Video of the day

Larry David.  John Hamm.  Danny McBride.  Oh man, I can hardly wait to see this.

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Chait (and me) on abortion

Really like this atypically tempered piece from Jon Chait on abortion politics.  One of the reasons I’ve always been drawn to Chait is that we are so similar politically– moderately liberal, but stridently so.  Anyway, his take on abortion is very similar to my own, and he’s a lot better writer, so:

The abortion debate, at its root, pits differing ideas on the fundamental question of what is a human life. Perry’s side thinks that sperm plus egg equals human life. My side thinks the fertilized egg does not approach human status until much later in the process, which means the mother’s prerogative supercedes any rights it has.

There’s no real resolution to this dispute. Nobody even makes much of an effort to resolve it. Both sides advance arguments that only make sense if you already accept their premise about what a human life is. That’s what Perry’s doing here. He’s saying we should force women to give birth even when they don’t want to, because babies born in bad circumstances can be happy anyway. That isn’t an acceptable burden to place on women, in my opinion, but it surely is if you think abortion is murder.

Likewise, liberals often call conservatives hypocritical for wanting to shrink government while expanding government’s power to ban abortion. Except, if you think abortion is murder, then banning abortion is the sort of thing government ought to be able to do, even if it does very little overall. “Stopping murder” is one function of government that even Grover Norquist would endorse. Anti-abortion conservatives aren’t hypocritical, they’re (from the pro-choice standpoint) wrongabout what a murder is.

I realize a plea for understanding sounds odd coming from me, not being known for gentleness. I suppose I find certain bedrock conservative beliefs, like that the poor are genetically inferior or it’s okay for people to be denied access to basic medical care, to be barbaric and often simply premised on obvious mistakes. Having a different idea about when human life begins strikes me as the ultimate example of an issue where reasonable people can disagree.

 

We pay more for health care because we pay more for health care

Great, great piece in the NYT today about how much money Americans waste on pregnancy and delivery care.  And I say waste because we spend way more than other modern democracies and its not like we get better babies or healthier mothers out of the bargain.  In fact, we get worse outcomes because in our patchwork system many mothers are priced out of the marketplace and don’t get the most effective care.  Here’s the key chart:

30procedures-intl-cost-popup-v3

And a little explanation:

In most other developed countries, comprehensive maternity care is free or cheap for all, considered vital to ensuring the health of future generations.

Ireland, for example, guarantees free maternity care at public hospitals, though women can opt for private deliveries for a fee. The average price spent on a normal vaginal delivery tops out at about $4,000 in Switzerland, France and the Netherlands, where charges are limited through a combination of regulation and price setting; mothers pay little of that cost.

The chasm in price is true even though new mothers in France and elsewhere often remain in the hospital for nearly a week to heal and learn to breast-feed, while American women tend to be discharged a day or two after birth, since insurers do not pay costs for anything that is not considered medically necessary.

Only in the United States is pregnancy generally billed item by item, a practice that has spiraled in the past decade, doctors say. No item is too small. Charges that 20 years ago were lumped together and covered under the general hospital fee are now broken out, leading to more bills and inflated costs. There are separate fees for the delivery room, the birthing tub and each night in a semiprivate hospital room, typically thousands of dollars. Even removing the placenta can be coded as a separate charge.

Each new test is a new source of revenue, from the hundreds of dollars billed for the simple blood typing required before each delivery to the $20 or so for the splash of gentian violet used as a disinfectant on the umbilical cord (Walgreens’ price per bottle: $2.59). Obstetricians, who used to do routine tests like ultrasounds in their office as part of their flat fee, now charge for the service or farm out such testing to radiologists, whose rates are far higher.

Add up the bills, and the total is startling. “We’ve created incentives that encourage more expensive care, rather than care that is good for the mother,” said Maureen Corry, the executive director of Childbirth Connection.

You want to change these high costs you need to change the incentives.  To do that, you need to effectively regulate the health care market via the government, as all these other nations do and the US fails to do.  Alas, in America we have the “freedom” to pay 2-3x times more for a childbirth than we need to.  The NYT piece is really good and has some great personal stories in it– you should read it all.

Photo of the day

Had a nice afternoon yesterday watching a couple of episodes of “How the Universe Works” with my son Evan.  When it comes to science, he just can’t get enough of this space stuff.  Though, it’s hard enough explaining dark matter, dark energy, etc., to adults, it can be tough for a 7-year old.  Anyway, it reminded me that last week I came across this cool gallery of the “year in space” photos in the Post and Evan and I really enjoyed looking at it together.  This was a typically cool photo:

space

Young stars in the Small Magellanic Cloud, one of the closest galaxies to our Milky Way, are seen in this image released April 3. The SMC is about 180,000 light-years from Earth.

NASA via Reuters

War on the unemployed

You can make life miserable for unemployed Americans all you want, but it’s not going to create more jobs.  Alas, Republicans seem to think that if you are mean enough to the unemployed new jobs will magically appear for them.  Paul Krugman gives the full economic accounting of of just how delusional this belief is in yesterday’s column and he does it by highlighting North Carolina:

Consider, for example, the case of North Carolina. The state was hit hard by the Great Recession, and itsunemployment rate, at 8.8 percent, is among the highest in the nation, higher than in long-suffering California or Michigan. As is the case everywhere, many of the jobless have been out of work for six months or more, thanks to a national environment in which there are three times as many people seeking work as there are job openings.

Nonetheless, the state’s government has just sharply cut aid to the unemployed. In fact, the Republicans controlling that government were so eager to cut off aid that they didn’t just reduce the duration of benefits; they also reduced the average weekly benefit, making the state ineligible for about $700 million in federal aid to the long-term unemployed.

I’ve been a little sensitive to wondering whether I’m writing too much about politics in my home state after a complaint (you know who you are M.S.), but it occurred to me that, heck, if Paul Krugman thinks NC is worth writing about, the politics here are not some parochial concern.  Rather, North Carolina has essentially become ground zero for all the policy instincts of the Republican Party that are just completely dead wrong.

Anyway, Krugman’s analysis of GOP beliefs is spot-on:

In general, modern conservatives believe that our national character is being sapped by social programs that, in the memorable words of Paul Ryan, the chairman of the House Budget Committee, “turn the safety net into a hammock that lulls able-bodied people to lives of dependency and complacency.” More specifically, they believe that unemployment insurance encourages jobless workers to stay unemployed, rather than taking available jobs.

Is there anything to this belief? The average unemployment benefit in North Carolina is $299 a week, pretax; some hammock. So anyone who imagines that unemployed workers are deliberately choosing to live a life of leisure has no idea what the experience of unemployment, and especially long-term unemployment, is really like.

He continues on to explain as one would expect from an Economics professor on how the Republicans’ beliefs are empirically false and gives us this great conclusion:

Can anything be done to reverse this policy wrong turn? The people out to punish the unemployed won’t be dissuaded by rational argument; they know what they know, and no amount of evidence will change their views. My sense, however, is that the war on the unemployed has been making so much progress in part because it has been flying under the radar, with too many people unaware of what’s going on.

Well, now you know. And you should be angry.

Of course, many in NC are angry and many more will be out at today’s Moral Monday.

War on food stamps

So, I wrote recently about how the farm subsidies were held up because Tea Party Republicans would prefer to see Americans go literally hungry, but I did not fully realize just how amazingly mean-spirited and divorced from reality these people are on the matter.  The Atlantic’s Matthew O’Brien has enlightened me:

After all, the battle over food stamps isn’t just a battle over budgets; it’s another battle in our not-so-cold war over ideology. As the Wall Street Journal editorial page makes clear, conservatives think the welfare state is so generous that far too many people aren’t, as they put it, “buying food, which is one of life’s most basic responsibilities.” In other words, they think the safety net has become a hammock stocked with snacks on the road to serfdom…

Now, to be fair, House Republicans do have a plan to save money by kicking millions of non-drug users off of food stamps: they want to kick the unemployed off too. As it already is, food stamps, like welfare, have a work requirement. Beneficiaries have to look for a job, accept any job they can find, get in job training if they can’t find one, and can’t quit a job. But as Robert Greenstein of the left-leaning Center on Budget and Policy Priorities points out, House Republicans wanted to add a “work requirement” amendment that would let states to cut off food stamp benefits to anyone without a job or in job trainingwithout providing any funding for jobs or job training [emphasis in original]. In other words, if you’re unemployed, you’re out of luck — and out of food stamps.

There are lots of words that come to mind here, but sociopathic might be the first one. As my colleague Jordan Weissmann points out, food stamp use has gone up because poverty has gone up. And poverty has gone up because there still aren’t enough jobs… there are still three unemployed people for every job opening

House Republicans are ideologically incapable of imagining a world where people can’t find a job because there aren’t enough of them. In other words, they won’t let themselves understand the world we live in. They think food stamp use is at record-highs, because people are drug addicts or just shiftless — not because the recovery has been so weak. This insistence that our problems are all supply, and no demand, is why Republicans have opposed any and all attempts to stimulate the economy, either monetary or fiscal. It’s bad economics, and worse morality.

At least Marie Antoinette wanted to let them eat cake.

 

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