The health care dog that’s not barking

With all the attention to the coming midterm elections, I think it is quite notable what a small role the Democrats’ passing of health care legislation seems to be playing in the election.  The Republicans kept insisting that it would bring about electoral disaster for Democrats (in which case they would’ve voted for it if they truly believed that), yet it really doesn’t seem to be playing a major role in any of the campaigns I’ve been reading about.  Jon Chait’s got some nice comments on the matter:

It’s obviously true that the Democrats lost a lot of support “during the health care debate.” The health care debate took about a year. My argument is that, during a period in which unemployment was rising and the Democrats controlled the entire government, Democrats would have bled support regardless of what they were debating. If they declined to carry out their campaign promises, they would have lost support. If they cooperated with Republicans to continue or deepen Bush-era tax cuts for the rich — the only policy upon which bipartisan cooperation was possible — they may have bled somewhat less support because people like bipartisanship, but it would have been terrible policy.

You can make some counter-factual argument that never attempting to pass health care would have been a good political alternative, although you have to account for the massive liberal firestorm this would have provoked. You can make a better argument that passing health care quickly instead of spend month after month sitting on Olympia Snowe’s doorstep would have been a shrewder plan. I think the conservative argument that, after investing months and months into health care, taking high profile votes in both chambers, it would have been shrewd to then abandon the whole thing to failure is transparently unconvincing. That’s a recipe for absorbing almost all the costs of passing health care reform, getting none of the benefits, and driving your base wild with rage at you.

As I argued back in March, these midterms are ultimately about the economy, not health care.

Chart of the day

From CBPP (who really know how to bring the graphs) via Ezra:


“The revenue loss over the next 75 years just from extending the tax cuts for people making over $250,000 — the top 2 percent of Americans — would be about as large as the entire Social Security shortfall over this period,” write Kathy Ruffing and Paul N. Van de Water at the Center on Budget and Policy Priorities. “Members of Congress cannot simultaneously claim that the tax cuts for people at the top are affordable while the Social Security shortfall constitutes a dire fiscal threat.”

Headline of the day

From Alternet:

“Hey Ladies, Want a Raise? Wash Your Vagina — Women’s Day Magazine’s Ultra-Sexist Ad”

This really is pretty amazing (in a disturbing and oh-so-wrong way)…

So, ladies, you say you want a raise? How should you go about getting it?…

What to do?

Fortunately, the good folks at Women’s Day and Summer’s Eve have a few words of advice for you…

What is the very first thing you should consider if you want a raise? What is the most important thing of all?

Yup, wash that vagina, and wash it good. Remember the sandalwood-scented balls. You don’t want any, ahem, untoward odors to interfere with your chances, do you? What’s that you say? You don’t have an odor problem? You’re clean, you bathe regularly, and you don’t really need advice to use a product that “cleanses away odor-causing bacteria from the external vaginal area?” What are you, a barbarian? This is a raise you’re talking about.

That was #1 on the “how to get a raise” list. What was last, least important? Well, after the “wash your vagina” advice, it must be something truly inconsequential, perhaps related to toenail hygeine with closed-toe shoes, right? Let’s look:

Accomplishments? Who cares? You’re a woman. Nobody wants to know about your accomplishments. No, what really matters is a great fresh cut flower smell from you-know-where.

Russia in color (from 100 years ago)

Amazingly cool color photographs of Russia from 100(!!) years ago.  Check ’em all out.

Obama the Muslim

So, that previous post reminded me from something I meant to blog about last week and forgot.  Political Scientist, John Sides, filling in for Ezra last week had a really nice post about why more people think Obama is a Muslim and who they are.

Here are the trends from the March 2009 to August 2010 polls in the perception that Obama is a Muslim. I divide the sample into Democrats and Republicans. Independents who lean toward a party are counted as partisans (see here for why), so this analysis includes about 90 percent of the sample. I then divide the sample into the education categories that Pew provided: those with a high school degree or less, those with some college education, and those with a college degree or more.

The growth in this perception among Democrats is small and is consistent across education levels: a 2-4 increase within each level.  By contrast, the growth in this perception among Republicans is more notable among those with some college education (a 19-point increase) or a college degree (15 points) than among those with a high school degree or less (9 points).  In other words, better educated Republicans have changed more than the less educated Republicans. This flies in the face of the “dumb Americans” idea and provides some support for Nyhan’s hypothesis. The people most likely to hear the “Obama is a Muslim” meme are the ones whose beliefs changed most dramatically in the past 17 months.

I was a bit surprised that Sides did not mention the work of John Zaller, as this ties in quite well with his work on opinion change.  Most people assume that it is the “dumbest” or least educated Americans who will be most influenced by the media and let Glenn Beck, et al., drive their opinions.  The truth is, though, that those Americans consume very little news and political media.  You have to be exposed to information to have your opinions change.  In this case, the more educated the Republican, the greater the media consumption and thus the more the exposure to all this Obama the Muslim absurdity.  Democrats, on the other hand, aren’t going to be as exposed to the right-wing sources spreading this junk, and even if they are, obviously not inclined to believe it.

I’m sure you could find something that makes Democrats look bad and credulous in comparison to Republicans, but I truly doubt you’d find anything near this egregious.  As much as David Broder and his type (including many of my students) always want to suggest, American politics is not symmetric.

Man knows everything he needs to about Muslims

This is going down as one of my all-time favorite Onion stories.  Damn is it good:

SALINA, KS—Local man Scott Gentries told reporters Wednesday that his deliberately limited grasp of Islamic history and culture was still more than sufficient to shape his views of the entire Muslim world.

Gentries, 48, said he had absolutely no interest in exposing himself to further knowledge of Islamic civilization or putting his sweeping opinions into a broader context of any kind, and confirmed he was “perfectly happy” to make a handful of emotionally charged words the basis of his mistrust toward all members of the world’s second-largest religion.

“I learned all that really matters about the Muslim faith on 9/11,” Gentries said in reference to the terrorist attacks on the United States undertaken by 19 of Islam’s approximately 1.6 billion practitioners. “What more do I need to know to stigmatize Muslims everywhere as inherently violent radicals?”

“And now they want to build a mosque at Ground Zero,” continued Gentries, eliminating any distinction between the 9/11 hijackers and Muslims in general. “No, I won’t examine the accuracy of that statement, but yes, I will allow myself to be outraged by it and use it as evidence of these people’s universal callousness toward Americans who lost loved ones when the Twin Towers fell.”

“Even though I am not one of those people,” he added.

When 22% equals 100%

I’ve been talking about electoral systems and how they translate voter preferences into representation in my class this semester.  One of the major problems with our plurality system (whoever gets the most votes, wins) is that somebody can win 100% of the representation with well less than a majority of popular support.  Former Republican Congressman Mickey Edwards has a nice essay in the Atlantic about the absurdity of the fact that Ben Quayle will likely represent Arizona as of next year:

It is clearly not a system that works perfectly — many citizens do not vote and a dutiful legislator will not follow even the most ardent wish of his or her constituents if thought to be contrary to the national interest, but by and large the fundamental idea — legislators are the voice of participating citizens — is generally accepted to be true.

It isn’t…

I served in Congress with Dan Quayle and have no quarrel with his son, but I do have a quarrel with a system that allows for the election of members of Congress (or governors or other officeholders) to whom most voters are opposed. Ben Quayle received 22.7 percent of the votes cast in his congressional primary; more than 77 percent of the Republicans who voted in that primary wanted somebody else to be their congressman. Quayle received just over 14,000 votes; more than 48,000 voted for somebody else, despite the fact that Quayle was the best known and most visible of the candidates. Running in a heavily Republican district, he will almost certainly become a member of Congress in January, representing a community that did not want him in that job.

Of course, Arizona voters–even the Republicans– have the option of not voting for Quayle, but barring huge personal scandal, a Republican will pretty much always win a very Republican district.  Thus, the Republican primary really is where all the action is at.  Thus, it is somewhat disconcerting that Arizona’s newest representative (even if it was one of Quayle’s competitors) will basically have one election by only winning 22% of the vote in the most competitive election he’ll face.

The “I vote for the candidate” self delusion

Most Americans when asked their voting preferences, give some variation on “I vote for the candidate, not the party.”  Not to put too fine a point on it, but for pretty much any federal of state legislative office this is just dumb.  The most important vote any member of the US House takes is for Speaker of the House.  Everything else is just details.  The majority party totally runs the show.  A Democrat that voted for Nancy Pelosi for Speaker and then voted against almost every individual Democratic agenda item is still a net plus for the Democratic party (except for the extraordinarily rare case where a single vote matters).  Yet, we go along fooling ourselves that the “leadership,” “integrity,” “character,” etc., of each individual candidate matters.   Ezra Klein has a post on Charlie Crist that ends in a nice riff on this:

Olympia Snowe is arguably the most independent Republican in the Senate — and she’s stuck with her party on 67.3 percent of votes in this Congress. That is to say, if you knew nothing about Snowe save that she was a Republican, you could predict her vote about 70 percent of the time.

And Snowe is actually uncommonly willing to vote with the other side. Ben Nelson is in Snowe territory, voting with the Democrats 67.6 percent of the time, and so is Susan Collins. But that’s about it. Scott Brown voted with the GOP 82.1 percent of the time. Joe Lieberman was there for the Democrats 90.6 percent of the time. Lindsey Graham showed up for the Republicans more than 92 percent of the time. (You can look up any politician you please here.) The reality is that the single most important thing to know about any politician is which party they’ll caucus with. Full stop.

Campaigns are built to fool us into thinking that we’re voting for individuals. We learn about the candidate’s family, her job, her background — even her dog. But we’re primarily voting for parties. The parties have just learned we’re more likely to vote for them if they disguise themselves as individuals. And American politics would work better if we understood that.

The Koch brothers

Jane Mayer has a great profile in the New Yorker about the Koch brothers, a pair of super-rich libertarians who use their money to fund political causes with the basic purpose of enriching themselves and their business (i.e., lower taxes on their fortune and less regulations for their pollution-prone companies).  You should read it— probably the most talked-about New Yorker article of the past few months– and it’s really stuff you should know (and Jane Mayer pretty much rules).   Obviously, a lot of interesting takes all over the blogosphere, but I most like Jon Chait’s take on how all the money has shaped the conservative agenda:

Conservatives are happy to acknowledge, and even celebrate, the role played by conservative donors in helping conservatives fight ideological battles against liberals. But they are loathe to acknowledge the role that conservative donors play in waging ideological battles within conservatism itself. I’d say conservative donors have made the conservative movement and the Republican Party far more responsive to the interests of corporations and high-income individuals. There is an unusually large supply of capital to finance propaganda extolling the benefits of lower taxes for the rich and casting doubt on proposals to account for the externality cost of carbon dioxide emissions. But you don’t see conservatives admitting that that fnancing has had an effect.

If all you knew about conservatism was its foundational ideological texts, you could just as easily imagine that conservatives would believe that it’s senseless to cut taxes without cutting spending, and that it would make perfect sense for the government to tax carbon emissions rather than something else, once science has established the harmful effects of such emissions beyond a reasonable doubt. That conservatism has evolved in a different direction owes a great deal to the interests of some its its richest donors.

And, if you’re more the auditory type, there was a great interview with Jane Mayer about the article on Fresh Air last week.  Listen.

“Limited Government”

In the “another great blog post I found in a friend’s facebook feed category” here’s a really nice one on the intellectual dishonesty and logical incoherence in conservatives’ cries for “limited government.”  Former Cato scholar, Timothy Blee:

In the conservative (and fusionist) worldview, government activities are evaluated using a simplistic “size of government” metric that treats every dollar of government spending as equally bad, regardless of how it’s used. This has some unfortunate results. It means that cutting children’s health care spending is just as good as cutting a dollar from subsidies for wealthy corporations. And since wealthy corporations typically have lobbyists and poor children don’t, the way this works out in practice is that conservative politicians staunchly oppose the former while letting the latter slide.

Worse, mainstream conservatives give programs involving the military and law enforcement a free pass. Conservatives vociferously (and correctlyoppose giving the FCC expanded power over the Internet, but they actively supported the NSA’s much more comprehensive and intrusive scheme of domestic surveillance. Conservatives support a massive expansion of government power at our southern border to restrict the freedom of Mexican migrants. They seem unconcerned by the fact that we have more people in government-run prisons than any other nation on Earth.

This distinction makes no sense. When American soldiers gun down Iraqi civilians and blow up a van that comes to rescue the survivors, that’s a government program. When a SWAT team conducts a military-style raid on the home of an innocent Maryland mayor and kills his dogs, that’s a government program too. Obviously, law enforcement and national defense are important functions of government, but these highly coercive government programs should be the subject of more public scrutiny, not less.

Personally I’m not interested in “limited government” as an end in itself, but as a means to greater individual liberty. I’m opposed to government programs that waste taxpayer dollars because higher taxes restrict my freedom. But I’m much more opposed to government programs that use taxpayer dollars to restrict freedom directly. I’m not interested in joining a “limited government” movement that considers the two equivalent. And I’m definitely not interested in being part of a movement that gives torture and preemptive war a free pass under the heading of “national defense” while it focuses instead on fighting the tyranny of SCHIP and unemployment insurance.

True dat.  Mostly, that is.  I really don’t feel like my freedom is particularly restricted when my marginal tax rate, etc., goes up by some modest amount, but Blee is exactly right in focusing on the fact that “limited government” in and of itself is just a non-sensical goal.

Meet the new drug; same as the old drug

I just discovered yet another site I’m going to have to become a regular visitor of (there’s really just way too much good information and analysis out there on the internet)– the Accidental Economist.  Anyway, here physician Austin Carroll has a really nice post about just how absurd some of the “new” drugs are and how we keep using them anyway.  For example, the oldest and cheapest blood pressure medication is the most effective, yet still routinely ignored for newer, more expensive (and much more marketed) medications.  Especially discouraging is the use of drugs in which the pharmaceutical companies simply take half the molecule of of a drug and patent and market it as a new drug:

However, in many other instances, new drugs are just sleight of hand “changes” to old drugs that have no expectation of being better.  When creating drugs through organic synthesis, mirror image molecules are created.

So, if drug D is created, in the last step you wind up with half D and half D’(the mirror image of D).  The mirror image is usually inert and has no effect on the drug or the individual taking the drug, but it is left in because there is an expense to remove it.  Years ago, the drug companies hit upon a brilliant idea.  If they removed that non-working, mirror image part of the pill, they could claim they devised a new drug!

Think this is rare?  Ever heard of Nexium (“the purple pill”)?  Nexium is just Prilosec, with the mirror image part removed.  And Prilosec is an effective, and now generic, drug for heartburn.  Prilosec is P + P’; Nexium is just P.  There is no reason to believe that equivalent amounts of the two drugs are not the same – and research supports this.  Four head-to-head studies compared 20 milligrams of Prilosec to 20 or 40 milligrams of Nexium.  But you have to remember – half of Prilosec is P’(filler)!  So these studies really compared 10 milligrams of P to 20 or 40 milligrams of P.  Shouldn’t more be better? One would think so, but it was barely so, and only in half the studies.  And, of course, none of the advertising stated that you could get the same improvement just by taking more Prilosec.

AstraZeneca, the maker of Nexium and Prilosec, isn’t the only drug company to do this.  Lexapro is “half” of Celexa (Forest Pharmaceuticals).  Nuvigil is “half” of Provigil (Cephalon).  Xyzal (Sanofi-Aventis) is “half” of Zyrtec (Pfizer).  Lunesta is “half” of Imovane (Sepracor).  Levaquin is “half” of Floxin (Ortho-McNeil Pharmaceutical).  Focalin is “half” of Ritalin (Novartis Pharmaceuticals).  And so on and so forth. In fact, since 1990, the proportion of these “half” drugs, among approved new drugs worldwide, has become greater than half of those new approvals.

I suppose I don’t blame the companies too much for this, but what in the world are doctors who should know better doing prescribing these things?  If any doctor ever tried to prescribe me Xyzal and 100 times the cost of my OTC generic Zyrtec, I would find another doctor immediately.  You think this is bad, here’s Carroll’s ultimate example:

These aren’t even the worst offenders.  In the worst cases, all that the drug companies change is the color of the pill.

Sarafem, marketed by Lilly for premenstrual dysmorphic disorder, is exactly the same molecule as that found in Prozac.  The only difference, besides the cost, is that Prozac has a green coating, and Sarafem’s is pink.  That’s it.  There is no reason you couldn’t just buy cheaper generic Prozac (Fluoxetine) and color it pink for the exact same experience and effect.

Again, this is nuts, but it only works so long as physicians are willing to write prescriptions for Sarafem instead of generic prozac.  The fact that apparently many are willing to, is the problem.

Friday Book Post (Game Change)

Yeah, I know, I’ve got a real problem with actually getting these out on Saturday.  Anyway, so I wanted to assign a fun and interesting read on the 2008 election for the Campaigns & Elections class I’m teaching this semester.  Despites my skepticism, several people suggested I consider Game Change by John Heilemann and Mark Halperin.

My students will not be reading this book.  My skepticism (based on various things I read when it came out) was most definitely warranted.  Sure, the book was filled with fun little observations and anecdotes (e.g,. Elizabeth Edwards screaming and ripping off her blouse in an RDU airport parking lot), but that’s ultimately all there was.  It was just detail after detail with almost no perspective or meaningful analysis.  It was the view of the campaign from 6 inches, when it would have been useful to also include the view from 1000 feet.  It also struck me as an almost perfect embodiment of the pathologies of modern political journalism.  Everything in the book was explained by the actions of various candidates and political actors.  The authors seemed oblivious to the fact that factors beyond the actual campaign (e.g., the demographic bases of each candidate’s support and how these varied across states) could have explained the results.  I don’t entirely regret reading this book, as there were some fun and interesting anecdotes about all the candidates (especially enjoyed the ones about Palin), but ultimately it does depressingly little to actually educate the reader.

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