Tyranny of the Supermajority Minority

Via Sullivan, Mary Matilan on health reform:

They’ve been on this jihad for 70 years, and they’re going to throw over all their competitive seats to do it. And I don’t know what kind of party that is. That leaves left in the Democratic Party the urban centers, this is tyranny of the minority. Two-thirds of the country don’t want this. And one-third of these jihadists, these health care jihadists do. I guess that’s how democracy in the Obama era works.

Yes, because nothing screams tyranny of the minority like 60 votes in the Senate. It may be possible that the 30 smallest states have a minority of the population, but that certainly isn’t the case here. And if she is basing it on polling, not only is it stupid, but hypocritical given Bush’s low ratings in his second term.

And the Republicans wonder why people are condescending toward them; they don’t even attempt to make valid arguements.

Does Health Care Reform Violate Civil Rights?

Via MattY who all but accuses Sen. Lindsey Graham of racism for this:

GRAHAM: We need to offer solutions. But the Medicaid deal, for Senator Nelson — there’s one state in the union where new enrollees for Medicaid will be signed up, and it won’t cost anybody in that state money. It’s not my state.
I’ve got 30 percent African-American population, a lot of low-income African-Americans on Medicaid
. I don’t know what the numbers are in Nebraska, but I want my attorney general — there are a lot of people, Republicans and Democrats, are upset by this.

Yglesias thinks this is making it seem like Medicaid is a program for black people. The idea that racial fears would be used to undermine a means-tested social program isn’t new. But in this case, my interpretation is that Graham sees an actionable civil rights violation in mostly white (and Hispanic) Nebraska getting better treatment than heavily black South Carolina.

The motive in this inequity is sausage factory politics, not racial, but the effect could certainly boost disparities. Either reason is a good one to be irked about this particular concession. But the, that might just be my third order intolerance talking.

Bad Anti-Abortion Policy, Bad Science

Oklahoma’s effort to collect information to figure out why women get abortions is a legitimate scientific endevor. The <a href=http://www.google.com/gwt/n?u=http%3A%2F%2Ffeeds.stateline.org%2F~r%2FStatelineorgRss-HealthCare%2F~3%2F4mnitzkMXuY%2FJudge-delays-Oklahoma-plan-to-post-abortion-details-onlineexecution sounds a bit more like persecution than science.

No survey that compelled participation (the census excepted) would pass the human subjects review. Further, someone who cared about the science of the issue would also want to know why women don’t get abortions, and survey other women as well.

The judge in this case is right to be suspicious and hopefully will prevent this policy permenantly.

The Corrupt Ruling Party?

Radley Balko at Reason has this take on Dems passing cloture on the senate hcr amendment:

Congratulations, Democrats. You’ve proven you can pass a major piece of legislation by buying off votes with last minute pork projects and special favors, then shoving it through the Senate in the middle of the night just as well as the Republicans. You’re an all-growed-up corrupt ruling party, now.

The voting in the middle of the night and using indiscrete means of attaining sufficient votes is true, and annoying. But it is also the only way to get anything accomplished. It is playing too innocent to act like this is corrupt at an equivilent scale to Republicans.

Knowing What You Are Talking About

I hear it is useful.

Pandagon has some good points here, but there are others that show a disturbing ignorance of what the bill actually does. Basically the post is laying out an argument for why she would accept the Stupak amendment to get the public option back. I’ll put aside the fact that no such option is possible, no bill with a public option passes the Senate, but you can get a version with the milder abortion language of the Senate bill through the House (but no milder).

2) Without a public option, there is a strong possibility that a lot of people are going to be financially ruined by this bill. We know that insurance companies will do everything they can to exploit the mandate, while still looking for reasons to kick people off or charge them outrageous amounts of money for insurance. If someone has a “pre-existing condition” and has to pay thousands of dollars a month for insurance, then the subsidies won’t matter. If the subsidies come as tax credits, they really won’t matter. Thousands of dollars in insurance costs for individuals versus hundreds of dollars for (most) abortions? Thousands is a more pressing concern.

The bill as it is currently incorporated in both House and Senate prevents insurers from kicking people off the insurance. It prevents insurers from charging people outrageous amounts (they can’t price based on medical conditions). And because of that, pre-existing conditions do not change one’s premium cost. They will be guaranteed access to the insurance at exactly the same premium cost as everyone else (except for the age based rating, which still makes it far cheaper than the status quo). And while it is possible someone with a health problem could still be ruined by out-of-pocket costs, but those costs will still be less than the status quo.

Further, the public option (at least in the form that has any chance of passing), would do almost nothing to otherwise guarantee that any of those things would be better. The public option really has taken on a place of mythology on its ability to reform the market. Single payer and, to a lesser extent a public option tied to Medicare, would do a lot simply through cost pressures, but those aren’t even close to the table. The public option on the table would do very little, the CBO has basically said as much.

I appreciate the goal of her argument (putting abortion in context of broader health needs) but these details are pretty basic and important to get wrong. Is it that some people just don’t trust that the government will be able to stop these practices through regulation rather than competition? I just don’t understand.

Superfreakonomics: Geoengineering

They state multiple times in the book that the law of unintended consequences is the most powerful principle as it relates to human behavior. Yet, from battling natural disaster to global warming, they seem eager to jump on board to so rather radical steps that would seem to be vulnerable to unintended consequences.

An example of a solution to hurricanes is a device that would funnel warm water deeper into the ocean where cold water would push up. Lower the surface water temperature in crucial areas, and you can prevent hurricane formation. The actual process is rather simple. But even in the book they acknowledge that it could seriously mess up climate cycles including rainfall patterns. I pointed out when talking about the book Forecast, that the problem seems to be lack of creativity in designing buildings that could be largely unaffected by high winds and heavy rains. That would seem to be set us up for less unintended consequences than stopping hurricanes (or as they ultimately suggest, perhaps just downgrading major hurricanes).

The climate change chapter has perhaps gotten the most attention. There are a few irksome elements (misdirection about the panic over global cooling in the 1970s and the fact that things have cooled in the 00s) that ignore the fact that science has gotten a lot better in 30-40 years and that no one is claiming that carbon or anthropogenic causes are the only thing affecting climate patterns (as I presented in a simple graph in a post on the topic a couple months ago). But generally speaking, their skepticism is reasonable, such as “will we be able to act fast enough,” “are we targeting the right thing,” etc.

But I think it is dangerous to casually dismiss carbon tax (or cap and trade) and shoot right on to aggressive geoengineering. A carbon tax, contrary to popular belief, is not likely to be very expensive. And while we may not be able to prevent global warming harm entirely through this mechanism (it may too late, the solution may be incomplete, etc), there are other externalities related to carbon (hence foreign policy experts supporting energy independence) that further offset the cost of the change. And if nothing else, being more mindful in this respect can motivate us to incentivize a great deal of efficiency/conservation programs that literally have no long term cost. We should be converting waste heat in factories into energy. We should be weatherizing houses. These acts have up front costs but have clear long-term gains and it is simply economic waste in the status quo.

What is confusing is they make out these steps as an attempt to make humanity self-sacrificing, making the decision to get less utility from the world in exchange for it not overheating, a charge that, if true, would certainly justify the developing world’s scorn. But there is no particular reason that less carbon means less stuff; it just means less carbon-intensive stuff. Switching to hybrids or fluorescent lights may not be a practical solution to global warming, but they provide an example of what carbon reduction would look like, applied to the true mega-sources of carbon. What you have is a substitute to the original product that provides equal function (moving you around or providing light respectively) but with less demand for energy. And so nuclear, wind, and solar are ways of providing the same electricity that coal produces but with less carbon. The same brains that come up with geoengineering ideas can also come up with new ways to get the same utility from fewer inputs (and less carbon). This makes us better off, not worse. It isn’t a sacrifice, it is simply a restructuring.

Levitt and Dubner may be too cute in avoiding this, but since it is worth having some options if these solutions are insufficient, I’ll play along. Even if having an 18-mile long hose lofted into the sky with giant helium balloons and pumping sulfur dioxide through it with a bunch of tiny pumps is practical (will the balloons need to be replaced/refilled? how would they replace pumps if they stopped working?), the biggest problem raised in the book is who gets to decide what the target is. The negative impact of global warming is not universal and so neither would the positive impact of averting it. Picking a goal for this geoengineering project will naturally be a political statement as there is no reason to think there is a scientifically “right” temperature. I don’t see how this political problem is less than carbon reductions.

On the whole, I have no major objections to the chapter like everyone else had (but then, I’m not a climate scientist). Really the only major problem in the whole book was the short bit on walking drunk in the introduction. I think the fuss over Superfreakonomics was a bit overblown. That said, the book didn’t wow me as much as the first, for whatever reason.

Superfreakonomics: Car Seats

As it turns out, I already tackled this issue before without knowing it was part of the book. I should say the books treatment is a little better than what I gleaned from the two academic papers from Levitt that I responded to in my prior post.

He is very open in saying that the advantage of child car seats in mild injuries may be sufficient to justify it even though it does not outperform seat belts on severe injury or death. As I argued, we can expect the number of injuries to decline as severity increases so this actually captures most crash injuries. Whether it is justified would depend on how much you value that extra safety.

Further, Levitt’s’ point in the book that we should be concerned about becoming complacent with what we have instead of pushing for something better is very useful. Considering the majority of child seats are improperly installed, clearly there is work to be done. However, I’m not sure these concerns argue against states mandating broader use of car seats, as it remains the best option we have.

Anyway, contrary to his walking while drunk analysis or even the academic work on car seats, the coverage of car seats in the book does express the sort of qualified assertions that I think are important in Levitt’s line of work. He uses the data to tell us something interesting and useful but hedges a little in what the personal or policy ramifications should be. And ultimately, that is all I’m asking for from him, because I do get the value in challenging assumptions by using economic methods in unconventional areas.

What Kids Believe

The Girl Scouts have published a survey of youth attitudes on a variety of issues. I don’t put much weight in this sort of survey. When you ask a question like “would you cheat on a test” you are bound to get a lot of self-presentation bias…saying what you think reflects best on you, not necessarily what you would do. And while comparing to similar questions 20 years ago controls for some of this, the degree and direction of social pressure can certainly change. 20 years ago, for example, it is debatable whether there would be any social stigma to voicing an anti-gay position, so there is no reason to think numbers would be inflated on views toward gay people. These days, there is (thankfully) a stigma against such intolerance that is growing, but this makes polling on the issue less reliable.

Anyway, the one number that caught my eye is that twice as many boys as girls (12% vs. 6%) would recommend an abortion (presumably in the case of a teen girl getting pregnant out of wedlock). This number seems pretty low (the Juno-effect?) but that more boys than girls are pro-abortion in this case is interesting.

The complaint about men being involved in the abortion debate is usually that they are anti-abortion which women find a bit convenient since it is a procedure that does not directly affect them. But I’m not sure it is much more useful in the opposite direction where it can start to seem like men just don’t want to deal with the consequences of their actions.

The Benefit of Liberal Outcry

I think I am safe with this usage of liberal. As much as I was and am very concerned with those on the left who actively voice support for opposing the bill, this from Jonathan Cohn shows the value of anger as it looks to have restored a ban on annual/lifetime caps:

By the way, one reason this issue got so much attention was that the left raised a huge ruckus over it. The bloggers at Firedoglake and like-minded sites deserve credit here.

I think it is absolutely positive and essential for everyone to push hard for good policy ideas. They pushed hard for a public option or Medicaid buy-in that may not have done wonders, but would have been good. Pushing for Medicaid expansion to 150 would be good, as would funding all of it federally (because like Ben Nelson, I am rather concerned about the state burden, small and eventual though it may be), though I would include a push to help early-adopter states so as not to punish those who expanded coverage early. Wyden’s constant efforts to expand the exchange is good.

No one is saying that people should start saying the bill is perfect and stop doing anything to make it better. I would argue though that it is going too far to threaten the bill’s failure in this process. Perhaps the argument is that threatening to fail the bill is necessary to get what you want, but that is a high stakes game I am not prepared to play. No lifetime cap is very good, but getting it added back in would not be a victory if the bill fails because so too would lifetime caps fail. You don’t win anything for passing an amendment to a failed bill.

Just as those aspiring to emulate the Republican (allegedly successful) tactics a few years ago was misguided; emulating the hostage-taking tactics of Lieberman or Nelson is not a suitable goal.

The Senate Bill’s New Sin Tax

I can’t claim to have really understood the feminist opposition to a tax on cosmetic surgery. Yes, it would mostly hit women, but that just means they will be the ones to respond by not getting surgery, which is good right? Well, it is now dead as Ezra Klein explains:

And then there’s my favorite sentence in the CBO report: “The 5 percent excise tax on cosmetic surgery was eliminated, and a 10 percent excise tax on indoor tanning services was added.” Alrighty then.

Tanning is another cosmetic procedure that causes harm and relates to problematic standards of beauty and the like. I would bet that women tan more than men and that being tanned somehow helps women compete so I’d think this would be just as likely to be opposed by those who opposed the cosmetic surgery tax. Maybe they take cancer more seriously than the other ways cosmetic practices can kill?