Month: December 2009

Equality In DC, Ctd

by Patrick Appel

Dale Carpenter gives his take:

If I’m right about the near-term prospects, marriage should be secure in the city. The lesson from Massachusetts and Vermont, and from California and Maine, is that the longer the day of electoral reckoning can be delayed the more likely it is that anti-SSM passions will subside. So, if gay marriage in D.C. survives 2010, it is probably here to stay.

D.C. will also be another test of the theory that, at least without expansive exemptions for religious objectors, there will significant erosion of religious liberty. The city’s Catholic leaders have already warned (some would say threatened) a loss of social services if the bill is passed because religious traditionalists who get city money won’t agree to treat gay couples equally.  These losses have not materialized in other jurisdictions recognizing gay marriage or civil unions, though Catholic Charities has stopped providing adoption services in Massachusetts.

What Should the Press Cover?

by Conor Friedersdorf

Here's one suggestion:

I read with great interest your plea for stories that the media generally misses out on, and my thoughts immediately turned to something I read about a long time ago, but which hasn’t been covered since, or in particularly great depth. I refer to the U.S. takeover of the agricultural industry in Iraq. The article was written at the height of the war and was concerned with how the Big Agri-business interests in the U.S. basically forced upon Iraqi farmers new strains of wheat and other produce, which necessitates the annual purchase of new seeds (from U.S. companies) since these new strains don’t produce seed themselves. This, in contrast to historical farming practices of saving and propagating the best growing/producing/ most resilient seed stock, constantly improving yields and enabling ongoing adaptation to changing climate conditions. I would love to see some more detailed coverage of this practice, whether it is widespread in other war-ravaged countries (such as Afghanistan), the real effect on farmers, what new profit streams are emerging through this practice of war profiteering and how this might affect agricultural practices in these countries in the future (i.e. will Iraqi farmers forevermore be beholden to U.S. corporations?), and whether this might be happening in other industries as well (for example, do U.S. or western corps have interests in water supply, the pharmaceutical industry etc, and how has this changed since the start of the war? Usually it is only the oil industry that is scrutinized in any detail, it would be interesting to know more about corporate stakes in these other areas. I have no suggestions as to who might cover this story, but I’m sure it’s worth some scrutiny.

And another:

Story: The Strategic Blunder that is U.S. Policy regarding the Eritrea-Ethiopia Border

Written by: Terrence Lyons

For a variety of reasons, the U.S., UN, and others dropped the ball big time in the way it handled the implementation of Algiers Agreement (the peace agreement reached between Eritrea and Ethiopia following their 1998-2000 border war).  The mishandling of the peace process and the intransigence of both belligerents has led to a stalemate that has serious implications for U.S. interests in the Horn of Africa.  Make no mistake, this is THE story of the region.

In 2006 Lyons wrote a brief for the Council on Foreign Relations about the situation, outlining reasonable steps that all parties could take to resolve the issue.  Those recommendations went largely unheeded, and the situation today is no better, with Eritrea and Ethiopia essentially continuing their conflict by proxy in Somalia.

A third:

Here's one story that I think has been missed by both MSM and blogosphere – the impact of the market crash on the newly retired and those about to retire.

A couple of anecdotes, fully understanding that the plural of anecdote is not data:

A 3rd grade teacher at the school where I teach retired (after more than 40 years of teaching 3rd grade!!) at the end of the 07-08 school year.  This fall she is back on campus subbing every chance she gets.  When we talked about it, she told me that the market crash had wiped out enough of her and her husband's investments that she had to go back to work if they were to have any more than the most bare-bones of lifestyles.

Secondly, several conversations with older peers (those aged around 60) have included statements of the class of : "I was planning to retire in year x.  However now it will be x+y."

I think that there are two aspects to this story.  One is macroeconomic. If people aren't choosing to retire, then it becomes that much harder for jobs to open up, and therefore for the unemployment rate to go down.

The second aspect is almost moral. These are people who "played by the rules" – who believed the part of the social contract which  stated, in effect "if you put aside x% of your income for y years then you will be able to have a comfortable retirement" and are now finding out that this is very far from the truth.

Why isn't this being covered?  If you'll allow me to get a bit meta, the blogosphere skews young (both in readers and, more importantly, writers.) But I'd love to see someone with a good grasp of both econ and demographics take a stab at this.

And a fourth:

The main stream media totally ignored President Obama’s recent announcement before Chinese students in Shanghai that “the United States will dramatically expand the number of our students who study in China to 100,000.” Written info at the time explained only that the expansion would be over four years. Kurt Campbell, Assistant Secretary of State for East Asia and Pacific Affairs, said in a more recent webcast that the program would include all education levels: high school for three or four month, undergraduate for an academic year, and graduate level. I’ve seen no further details.

There is no bigger long-term strategic issue than US-China relations. Progress on all global issues from climate change to pandemics to economics to many security issues and more depend up cooperation with China. The US is way under investing in developing the skills and knowledge that our next generations will need to work with China successfully. Many more students need to learn Mandarin and to spend time in China. Both our economic and national security futures depend upon it. Currently less than 1% of US K-12 students study any Mandarin. Only 16 US high school students, as reported by CSIET, studied for a semester or year in China in 2008/09. In 2007/08, 13,165 US college students studied in China. China has almost 100,000 university students studying in the US each year. Tom Ricks reported on his blog that in 2000 the Chinese military had more students in U.S. graduate schools than the U.S. military did. A related, overlooked shortcoming of American education is that it does not pay to send high school students to study abroad. This is a strategic shame because many high school year abroad programs (including tuition, room and board with a family, and international transportation) cost less than the per pupil spending in many states or local school districts…

The US could easily have 100,000 high school students alone studying in China each year. With something over 3 million nationwide per US high school class, having 100,000 high school students studying in China would only be about 3 percent of a US graduating class. Strategically this is, IMHO, where the US should be in terms of numbers. If US states and local school districts paid for China study abroad like they now pay for in-district programs, and the Chinese cooperated, sending 100,000 high school student to China need not cost any additional funds. Currently we seem to lack the strategic vision to do this… Obama’s announcement was very significant. I hope it is just the start of a strategic push to have many more US students studying in China.

Inferiority Complex

by Conor Friedersdorf

This whole Julian Sanchez post on "the politics of ressentiment" is worth a read. "Conservatism is a political philosophy," he writes. "The farce currently performing under that marquee is an inferiority complex in political philosophy drag."

There are a whole lot of intelligent conservative voices who don't fit that characterization, as I'm sure Mr. Sanchez would agree. I hope readers who share in his lament will check out some of the great work being done at Cato and the Institute for Justice, or the writing of folks from Reihan Salam to Tim Carney to James Poulos to Rod Dreher to Yuval Levin to Eugene Volokh to Daniel Larison, some of the writers at National Review, especially the print version, old standbys like City Journal and The New Criterion, the always intelligent Claremont Review of Books, even the radio show of Dennis Prager and certain feature pieces at The Weekly Standard that involve neither foreign policy nor Sarah Palin — this is a woefully incomplete list, but it begins to signal that there is indeed an intelligent loyal opposition in America, one that gets some things right and other things wrong, but that would certainly improve upon our politics if its best ideas were more influential.

Unfortunately, the conservative base and the media at large are more interested in rallying behind or lavishing attention on Rush Limbaugh, Glenn Beck, and Sarah Palin, all of whom fit Mr. Sanchez's description. One piece of evidence confirming his diagnosis is the kind of insults the talk radio right and its lackeys in the blogosphere use when they're trying to discredit political or ideological opponents via insults. Mark Levin, a man intelligent enough that he needn't have an inferiority complex, for some reason adopts the rhetorical style of the classic insecure bully — juvenile name calling, constant self-aggrandizement, vituperative outbursts. It hardly matters whether he actually feels these things (you wouldn't think so when you read him in print) or just feigns it because it's what attracts an audience. Mr. Sanchez's point is made either way.

The most absurd example of an inferiority-complex driven insult? It's here:

When Obama and Vice President Biden made a surprise lunch stop at a burger joint in Virginia this week, the President reportedly asked for a burger with “spicy” or “Dijon mustard.” 

Right-wing talk show host Laura Ingraham weighed in: “What kind of man orders a cheeseburger without ketchup but Dijon mustard?”

Fox New's Sean Hannity invoked the Grey Poupon commercial. “I hope you enjoyed that fancy burger, Mr. President,” Hannity said. 

Later in his post, Mr. Sanchez writes, "The secret shame of the conservative base is that they’ve internalized the enemy’s secular cosmopolitan value set and status hierarchy." The Tea Party and Ditto-head crowd do not make up the entire base of the Republican Party, to be sure, but I think that this description is substantially correct. I've written at length about the way Rush Limbaugh has adopted the race-baiting tactics of Al Sharpton.

With regard to status hierarchy, consider the term "the mainstream media" as used on the right — it is telling that hosts on Fox News whose books make the New York Times bestseller list and whose ratings are higher than anyone on CNN unironically denigrate that network as part of "The MSM," as if they're somehow outside of mainstream infotainment. There is also the "Fair and Balanced" slogan. Taken literally, without the baggage journalism produced by Roger Ails and company has given it, those words express values that the average Columbia Journalism Review staffer would champion. Despite the pose, however, what Fox News has done isn't to improve upon the biased journalism so often denigrated by the conservative base — it has instead self-consciously created its own version of that bias. Imitation, flattery, yada yada yada. 

That is one perverse tragedy of the present political moment. The left has its flaws, as all political coalitions do, and the right has offered valid critiques of these blind spots and excesses over the years, but rather than creating an improvement on CNN, or identity politics, or Medicare scare-mongering, or Bush Derangement Syndrome, the present leaders of Conservative Inc. regard these as tactics that worked for the left, and are thus worth emulating.

The other perverse tragedy?

The conservative base is right to oppose certain policies born of an elite, New York to DC corridor consensus, and right to feel that they are sometimes disrespected by elites, but the folks they count on to look out for them — the leaders of Conservative Inc. — often disrespect them most profoundly, playing them for bigger fools than anyone else. Inevitably, you'll see some bloggers on the right cite this blog post as another instance where I am supposedly disloyal to conservatives, but search the archives of their blogs to see whether they've ever objected when people on the right far more wealthy and influential than I am enrich themselves by selling out the health and wealth of the base. To confront these people would be to admit that they're being taken for a ride — and that too often, they're helping to navigate.

The Mandate

by Patrick Appel

Ezra defends the individual mandate against Kos:

In a world with an individual mandate, insurance has to be affordable. If it's not, there's a huge political backlash. That gives Congress a direct incentive to focus on cost. Remove the individual mandate and … eh. If insurance isn't affordable, people simply go uninsured. It's exactly what happens now. Same incentives, or lack thereof, to make the system better.

Blumenthal looks at how it polls:

Requiring that everyone buy affordable insurance sounds mostly inoffensive. Requiring people to buy coverage that is too expensive could prove to be a very unpopular proposition. The real impact that this proposal will have on the cost of insurance is what should be the focus. That's the subject of Nate Silver's analysis this morning and is a worthy subject for further discussion and debate.

Reihan imagines a mandate-less world:

Without a mandate, a "nondiscrimination" rule would lead to a situation in which no one would buy health insurance until it became clear that they needed it, thus destroying the viability of the industry as we know it. One could argue that a mandate would create powerful political pressures to restrain growth in insurance premiums. But would the end of health insurance as know create powerful market pressures to restrain growth in the cost of various medical procedures, and create a market for true insurance policies that cover unforeseen, catastrophic expenditures?

Searching For Common Ground, Ctd

by Patrick Appel

DiA nixes the temperature tax:

[T]he contentious issue at Copenhagen isn't whether or not CO2 emissions are causing global warming. The contentious issue at Copenhagen is how to apportion the burdens of reduced emissions between developed and developing nations. In all of the discussions over global warming, there's one thing nobody seems to talk about, a gigantic…well, not an elephant in the room exactly—more like a huge tame tiger that people don't notice because it doesn't make much noise. And that tiger is this: There are virtually no climate-change sceptics in China.

This is all the more remarkable when one reflects on how advantageous it would be for China to cast doubt on the science of global warming, if it were really interested in forestalling restrictions on its carbon emissions. But in any case, the temperature tax would be useless in achieving global consensus on carbon-emissions reductions, because the existence of global warming is not the subject under international dispute. The subject under international dispute is who pays for the reductions.

The best health care in the world, cont.

by Andrew Sprung

Patrick links to libertarian Matt Welch's stunning confession and demonstration, based on extensive personal experience, that the "socialist" French health care system is vastly superior to the U.S.'s disintegrating patchwork. (The French enjoy universal coverage with small co-pays, minimal wait times, access at will to any doctor in the country, and complete medical records embedded in a chip on each citizen's national health card).  Patrick also links to Clive Crook, who argues that the virtues of the French system can't be duplicated in the U.S.  I take issue with that.

Crook quotes as follows from an article he wrote this summer:

The success of the French system does not establish the superiority of public insurance. It establishes the superiority of a system that, as much by historical accident as by design, has kept doctors' pay very low. This, in turn, requires a medical-liability regime that minimizes litigation (so much for patients' rights in that sense) and guarantees essentially free training for medical professionals.

The idea that France's system could be grafted onto the American setup is most misleading. To be sure, in organizational terms, it could be. Structurally, the two countries' systems are not that different. The French scheme is like Medicare on a much larger scale — with all the virtues and drawbacks of that system. But plug American rates of pay into that design and the impressive cost advantage vanishes.

It's true that Americans pay more than twice as much per person, and probably way more than twice as much per procedure, as the French do, and that that gap won't be closed any time soon. But it's also true that if we adopted the key element in the French system, along with a series of cost control measures seeded into the pending reform bills, we could begin to close that gap.

France's system is not single payer: there are about 14 nonprofit "sickness funds" that pay patients' bills. But it is single pricer — the government negotiates payment rates and sets the coverage rules for all insurers. The government has monopsony pricing power — as does the government in every other country in the world that offers universal health insurance (i.e., every wealthy country in the world except the U.S).

Obviously, the pending health care reform bills in the U.S. do not create a "single pricer" system. Either a strong public option or a Medicare expansion would have been a large step in that direction. Cost pressures down the line will probably push us in that direction, though.  When Medicare essentially sets the baseline payment rates for all procedures, we'll have plugged the hole in our system that makes it more expensive than any other.

Of course, we'll be starting from a baseline where we pay twice as much as the French and other wealthy countries.  But that's where the reform bills' pilot programs come in.  The French system does share a core weakness of ours, a fee-for-service payment structure, which provides no incentives either to providers or to patients to limit care to what's proven to work.  The Senate bill in particular has impressed a wide spectrum of top health care economists with a series of initiatives designed to chip away at that system. These include pilot programs to seed reforms like accountable care organizations, bundled or global payments, and incentives or penalties for things like infection rates and readmission rates.  

The pilot programs strike many people as small bore. But Atul Gawande has come up with a startling precedent for pilot programs seeding (literally) an explosion of efficiency and efficacy with an industry basic to our biological well being: the model farms and other demonstration projects implemented by the Department of Agriculture in the early 20th century.  These, in conjunction with comparative effectiveness research projects and a "hodgepodge" of other USDA programs, led to a halving of food prices and of the percentage of Americans tied to the land within three decades.

"The government never took over agriculture," Gawande writes,

but the government didn’t leave it alone, either. It shaped a feedback loop of experiment and learning and encouragement for farmers across the country. The results were beyond what anyone could have imagined. Productivity went way up, outpacing that of other Western countries.By 1930, food absorbed just twenty-four per cent of family spending and twenty per cent of the workforce. Today, food accounts for just eight per cent of household income and two per cent of the labor force. It is produced on no more land than was devoted to it a century ago, and with far greater variety and abundance than ever before in history.

Gawande enumerates in loving detail a host of pilot programs in the Senate and House bills that he suggests have the potential to drive a similar revolution in health care. Like Obama, too, he looks to American history to find hope, and to renew faith in government.

John Cole Is Not Smoking Rock

by Patrick Appel

But he thinks others are:

[W]here we are right now, clearly our options are some version of the bill in the Senate, or no bill at all.

Anyone who thinks the House and the Senate are going to just say “to hell with it” and start over from scratch is just smoking rock. How many months did it take for a bill to get out of Baucus’s committee alone. On top of that, we would be treated to another six-eight months of teabaggers throwing things at congressmen, wildly inflated claims on Sarah Palin’s Facebook page and the op-ed pages of the Washington Post (although, in reality, those two things are pretty much one and the same these days), and so on. And then, you have to filter in that all of this would be happening in an election year, and with the notoriously timid Democrats, you have to be sniffing glue to think that the bill is going to be easier pass and more progressive. And then, assuming the House does manage to get it passed, does anyone think Ben Nelson and Joe Lieberman are going to suddenly decide the public option is a good idea? If so, why? Does anyone think that the blue dogs and “moderates” are going to become less of a wholly owned subsidiary of the insurance and pharmaceutical industries?

Drum says much the same.