Quite a caveat

I saw a headline at the Times website today about Obama allowing states more ability to experiment with and opt-out of requirements from the health care law.  I figured that in no way did this actually signal any meaningful policy change (or if it did, I’d hear about it from Ezra and Jon Cohn with a much more sophisticated explanation).  Anyway, checking in on Kevin Drum today, I see that it’s really all about the caveat to Obama’s statement (which really suggests the headline I saw was overplaying it.  Anyway, here’s the explanation from the Times:

The legislation would allow states to opt out earlier from various requirements if they could demonstrate that other methods would allow them to cover as many people, with insurance that is as comprehensive and affordable, as provided by the new law….If states can meet those standards, they can ask to circumvent minimum benefit levels, structural requirements for insurance exchanges and the mandates that most individuals obtain coverage and that employers provide it.

Italics mine. (And Drum’s).  That’s one really big “if.”  So, if states can do everything the ACA does better and for less money, they can opt out of the law.  Not exactly a major threat to the legislation.  Drum think’s Obama is just calling the Republican’s bluff, which seems like a reasonable supposition:

Basically, Obama is calling the bluff of Republicans who insist that they can build a healthcare system that’s as extensive and affordable as PPACA using some combination of tea party-approved “free market” principles. He’s telling them to put their money (or, rather, money from the feds) where their mouths are, which will probably demonstrate fairly conclusively that they can’t do it. It’s possible that a state like Oregon might enact a more liberal plan that meets PPACA standards, but I doubt that Alabama or Tennessee can do it just with HSAs and high-deductible health plans.

Still, we’ll see. This is a chance for conservatives to show that they have a better healthcare answer in the real world, not just as talking points at a tea party rally. Obama is betting they’ll fail, and he’s also betting they’ll tear each other apart arguing over details while they do it. Life is easy when all you have to do is yell “Repeal Obamacare!” but it gets a lot harder when you have to produce an actual plan.

 

 

 

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Egypt and Al Qaeda

I’ve got nothing original or unique to contribute on this story about what the events in the Middle East might mean for Al Qaeda, but I did find it really interesting.  And I sure do hope that what we’ve seen means that Al Qaeda is on the wane.  I do love that this revolutionary change was accomplished not through violence, but through non-violence:

For nearly two decades, the leaders of Al Qaeda have denounced the Arab world’s dictators as heretics and puppets of the West and called for their downfall. Now, people in country after country have risen to topple their leaders — and Al Qaeda has played absolutely no role.

In fact, the motley opposition movements that have appeared so suddenly and proved so powerful have shunned the two central tenets of the Qaeda credo: murderous violence and religious fanaticism. The demonstrators have used force defensively, treated Islam as an afterthought and embraced democracy, which is anathema to Osama bin Laden and his followers.

 

Baby Brains

Friend of mine posted this link to 11 cool facts about baby brains on facebook.  Given that I’m intensely interacting with a particular baby brain every day, I found it of particular interest.  Some of these I already knew, some I didn’t, and some in the first category were well worth being reminded of.  Anyway, fact #1: very true:

All babies are born too early

If it weren’t for the size limitations of a woman’s pelvis, babies would stay developing in the womb for considerably longer, comparative biologists have suggested.

“We have to keep our pelvises relatively narrow to keep upright,” said Lise Eliot, neuroscientist and author of What’s Going on in There? How the Brain and Mind Develop in the First Five Years of Life (Bantam, 2000). To fit through mom’s, er, escape hatch, the newborn brain is one-quarter the size of an adult’s.

Accordingly, some pediatricians label a baby’s first three months of life as the “fourth trimester” of pregnancy to emphasize how needy, and yet devoid of social skills, babies are at this stage. The first social smile, for example, doesn’t usually appear until the infant is 10-14 weeks old and the first phase of attachment, scientists suggest, begins around five months old.

This understanding is the basis for one of the two books that truly changed my life.  The Happiest Baby on the Block.  All about how to best soothe this unhappy creature.  Sarah just turned 3 months, and it really is pretty amazing how much more interesting and engaging (and calm) she is now compared to just a few weeks ago.  Found the following new to me and pretty interesting:

Lantern (vs. flashlight) awareness

Baby brains have many, many more neuronal connections than the brains of adults. They also have less inhibitory neurotransmitters. As a result, researchers such as Gopnik have suggested, the baby’s perception of reality is more diffuse (read: less focused) than adults. They are vaguely aware of pretty much everything – a sensible strategy considering they don’t yet know what’s important. Gopnik likens baby perception to a lantern, scattering light across the room, where adult perception is more like a flashlight, consciously focused on specific things but ignoring background details.

As babies mature, their brains go through a “pruning” process, where their neuronal networks are strategically shaped and fine-tuned by their experience. This helps them make order out of their worlds, but also makes it harder to innovate and come up with such breakthroughs as spinach puree face paint.

Creative people, Gopnik and others have argued, have retained some ability to think like an infant.

The whole thing is pretty cool.

Liberals in Academia myths

A couple acquaintances from grad school, Matt Woessner and April Kelly-Woessner, have gone on to make quite the name for themselves by studying the role of ideology in academia.  Yesterday, they had a “5 myths” piece about liberal academia.  From what I recall, at least Matt is one of those rare conservatives in Academia.  I think they set up some straw men, to a degree, in some of these, but still an interesting read.

I’m going to quote number 4, as it certainly comports with my experience:

4. Conservative academics are ostracized on campus.

We have found little evidence that right-leaning college professors are treated poorly. In our survey, 33 percent of Republican and/or conservative faculty say they are “very satisfied” with their careers, while 24 percent of Democratic and/or liberal faculty say so. More than 90 percent of Republican professors report that, given the chance to “begin your career over again,” they would definitely or probably still become a professor. Meanwhile, fewer than 2 percent say they have been treated unfairly because of their political views. These results are nearly identical to those of their liberal counterparts.

However, conservative professors can have trouble publishing in peer-reviewed journals and academic presses. A recent study of Harvard University Press by Econ Journal Watch concluded that the publishing house is heavily biased toward liberal views. Only eight of 494 books published in the past 10 years were classified in the study as “conservative” or “classical liberal” in orientation. Since the ability to publish is a key requirement of securing tenure and promotions, this issue cannot be ignored.

Despite 90%+ of my colleagues being liberals over the years, and being the part of many hiring (and fewer promotion) decisions, I’ve never seen any evidence whatsoever of ideological bias in this all-important realm.  I’m sure it’s annoying for conservative academics to have all their colleagues initially assume they are likewise liberal (presumably, there’s a lot of awkward pauses after, “actually, I voted for George W. Bush” etc., statements), but if that’s the worst of it, there’s really not much to complain about.

Government is not a business (the post I should’ve written)

A few days ago I wrote a post on the matter in reference to some “educator” who argues that education really is a business– on in which it is simply not profitable to educate special needs kids.

Seth Masket takes this idea and writes a much better take on the general topic.  Since I at least have inspired him on the matter, I’m going to quote liberally (I agree 100%, so just pretend I wrote it):

There’s nothing wrong with the idea that governments should be run more efficiently or with better customer service, and if that’s what people mean, they should say that. But to say that governments should be run like businesses is to reveal ignorance about what either governments or businesses — or both — are. Businesses exist to turn a profit. They provide goods and services to others only insofar as it is profitable to do so, and they will set prices in a way that ends up prohibiting a significant sector of the population from obtaining those goods and services. And that, of course, is fine, because they’re businesses. Governments, conversely, provide public goods and services — things that we have determined are people’sright to possess. This is inherently an unprofitable enterprise. Apple would not last long if it had to provide every American with an iPad.

I’m also always surprised to hear people tout the efficiency of the private sector. There’s a great deal of inefficiency in the private sector, of course. How many CEOs end up hiring dim, unqualified brothers-in-law or grandkids who are taking time off college? And that’s just not considered a big deal as long as it doesn’t noticeably hurt the bottom line. If a member of Congress does that, it becomes a major scandal.

This isn’t to say that government is a paragon of efficiency and thrift, either, but there’s a whole subfield in journalism and several citizen activist groups devoted to rooting out waste in the public sector. There’s not much interest in rooting out waste in the private sector unless a business is seen as misusing public money (e.g.: Halliburton). And again, that’s fine — they’re private entities that are free to do what they want with their money. But let’s not just assume they’re waste-free and that our governments would improve by emulating them.

Really love that last point.  Many businesses are incredibly corrupt and inefficient (ever worked in a private office?), but there’s simply not any incentive for media to keep them honest and accountable unless the corruption and inefficiency is directly cheating the public.

Chart of the day

I used to lecture about “job lock” as  a regular part of my health care policy lecture.  I largely stopped, not because it’s not important, but because there’s so much wrong with our current system and I only use three days to cover it.  It’s not an unimportant issue, though.  Basically, a lot of Americans are essentially trapped in their jobs for fear of losing health insurance in our employer-based system.  This, of course, leads to a fairly inefficient distribution of workers and stifles opportunities for entrepreneurship.  Austin Carroll demonstrates this nicely in chart form:

That’s almost a 14% increase in business ownership attributed to turning 65 and going on Medicare. It would seem that there are substantial gains to be had in moving away from the employer-based health insurance system. Is there really any good argument for retaining it?

Other than the fact that there’s always a fair amount of trouble in disrupting a major status quo such as this, I sure cannot think of one.  Of course, if the only reason to keep a bad idea is that it’s a pain to get rid of it, we could still have slavery.

The Soylent Green solution

In keeping with the “it’s not a business theme,” Yglesias has a great post on a really good reason we should not consider business a good analogy for what we’re doing with our government.  If we did run government like a business, the first thing we should do is get rid of all the old people.  Yglesias:

A state is fundamentally an ethical enterprise aimed at promoting human welfare. A business isn’t like that. If you’re trying to look at America from a balance-sheet perspective the problem is very clear. It’s not “entitlements” and it’s not “Social Security” and it’s not “Medicare” and it’s not “health care costs” it’s the existence of old people. Old people, generally speaking, don’t produce anything of economic value. They sit around, retired, consuming goods and services and produce nothing but the occasional turn at babysitting. The optimal economic growth policy isn’t to slash Social Security or Medicare benefits, it’s to euthanize 70 year-olds and harvest their organs for auction. With that in place, you could cut taxes and massively ramp-up investments in physical infrastructure, early childhood education, and be on easy street. The problem with this isn’t that it wouldn’t work, it’s that it would be wrong, morally speaking.

Now obviously an idea like raising the retirement age to 70 isn’t as wrong as mandatory euthanasia at the age of 70. But by the same token, it doesn’t “work” as well at boosting per capita GDP or cutting down on American red ink. And both ideas exist on a continuum of the same tradeoff—bolstering the living standards of old people is an economically inefficient undertaking that we sentimental human beings find ethically appealing. That’s not to say that the spot on the continuum occupied by current policy is the best possible way to make the tradeoff. But it’s simply to dramatize the nature of calculus we’re talking about. As a “business strategy” it’s ridiculous—on a par with preserving the natural beauty of the Grand Canyon or having the military pay health care costs of soldiers who are too injured to fight—but that’s because it’s not a business strategy.