Quick hits (part II)

1) This is just horrible, horrible news.  Mark Binker— a longtime NC Statehouse reporter– literally knew NC politics better than anyone I knew.  I loved having him come to my classes to give a reporter’s perspective.  And I loved talking Rec soccer with him and hearing about his two boys.  He will be sorely missed by so many.  Makes me so sad.

2) These time-lapse gifs (soft “g” damnit) are awesome.

3) Plenty of good takes on Trump’s admission, that, what do you know, being president is hard work.  Drum’s:

There are three takeaways from this. First, Trump’s old life was pretty easy because other people ran his companies and he didn’t really do much. Second, he thought presidents just consulted their guts and made decisions, sort of like Celebrity Apprentice, and then stuff magically happened. Third, he still can’t maintain discussion of a real topic (Chinese President Xi Jinping) for more than a few moments before getting sidetracked by one of his obsessions (his huge victory in November).

4) The reality of sweatshops and economics.

5) Raise your hand if you are at all surprised that a vicious, misogynistic Reddit forum was founded by a Republican state legislator.

6) Greg Sargent on the collapse of the latest ACA repeal effort:

I’d like to propose another explanation. What if the GOP repeal effort once again failed because the Affordable Care Act has actually helped a lot of people, and this whole process has made that a lot harder for Republicans to deny? …

In short, many Republicans objected to the new version on the grounds that it would take coverage away from untold numbers of poor and sick people.

At the same time, though, many of these Republicans avoided openly crediting Obamacare with achieving the very protections for those with preexisting conditions and the vast coverage expansion via Medicaid that they now want to preserve. And they pledged to continue trying to repeal the law. These Republicans cannot affirmatively applaud Obamacare’s success in accomplishing ends they now recognize as imperatives, but they can stand up and say they won’t remove or badly weaken the provisions of it that are accomplishing those ends, provided they also say they’ll replace the law whenever some more acceptable alternative — which would also accomplish those ends — comes along.

7) Nice Washington Post article about the value of on-line support for families of children with rare diseases.  When Alex was young, the Tuberous Sclerosis Alliance on-line support was a lifesaver.

8) Some good advice to help keep college students on track for graduation.

9) Seems pretty clear we should no longer be paying TV writers per episode any more.

10) Do we have too many restaurants in America.  Almost surely.  Interestingly, I notice Burger Kings go out of business all the time; never McDonald’s.

11) Drum and Conor Friedersdorf on free speech (or not) on campus.  I strongly agree with both.


12) Mark Joseph Stern on NC Republicans.

13) Jamelle Bouie on lower income Americans supporting Trump despite his tax policies that so clearly favor the wealthy:

At first glance, it’s an odd populism that takes from the many to give to the few, that abandons the anxious and suffering in favor of the wealthy and comfortable. But remember, Trump’s populism wasn’t just an appeal to jobs and economic interest—it was a racial appeal. Trump cast blame on Muslims, Hispanic immigrants, and foreign others; he pledged to reopen the mines, recover the factories, and restore the white male industrial wage-earner to his perceived place at the top of the material and social hierarchy.

Trump is busy delivering the latter part of this formula, extolling archetypes of white male masculinity and—through his attorney general, Jeff Sessions—using federal power to crack down on those he defined as racial threats during the campaign. That is populism too, and it is potentially potent enough to satisfy those supporters who may lose out under Trump’s economic program. If nothing else, the racial interests of white Americans have always been at the forefront of white politics, a powerful force across class and social lines. The collapse of support for all kinds of public goods, from robust schools to neighborhood pools, is tied to the perceived beneficiaries. When the majority of white Americans believed those beneficiaries looked like themselves, they backed those investments. When they didn’t, they rejected them, either explicitly or eventually under the guise of “color blind” ideologies. With that said, there are exceptions to this general story, among goods that don’t have the same spatial dimensions as schools or housing but still deliver benefits, which is one reason the conservatives have had little traction fully gutting the welfare state.

14) Philip Carter certainly strikes me as right on this, “How Trump Made America Less Secure in 100 Days: His foreign policy makes no sense, and nearly every military move has been a mistake.”

15) Partisanship is a hell of a drug, part 8 million.

16) Excellent Gillian White piece on the difficulties of escaping poverty:

After divvying up workers like this (and perhaps he does so with too broad of strokes), Temin explains why there are such stark divisions between them. He focuses on how the construction of class and race, and racial prejudice, have created a system that keeps members of the lower classes precisely where they are. He writes that the upper class of FTE workers, who make up just one-fifth of the population, has strategically pushed for policies—such as relatively low minimum wages and business-friendly deregulation—to bolster the economic success of some groups and not others, largely along racial lines. “The choices made in the United States include keeping the low-wage sector quiet by mass incarceration, housing segregation and disenfranchisement,” Temin writes.

And how is one to move up from the lower group to the higher one? Education is key, Temin writes, but notes that this means plotting, starting in early childhood, a successful path to, and through, college. That’s a 16-year (or longer) plan that, as Temin compellingly observes, can be easily upended. For minorities especially, this means contending with the racially fraught trends Temin identifies earlier in his book, such as mass incarceration and institutional disinvestment in students, for example. Many cities, which house a disproportionate portion of the black (and increasingly, Latino) population, lack adequate funding for schools. And decrepit infrastructure and lackluster public transit can make it difficult for residents to get out of their communities to places with better educational or work opportunities. Temin argues that these impediments exist by design.

17) Even more evidence that vouchers are far from the solution to improving public schools:

For more than a decade, House Republicans led by the former Speaker John A. Boehner have used school children in the nation’s capital as an experiment for school choice, funding a far-reaching voucher program to send poor children to private schools over the opposition of local teachers and unions.

Now, with Betsy DeVos, one of the country’s fiercest advocates of school choice, installed as education secretary, that experiment is poised to go national. But Ms. DeVos’s own department this week rendered judgment on the Washington school choice program: It has not improved student achievement, and it may have worsened it.

18) Good piece from German Lopez arguing that although our current drug policy is a disaster, full-on legalization of all drugs is probably not a good idea.  Why?  That’s kind of what we did with prescription opioids and the results sure aren’t pretty.

19) Awesome news from a US District judge in Texas.  More of this, please:

U.S. District Judge Lee H. Rosenthal issued her decision in a sweeping 193-page ruling, finding that the plaintiffs had a high chance of proving at trial that the county’s bail system is unconstitutional. The plaintiffs—Civil Rights Corps, Texas Fair Defense Project and Houston law firm Susman Godfrey, representing all indigent misdemeanor defendants—had charged that Harris County’s bail system punishes the poor and favors the wealthy because bail hearing officers fail to consider people’s ability to pay bail, as the Constitution requires. Instead, plaintiffs claimed, they set bail based on an arbitrary bail schedule and often ignored recommendations to release non-violent people on personal bonds.

20) I might have mentioned this before, but worth doing again.  Had a conversation with a friend the other day who said I basically changed her life in a very positive way by explaining the concept of ego depletion to her.  Alas, I was forced to inform her that the science of that had largely been over-turned since our earlier conversation.

Quick hits (part I)

1) Nice profile of Reverend William Barber in Esquire.  Love this part:

His policy positions fall far to the left on today’s political scale. But he sees most of them as coming from conservative traditions rooted in the Bible—traditions that don’t line up with conservative politics today.

People who focus their moral energy on gay marriage and prayer in schools, he says, are missing what Jesus cared about the most: justice and mercy. It’s a stock line in his sermons: “They are saying so much about what God says so little, and so little about what God says so much.”

2) Ryan Lizza on Trump giving up on the border wall.  Love this take:

One reliable way to know that Donald Trump has reversed himself on an issue is if he denies having done any such thing. The pattern repeats itself: his Administration is dealt a major setback—the courts blocking his travel bans, the G.O.P. health-care bill dying in the House—and Trump responds by decreeing that “great progress” is being made and the media is neglecting to cover it. It’s easy to become inured to how bizarre this is: America has a President who denies observable reality and uses his social-media accounts to feed his supporters an alternate version of the truth. All politicians spin. Trump lies, regularly and brazenly.

It should have come as little surprise, therefore, when Trump tweeted the following on Tuesday morning: “Don’t let the fake media tell you that I have changed my position on the WALL. It will get built and help stop drugs, human trafficking etc.” Of course, he did change his position. The tweet came just a day after the White House had retreated from its stance that funding for the wall had to be included in the spending bill that Congress must pass by Friday to keep the government open.

3) The New Orleans monument that conservatives are all upset that just came down was literally  a monument to white supremacy.  And the Minnesota native running as a Trumpist for Governor in Virginia who is all about protecting confederate memorials.

4) Frum says that Trump is showing that really turning up the heat on immigration enforcement is actually effective policy for cutting illegal immigration.

5) Pew on the changing fortunes of the middle class.

5) Drum on Comey:

Once again, the primary concern was protecting Comey and the FBI. Republicans had made it clear that their retribution against anyone who helped Clinton would be relentless, and that clearly had an impact on Comey. Steinbach’s suggestion that Republican vengeance would have destroyed the FBI is clearly nuts, but Comey was taking no chances. He didn’t want the grief.

Even after it was all over, Comey’s partisan influences continued to work on him:

Officials and others close to him also acknowledge that Mr. Comey has been changed by the tumultuous year.

Early on Saturday, March 4, the president accused Mr. Obama on Twitter of illegally wiretapping Trump Tower in Manhattan. Mr. Comey believed the government should forcefully denounce that claim. But this time he took a different approach. He asked the Justice Department to correct the record. When officials there refused, Mr. Comey followed orders and said nothing publicly.

Daniel Richman, a longtime friend of Comey’s, said this represented “a consistent pattern of someone trying to act with independence and integrity, but within established channels.”

The evidence does indeed show consistent behavior, but of a different kind. At every step of the way, Comey demonstrated either his fear of crossing Republicans or his concern over protecting his own reputation from Republican attack. It was the perfect intersection of a Republican Party that had developed a reputation for conducting relentlessly vicious smear campaigns and a Republican FBI director who didn’t have the fortitude to stand up to it. Comey may genuinely believe that his decisions along the way were nonpartisan, but the evidence pretty strongly suggests otherwise.

6) And Tomasky on Comey:

And through it all, he was worried about what Republicans would do to him, but apparently never concerned about how Democrats would react to anything he did. In fact the only lengthy discussion of a Democrat in the piece involves Comey’s anger at Loretta Lynch for agreeing to meet with Bill Clinton on that tarmac; he had every right to be upset about that boneheaded move, but as the article shows—and as we already knew in real time—he didn’t care at all how Lynch and other Justice Department lawyers would react to his taking it upon himself to say the things he said about Clinton.

There are two morals to this story. The first is, well, good on the Democrats, I guess, for not playing politics (Lynch excepted) with such a sensitive matter. This is how things are supposed to work in this country.

But the second moral is that, regrettable as it may be, this isn’t how things work in this country anymore. Republicans were so ferociously partisan about everything having to do with Hillary Clinton—and Bill Clinton, and Barack Obama, and fill in the blank—that they created a reality in which the nation’s top law enforcement official was thinking more or less constantly about how he could avoid incurring their wrath. Of course, he’s a Republican himself, and was involved in Clinton probes in the 1990s, so there’s also that. But how that factored in we can’t know.

7) Somehow I had never heard of the mass pet euthanization in Britain at the start of WWII.

8) We actually still need proof that reducing blue light in the evening helps with sleep (since it’s free, I’ll stick with Flux until evidence says otherwise):

Does blue light actually make you more alert? It sure does. But does removing it from your smartphone’s screen help you fall asleep? That, my friends, hasn’t actually been solidly proven—at least not yet…

The bottom line? “There’s actually no studies that have systematically seen if blue-depleted light at very dim intensities is effective in preventing or reducing the biological disruption caused by light exposure at night,” says Rahman. So that blue dimmer on your phone isn’t yet backed by solid science.

9) You’ll be shocked (shocked!) to learn that much of the legal representation of the folks Arkansas is trying to execute this week was piss-poor.  I’ve got to agree with this conclusion from a Harvard law researcher on the matter:

SHAPIRO: If we assume that the death penalty is not going away but that the process can be fixed, what will it take to fix it?

BRAND: Well, the first thing I would say is, I don’t think it can fix it. For 40 years in the modern era of the death penalty, the court has been trying to issue procedural fixes. It’s been trying to say intellectually disabled people can’t be executed. It’s tried to say juveniles can’t be executed. It said, you really need a lawyer. And as much as the Supreme Court has tried to fix it, it has completely failed. So I think rather than trying to fix it, it is time for the Supreme Court to recognize its sort of complicity in this system where people don’t get counsel is calling into doubt the whole integrity of our judicial system.

10) I’ve yet to come across a really good piece on the ideology of France’s Emmanual Macron.  Thus far, this Roger Cohen is the best I can do.  From what I have read, sounds like most center-left liberals in the U.S. (i.e., people like me) should be pretty happy with him and his ideas for France.

11) WRAL with a nice editorial on the NC legislatures Tax Cuts uber alles policy running our state into the ground.

12) Meanwhile, NC Republicans also want to basically create corporate schools funded by taxpayers.  I just cannot believe the people running my state.

13) Yes, the human brain is a time machine:

And there’s something distinctly human about this? Animals have the ability to look into the future and plan, but not to the extent that humans do.
Yeah, so whether it’s the brain of mammals or other humans, the brain is always attempting to predict the future. If you’re a herbivore or you’re looking for a mate, your brain is telling you to go one way or the other because it’s making its best estimates as to what will optimize its chances of achieving that goal.

But what seems to be distinctly human is certainly the extent that we can engage in what we call mental time travel — this idea that we can consciously project ourselves back into the past and relive experiences. And it’s the ability to see the long-term future that I think is distinctly human. It’s impossible to overestimate how important that is, how much of your life is future-oriented, from going to school — from getting a job to saving for retirement to exercising and going to the doctor. These are all things that would be very difficult for other animals to engage in because they’re for the short- and long-term future. And one of the most transformative inventions humans have ever engaged in was agriculture. The notion of planting a seed and coming back a year later is something we take for granted now, but it’s hard to think of anything more important than that ability.

14) Turns out all those mindless eating studies have not replicated so well.  That said, I literally have no doubt that keeping tempting food out of my sight and easy access makes it way easier for me to resist (unlike the lollipops that were left out in our kitchen tonight).

15) Love this idea of a metacookbook.

16) Salt is the bomb.  Only use it if you want your food to taste good.

17) Will a college tour lead prospective students to choose the wrong college?  Quite likely, says social science:

But insights from research in psychology and behavioral economics suggest a counterintuitive reason to skip them: College tours may hinder students’ ability to pick a college that will further their interests and goals.

This has to do with the difference between our present selves (the self making the decision — in this case, where to attend college) and our future selves (the self experiencing the outcome of this decision). As Daniel Gilbert of Harvard University and Timothy Wilson of the University of Virginia have argued, our present selves believe we are good at making decisions for our future selves, but in fact we all do a relatively poor job of predicting what our future selves will actually value and enjoy…

So why isn’t there an epidemic of students who find themselves in the wrong place and either transfer or drop out? Maybe there is. The only way to know would be to compare transfer and dropout rates between incoming students who used imagination to inform their decision, and those who relied on experience surrogates instead. Such data is lacking.

That said, most students would probably say they feel good about their college choice (even if they could have done objectively better) because of our “psychological immune system,” which buffers us from the unpleasant effects of negative events, and helps us to find the good in whatever situation we find ourselves in.

18) Interesting discussion of the debate over homework in elementary school.  My take: a small amount of thoughtful homework> none > any amount of non-thoughtful homework > too much homework of any kind.  I will definitely err towards none over the last two options.

19) Can plastic-eating caterpillars save the earth?  Maybe.

20) Drum on Paul Ryan and health care:

It’s increasingly obvious that Republicans aren’t actually trying to pass a health care bill. They just want to be able to tell their base that they tried. And President Trump wants to erase the taste of defeat from the first health care bill.

If House Republicans were serious, they’d engage with the health care industry. They haven’t. If they were serious they’d care about the CBO score. They don’t. If they were serious they’d be crafting a bill that could pass Senate reconciliation rules. They aren’t even trying. If Senate Republicans were serious they’d be weighing in with a bill of their own. They aren’t wasting their time.

In the beginning, I think Paul Ryan really did want to pass something, mainly so that it would make his tax cut plan easier to pass. But he’s given up on that. At this point he just wants a piece of paper that gets 218 votes and demonstrates that the Republican caucus isn’t hopelessly inept. He knows it will be DOA in the Senate, but at least it will get health care off his plate once and for all. Then he can move on to cutting taxes on the rich, which is what he really cares about. And he’ll have no trouble rounding up votes for that.

21) Several of my students told me about “Adam Ruins Everything.”  If this excellent video on marijuana is representative, I’ll definitely have to check out more.  Watch it!



About that wall

Gallup with a piece on the unpopularity of the border wall:

We most recently included the concept of building a wall in a list of 15 different actions that Trump could take or has already taken. The precise wording was “begin the construction of a wall between the U.S. and Mexico.” The idea received 36% agreement and 56% disagreement, putting it dead last on the list based on net agreement.

In January, we asked about the importance of Trump keeping a list of campaign promises and included this wording: “Build a wall along the border with Mexico.” The results: 26% of Americans said that it was very important, putting it second to last on an even longer list, ahead of only requiring that for each new federal regulation, two be eliminated.

We asked about the wall last year with a different phrasing: “Use money from Mexican visas to pay for border wall with Mexico.” The results showed that 31% agreed and 51% disagreed.

Polling by Quinnipiac just a couple of weeks ago showed 33% support for “building a wall on the border with Mexico.” A CBS News poll in January found 37% support for “… building a wall along the U.S.-Mexico border to try to stop illegal immigration.” And Pew Research Center in February found 35% support for “building a wall along the entire border with Mexico.”

The finding that between 30% and 40% of the American population favors building a wall appears to be reliable and robust across question wordings.

This lack of interest in building a wall doesn’t appear to be directly related to money. Most Americans, for example, support spending $1 trillion on infrastructure. The issue may be that citizens directly benefit from better roads, highways, tunnels and bridges. Any benefit from the wall is more indirect.

Also, it’s not the concept behind the wall that is in disfavor. Most Americans agree that keeping people from entering the country illegally is a good thing. As a rule, if it is illegal, Americans want it stopped.

Previous Gallup research has shown that 77% of Americans say that “controlling U.S. borders to halt the flow of illegal immigrants into the U.S.” is extremely or very important. And 83% favor “tightening security at U.S. borders.”

Interesting that Americans really want “tight borders” but don’t see much utility in the wall.


Plenty of stuff to say on Trump’s horrible, no good, very bad tax plan.  In many ways, what’s most exasperating is the voodoo economic pitch, ignoring the fact that we now have incontrovertible empirical data that tax cuts (within the range of American tax policy) absolutely, postively don’t pay for themselves.  Even serious Republican economists will tell you as much.  Nice Times article:

But what the president has called a tax reform plan is looking more like a tax cut plan, showering taxpayers with rate reductions without offsetting the full cost by closing loopholes or raising taxes elsewhere. In the short run, such a plan would add many billions of dollars to the national deficit. Mr. Trump contends that it will be worth it in the long run.

“The tax plan will pay for itself with economic growth,” Steven Mnuchin, the Treasury secretary and main architect of the plan, told reporters this week…

“Under dynamic scoring, this will pay for itself,” Mr. Mnuchin said at a public forum last weekend. “Under static scoring, there will be short-term issues.”

Critics scoffed at the math. “There is not a shred of evidence to support the secretary’s pay-for-itself claim,” said Jared Bernstein, a top White House economics adviser under Mr. Obama. “Sure, significantly faster growth would spin off more revenues. But there’s simply no empirical linkage between tax cuts and growth that’s both a lot faster and sustained.”

Douglas Holtz-Eakin, a former Congressional Budget Office director who advised Senator John McCain’s Republican presidential campaign in 2008, was equally skeptical. “I can imagine cutting the rate to 15 percent,” he said. “I can imagine growing a percentage point faster. I can imagine raising $2 trillion in revenue. I can’t imagine them being one and the same policy.”

N. Gregory Mankiw, a Harvard University economist who was chairman of the President’s Council of Economic Advisers under the younger Mr. Bush, said tax cut supporters exaggerate the possible growth benefits while opponents overemphasize the budgetary cost. “A reasonable rule of thumb, in my judgment, is that about one-third of the cost of tax cuts is recouped via faster economic growth,” he said.

Got that.  Even  Mankiw– not exactly a Krugman-esque liberal– gives it a 1/3 offset.  And more centrist economists would dispute that.  Thus, to be clear, the idea of tax cuts paying for themselves is unicorns and rainbows preposterous.  Holz-Eakin even takes to the pages of the Post to refer to the plan as a fairy tale.

Meanwhile, Drum with a nice chart that puts the Trump team economic assumptions into a proper perspective:

That’s the 3.8% productivity growth that Trump’s numbers are counting on.  Suuuuure.

Of course, there’s the debt angle:

“We’ve only done the rough numbers, but this looks like a tax cut of a magnitude of about $5 trillion,” said Maya MacGuineas, president of the Committee for a Responsible Federal Budget, a bipartisan advocacy organization for fiscal responsibility. “That is simply unimaginable given our fiscal situation and the size of the deficit, which is already the worst since World War II.” …

Tax cuts, as opposed to tax reform, are easy, Ms. MacGuineas agreed: “Who doesn’t love a tax cut, especially if no one has to pay for it? This is a free-lunch mentality.”

That Mr. Trump would embrace such a cut-now, pay-later approach probably shouldn’t be too much of a surprise, considering the Trump Organization’s reliance on borrowed money. “I’m the king of debt,” Mr. Trump said last year on CNN. “I love debt.”

Just how much Mr. Trump’s plan would cost the government is hard to determine, given the sketchy details. But the conservative-leaning Tax Foundation estimates that two prospective elements — reducing individual rates to three brackets of 35, 25 and 10 percent, and cutting the tax rate for corporations and pass-through entities (businesses that pay taxes at individual rates) to 15 percent — would cost the Treasury $4 trillion to $6 trillion over 10 years, said Alan Cole, an economist at the foundation.

The Urban-Brookings Tax Center estimated the cost of the cuts Mr. Trump proposed during the campaign at $6.2 trillion, assuming no additional growth, and just under $6 trillion when growth is factored in.

And, of course, we know what this is really about.  Tax cuts for rich people.  NYT with a nicely honest headline, “Trump Tax Plan Would Shift Trillions From U.S. Coffers to the Richest.”

President Trump’s proposal to slash individual and business taxes and erase a surtax that funds the Affordable Care Act would amount to a multitrillion-dollar shift from federal coffers to America’s richest families and their heirs, setting up a politically fraught battle over how best to use the government’s already strained resources.

The outline that Mr. Trump offered on Wednesday — less a tax overhaul plan than a list of costly cuts with no price tags attached, rushed out by a president staring down his 100-day mark in office — calls for tax reductions for individuals of every income level as well as businesses large and small.

But the vast majority of benefits would accrue to the highest earners and largest holders of wealth, according to economists and analysts, accounting for a lopsided portion of the proposal’s costs.

“The only Americans who are very clear winners under the new system are the wealthiest,” [emphasis mine] said Edward D. Kleinbard, a law professor at the University of Southern California and former chief of staff of Congress’s Joint Committee on Taxation, which estimates the revenue effects of tax proposals.

And, lastly, count on CBPP to put this monstrous giveaway to the wealthy in chart form:

Trump Campaign Tax Plan Gives Big Tax Cut to the Top

Of course, who knows what we’ll exactly see.  What we do know is Republican priorities: budgets be damned– cut rich people’s taxes a lot!

The secret to Singapore’s “free market” health care

Conservatives love to talk up Singapore as a great example of how a country can have universal, low-cost, market-based health care.  Erza provides a great explanation of Singapore’s system and explains the ultimate way costs are held down– government intervention, just like every other advanced country with universal, affordable health care.  Now, Singapore does some really interesting things that do allow more of a role for a free market and consumer choice– in very basic health care, not for your heart attack– but the whole damn system is predicated on massive government intervention and regulation to keep prices down.  Ezra:

But Singapore isn’t a free market utopia. Quite the opposite, really. It’s a largely state-run health care system where the government designed the insurance products with a healthy appreciation for free market principles — the kind of policy Milton Friedman might have crafted if he’d been a socialist.

Unlike in America, where the government’s main role is in managing insurance programs, Singapore’s government controls and pays for much of the medical system itself — hospitals are overwhelmingly public, a large portion of doctors work directly for the state, patients can only use their Medisave accounts to purchase preapproved drugs, and the government subsidizes many medical bills directly… [emphases mine]

It’s easy, looking at Singapore’s insurance scheme, to see what conservatives find so attractive in the system. While there’s significant coercion, there’s also a real focus on pushing patients to act like consumers, and reserving insurance for unexpected, unusual costs. In addition, Singapore’s safety net — Medifund — is limited in its commitments and administered at the local level.

But all that happens within the context of a government-controlled — and often government-run — medical system

Singapore’s system is probably better designed in terms of how consumers spend their own money. But the lower overall prices make them much less exposed to health costs than both patients and employers inside the American system — which suggests to me that Americans have at least as much incentive as Singaporeans to try to use their power as consumers to cut costs.

The fact that that hasn’t worked is, I think, a reason to believe we’ve gotten the lesson of Singapore’s health system backward. Singapore heavily regulates both the pricing and provision of medical care to keep costs low (as do all other developed countries) and then, working off that baseline of low costs, has Singaporeans pay out of pocket in order to keep them mindful of how much they’re spending.

In America, conservatives want to apply that strategy in reverse: working off a baseline of extremely high prices, they want to force people to pay out of pocket as a strategy to bring those prices down. That hasn’t worked so far, and my guess is efforts to double down on it — of which the Republican Obamacare alternative is one — will continue to fail.

Yes, there really are some “conservative” lessons to be learned from Singapore.  It would be great to try and apply some of these after we used government to aggressively control prices in the non-free market that is health care.  The biggest lesson is that, no matter the details of the particular design, the ultimate key to holding down health care costs is effective government regulation.

Oh, no, poor people in Cary!

My hometown of Cary, NC (Containment Area for Relocated Yankees) comes in for a lot of criticism for being a bunch of snobby, elite, white people.  Not true!  Okay, not true, at least in my part of Cary, as I’ve written about when discussing my kids’ schools.  But, alas, it looks like some Cary-ites in the wealthier western part of town cannot even stomach lower income folks living near them.  From an Op-Ed in today’s N&O, this is just pathetic:

This week’s decision by the Cary Planning and Zoning Board to recommend that the Town Council deny a rezoning request by Habitat for Humanity of Wake County is disappointing. Through its connections with a local church, Habitat Wake acquired 2 ½ acres of land and planned to build 23 townhomes but needed the land rezoned. Some neighbors complained and Habitat held several community meetings to hear their concerns.

After the meetings, Habitat Wake amended its plans and proposed nine detached single family homes. The neighbors continued to complain about flooding and property values and this week the Planning and Zoning Board made a recommendation to deny Habitat’s request. While the board’s recommendation is not binding, it is a strong recommendation nonetheless. It would be a short-sighted move by the Town Council to deny the request, particularly since their recently approved Cary 2040 Community Plan calls for more affordable housing…

Next, let’s look at the policy. Local zoning laws can either be barriers or aids to development. Zoning laws that restrict where and how housing can be built are especially controversial. As advocates, we often hear local support for affordable housing, as long as it is “not in my backyard”. NIMBYism is difficult for even a respected and conscientious developer like Habitat to overcome. Local governments must take leadership and really examine where their zoning decisions are restricting housing based out of fear rather than health and safety concerns.

Habitat Wake went through a great deal of effort to be responsive to neighbors. It was transparent about the quality of its building methods and how homeowners are chosen. It is the responsibility of the Town Council to honestly weigh factors like bias when considering the zoning request. Kevin Campbell, President/CEO of Habitat Wake commented, “Throughout this process, we have held the legitimate development concerns of the surrounding neighborhood in high regard. We reduced density from our original proposal by 65 percent. We eliminated attached housing units from the proposal based on concerns about compatibility. Twice we adopted plans that were suggested by neighbors only to have that support dropped leading us to the conclusion that there is perhaps an underlying concern about welcoming the future residents to the neighborhood.” [emphasis mine]

As I wrote in my email to Cary’s mayor, let’s not have our town actually live up to the ugly stereotype about us.  Also, of note.  Literally the next street over from mine is Habitat homes.  Good by me, obviously.  It’s just a nice, little, neighborhood with somewhat smaller homes than the rest of the area.  Literally zero problems in 15 years.  But, who knows, maybe it’s been keeping my own property value down because bigots are freaked out by having lower-income people nearby.  Then again, bigots would not be happy in my neighborhood.  Anyway, this is only one side of the story, but it’s a pretty damning side.

The science of self-perpetuating poverty

This essay from Christian Cooper in Nautilus is so, so good.  I’m disappointed I’ve only seen it shared by one person.  Really strikes me as a must-read.  Cooper summarizes a lot of the evidence from epigenetics of how poverty literally changes human biology in negative ways, which, of course, make it that much harder to escape from poverty.  In other words, poverty is like a disease.  And, of course, hits upon so many of the myths of the American dream.  Really good stuff.  A bit:

Now, new evidence is emerging suggesting the changes can go even deeper—to how our bodies assemble themselves, shifting the types of cells that they are made from, and maybe even how our genetic code is expressed, playing with it like a Rubik’s cube thrown into a running washing machine. If this science holds up, it means that poverty is more than just a socioeconomic condition. It is a collection of related symptoms that are preventable, treatable—and even inheritable. In other words, the effects of poverty begin to look very much like the symptoms of a disease…

This science challenges us to re-evaluate a cornerstone of American mythology, and of our social policies for the poor: the bootstrap. The story of the self-made, inspirational individual transcending his or her circumstances by sweat and hard work. A pillar of the framework of meritocracy, where rewards are supposedly justly distributed to those who deserve them most.

What kind of a bootstrap or merit-based game can we be left with if poverty cripples the contestants? Especially if it has intergenerational effects? The uglier converse of the bootstrap hypothesis—that those who fail to transcend their circumstances deserve them—makes even less sense in the face of the grim biology of poverty. When the firing gun goes off, the poor are well behind the start line. Despite my success, I certainly was. [emphases mine]

Why do so few make it out of poverty? I can tell you from experience it is not because some have more merit than others. It is because being poor is a high-risk gamble. The asymmetry of outcomes for the poor is so enormous because it is so expensive to be poor. Imagine losing a job because your phone was cut off, or blowing off an exam because you spent the day in the ER dealing with something that preventative care would have avoided completely. Something as simple as that can spark a spiral of adversity almost impossible to recover from. The reality is that when you’re poor, if you make one mistake, you’re done. Everything becomes a sudden-death gamble.

Now imagine that, on top of that, your brain is wired to multiply the subjective experience of stress by 10. The result is a profound focus on short-term thinking. To those outsiders who, by fortune of birth, have never known the calculus of poverty, the poor seem to make sub-optimal decisions time and time again. But the choices made by the poor are supremely rational choices under the circumstances. Pondering optimal, long-term decisions is a liability when you have 48 hours of food left. Stress takes on a whole new meaning—and try as you might, it’s hard to shake.

The standard American myth of meritocracy misinterprets personal narratives like mine. The accumulated social capital of American institutions—stable transfer of power, rule of law, and entrepreneurship—certainly create economic miracles every day. But these institutions are far more suited to exponentially growing capital where it already exists, rather than creating new capital where society needs it.

Cooper concludes by briefly discussing at least some of the policy implications:

We should leverage the lessons of the science of poverty rather than ignore them. Poverty alleviation programs like conditional cash transfers, for example, reward parents or caregivers with direct payment for taking actions, like ensuring school attendance or arranging for preventative care. They encourage stress alleviation and long-term planning that is far upstream of doing well on an exam—they provide exactly the kind of certainty that the poverty-stricken brain needs. In a paper released in June of 2009, Lia Fernald and Megan Gunnar showed that such programs lowered salivary cortisol levels and reduced lifetime risk for a range of mental and physical disorders.12 There should be more programs like these: For example so-called whole-child policies, which focus on the long-term development of children starting from birth while reducing uncertainty during the first three years of childhood development.

Now, now all of what Cooper relies upon is definitive science at this point, but it is highly suggestive.  And any open-minded, empirically-minded person should be well aware of the psychological and sociological (if not biological) ways in which poverty is clearly self-perpetuating through generations.  It is high past time to take these insights seriously and think more deeply and comprehensively about what public policies can best reduce and mitigate poverty.

One thing I can absolutely tell you– demanding that the poor simply pull themselves up by their bootstraps and pulling away needed social welfare programs as “a hammock” are sure as hell not part of the solution.

Infographic of the day

Where the energy jobs are, via NYT story:

Amazing the power that coal holds in symbolic impact.  Especially on Trump.


What it takes for kids to get ahead

Yesterday’s post reminded me of this terrific Thomas Edsall column from about a month ago that I had meant to share.  It’s about the role of non-cognitive skills in how children get ahead.  One of my favorite topics ever since reading How Children Succeed.  (Seriously, read it).  Edsall:

In a 2014 paper, “The Character Factor: Measures and Impact of Drive and Prudence,” Reeves and two co-authors, Kimberly Howard and Joanna Venator, focus on what they call “performance character strengths” and the crucial role played by noncognitive skills in educational attainment, employment and earned income. These character strengths — “perseverance, industriousness, grit, resilience, curiosity, application” and “self-control, future orientation, self-discipline, impulse control, delay of gratification” — make significant contributions to success in adulthood and upward mobility…

Paul Tough, a writer heavily influenced by Heckman’s work, noted last year in an essay in the Atlantic, “How Kids Learn Resilience,” that research reveals that “students will be more likely to display these positive academic habits when they are in an environment where they feel a sense of belonging, independence, and growth” and where they “experience relatedness, autonomy, and competence.”

This kind of environment is difficult to replicate in neighborhoods of concentrated poverty. Instead, Tough writes, many of the kids brought up in these desolate areas have developed “a hyperactive fight-or-flight mechanism,” which conveys the warning

at car-alarm volume: I don’t belong here. This is enemy territory. Everyone in this school is out to get me. Add to this the fact that many children raised in adversity, by the time they get to middle or high school, are significantly behind their peers academically and disproportionately likely to have a history of confrontations with school administrators.

The result is a vicious circle: family disruption perpetuates disadvantage by creating barriers to the development of cognitive and noncognitive skills, which in turn sharply reduces access to college. The lack of higher education decreases life chances, including the likelihood of achieving adequate material resources and a stable family structure for the next generation…

What is to be made of all these findings?

First, the spectrum of noncognitive skills and character strengths are a major factor in American class stratification. Whether these factors are more or less important than extrinsic forces like globalization, automation and declining unionization remains unclear, but changing family structures are evidently leaving millions of men and women ill-equipped to ascend the socioeconomic ladder.

Second, neither religious leaders nor practicing politicians nor government employees have found the levers that actually make disadvantaged families more durable or functional. As a corollary, the failure of government efforts to affect or slow down negative developments has left an opening for conservatives to argue that government interventions make things worse.

For liberals and the Democratic Party, the continued failure of government initiatives to achieve measurable gains in the acquisition of valuable noncognitive skills by disadvantaged youngsters constitutes a major liability.

So, here’s the damn agenda.. figure out what policies and programs (and there’s increasing evidence and research on the matter) best promote non-cognitive skills (and if they are not government programs, figure out how to encourage them through public policy) and advocate like hell for these policies.



Perverse incentives to the left; greed to the right. Stuck in the middle with American health care

love Elisabeth Rosenthal’s  2013 NYT series on the high cost of American health care and have been assigning portions of it to my classes for years (including this semester).

So, when I learned she had written a new book about the American health care system, I was all over it and ordered it the day it was published and finished it in less than a week (that’s definitely fast for me– too much time with the internet, not enough with books).

The book is terrific.  I literally cannot recommend it highly enough.  Even if you think you are not interested in health care policy, chances are you’ve had plenty of interactions with our medical establishment and would be fascinated to learn just how perverse so many of the incentives are.   I’ve been a health care policy junkie for at least a decade and I still learned a lot that was new to me.  To some degree, what I learned was just how absurdly depraved and money-hungry the whole system has become.  In many ways, we are looking at a medical system of capitalism amok.  So many people are looking to monetize every last dollar off of human sickness and suffering.  There’s lots and lots of good people who just want to help, but they have been caught up into a perverse and greedy system where, often just practicing medicine, means partaking in a series of sleazy and ethically dubious practices and organizations that are looking to squeeze every last dollar out of patients and the government (i.e., all of us).  And it’s working.  And, as I’ve written time after time, this is largely a matter of policy choice.  Political Scientist Jacob Hacker sums it up quite nicely in his NYT review of the book:

The difference between the United States and other countries isn’t the role of insurance; it’s the role of government. More specifically, it’s the way in which those who benefit from America’s dysfunctional market have mobilized to use government to protect their earnings and profits. In every country where people have access to sophisticated medical care, they must rely heavily on the clinical expertise of providers and the financial protections of insurance, which, in turn, creates the opportunity for runaway costs. But in every other rich country, the government not only provides coverage to all citizens; it also provides strong counterpressure to those who seek to use their inherent market power to raise prices or deliver lucrative but unnecessary services — typically in the form of hard limits on how much health care providers can charge. [emphasis mine]

In the United States, such counterpressure has been headed off again and again. The industry and its elected allies have happily supported giveaways to the medical sector. But anything more, they insist, will kill the market. Although this claim is in conflict with the evidence, it is consistent with the goal of maximum rewards to (and donations from) the industry.

There’s literally dozens of examples from the book that left me open-mouthed that people were able to get away with such greed and perversity, supposedly in the service of human health.  One that really stuck out though, is that of Duexis.  It’s literally a pill that’s just ibuprofen and famotidine.  You can dose yourself with those two for literally pennies a day.  Yet somehow– only in America, of course– they manage to charge $1500 a month for it and get doctors to prescribe it and insurance companies to pay for it.  Ugh.  If I ever had a doctor prescribe something like this to me, I would find a new doctor the next day.

Now, imagine a book full of other such shocking and disturbing examples.  Not exactly fun to read, but totally engaging, and disturbing.  And, also designed to be useful for helping readers navigate this giant mess with their own health care needs.  Or, at least listen to the terrific Fresh Air interview.

Photo of the day

In case you haven’t seen this awesome viral image of earth viewed through Saturn’s rings:


NASA’s Cassini spacecraft captured this view of planet Earth as a point of light between the icy rings of Saturn NASA/JPL-Caltech/Space Science Institute

Environmental polarization

From Pew fact tank.  This is just sad:

Basically, what were modest differences between Democrats and Republicans on the environment have grown into substantial ones.  And most of this has been driven by the Republican Party increasingly subscribing to the view “screw the environment” as the party line.  Ugh.

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