Friday, October 30, 2009

Wankers of The Day

Republican members of the Senate EPW Committee.

It's really quite clear that the current GOP political strategy is to shut down the government without shutting down the government.

Why Didn't China Invest In China?

I've wondered why China invested so much money in America for a long time now. If you're the Chinese government and you've got a lot of investment capital, it seems like you'd do well to invest in China. You aren't afflicted by the kinds of problems that face foreign investors in emerging markets like "What if the government makes a policy change that screws me?" since you are the government. You're better positioned than any foreign investor to capture positive externalities that spill over from your investment, since they mostly spill into your country. Plus, China looks like a place that's ripe for investment that allows it to become more productive.

My thought is that you'd want something countercyclical that wouldn't lose tons of value if the global economy tanked, and US Treasury bonds can work that way, so that's a benefit. I don't know how well that works when you've made such a big investment that it's tough to get out, though. Matt's view is that this is a result of IMF failures from the 1990s. There's probably a bunch of things going on here, and I'd be curious to hear more thoughts on this.

Minor Pelosi Highlight

In keeping with my agenda of turning this into a Nancy Pelosi fan blog, I bring you Meredith Shiner's reporting from the rollout of the House health care bill:
An anti-Pelosi activist started screaming into a bullhorn, "Nazi Pelosi! Nazi Pelosi! You'll burn in hell for this!" as she was announcing the plan, which includes a public option.

Pelosi, scarcely missing a beat, responded, "Thank you, insurance companies of America."

Her greatest skills are as an indoor politician -- working behind closed doors with her caucus to get just enough support for the most progressive option possible -- and she's often out of her element in front of a microphone. So I guess the sports highlight equivalent would be Shaq crossing somebody over on the perimeter and driving the lane.

Thursday, October 29, 2009

Stacking The Deck

I'm trying to understand why Barney Frank is listening to this witness list as he's thinking about financial sector reform:
For those of you keeping score, that's two voices from the left (Trumka and D'Arista), two from the right (Swagel and Wallison) and six industry shills. People tell me that Democrats control both houses of Congress, but given the witness list I'm skeptical.

Wednesday, October 28, 2009

The Last Hurrah

This looks like a fairly even series, except that the Yankees will go with a three-man rotation featuring CC Sabathia and Andy Pettitte. As Scott Lemieux observes, the Phillies lineup is so heavy on lefties that this puts the team at a severe disadvantage. So I have a hard time convincing myself that the Yankees, the slightly superior team in the substantially superior league with a number of small advantges, will lose. Yankees in 6.

Collective Aspirin Problems

Having just taken an 14-months-expired aspirin, I felt that I should check to see whether taking expired aspirin is safe. (Note to self: do this in the opposite order from now on.) Fortunately, it seems that it is -- there was a big study on this:
The military was sitting on a $1 billion stockpile of drugs and facing the daunting process of destroying and replacing its supply every 2 to 3 years, so it began a testing program to see if it could extend the life of its inventory. The testing, conducted by the US Food and Drug Administration (FDA), ultimately covered more than 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective as far as 15 years past their original expiration date.
As the author of the article says, this is one of those things where medicine manufacturers don't have any incentive to tell us that their drugs are good for a longer period of time. If I don't have any aspirin and I'm hung over, I'm going to buy some regardless of what expiration date is printed on the package. Short expirations don't keep me from buying the product. But if I have some expired aspirin, I might throw it away one afternoon and plan to buy a new bottle. Knowing this, manufacturers are going to err on the side of short expiration dates.

So who does the studies to figure out the truth about this? Well, the military, since they have a $1 billion drug stockpile that they don't want to throw away. You have to be really big -- like, Army big -- before funding a study like this is in your own interest. Otherwise, it's a classic collective action problem. All us consumers would be happy to pay a dime each for a big study on the issue, but there's no way for us to coordinate our action, especially as free riders could find ways to get the information without paying in. There's probably tons more information like this out there that could save us money or improve our health, but which we don't know because no one entity finds it in their interest to pay for the relevant study. Until then, drugmakers and medical device manufacturers will continue to take our money with marketing gimmicks (they spend far more on marketing than R&D) and give us poor value.

This will continue until there's some Army-like health care provider large enough that it's worth its while to pay for expensive but comprehensive and rigorous studies. And that's why we love Comparative Effectiveness Research, and look forward to the day when medical innovation is saved by a big government health care plan.

[Update: Medscape is behind a paywall. For some reason I can get to the article through Google, but not via the link above. Minus the approving comments from a UChicago psychopharmacologist, the link to the expired medicine article is here.]

Monday, October 26, 2009

Problems with the excise tax

The excise tax discriminates against women. Picture 2 companies of 200 employees with identical health plans - same benefit levels and network. One company has 100% male employees and the other has 100% female employees. It is entirely possible that the first company will not hit the excise tax and the second company will. What should the second company do to lower its costs per employee - is that really the kind of cost control we want to incentivize?

This is one reason I don't like the excise tax as a funding mechanism - it is a compromise I am reluctantly willing to make to pass reform but as written it will not in general hit the plans with the richest benefits or the highest payments to providers. This article makes some good points on the characteristics which cause variation in premiums. Some of the issues have been addressed by modifications to the tax but there are numerous factors that have little to do with the generosity of the benefit that cause variations in cost of health benefits. Much has been made of the gold plated plan of executives at Goldman Sachs but an example closer to home shows how benefit generosity alone is tenuously related to the cost of the plan. The default Microsoft health plan would fit almost anyone's definition of "gold-plated" insurance with an expansive PPO Network, no deductible, copays or cost sharing In-Network, no copay for most prescriptions, infertility and other special coverages - 100% coverage of employee and dependent premiums. The 2009 COBRA Rates for the Microsoft plan work out to $5,748 annual for an individual, and $16,680 annual for a family.

This includes Medical and Vision - does not include dental but overall still comes in well under the limits for the "Cadillac" excise tax.

Why is this? A couple of reasons:

- Location - WA where a large percentage of MSFTs workforce lives is a relatively lower cost area
- Demographics - younger male workforce is less expensive
- Bargaining power/economies of scale - Microsoft as a large employer can negotiate for a low administrative cost per employee
- Self insured status - since Microsoft self insures they are not charged a risk premium

What does this suggest about the types of plans that are likely to hit the excise tax irrespective of benefit generosity:
- High cost areas
- Unfavorable demographics - adult women of working age are much more expensive than men, older people are more expensive
- Fully insured plans for medium size employers - these types of businesses have less bargaining power and economies of scale
and are charged a risk premium.

Other potential consequences:

Since there is only one threshold for family it will encourage covering fewer family members - penalizes single earner families and companies with large family size.
Ancillary benefits like dental, vision and FSAs are included in the threshold - employers may decide to drop these rather than making their medical plans less generous. This could particularly affect dental benefits.

Introduction and public option compromises

Thanks Nick for inviting me to guest blog! The majority of my experience in health care has been working for health insurers as an actuary. Health insurance companies have not exactly covered themselves in glory recently with their flawed analysis of reform, aggressive recissions and high profile controversial coverage decisions. But the biggest driver in health insurance cost is not health insurance company profits or overhead - it is health care costs and historically effectively controling health care costs requires reductions in fees to hospitals/doctors, and controls on utilization of services that have generated their own backlash.

My first topic is the various "public option" proposals.

First off I support a strong public option. I think it is good policy, contributes to cost control, and mitigates some of the affordability and feasibility issues that arise with an individual mandate. The strongest public option proposed so far is a national plan using Medicare payment rates and tied to participation in Medicare, administered by HHS. Ideally everyone would have access to this public plan using some type of voucher mechanism where employer contributions towards current coverage could be applied to the cost of the public plan (similar to what is proposed in the Wyden-Bennett bill). This has the maximum bang for the buck in cost control/leverage with providers, and administrative simplification. In addition any positive changes implemented in payment from the new independent MedPAC would flow through to the public option (FYI MedPAC produces many informative reports on Medicare payment and has a great series on the Medicare payment basics ).
Current State of the "Public Option" in the committee bills. Given the political landscape it seems likely that the house version will end up closer to the strongest public option proposed.
The house bill passed by Rangel's committee is the strongest version of the public options - offers a national plan using Medicare + 5% for physicians + opt out, Medicare rates for hospitals - the Energy and Commerce committee ammendment : "Require the public health insurance option to negotiate rates with providers so that the rates are not lower than Medicare rates and not higher than the average rates paid by other qualified health benefit plan offering entities" ( This is much weaker.

In the Senate the HELP bill requires negotiating with providers with the "public option" plan paying no more than average payment rates of the other plans in the exchange. The Finance committee bill so far does not have a public option and relies on State Exchanges. Maria Cantwell's amendment allows states to create a program for 133-200% of Federal Poverty Line modeled on the Basic Health plan in Washington State - this is not a public option and is more akin to SCHIP as an incremental state-run program for a small slice of people/why not just extend medicaid to 200% of FPL - arguably a better incremental measure.
State based Co-ops as proposed in the Finance bill are unlikely to work or do much for costs as proposed.

Sen. Tom Carper floated the idea of states opting to create a public option/open their public employees plan in their exchange and/or banding together with other states to form regional exchanges and public options - . There are a couple of problems with this idea one it puts the onus on the state to proactively create a public option from scratch (and prohibits them from using Medicare rates even with an added percentage), adding a bunch of states together may create some administrative efficiencies but as far as increasing leverage with providers it is not very effective (maybe on the East Coast there are some areas where it would increase leverage, but in most of the country what matters is market share in the local area that rarely spans states) . Fundamentally the problem with making provisions state based and optional is that many states do not have the institutional capacity to effectively implement them, it perpetuates the fragmentation of our health insurance system *and* there is a danger of creating unfunded mandates which state budgets are in no position to absorb,.
The flip side is the new compromise proposal gaining momentum of a national public option with states having the ability to opt-out. Even if this turns out to be a relatively weak public option I think this is far better than an optional strong state-based public option. In practice there are budgetary mechanisms that can make it extremely difficult for states to opt-out - think conditions for receiving federal transportation funds. Any state that opts-out is one that would not likely opt in to create a public option in the first place and when a strong national public option proves popular and effective it is much easier to participate in an existing program than start a new state based one.

Please Welcome Rebecca Stob!

As we're in the health care home stretch, Inshallah, we thought it would be a good idea to let our readers hear from someone with actual domain knowledge of health care financing and logistics. As I've said before, I'm not a health care wonk. I'm just a guy with  decent mathematical intuition who's handy with a spreadsheet. When Finance Committee amendments get into the nitty-gritty of America's health care system, I'm less and less useful.

Thankfully, I happen to have friends in high places who are actual health care wonks. And one of them has agreed to guest blog for us. Rebecca Stob currently works for a health information company in the Dental market. Previously she's worked in the belly of the beast at Wellpoint in  California mainly on their Medicare products, and at Premera Blue Cross here in Seattle measuring cost and quality for their Health Care  conomics department. She has probably forgotten more about the delivery of health care than I will ever learn.

Rebecca's going to provide our dear readers with a deeper look at the likely impact of each of the public options, as well as a look at the impact of some of the more important amendments that have passed. One thing I'm sure of is that she'll try to convince you that taxing "high-end" plans won't necessarily accomplish anything. 
We hope you'll enjoy Rebecca's stay here at Donkeylicious.


Early reports are that Harry Reid is going for the opt-out public option despite Obama's nervousness! This post may soon have an update below it, as these are early reports and we all remember the crazy blizzard of thinly sourced rumor action with which last week ended.

This appears to be your update :)

Sunday, October 25, 2009

Humans Of The Future

My guess is that the most obvious genetically rooted physical difference between humans today and humans 400 years hence will be their relative racial homogeneity. 12 or so generations in the modern world gives plenty of time for human beings to mix themselves up pretty well. Of course, there's no telling what effect futuristic genetic technologies could have. Maybe weird fads will catch on and people will want their kids to have prehensile tails or something. Assuming that the technology works, that doesn't strike me as a bad thing. I could use a prehensile tail, though I might need to buy new pants.

The Peter McAllister character cited in the article seems more like some dude who got a contract to write a provocative book (about how humans today are way less physically capable than those of millennia past) than any kind of expert. Google doesn't give me any sign that he has a Ph.D or an academic post or anything. Considering the impact of unsteady nutrition, parasites, and other problems of the premodern world, I'd be surprised if they were able to keep up with us.

Hummus: Better Than Hamas

A team of Lebanese chefs has prepared a two-ton plate of hummus. They're trying to take a world record away from Israel. The recipe includes 2,976 pounds of mashed chickpeas, 106 gallons of lemon juice and 57 pounds of salt, with a total weight of 4,532 pounds. On Sunday, the chefs will try to set a world record for the largest serving of tabbouleh. This is the kind of Middle Eastern conflict I can get behind. I would support it even more strongly if I were able to eat some of the delicious hummus.

I like Lebanon, which from all I've read seems like the hipster capital of the Arab world. Hipsters can be annoying, but in foreign policy you often have to embrace imperfect allies.

Post-Rapture Pet Care

Via Pam Spaulding, this is awesome. There's a network of atheists advertising their post-Rapture pet care services to Christians. Since the atheists will still be left on earth, they'll make sure your pets are being cared for after Jesus takes you to heaven. They really should develop the web site a little more and have photos of the atheist pet caretakers for each location.

Saturday, October 24, 2009

A Better Reid On The Situation

Nate Silver's take is that the White House wants Olympia Snowe's support because a few conservative Democratic Senators may be attached to her, and if you lose her vote you could lose theirs. Maybe. But in that case, why would the White House be more solicitious of her support than Harry Reid is? Reid is going to have a better grip on how his caucus votes than Obama. If he says they can do it without her, they probably can.

If the White House message to Reid was just the "We hope you guys know what you're doing," from Ezra's post, that's all well and good. That is, assuming Reid knows what he's doing. And I'm inclined to think he does, because I can't remember Reid pushing his caucus so hard he lost a vote before.

Update: Matt tweets about how Reid muffed the vote count on the Medicare doctor rates fix. I'd count that as a screwup if I hadn't read Ezra's comment that "This is arguably the best possible outcome for the Democrats: They don't have to pass a bill that increases the deficit, but they get with the docs credit for trying, and the American Medical Association is furious at the Republicans." If Ezra's right about that and the Senate leadership saw it the same way, Reid may have been playing a crafty game against the legislation or (more likely) just not caring much about the outcome. I assure you that we're not seeing either of those with the public option.

Push Poll Fail And Other Stories

The image at right is from the website of Rep. John Culberson (R-TX), who put his feeble push poll up against the mighty tubes.

Culberson, of course, isn't going to be a persuadable vote. But Chris Bowers is telling us that these Congresscritters are undecided on the robust public option. It's been a long hard slog for several months, but we're getting really close to a vote, and they're counting votes in the House. He's got the phone numbers and all, so give them a ring, especially if you live in their district or their state. It's kind of frustrating to be in the wrong hemisphere for this. I don't have an American number, but most of you do. If your representative is on the list, put in a call.

Also if you're in Indiana (where Evan Bayh is making trouble) or Nebraska (where Ben Nelson is being Ben Nelson) make a call for the opt-out public option. Chris thinks they're the two who are holding things up. We could also use help with Pryor, Lieberman, and Landrieu. And while Conrad and Baucus are probably going to vote for whatever they decide on, the fact remains that they're making the decisions and their staffers are always deserving of a nice chat with you.

Friday, October 23, 2009

Friday Obama Caption Contest & Kitsch Cover

"President Barack Obama, along with members of Congress and Cabinet secretaries, jockeys for a rebound during a basketball game on the White House court, Oct. 8, 2009.
(Official White House Photo by Pete Souza)"

The Kitsch cover is Gossip's version of Aaliyah's "Are You That Somebody?". They've disabled embedding but it's worth clicking over.

Thursday, October 22, 2009

It's Just About The Music

Ezra is trying to make this about something more than the music, but my suspicion is that there's bipartisan agreement that just based on their tunes alone, Creed is awful, awful music. Somehow, though, it wasn't bad enough for the Guantanamo prisoners.

Why is Creed the band that has been so singled out? Why not Hinder or Nickelback or Three Days Grace or Rob Thomas or some other faceless duderock band? Discuss.

College Football Playoff Objections Answered

Like Barack Obama, Orrin Hatch, and everyone, I think college football needs a playoff. The current system is preferable to the pre-BCS chaos, where the #1 and #2 teams usually didn't meet in the postseason, regularly leading to controversy. But there's tremendous room for improvement.

Apparently one of the big hurdles is integrating playoffs into the current bowl system, as the bowls themselves are powerful entrenched interests. I don't really understand why this is a problem. Why couldn't the playoff just absorb the larger bowls? If you had an 8-team playoff, that gives you 7 bowl games, maybe the Rose, Orange, Fiesta, Sugar, Cotton, Gator, and somebody. They could stick around and keep doing their thing, with the only difference being that the teams playing in the games would be automatically chosen. The smaller bowls could just keep operating along the side like they've always done. If Rutgers and NC State don't make the playoff and want to play another Bowl against each other, nobody's stopping them.

If there's some problem with a large playoff, just expanding to 4 teams from the current 2 would be a major advance. In the current system, there's a solid chance that you'll end up with 3 equally deserving teams looking for the two championship game slots. Then if #2 squeaks by #1 while the left-out #3 dominates #4 in a non-championship game, there's going to be serious argument about who deserves the championship. But in the 4-team playoff, any #4 team that beats #1 and then wins another game is going to be regarded as the legitimate champion, because of its awesome late-season feats.

Wednesday, October 21, 2009

The Stomachs Of Dead Albatrosses

Amazing photos, and sad. You won't believe what was in these poor birds.

It's Carnegie Hall

Kevin Drum and Philip Boroff shouldn't be surprised that the five full-timers on the Carnegie Hall stage crew are making $400K-$500K. Of people making big money in New York there are far greater absurdities.

If you're running Carnegie Hall, you'll be ready to hire the best damn carpenters since 33 AD. They'll want enough money to live very well in New York, so you give it to them. Huge stuff happens there, and you want to make sure it doesn't screw up.

Getting Closer

If Ezra's right about this, the pragmatic import of Harry Reid saying "We’re leaning towards talking about a public option" for good lefty folk is "Call your Senator now, especially if you live in Maine, Nevada, Montana, or Connecticut." If the public option makes it into the floor bill, there's no way they're going to be able to strip it out. But if it doesn't, it'll be very hard to put it in.

Meanwhile, Nancy Pelosi is going to push forward with a public option that reimburses at 5% over Medicare rates, and use "the fiscal responsibility of the robust public option to win over enough skeptics in her caucus to pass it." I continue to be in love with a 69-year-old woman.

Monday, October 19, 2009


Using the CBO to make an argument based on policy? The city "tends to judge such things out of bounds".

And people wonder why it's hard to get anything done in this country.

More Health Care Charts

The Center for Budget and Policy Priorities has put out a great wishlist for the final health care bill. At the top of their list is the fact that the insurance premium subsidies don't really make insurance affordable. I took the data they produced and put it in chart form, along with the premium payments under Commonwealth Care in Massachusetts. Note that in Massachusetts, there is no subsidy for households earning more than 300% of FPL; they're buying well-regulated insurance on the private market.

As you can see, the Senate HELP bill is within shouting distance of Commonwealth Care; in fact, it addresses the largest problem with the Massachusetts plan, which is the difficulty faced by households too well-off to qualify for subsidies, but not well-off enough to afford the full price of insurance. If it were to pass, its combination of new revenue and spending cuts would leave people paying premiums they could live with. A family of three earning $45,000 who pays $200 per month for insurance will feel like they're getting value for their payments; wellness checkups for their children will be covered, and they have peace of mind that they won't go bankrupt if they get sick (though they may end up paying off a four-figure deductible for a while). But the same family paying $360/month for crappier insurance, as dictated by the Finance bill, will be much less happy. The bill that emerged from the Energy and Commerce Committee is a middle ground, but it's much closer to the Finance bill. The House bill coming from the other two committees—Ways & Means and Ed-Labor— is much closer to the product that HELP produced.

Sunday, October 18, 2009

Reefer Gladness

In a victory for rational policymaking, the Obama administration is telling federal prosecutors not to go after people who use marijuana for medical purposes in accordance with state laws.

Polling on the broader issue of marijuana legalization is interesting. A Gallup survey done over the first half of this decade showed a pretty big gender gap among people under 50, with men opposing it only 52-44 while women oppose it 65-34. It's rare to see a stereotypically lefty issue where a big slice of the male demographic is 23 points left of women. I'm not sure what's going on there. Maybe moms (including otherwise reliably liberal single moms) are especially nervous about their kids smoking pot?

One big thing you see in all the polling data is that people are more open to legalizing marijuana than they were in decades past. The time is ripe for folks who don't give off a dirty hippie vibe to stand up for some form of legalization, moving the Overton window to where it's respectable enough that people who run for office can support it without too much risk.

In related news, Miami Dolphins running back Ricky Williams (who proclaimed that marijuana was 10 times better than Paxil for his social anxiety disorder) is running for more than 5 yards a carry this season, with zero fumbles. Keep it up, big guy.

Classic Hilzoy

Lots of work to do, so I don't really have anything new for you blogwise. So let me link to Hilzoy's post on the use of violence in overturning oppressive regimes, from two and a half years ago. It's one of the best posts I've ever read.

Friday, October 16, 2009

Friday Kitsch Cover

Some incredibly effective Feist ripoff does Beyonce's "Single Ladies":

Leave your nominations for next week's Kitsch Cover in the comments.

I'm Glad I Don't Live In Tangipahoa Parish

That's where Justice of the Peace Keith Bardwell is refusing to let people of different races marry each other. In his own words, "I'm not a racist. I just don't believe in mixing the races that way." Classic.

This is bad for everybody. But assuming that the judge is consistent about this sort of thing, the people who really have it bad are Asians, who make up 0.39% of Tangipahoa Parish's 100,000 or so residents. They've only got 195 Asians of the opposite sex to marry. Maybe an eighth of those people are around their age, leaving them with 24 or so potential partners, of whom like ten will already be married or gay or something, leaving 14 in the parish, of whom they may know three. (And who knows if Bardwell will let a Japanese dude marry an Indian girl?) Even if you don't have country fever like I do, it's a pretty bad deal.

Wednesday, October 14, 2009

Policy Isnt Made in a Vacuum

I'm listening to Bob Corker ask a collection of wonks whether or not a carbon tax would be a less complicated way of reducing carbon emissions. This is all very nice of him, but until Corker can convince a bunch of his Republican colleagues to draft a legitimate carbon tax proposal and promise to support it, hold the coal industry (one of his constituent interests!) at bay, and in general show that he's not just hiding behind the carbon tax so he can be for "something" while opposing the cap-and-trade-bill, he can, in the words of Dick Cheney, go fuck himself.

Lately I seem to be having conversations with wonkish right-of-center types who have this-or-that idea about how to design a simpler, more efficient, and more effective policy to deal with taxation, climate change, health care, whatever. But it always stops there. No one talks about managing the transition. No one talks about convincing Mitch McConnell to back these ideas. No one talks about sixty votes. No one talks about the interest group dynamics in Washington. No one even talks about working for a decade to elect members of Congress who might be more amenable to these sorts of policies. It's just policy in a vacuum. Which is an interesting intellectual exercise, but not a legitimate substitute for governance, an ultimately messy endeavor.

Tuesday, October 13, 2009

Why I Am So Chill

Matt mentions that he started freaking out over health care reform just after returning to the United States, until he realized that it was just because he had been put back in touch with cable news.

Not to get all I-don't-have-a-TV on you, but I unplugged my TV when Buffy went off the air. And then I moved to Singapore, where my apartment came furnished with two TVs that I never watch. Text is so much faster as a way of taking in information that I use it exclusively, and I find the emotional agitation of cable news overstimulating. Sometimes if there's something everyone's talking about, I'll watch it on YouTube, but that's about it.

This has resulted in me being more or less perpetually sanguine about the prospects for health care reform. Okay, during the months when Max Baucus was blocking the legislation, I got kind of annoyed. But for the most part I've spent the last few months telling Facebook friends that things will turn out okay. Write your Senator and all, but be mostly confident that it's gonna work out.

Nick has a TV, so I don't know how he does it.

Sunday, October 11, 2009

Republicans Or The World? You Must Choose

A lot of smart people in America are uncomfortable with the idea that they should treat similarly educated folks from other advanced democracies as generally ignorant, deluded, or crazy on global political issues. Instead, we should treat them as what philosophers call 'epistemic peers' -- people just as intelligent as us, working from the same body of evidence, who are roughly our equals in ability to know the truth. In the case at hand, the bodies of evidence differ somewhat, since we have different news sources. But we can mostly solve this problem by sharing our evidence in discussion. If the evidence conflicts and we try to argue that their news sources are unreliable, all we usually have to go on is our news sources, and they can argue the same against us.

Similarly, a lot of smart Democrats are uncomfortable with the idea that they should regard Republicans as generally ignorant, deluded or crazy on global political issues. Many of the same considerations apply here. If we argue that their news sources are unreliable, they can argue that ours are, they're in possession of a basically isomorphic argument. Ordinarily, treating Republicans as epistemic peers would be a reasonable position, just as treating foreigners that way is. But the trouble at our historical moment is that we're no longer able to treat Republicans and educated people throughout the world as epistemic peers at the same time.

I think the following is a fair characterization of the reasoning that resulted in Obama's recent honor: The Republican Party has gone mad and become so destructive of world peace that you get a Nobel Peace Prize for removing them from power. That's an incredibly strong way to to put the point, and I don't know if the consensus of educated people outside America is willing to go quite that far. But if it stops short, it doesn't stop too far short. The 2008-2009 jump in favorable views of America, especially in Western Europe but including many other nations, is a sign of how differently people see Obama-era America from what preceded it. Foreigners will have many different views of what exactly is going on, but they're generally going to include the idea that Republican views on foreign policy are so tainted by the xenophobia, bloodthirst, and misinformation of influential people in the party that they can't be regarded as epistemic peers.

Republicans regard world opinion as badly as it regards them. You can see it even in their relationship with mainstream American opinion, where they've constructed an alternative news infrastructure in Fox News and talk radio that they regard as free from the distortions of the mainstream media. While Democrats have their own preferred blogs and websites, they haven't built full-fledged Fox-News-style alternative versions of mainstream news institutions. Globally, this becomes even stronger. Republicans' relation to respected international institutions like the UN (on the political side) and the BBC (on the news side) has long been hostile. When international weapons inspectors claimed that Iraq didn't have weapons of mass destruction, Republicans ridiculed them. Thinking the Wikipedia editors of the world are biased against them, Republicans created Conservapedia. If you don't regard educated people throughout the rest of the world as your epistemic peers, this is what you do, and maybe you start ordering freedom fries. Of course, this leaves you in a situation where the rest of the world isn't going to think you're an epistemic peer of theirs.

So where does this leave Americans who aren't Republicans? I don't think it's possible for us to treat both Republicans and educated people throughout the world as epistemic peers. This would involve having some level of trust each group's deeply held belief that the opposite group has gone totally off the rails. This leaves you suspecting that two different groups of people are deluded on the say-so of people who you suspect are deluded about issues like who is deluded. That's a pretty bad position, and not one we can stay in very long. We could also just regard global affairs as a huge area of general confusion where nobody knows what is going on, and withdraw from politics. If we're going to continue doing politics, however, we need to decide which group we're going to treat as epistemic peers and whose opinions we're going to regard as tainted by bias and misinformation.

There's plenty to be said about how exactly we should make that decision. But I'm going to conclude this post by observing that the noble intentions of Democrats and independents to treat both Republicans and educated foreigners as epistemic peers about global affairs can't be satisfied in our unhappy world. If we're going to engage in politics, we have to be either xenophobes or partisans. There are no other options.

Friday, October 9, 2009

Why Barack Obama Deserves The Nobel Peace Prize

When you look over the list of Nobel Peace Prize winners, you can mostly divide them into three categories.

First, there are those whose situation in the world could've led them to live ordinary lives under unremarkable circumstances, but found ways to accomplish great things for the betterment of humanity. In this category you have agricultural pioneer Norman Borlaug, father of microlending Mohammed Yunus, the humanitarian heroes of Doctors Without Borders and Amnesty International, and Jody Williams of the International Campaign To Ban Land Mines.

Second, there are the peacemakers, who are often honored in pairs, since that's how peace is often made. Menachem Begin and Anwar Sadat fit into this category for making peace between Israel and Egypt, as do John Hume and David Trimble for reconciling Catholics and Protestants in Northern Ireland, and Nelson Mandela and F. W. de Klerk for working towards a post-apartheid South Africa.

Third, there are those who actively participate in politics to oppose regimes destructive of human welfare. Here you have Aung San Suu Kyi who continues to fight against the brutal military dictatorship in Burma, Soviet dissident Andrei Sakharov, Polish activist and trade unionist Lech Walesa, and anti-apartheid activist Bishop Desmond Tutu.

It's far too early in Barack Obama's presidency to see if he'll deserve the Nobel Peace Prize for the first or second reason. In nine months he hasn't had time to achieve any grand feats or make peace between long-standing enemies. The best way to see him, I think, is as a member of the third category.

America had, for a long time, been the great power that citizens of the world could best rely on to be on the right side of human rights issues. Our record was very far from perfect, and we sometimes fought brutal and foolish wars or supported horrific regimes that did horrific things. But looking at the other nations and empires in the world that have achieved the highest levels of global dominance -- most recently, the USSR, the European colonial powers, and the Axis governments -- America looks pretty good. It may strike you that these are, on the whole, horrific regimes, and being the best among such a lot is no great achievement. There may be some deep indictment of human nature in the fact that great power correlates so well with great viciousness. But as superpowers go, those are your choices. In Singapore, the general opinion I've heard attributed to policymakers is that if somebody else is going to be the big power in the neighborhood, it's better that it be America than China. Now, that's not high praise. But it's a kind of praise that really matters, both as a moral evaluation of America qua hegemon and as a sign that we're a force for good in the world.

The Iraq War, the treatment of prisoners at Guantanamo and Abu Ghraib, and Republican conduct of foreign policy showed the world an America very different from the America they knew. The Bush Administration took many hundreds of billions of dollars that could have been spent on human betterment, and squandered it on a destructive and ultimately pointless war that killed thousands of our citizens and tens if not hundreds of thousands of Iraqis. The signs that had for so long distinguished us from our enemies -- our humane and dignified treatment of prisoners, even those who had killed Americans -- began to vanish. On issues essential to the well-being of humankind, like nuclear nonproliferation and climate change, progress either ceased or was actively reversed. And at the end of Bush's time as President, financial problems originating within our economy engulfed the world.

The idea that the Bush Administration marked the new direction America in the 21st century, a direction that future Administrations would continue to pursue, rightly struck the citizens of other nations with horror. It matters immensely that the tremendous economic and military power of the United States continue to operate at least as well, on the global scene, as it has over the past decades. I'm not really sure how to morally evaluate a superpower like America as good or bad -- there's an element of context-sensitivity to moral evaluation that I don't know how to apply in the case of gigantic political bodies that have few peers and do tremendous world-changing things. But I know very clearly what it would mean for a superpower to get worse, and to get even worse than that. People of the world were struck by the prospect of America turning into something much worse than it had been before, with terrible consequences for humanity, and they were rightly horrified by that.

Barack Obama hasn't faced the personal brutality that many of the heroes in the third category of Nobel Prize winners have. Nobody threw him in prison, tortured him, or assassinated his staffers. America's democratic traditions kept us from falling into the sort of misrule that typifies, say, the Burmese military dictatorship which Aung San Suu Kyi fights against. But while the SLORC regime in Burma is terrible for the Burmese, the global impact of America being ruled by mad people is far worse than that of Burma being ruled by mad people. The degree of one's impact is in some sense a criterion for the Nobel Prize, and that's what Obama brings to the table over and above so many other candidates. However well or badly he does in fixing the chaos that Bush left behind, the world is happy enough that he won't go around actively creating more chaos as Bush did.

The argument for giving Obama a Nobel Prize is that America is important enough and Republicans are bad enough. As much as the first part will flatter the sensibilities of our political culture, the second will seem totally beyond the pale. Well, so much the worse for our political culture. It's still wide open whether the Obama Administration will make the right decisions on Afghanistan, the Middle East, China policy, and any number of domestic issues. Many of my fellow Democrats will certainly be disappointed by the Obama Administration on any number of issues. But the sheer misrule of the Republican Party was so great that Obama deserves the Nobel Peace Prize just for his role in bringing it to an end. This will strike many in the elite center of American opinion as a partisan conclusion. If they're not willing to hear it from American Democrats, I hope they're willing to hear it from the rest of the world.

People all around the world see the difference between an America led by Obama, Biden, and the Democrats, and an America led by Bush, Cheney, and the Republicans. You can take this award as one clear and forceful expression of their preferences. I hope Obama does well enough as President to deserve a Nobel Peace Prize as a member of the first and second categories of winners -- the benefactors and the peacemakers. But he already deserves it for taking executive power out of the hands of a party that was a tremendous enemy of human progress and betterment, through its control of the mightiest nation in the world. The forces in charge of the Republican Party are destructive enough that you can deserve a Nobel Peace Prize for fighting them and winning.


Capital Hill Blue, October 2: "Obama's Olympics failure will haunt him in future"

Bryan McAffee, October 2: "Rio Wins 2016 Olympics, Obama Loses Face"

Alex Spillius, October 2: "Olympics: Obama loses his golden touch"

Josh Kornfield, October 8: "President Obama, the national messiah and embodiment of change, fell from Olympus and lost his divine radiance."

Speaking of faces and gold and radiance and such, there's something you should see:

Wednesday, October 7, 2009

Health Care Free Lunch

Conor Friederdorf asks "Can someone write an easy to understand blog post explaining to an ignorant non-wonk like me how you cover millions more people, avoid government rationing, and save all that money?" Well, I'll give it the old college try.

In terms of spending changes, the Baucus Bill mainly does two things:
  1. It spends money to help people buy insurance; or in the case of poor people who are currently uninsured, it insures them outright thorugh Medicaid.
  2. It rearranges the way the goverment currently spends money on health care, primarily Medicare and Medicaid, in ways that will reduce spending overall.
To some extent, the second helps pay for the first. But not entirely. To make up the difference, the bill raises revenue in a variety of ways. The biggest one is a tax on "Cadillac" insurance plans, to try to convince these consumers or insurers to find ways to keep their health care costs down. There's also some revenue that comes from taxes on employers who don't provide low-wage employees with insurance, and fines to individuals who don't buy insurance. Between these revenue provisions (plus a few other sources here and there) and the changes in health care spending, the government is spending more money, but it's also taking in more money too, and the new revenues (and spending cuts) outweigh the spending increases.

Note that we're talking about the government's balance sheet here, not America's overall health care spending. Whether or not that goes up or down is a different question. But the experience of Taiwan suggests that it's at least possible to expand coverage without spending more money. After all, the US spends more on health care than any other country, so if we can figure out how to spend that money more efficiently we ought to be able to cover everyone.

How'd I do?

Fearless Forecasting

Check out Scott Lemieux for more.

I think we only agree on the AL picks this year; the Yanks are serious favorites over Minnesota, and while the Angels are better this year, the emergence of Jon Lester makes the Sawx a tough draw in the postseason.

In the NL, things are different. Jim Tracy is one of the soundest Moneyball managers, but he's adapted to the higher rate of base-stealing of today's game. Since Tracy took over as manager, only the Yankees have a better run differential. Cole Hamels hasn't been terribly effictive this year, while the Rox have started letting Jorge de la Rosa pitch a bit deeper into games, giving them a two to go with Ubaldo Jimenez at 1. So I'll take Rockies in 4 in that series.

As for the Dodgers-Cardinals match-up, it looks like it's going to come down to starting pitching. Both teams have lineups that can mash, but the Dodgers' staff is limping into the post-season, with Billingsley gimpy and Kershaw likely to have his innings limited. That said, Torre has a history of effective in-game management during the post-season, so I'll take the team that's the underdogs on paper. Dodgers in 5.

Tuesday, October 6, 2009

Okay, Maybe The President Is A Nerd

Seriously, can you imagine Dubya putting drawings of the Telegraph in the Oval Office?

Jews In The Iranian Parliament

It's looking like Mahmoud Ahmadinejad is not going to join George Allen on the list of the world's surprise Jews. But if you're looking for Jews in Iranian politics, meet Ciamak Moresadegh and his predecessor Maurice Motamed, the present and previous Jewish members of the Iranian Parliament.

Motamed (pictured at right) was in office while Ahmadinejad was denying the Holocaust, so he spoke out against that. But overall their public pronouncements generally seem to be positive about Iran, and they like to make the point that Iranian Jews aren't doing too badly. I'm sure this is partly because it's risky to be a dissident in Iran, but there's also the fact that members of any parliament are generally going to be patriotic people. Obviously there's a pretty clear limit to how high a Jew can rise in Iranian politics, support for Israel is a no-no, and the Iranian Parliament isn't the real power in the country, but it's still pretty impressive that they're there.

According to the 1906 Iranian Constitution, one seat in Iran's Parliament is reserved for Jews. (My joke here is that 'seat' does in fact mean a office with voting powers, and not some kind of chair that blows up.) I was really astonished when I first learned that some countries organize their legislative bodies in this way, with dedicated numbers of seats set aside for various ethnic groups.

Sunday, October 4, 2009

Dick Gephardt: Still Betraying Democrats After All These Years

When you're making your list of the worst Democrats of the decade, put Dick Gephardt close to the top. A lot of the mistrust between the Democratic base and the Congressional leadership over the past five years is just the bill for things Gephardt broke. His grand moment of treachery came in 2002, where he wrote the Iraq War Resolution with Dennis Hastert, undercut antiwar Democrats and moderates who wanted more safeguards in the legislation and pushed the thing through the House. The version of that legislation which passed the Senate had Joe Lieberman in the Gephardt role as Democratic co-sponsor.

That's the founding painful memory of the left-wing blogosphere. Amid the shock of November 2004, the fact that Pelosi and Reid replaced Gephardt and Daschle wasn't fully appreciated as a new direction. But the new management has done quite well, blocking Social Security privatization, winning bushels of House and Senate seats in 2006 and 2008, passing a big stimulus bill this year, and now getting health care reform through every committee. It's one of the reasons I'm such a huge fan of Nancy Pelosi -- when you've seen the devil, you'll know what an angel she is.

Via Matt, Sebastian Jones' article in The Nation details how Gephardt is using his new career as a corporate lobbyist to betray Democrats in new ways. He's lobbying for a coal company that funds climate change denialists, "Professional Employment Organizations" that allow employers to split employees in the same workplace between several different subcontractors so they can't unionize effectively, and pharmaceutical companies that want to keep generic drugs off the market. Back in April he was telling people that universal health care couldn't pass this year and Democrats should think smaller. I'm glad that the guy retired from the Congressional leadership, but I wish that meant that he was off playing video games somewhere instead of lobbying against progressive interests. (Though if he was playing first-person-shooters, he'd probably just go around teamkilling.)

Saturday, October 3, 2009

Lawless MILF Groups

I was intrigued by a recent headline from Mindanews in the Philippines: "NorthCot jail on alert with reports of MILF rescuing a detained commander." Another regional headline tells us that "Bombers used rogue MILF’s signature."

There is more interesting news on the issue from a variety of Filipino sites. According to one, "threats of MILF attacks are being feared in several towns." Another tells us that "The next generation of MILF leaders have been described at in their 30s to early 40s and were born during the war years." While setbacks in a previous negotiating process resulted in a "resurgence of violence between the government and lawless MILF groups," recently "the government and the MILF signed a historic agreement" that may bring an end to the conflict.

In these contexts, "MILF" of course refers to the Moro Islamic Liberation Front.

Friday, October 2, 2009

Friday Obama Caption Contest

Brynja Hammer smiles at President Barack Obama during a visit to the Oval Office on her eighth birthday, August 21, 2009. Byrnja's father Mike is spokesman for the National Security Council. (Official White House Photo by Pete Souza)

Playing Fetch With Blue Dogs

Warms my heart to see Ellen Tauscher in an honest line of work. When you can turn a more-conservative-than-her-district centrist Democrat who is doing the banking industry's bidding into an administration spokesperson against missile defense pork that destabilizes our relationship with Russia, you've done well. Russian cooperation on nonproliferation issues has a greater security value than extremely unreliable missile defense technology. Tauscher, Matt told us a while ago, was always right on this one. I'd love to see similar executive branch offers made to Blue Dogs who have the right positions on some narrow issue or other, but are otherwise causing trouble. (If next year's elections turn out badly, of course, many of them may need new jobs.)

Thursday, October 1, 2009

The Carper Compromise of a Compromise of a Compromise

If states are allowed to form band together to form a multi-state public option under Tom Carper's compromise, then if it turns out to be a way to get 60 or 61 votes it's pretty attractive. I would prefer to get the Schumer option written into the merged Senate bill, but perhaps this is a way to square the circle.

Update: looks like a mixed bag. States can band together, but they can't force providers to participate or tie rates to Medicare, or even Medicare plus some fixed percentage. If you can convince Carper to allow states to tie rates to Medicare+5% or something like that, it'd be a good start.