the prime minister of Ireland:

    The President of America is always welcome here. We respect the role no matter what we think of the person themselves.

    Roger that. Just to drive the point home, Varadkar also says that if Trump visits Ireland, protesters are more than welcome to greet him. “Leo is doing his best to minimize his exposure to Trump on this visit,” an Irish diplomatic source explained.

    I never could have guessed. You’ll be unsurprised to learn that Trump is making this easier than it might be by demanding that the meeting take place at his golf club in Doonberg. The Irish are not amused.