Ten Miles Square

Blog

March 24, 2015 11:02 PM Not Logic but Experience: Why I Was Wrong About the ACA Then, and Will Be Right in the Future

By Andrew Sabl

The Affordable Care Act turned five years old yesterday. As any honest parent knows, that’s a common occasion for saying, “thank goodness: we survived.” And it’s as good an occasion as any for me to write a post I’ve been considering for some time but never got around to because I lacked the time for proper research on public opinion. Rather than delay longer, I’m writing it now as a thought piece. My confidence that I’m right is, for the moment, strong but fragile. It relies on the evidence of things not cited.

The basic point is this: the ACA is set up to mimic private insurance coverage for those who previously lacked it. I claimed that would and should make it, over time, acceptable and routine. That claim tacitly assumed, though, that everyone had experience with private insurance coverage and thought it worked OK. The uninsured in fact lacked that experience, and that more-or-less automatic judgment.

Right after the ACA passed, I wrote a post saying the proper (and accurate) framing was not “mandate” plus “subsidies” but this:

If you or your family aren’t getting health insurance through your job, the government will pay to get you private insurance coverage, just as an employer would.  You’ll have to contribute something—but the law guarantees, with specific numbers, that it will be no more than you can afford. It’ll be less than three percent of your paycheck if your family makes $33,000 a year, less than ten percent if you make as much as $88,000.  Pre-existing conditions won’t matter.  The government will still pay for your insurance, with the same affordable contribution from you.”

(There was more, but that’s the kernel.)

When I wrote that, what I didn’t realize was that my analogy wasn’t so much wrong as unfamiliar. That is: the marketplace for private health insurance is regulated; as Krugman wrote in a column long ago, that’s the only reason it works. Employers can’t charge employees with preexisting conditions more than those who lack them. They can’t, normally, let healthy employees opt out of the health plan in return for higher wages. And of course there’s a government “subsidy”—before the ACA, a non-progressive one—in the form of tax deductions for employer-provided coverage. Those of us with private insurance often, though not always, have to pay a sum of money—sometimes invisibly, as a payroll deduction—as our share of the monthly premiums. And, especially for plans allowing a lot of doctor choice, we often must pay a certain proportion of our health costs because our insurance only pays for 80 percent or whatever. (The 20 percent is called “coinsurance,” not that the average intelligent person needs to know that.)

Those of us with employer-provided health insurance are used to all that. And because I’ve had such insurance pretty much my whole adult life I assumed that pretty much everyone was used to the idea of all that, and wanted it. But I assumed wrong.

There are lots of working poor and moderate-income people who have never been able to afford health insurance and had little experience with how it works. (That more and more people were working for employers who provide no insurance was of course a reason for the ACA in the first place.) In some rural areas, especially where public employment with good benefits is nonexistent or uncommon, lots of people before the ACA didn’t even know much of anyone with health insurance. From their perspective, pre-ACA, visits to an emergency room were the source of great financial anxiety, even bankruptcy, when they got sick but financially costless until then. Paying even fairly low premiums up front seemed a burden, not the price of a benefit they were used to. Many self-employed people with substantially higher incomes also lacked health insurance and reasoned similarly. Because they weren’t used to having health insurance as a routine part of their pay package, they didn’t think of health insurance as a standard part of what everyone got as compensation (before money income and, in a psychic sense, separate from it). They thought of its actual cost and, if healthy for the moment, often didn’t like the cost. When conservative economists want to end the tax deductibility of health insurance so that we perceive its “real cost,” they want us employer-insured people to think as the well-off uninsured always have.

These categories of people don’t find comfort in the fact that the ACA treats everyone as insured employees have always been treated. That fact is, as community organizers would say, “outside their experience”: irrelevant to the context of choice that they’re used to. (This isn’t even to mention people on the serious Left who know about other countries and don’t think health insurance should be provided by employers, through private insurance companies, in the first place. That’s a separate issue, a matter not of experience but of principle—a principle that I sympathize with but that lacks wide support in the US.) By the way, the argument that the ACA prevents people from “choosing their own doctor” often blindsides ACA opponents because it’s outside our experience. Most of us have for decades had plans that place certain doctors “in-network” and others “out-of-network.” We’re used to having the latter covered only partially, or not at all. That’s the only way to hold costs down: your insurer will only cover doctors willing to accept its fee. But if you’ve never had insurance, all the doctors you might want to see are, in a sense, equal. If you’re working poor, all the doctors you know, at the emergency room or health clinic, will equally have to write off the cost of your treatment (or badger you with bills you can’t pay). If you’re wealthier but self-employed, all doctors—your choice of which—will bill you for the full cost of treatment. In neither case will doctors normally compete explicitly with patients on price. They do so only when dealing with large insurance companies.

This lack of experience explains, I think, lots of the continued opposition to the ACA. For most of those for whom the system of doing business with private insurers is familiar, it stands to reason that the ACA does a good thing by bringing as many people as possible into it. But for those to whom the system, with its annoyances and burdens, is unfamiliar, being brought into it on pain of tax penalties seems a pure imposition of costs. The benefit—the peace of mind that comes with not having to worry about serious illness rendering you destitute or consumed with worry about bills—seems abstract and notional because it’s never been felt. And to the extent that ACA implementation has responded to complaints about plan costs by letting some plans be mostly or exclusively catastrophic-only—contrary to its initial intentions—it has guaranteed all the more that the benefits will, for most, remain abstract and notional. Only those who experience serious injury or disease will ever feel them.

For the same reason, though, another post I wrote remains, I think, valid. Once experience with the ACA has built up, over many years, the system won’t grate anymore. It won’t even seem like government. It will just seem like the way people get health care—just as a little paper or online brochure from our employer has been the “way we get health care” for those of us with employer insurance all along.

Update: the original version of the post said that employers providing group health insurance weren’t allowed to let employees opt out of the health plan. What I meant, of course, was that they couldn’t let employees opt out in return for higher wages. One may always turn down health coverage, but those with group insurance have no reason to (unless they have better coverage through another means, e.g. through a spouse). The current text reflects the change.

[Cross-posted at The Reality-Based Community]

March 24, 2015 10:50 AM Israel and the Politics of Paroxysm

By Jim Sleeper

Any development involving Israel becomes a Rorschach test for many Americans, probably even for larger numbers of non-Jews than Jews. Israel’s recent elections lit up a spectrum of reactions that revealed more about the reactors’ own temperaments, ideologies, and even their feelings about Jews, than about what the elections themselves actually reflected and portend. At one end there is gloating, and at the other doom-saying, but to assess the situation intelligently, we need to look at it morally and politically — not moralistically or ideologically— or we will only exacerbate a politics of paroxysm that forecloses politics itself.

My assessment is that the situation is indeed grim and spiraling away from politics into tragedy, but not because “Palestinians never miss an opportunity to miss an opportunity,” as Abba Eban, an Israeli foreign minister, once quipped. For some time now, it has been Israeli leaders who’ve never missed an opportunity to miss an opportunity, and what they’re missing right now is that many Palestinians are terrified enough of ISIL and resentful enough of how Hamas is ruling Gaza to contemplate a reasonable deal, perhaps one involving nominal Palestinian statehood and a functional federation, funded generously with EU and US help.

I first toured Israel in the mid-1960s with cheerleading Jewish student groups. I returned again in 1969, only two years after Israel’s supposedly glorious victory in the Six Day War, on an Arab-Jewish relations project that involved long conversations with Israeli Arab citizens, including college students in Haifa and writers and activists in Acre and the Galilee. After these experiences, I was something of an optimist about Israel’s incredible accomplishments and potential, and I wrote up my impressions for an anthology, The New Jews (Vintage, 1971) that I edited with Alan Mintz.

I am no longer an optimist, but neither have I much patience for people who enjoy taking warm baths in morally self-righteous pessimism. You can read my more recent assessments in a collection of columns, “Israel’s Tragedy, America’s Folly,” here.

The outlines of the deal that Israel should still invite Palestinians to make were sketched last year somewhat wistfully by Sari Nusseibeh, the Palestinian writer and former president of Al Quds university, in a poetic, heart-rending lament for the Israel in which he’d once placed some hope. That essay has been brought to Americans’ attention by the Bard College Hannah Arendt Center’s director Roger Berkowitz in his own powerful and poetic essay.

These are the two most important pieces I’ve read anywhere about the current situation, although there are many other, well-grounded contributions.

Nusseibeh writes:

“Indeed, the one thing that Israel can do right from the outset is to declare… that it henceforth will begin a wide-ranging initiative aimed at changing the political climate, in preparation for a proper solution… Israel can turn over a particular part of Area B (under shared Israeli and Palestinian control) into part of Area A (under full Palestinian control), somewhere; likewise, a particular part of Area C (under full Israeli control) into an area B. And it can allow, experimentally, people over age 60 from the West Bank or Gaza to begin to move freely throughout the country, therefore enabling them also to visit their holy sites in Jerusalem.

“Supposing the first steps work (meaning, without negative security consequences, and with decreased sentiments of hostility), Israel could take the next step. Margins of breathing space can be incrementally expanded, each time providing more space for the well-being of Palestinians. Will Palestinians go for such steps? Who wouldn’t? And why wouldn’t they?”

Does Netanyahu’s Likud Party victory prove that the Israelis are incapable of seizing the moment? Very possibly. This is a polity whose original idealists, whom Nusseibeh describes unforgettably in his essay, are being swamped by “Greater Israel” religious fanatics, nationalist yahoos, real-estate profiteers, a million politically cauterized, right-wing Russian immigrants from the Soviet Union, and their pathetic American neoconservative cheerleaders and funders. Collectively, they have no idea how the nature of war-making and wealth-making have changed and are changing the circumstances under which they think they can win.

Still, The Atlantic writer James Fallows cautions wisely that detractors from abroad would be as wrong to blame Israelis as a whole for Netanyahu’s victory (and the demagogic intransigence it reinforces) as other observers abroad were wrong to blame all Americans for George W. Bush’s reelection in 2004.

Fallows reminds us that even after Bush won, he changed: “Dick Cheney was corralled; the U.S. undertook no new wars and began repairing some of the relations it had frayed or broken.” The American electorate changed, too, not so much in composition as in judgment: Four years after Bush’s victory, “the same U.S. electorate made an entirely different choice.” Fallows doesn’t predict any such shift by Netanyahu or the Israeli electorate, but he reminds us that elections often have unintended consequences.

I’d add that Americans who’ve called for boycotting Israeli universities as carriers of Netanyahu’s doom-eager worldview (actually, Israel’s universities are often centers of dissent) should, by their own logic, have called for a boycott of American universities between 2004 and 2009. They didn’t, of course: They’d have had to boycott themselves. You might imagine that this thought would give them pause before broad-brushing Israelis, but you’d be wrong. Moral passion and distance eclipse moral and political judgment.

The New Yorker’s David Remnick, as close and sober an observer of Israel and Palestine as any American writer, notes that even though “nearly two hundred former Israeli military and security chiefs, none of them naïve about the multiple dangers of the Middle East, have declared that further brinkmanship threatens the long-term stability of the nation,” Netanyahu is still “sure that he knows better. The tragedy is that the likely price of his vainglory is the increasing isolation of a country founded as a democratic refuge for a despised and decimated people… [A]s he forms an unabashedly right-wing and religious government, he stands in opposition not only to the founding aspirations of his nation but also to those Israelis—Jews and Arabs—who stand for tolerance, equality, democratic ideals, and a just, secure peace.”

We’ll learn, probably all too soon, whether Israel vindicates Fallows’ characteristically American hopefulness or Remnick’s moral pessimism. Berkowitz’s must-read essay argues that the nature of war itself has changed enough that massive militaries are useless and that war itself is unwinnable by any “side.” His essay opens with Hannah Arendt’s prescient observation that since sovereign states have no “last resort” except war, then “if war no longer serves that purpose, that fact alone proves that we must have a new concept of the state.”

What Netanyahu’s victory probably does prove is that many Israelis, for compelling, understandable, but tragic reasons - and their American cheerleaders, for reasons that are far less compelling or excusable - aren’t ready to internalize this new truth about war and make new history by supporting a viable federation with Palestinians along the lines Nusseibeh sketches. Paroxysms can’t be reasoned with. And Berkowitz explains why, when they’re militarized, paroxysms can’t win. We have to hope that they’ll burn themselves out before they draw everything else down with them and that some new combination of circumstance and persuasion will deter them.

March 24, 2015 9:22 AM When You Come to the Bridge, Jump Off It

By Martin Longman

This made me laugh out loud.

Rep. Peter King (R-NY) appeared on CNN’s The Situation Room Monday afternoon and when Wolf Blitzer asked him to explain his statement that compared Sen. Ted Cruz (R-TX) to a “carnival barker,” the Republican congressman opted not to walk back his comments but instead take about a dozen steps forward.

“We need intelligent debate in the country. Ted Cruz may be an intelligent person, but he doesn’t carry out an intelligent debate,” King said. “He oversimplifies, he exaggerates and he basically led the Republican Party over the cliff in the fall of 2013. He has shown no qualifications, no legislation being passed, doesn’t provide leadership and he has no real experience. So, to me, he is just a guy with a big mouth and no results.”

But would King support Cruz if he ended up becoming the Republican Party nominee for 2016?

“I hope that day never comes,” King told Blitzer. “I will jump off that bridge when we come to it.”

I might add that Rep. King lumped Sen. Rand Paul of Kentucky in the same lack-of-talent pool.

This is what I predicted would happen. The early attacks on Senator Cruz are more personal than ideological in nature. Of course there is a big ideological divide between Rep. Peter King and Senator Cruz, but King would rather not get into the specifics too much. Rather than pointing out precisely where he disagrees with Cruz, he attacks him for lacking experience, temperament, judgment, and seriousness. I expect this to be the path that most of the Republican candidates follow.

[Cross-posted at Progress Pond]

March 23, 2015 9:53 AM Prohibition and Marijuana Potency

By Keith Humphreys

At Washington Post Wonkblog, Christopher Ingraham notes that the potency of available marijuana has been increasing:

Retail outlets in Denver and elsewhere advertise strains that contain 25 percent THC or more. As legalization opponents are forever fond of saying, this isn’t your daddy’s weed.

There is extensive evidence available to support Christopher’s observation about rising marijuana potency. But I am not sure that his causal explanation for the potency increase comports with the facts. He attributes it to prohibition and believes therefore that legalization will reverse the trend:

As prohibition eases and legal markets open up, growers now have the breathing room to select for traits beyond high THC content. Demand from new users looking to experience a social high, rather than four hours of couch lock, will likely drive this. The end result may be a resurgence of milder strains of weed that are more akin to fine wines than to bathtub gin.

There are a couple analytic problems here. First, over the past 5-10 years, legalized marijuana markets (medical and recreational) have expanded dramatically and marijuana enforcement has dropped sharply, but as the data Christopher himself presents show, potency went up rather than down during that time. Second, if one looks at other legal industries that sell psychoactive drugs, they typically do anything they can to give customers as much potency as possible for every dollar they take in.

For example, the British alcohol industry has been warring with the government from at least 1751 (e.g., The Gin Act) to the present day (e.g., minimum unit pricing) over the former’s efforts to churn out cheap, high potency alcoholic beverages. Even if one restricts analysis to the “fine wine” analogy that Christopher evokes, it has to be said that over the past quarter century, the alcohol content of wine sold in the U.S. has crept up from the 8-10% range to 12-14%.

For drug producing industries, higher potency products are a good. They lower transport costs because the product has less mass and weight. Consumers like getting more bang for the buck. Finally, higher potency products are more addictive, and addicted customers are the best customers. I can’t stress strongly enough that all these advantages accrue to both legal and illegal drug sellers. There is nothing in the legalization of drug-producing industries that eliminates these financial incentives and because they can operate openly, such legal sellers actually may be better at achieving a saturation of lower cost, high-potency products in a market than are sellers constrained by prohibition.

People who enjoy the occasional low potency marijuana cigarette tend to assume that sellers have a big economic interest in catering to them. But about 90% of the weed being sold in Colorado is used by people who smoke every day or almost every day. There just isn’t as much money in the “fine wine” set of occasional marijuana users as there is in daily, physically dependent users of high-strength pot.

A legal market thus doesn’t inherently bring us low potency. Rather, it brings us a fight between regulators who generally want low potency products to dominate the market and sellers who generally want high potency products to dominate the market. Sometimes the regulators win, sometimes the industry does. When the industry wins, higher potency products are more available than they are under prohibition. When the regulators win, industries are forced against their economic interests to produce more of the lower potency products that Christopher and I agree pose less risk to consumers.

[Cross-posted at The Reality-Based Community]

March 22, 2015 11:31 PM Has the Republican Presidential Nominating System Changed Since 2008?

By Seth Masket

In the cover article of Sunday’s New York Times Magazine, Jim Rutenberg asks, “How Do You Solve a Problem Like Ben Carson?” To get a sense of what the article is driving at, it’s helpful to skip to the very end, where we read this:

I spotted Newt Gingrich, himself a fleeting presidential front-runner during those strange primary days of 2012. I asked him whether he thought all the party maneuvering — all the attempts to change the rules and fast-track the process — would preclude someone from presenting the sort of outside primary challenge he had carried out in the last election.

“No,” he told me, as if it was the most obvious thing in the world. “Look at where Ben Carson is right now.”

Um, where is Ben Carson right now? Okay, granted, he’s got a reasonably positive profile story in the NYT magazine, but that’s hardly the fast track to the Republican presidential nomination. He’s certainly not the poll leader (even thought that isn’t great indication of nomination prospects this far out anyway), and it’s not like he’s amassed an intimidating warchest or garnered fantastic endorsements from party insiders. Some early staff he hired came from the 2012 campaigns of Michelle Bachmann and Newt Gingrich — hardly evidence of insider approval. And even though he may have an admirable personal story, most of what people know about him revolves around his tendency to say truly outlandish things, such as comparing Obamacare to slavery or suggesting gay marriage will lead to bestiality.

But the article really pivots on this description of Republican presidential nomination politics:

A candidacy like Carson’s presents a new kind of problem to the establishment wing of the G.O.P., which, at least since 1980, has selected its presidential nominees with a routine efficiency that Democrats could only envy. The establishment candidate has usually been a current or former governor or senator, blandly Protestant, hailing from the moderate, big-business wing of the party (or at least friendly with it) and almost always a second-, third- or fourth-time national contender — someone who had waited “his turn.” These candidates would tack predictably to the right during the primaries to satisfy the evangelicals, deficit hawks, libertarian leaners and other inconvenient but vital constituents who made up the “base” of the party. In return, the base would, after a brief flirtation with some fantasy candidate like Steve Forbes or Pat Buchanan, “hold their noses” and deliver their votes come November.

I could certainly quibble with parts of that description, but basically, yeah, the party tends to nominate a certain type of candidate — a current or recent senator or governor who is broadly acceptable to various factions within the party. The real question is whether that dynamic has changed. The article suggests that this system has been undermined since 2008, given the rise of the Tea Party, changes in media and fundraising practices, and various nomination and delegate selection rules changes. Has it? That is, has the increased factionalization with the Republican Party, combined with the ability of candidate to go around traditional partisan sources to get their message out to voters and raise funds, made it easier for non-traditional candidates like Carson to win the nomination?

We basically have one presidential election — 2012 — to draw on as evidence. And that evidence largely suggests that the system hasn’t changed much. Yes, it was a noisier nomination cycle than most, with nearly every candidate serving as the front-runner for at least a few days, and lots of entertaining debates to give long-shot candidates some air time. And non-traditional funding sources allowed some candidates to keep campaigning long after they would have run out of cash in an earlier cycle.

Nonetheless, the outcome of that nomination contest was entirely predictable from very early on. Romney had a lot of major party endorsements locked down early in the cycle, Perry could have threatened that but fizzled in public appearances, and no one else really came close to undermining Romney’s support among party insiders. Changes in the nomination system generated a lot of noise but ultimately didn’t change the outcome.

What other evidence do we have? Well, Democrats are operating in the same political environment. If recent changes have made it easier for long-shot candidates to do well, we might see more of them running for president. Instead, the opposite has occurred — Hillary Clinton has sown up the nomination earlier and more overwhelmingly than any other non-incumbent in modern presidential history.

It’s certainly possible that the post-1968 presidential nomination system has finally shifted to something new. But what evidence we have suggests that it hasn’t, at least not yet. Ben Carson is following the path of Michelle Bachmann, Herman Cain, and Newt Gingrich, and there’s little reason to expect he won’t wind up at the same destination.

[Cross-posted at Mischiefs of Faction]

March 22, 2015 10:41 AM All the Bush Family’s Horses…

By Martin Longman

Senator Ted Cruz of Texas will become the first presidential candidate (in a strictly legal sense) of the 2016 campaign on Monday. He’s not going to go the whole “exploratory committee” route and intends to jump in with both feet.

Senior advisers say Cruz will run as an unabashed conservative eager to mobilize like-minded voters who cannot stomach the choice of the “mushy middle” that he has ridiculed on the stump over the past two months in Iowa, New Hampshire and South Carolina.

“Ted is exactly where most Republican voters are,” said Mike Needham, who heads the conservative advocacy group Heritage Action for America. “Most people go to Washington and get co-opted. And Ted clearly is somebody that hasn’t been.”

I’ll have to look at the financial implications of Cruz’s decision, but getting an early start is important regardless of how you legally organize your campaign.

This guarantees that Cruz will get the attention he craves, and that won’t be a good thing for the Republican Party. I don’t think he plans to leave any room on his right for his competitors to maneuver in, and his schtick is going to be that everyone else is a weak-kneed conservative wannabe. I expect this to get very personal, very quickly. Because the other candidates will be more comfortable attacking Cruz than the outlandish conservative ideas he espouses, I think they will talk about his knowledge, temperament, and effectiveness rather than challenge him from an ideological point of view.

The exception will be Jeb, who will attempt to be the voice of reason. He’ll have to hope that his opponents divide up the majority into enough pieces that he can win with a small plurality.

We ought to remember that Ted Cruz isn’t a former pizza executive, backbench representative from Minnesota, or even a disgraced former Speaker of the House. He is one of two U.S. senators from the largest red state in the country, the same state that gave us Lyndon Johnson and both Bush presidents. How he behaves and what he says helps define the Republican Party to the nation and the world. This will be more true than ever now that he’ll be a presidential candidate.

That most of his Republican colleagues in the Senate despise him and disagree with his critiques means that there will be a lot of pushback. It’s not only the Republican Establishment, but a much broader segment of the Republican base that doesn’t want Cruz to speak for them. This should quickly become evident even on Fox News, and it’s going to take existing wedges on the right and pry them wide open.

I can see Jeb prevailing as a kind of champion against Cruz, but there will be a Humpty Dumpty effect even if Jeb is successful.

[Cross-posted at Progress Pond]

March 22, 2015 1:47 AM For Fear of an Unguarded Comment, All Comments Will Be Guarded

By Hans Noel


There’s a chance this post is just an excuse to show a cute picture of a meerkat.

My news feed is breathlessly telling me about Meerkat, the new social media platform touted at SXSW that makes it really easy to livestream video from your phone to Twitter. I’m told it’s a game changer, which is cool, because this game has gone several days without being changed.

I’m generally cynical about the potential of social media to completely change the nature of politics. Parties still need to mobilize voters and manage coalitions. But even a skeptic can’t deny that radio and television, cable news and the Internet, Facebook and Twitter have all had effects. Not always the ones people expected, but effects.

People seem to be expecting that Meerkat, like other social media, will have a democratizing effect on politics. If every citizen is a journalist, if every gaffe is live-streamed, then politicians will have nowhere to hide. As former Obama advisor Dan Pfeiffer puts it here “This year’s “47 Percent Moment” will be on live video. … This is a good thing, … because it breaks down barriers between the voters and campaigns.”

Maybe so. But politicians are strategic. They may not be able to outsmart technology, but they will try. At at least some will succeed.

What would that look like? One possibility is that politics will become more sterile, as Matt Yglesias argued after Obama was criticized for using the word “random” to describe an attack on a kosher deli in Paris. For fear of an unguarded comment, all comments will be guarded. To take another deep cut from John Zaller’s A Theory of Media Politics, politicians who wanted to control their message thirty years ago would orchestrate “closed photo ops,” in which they limited journalist access. If every citizen is a journalist, then everyone’s access may be controlled.

There is another way that can happen. Recall that the “47 percent” comment (see also “cling to guns or religion”) was meant for a semi-private audience, at a fund raiser. Romney’s comments were surreptitiously recorded. As it becomes harder and harder for politicians to control their semi-private events, important discussions of policy may move into still more private places.

I don’t know how the latest round will play out. Meerkat is hardly the first technology that makes it easier to spread unfiltered political information. But whatever the effect, it won’t just be the result of journalists and voters using the technology. It will also involve politicians responding to it.

[Cross-posted at Mischiefs of Faction]

March 20, 2015 9:22 PM Cannabis Policy for Conservatives: the Unpalatable Versus the Disastrous

By Mark Kleiman

Josh Barro’s report in the New York Times starts with the debate about the Washington D.C. grow-and-give system and opens out into the broader question of whether it’s possible to create a system of cannabis controls that:

(1) Allows adult access;

(2) Substantially eliminates the harms from organized illicit business;

(3) Minimizes arrest and incarceration;

(4) Minimizes the increase in heavy use and use by minors.

Those seem to me to be the four key objectives in designing a cannabis policy. (Of course supporters of the current laws don’t regard #1 as an objective at all; tax revenue is relatively unimportant substantively, though a winning argument politically.)

Prohibition is a disaster in terms of illicit markets and law enforcement. Decriminalization might reduce the number of arrests, but wouldn’t reduce the extent of the illicit traffic (currently $40B/yr.) or do much incarceration (about 40,000 behind bars at any one time).  No one seriously proposes mounting the sort of enforcement effort that would be required to shrink the illicit trade back to the level of 20 years ago.

So prohibition is no longer a viable option, and the question is what to do instead. There’s no reason to think that commercialization on the alcohol model will have acceptable results in terms of heavy use and use by minors. “Grow and give” is one among a family of options for non-commercial legalization, alongside state-monopoly retailing, cooperative and other not-for-profit production, or production by public-benefit corporations.

Barro quotes David Frum, an adviser to an anti-legalization group, as praising grow-and-give as an “elegant” approach to finding a middle way, but doubting that it’s sustainable in the face of lobbying pressure. I share that doubt. But if a reasonable option such as grow-and-give is unsustainable, what does that say about an unreasonable option such as continued prohibition?

If the voters are given a choice between the current system and commercial legalization, it’s increasingly clear that they will choose to treat cannabis the way we treat alcohol. So if, like Frum (and me), you’re worried about the bad   consequences of commercialization, you ought to be working hard at building a political coalition to support some non-commercial option, even if (like from but not me) you would really prefer prohibition.

Twenty years ago, the anti-pot forces made the historic blunder of resisting the development of cannabis-based medications, leaving the political field clear for the “medical marijuana” bamboozlement.  Now they’re doubling down on that mistake, resisting non-commercial legalization and paving the way for the very Big Marijuana they most fear.

When the predictable upsurge in problem use arrives, the prohibition forces will have the gloomy consolation of being able to say “I told you so.” But what will console the victims of the avoidable increase in cannabis use disorder, and their parents?

John Kenneth Galbraith once defined politics as “the art of choosing between the disastrous and the unpalatable.” I appreciate that Frum finds the thought of people getting stoned unpalatable. But I hope that he, and his allies, will figure out – before it’s too late, if it isn’t already too late – that the results of allowing cannabis to be pushed the way alcohol is pushed are likely to be disastrous.

[Cross-posted at The Reality-Based Community]

March 20, 2015 6:06 PM Marco Rubio Needs to Ramp Up The Stupid

By Martin Longman

I don’t read Steve M.’s blog every day, but I read it often enough that I think I recognize a mantra when I see it. Steve uses a lens to interpret the right, and it seems to have a lot of explanatory power. It basically works like this: the right revels in annoying us, and the more a right-wing mouthpiece annoys us, the more popular they will get. So, for example, if you can’t figure out why Marco Rubio isn’t more popular among wingnuts, the answer is that we think he’s a harmless, mildly corrupt, non-entity. He does nothing to raise our blood pressure and isn’t even obnoxious enough to arouse our contempt.

Besides the obvious problem (Rubio used to support immigration reform), Rubio is struggling because he “wears his ideology lightly.” He’d be doing much better if Republicans thought he scared Paul Waldman and the rest of us liberals and lefties, the way Scott Walker does.

Of course Walker impresses GOP voters: his union-busting, electoral victories, and mutually beneficial relationship with the Koch brothers drive us nuts. Republican voters love that. By contrast, when has Rubio ever left us sputtering with rage? When has he gotten the better of us?

Ben Carson is popular on the right because he launched an attack on President Obama at the ostensibly apolitical National Prayer Breakfast. Chris Christie used to be popular on the right because he fought unions and publicly dressed down teachers and other critics. That’s how you win favor on the right — and Rubio doesn’t do it.

The easiest thing for Rubio to do to remedy this is to ramp up The Stupid substantially. He made a good start of it this week by saying some painfully idiotic things about the Middle East. That got him some positive attention from the morons.

This is a good start, but he needs to start saying things that aren’t merely addled but that cause actual cramps in normally functioning brains. The bigger and more brutal the logical fallacy the better. He’ll get extra points for thinking up things that are so insane that we can’t even imagine how he came up with them in the first place. I am looking at Louie Gohmert and terror babies here. David Vitter understands.

In any case, unless and until Rubio truly embraces Steve M’s theory of wingnut politics, he’s going to be stuck at the back of the pack.

[Cross-posted at Progress Pond]

March 20, 2015 1:33 PM The Sodomite Suppression Act

By Martin Longman

Interestingly, it does not appear that California has a way to avoid proceeding with a ballot initiative that advocates the murder of homosexuals. The ballot measure was initiated by a lawyer from Huntington Beach named Matt McLaughlin:

For less than the cost of an Apple iPad, Matt McLaughlin started a statewide legal conversation.

An attorney from Huntington Beach, McLaughlin in late February spent $200 to propose a ballot measure that authorizes the killing of gays and lesbians by “bullets to the head,” or “any other convenient method.”

McLaughlin’s “Sodomite Suppression Act” now is testing the limits of free speech and raising the question: Why can’t the state’s initiative process screen out blatantly illegal ideas?

Simply by paying the $200 fee, McLaughlin has apparently compelled state Attorney General Kamala Harris to take formal action.

Yet the measure is likely to proceed to the signature-gathering stage. At the moment, its fate rests with state Attorney General Kamala Harris, who is charged with writing a title and summary for the proposal. Legal experts say she has little choice but to let the process continue and that McLaughlin is unlikely to face professional repercussions.

Naturally, Ms. Harris would rather not write up a title and summary of this initiative, but it appears that her hands are tied by the law and prior court rulings. And a lot of experts think giving her the discretion to blow off this submission as clearly illegal would be the more dangerous precedent.

Then there’s the issue of Mr. McLaughlin and his law license. It doesn’t appear that anything can be done about that either.

“It’s offensive to anybody with a rational mind, but I don’t know that it necessarily rises to the level of an ethics violation,” said Jonathan Arons, a legal ethics attorney in San Francisco.

David Cameron Carr of San Diego spent a dozen years at the State Bar disciplining lawyers and the last 14 defending them. He said while attorneys could be disciplined for acts of “moral turpitude,” that requirement relates to the ability to perform their work.

“This is not obviously the kind of act of moral turpitude that calls into question his fitness to practice law,” Carr said.

I guess we can quibble about what the word “obviously” means in this context, but it’s probably true that it’s not the kind of thing that normally costs someone their law license. I think an argument can be made that advocating murder and hate crimes calls into question his mental stability, but that doesn’t mean he has unhappy legal clients or is incapable of offering sound legal advice.

To get this initiative on the ballot, McLaughlin will need 365,880 signatures, which seems like an impossible number to me. So, while it’s highly offensive, it really only matters as an opportunity to revisit the ballot initiative process. Should the fees be higher than $200? What kind of discretion should there be about which initiatives should be allowed and who should have that discretion?

I’m no fan of ballot initiatives, but it does seem that there’s always someone who is intent on ruining things for the rest of us. Don’t you think?

[Cross-posted at Progress Pond]

March 20, 2015 11:12 AM Sarah Chayes on Kleptocracy as a Security Issue

By Mark Kleiman

Now that the teaching quarter is over, I can get to my piled-up “must-read” list.

Sarah Chayes’s Thieves of State is high on that list. My students doing their master’s project on income maintenance in Afghanistan found it invaluable.

Fortunately, today I was treated to the low-cost substitute for reading a whole book: Chayes gave a talk at UCLA. She wasn’t as funny as she was on The Daily Show, but the analysis was pretty damned compelling.

I’ve always made fun of “corruption” as an academic topic because of its excessive focus on relatively minor cash payoffs, to  the exclusion of other forms of rent-seeking. That’s not an objection that anyone could raise to Chaye’s presentation. Even the talk was too complex to be well-summarized in a blog post, but these seemed to be the key points:

1. The idea of corruption as a malfunction in governance due to poor institutional design misses the point with respect to full-on kleptocracy, which is an increasingly widespread form of government (Afghanistan, Iraq, Russia, Ukraine, Pakistan, Nigeria). In a real kleptocracy, stealing isn’t something that happens in the course of governing; rather, governing is a means of stealing, and what look like bugs in the system are in fact features from the viewpoint of the people running it.

2. Insurgency, whether it takes a religious form or not, is often motivated primarily by corruption.

3. Petty extortion always involves insult as well as financial injury, and sometimes involves physical injury. That makes people mad; sometimes mad enough to want to kill a cop. When someone from ISIS or Boko Haram (or, I would have added, Sendero Luminoso) hands such a person a gun and tells him that cop-killing is not only justifiable but is a religious or patriotic duty, he may well take up the suggestion.

4. In a real government, taxes are paid by ordinary people and businesses to the central government, and then sent back down to officials and contractors who do the work and to citizens and businesses in the form of services and benefits. In a kleptocracy, lower-level officials exact bribes and extortion payments from citizens and businesses, and pass the money up the chain.

5. Sometimes there’s a single fount of corruption. Sometimes there are cooperating kleptocratic networks. Sometimes those networks compete rather than cooperating, in which case politics becomes a blood sport.

6. Lots of Westerners shrug and say, “Well, that’s the way business is done over there; it’s in the culture.” But no one Chayes has talked to living under kleptocracy has that viewpoint; they’re all outraged.

7. The free flow of international capital, currency convertibility, and the sale of state assets to private parties have increased the opportunities for, and benefits of, massive corruption. A Soviet official could have a dacha, but not much of a Swiss bank account, since the ruble wasn’t actually worth anything. A Russian kleptocrat can have a bank account in London and a $20 million apartment in New York.

8. Ignoring corruption and governance in order to deal with “security issues” – or, worse, making corrupt payments to kleptocrats to keep them on our side (in Iraq or Afghanistan, for example) gets the causal arrows wrong. Corruption and government are security issues, perhaps the paramount ones.

9. Since the money winds up in the West, Western institutions, including governments, have both culpability for allowing the theft to continue and some capacity to tamp it down.

10. A serious attack on kleptocracy would involved the same sort of careful network diagrams that characterize counter-terrorist work. And it would use visa denial and in rem seizure of assets in the U.S. as systematic techniques.

11. Kleptocracy can happen here.

The talk included lots of interesting historical material (including an analysis of Luther’s 95 Theses as an anti-corruption tract) and several terrific illustrative events. Here’s my favorite. Several months before Boko Haram kidnapped 300 girls, the head of the Nigerian Central Bank – brought in to bail out the banking system in the 2009 financial crisis – discovered that $20 billion had gone missing from the state’s oil revenues. When he announced that he was going to examine banking records to figure out who had stolen the money and where had landed, the President of Nigeria fired him.

Chayes then asked how many in the audience knew about the kidnappings (all of us) and how many about the theft of $20B an the firing of the central banker (three out of about 75, at a law school talk advertised as being about corruption). [No, I wasn’t among the three.]

The punchline, from Chayes’s viewpoint: when the President of the United States offered the President of Nigeria sympathy, and aid against Boko Haram, in the wake of the kidnapping, no one asked about the $20 billion, or about who had stolen the money that was supposed to pay for the bullets that the Nigerian soldiers fighting Boko Haram didn’t have. Terrorism is punished, or at least is the source of serious outrage; systemic corruption is shrugged at.

Sounds like a problem we ought to do something about. And – for the first time – I now think that there is something to be done about it, over and above my usual prescription of raising the salaries of cops and other civil servants so they can afford to be honest.

[Cross-posted at The Reality-Based Community]

March 20, 2015 11:08 AM “Pre-Existing Condition” Gets Personal: the Case of Kevin Drum

By Mark Kleiman

Kevin Drum explains what would happen to him if ACA were repealed: due to his cancer, he’d be uninsurable. If his current employer folded – not a remote eventuality, in the world of magazine and online journalism – he’d be s.o.l.

Kevin, let us recall, is neither poor nor reckless. He didn’t choose to get cancer. He did choose to have health insurance. Nothing he could have done – short of working for a government or TBTF private outfit – could have protected him from the risk he will face if a Republican is elected President in 2016 and does what he will have promised to do in order to become the Republican nominee.

So, here’s a challenge to my conservative and libertarian readers:  Tell me, if you can, why that would be OK with you.

I promise to publish any literate and coherent reply verbatim, or link to any post elsewhere that answers the challenge.

Update A reader points me to this Megan McArdle post from 2012, which explains in detail how a little-known provision of HIPPA (a law that long pre-existed ACA) would protect someone in the position Kevin would be in should Mother Jones fold. Anyone who has continuously maintained health insurance is, apparently, eligible to buy new insurance without underwriting. That’s not much help to people who, when they lose their jobs, don’t have enough in the bank to keep paying for unsubsidized health insurance. But that’s not Kevin’s situation. Unless some health care wonk tells me otherwise, I’ll count my challenge as having been fully met, and will have to fall back on the other 69,000 reasons Friends Don’t Let Friends Vote Republican.

[Cross-posted at The Reality-Based Community]

March 20, 2015 11:03 AM Weekend Film Recommendation: Psycho

By Keith Humphreys

psycho-12
Part of Alfred Hitchcock’s magnificence as a filmmaker stemmed from his restlessness. He ruled 1950s cinema, delighting both audiences and critics with big budget, suspense-and-romance movies shot in glossy color. The studio heads at Paramount Pictures expected that for the final film he was contracted to shoot for them, he would go back to the well that had made him world-famous and Paramount executives very rich. But the suits misjudged the genius’ desire to keep pushing the envelope rather than repeating himself. Hitch announced that he wanted to make a low-budget, black-and-white horror film based on the exploits of real-life serial killer. The studio execs wouldn’t touch it, so he got the money together on his own and used the crew from his Alfred Hitchcock Presents television show to shoot the movie. The result was a trendsetting, nerve-shredding masterpiece: 1960′s Psycho.

The story opens with Marion Crane (an achingly vulnerable Janet Leigh) and her lover (John Gavin) discussing how they can never get married because of the financial constraints they face. Enter one of Hitchcock’s most inspired MacGuffins: $40,000 in cash that Marion is entrusted by her boss to deposit in the bank. Impulsively, she steals the money and drives to visit her lover, getting lost on a lonely road in a rainstorm. Fortunately, she finds an empty motel, where she meets Norman Bates (Anthony Perkins, in his signature role). The lonely young man tends the failing motel, while also watching over his emotionally disturbed mother. As shown in one of the movie’s many beautifully scripted and acted scenes (with evocative incidental music), Marion and Norman connect with and at the same unnerve each other:

I was blessed to see Psycho many years ago with no idea of the plot or legend of this film, and for that reason I will reveal no more of the story other than to say that it’s a masterclass in horror and psychological tension, with coruscating performances, direction and camerawork (The staircase sequence with private investigator Arbogast and the subsequent shot of Norman carrying his mother down to the fruit cellar are both technical marvels). The famous score by Bernard Herrmann is one of his best, and amps up the terror almost beyond belief. Credit also must go to screenwriter Joseph Stefano for realizing that Robert Bloch’s novel had to be significantly altered to work as a film, particularly in terms of building out the backstory of Marion Crane and re-conceptualizing the character of Norman Bates.

It is difficult to appreciate today how challenging it was for Hitchcock to get this film past the censors in 1960, but to give you one example of how strict the prevailing norms were, this is the first American movie to show someone flushing a toilet (Think of the children!). There is of course much more here than that to upset the censors, but Hitch mostly got the sexuality and graphic violence he wanted, thus pre-figuring what the 1960s would later bring in a flood to movie audiences. As ever, the Master was ahead of the curve.

p.s. With the aid of fellow director Barry Levinson, Mel Brooks brilliantly parodied the most famous scene in Psycho in his 1977 film High Anxiety.

p.p.s. The 2012 film Hitchock focuses heavily on the making of this movie. Although it garnered mixed reviews, I thought that Anthony Hopkins and Helen Mirren have rarely been better.

[Cross-posted at The Reality-Based Community]

March 19, 2015 6:41 PM The Hill’s Just Horrible Reporting

By Martin Longman

March 23rd, 2010 was a Tuesday. It was also the day that this supposedly happened in the White House:

[Obama] immediately presented Mr. Netanyahu with a list of 13 demands designed both to the end the feud with his administration and to build Palestinian confidence ahead of the resumption of peace talks. Key among those demands was a previously-made call to halt all new settlement construction in east Jerusalem.

When the Israeli prime minister stalled, Mr Obama rose from his seat declaring: “I’m going to the residential wing to have dinner with Michelle and the girls.”

As he left, Mr Netanyahu was told to consider the error of his ways. “I’m still around,” Mr Obama is quoted by Israel’s Yediot Ahronot newspaper as having said. “Let me know if there is anything new.”

It’s also the day that this actually did happen:

First lady Michelle Obama took daughters Malia, 11, and Sasha, 8, mother Marian Robinson and some pals to New York for a spring break trip where they hit Broadway shows, toured the Empire State Building and visited Harlem and Brooklyn…

…• Tuesday. Harlem was a focus. The Obama group toured the Studio Theater and the famous Apollo Theater. Mrs. Obama and friends dine at Aquavit, owned by Marcus Samuelsson, the guest chef at White House first state dinner for the Prime Minister of India. She ordered the tasting menu.

You can see that Michelle, Malia, and Sasha also spent Wednesday the 24th in the city, visiting the Sesame Street studios and the Brooklyn Bridge Park, and stopping for pizza and ice cream.

So, you know, it wasn’t actually possible that President Obama told Netanyahu to cool his heels and consider the errors of his ways while he had dinner with his family.

Why?

Because he was in the White House in Washington DC and his family was in New York City having dinner at Aquavit.

So, probably, Alexander Bolton could have been a little more definitive about this incident in his piece in The Hill:

The [Obama-Netanyahu] relationship hit a low point in March of 2010, when Obama interrupted negotiations and left the Israeli leader cooling his heels in a White House waiting room while he had dinner with the first lady, according to news reports at the time.

The White House later disputed those reports by asserting Michelle Obama was in New York that evening.

The alleged snub was seen as payback for Netanyahu’s approval of a controversial Jewish construction project in East Jerusalem.

How does a relationship reach a low point based on erroneous “news reports at the time”? Didn’t the White House do more than “dispute” those reports? Didn’t they completely disprove them?

And how about this next bit from Bolton?

Netanyahu poked Obama earlier this week, when he declared just before the Israeli elections that he no longer supported a two-state solution to the Israeli-Palestinian conflict, a goal that has long served as the basis of American-brokered peace talks.

Shall we list the ways in which “poked” is the wrong verb here?

[Cross-posted at Progress Pond]

March 19, 2015 6:00 PM Why Graduated Re-Entry Isn’t Just Another Halfway House

By Mark Kleiman

Chris Ingraham at the Washington Post’s Wonkblog has an interesting take on the graduated re-entry idea.

Ingraham’s piece addresses an obvious question: isn’t graduated re-entry just a halfway house under another name?

The answer to that, as usual, is “Yes and no,” but in this case mostly “No.”

A halfway house is a correctional facility for people being released from prison or jail, or sometimes for people who have been convicted of something that the judge doesn’t want to jail them for but also doesn’t want them to walk away from entirely, even on probation. It’s a physical facility with an actual location: that is, it needs to be built, which means it needs to be sited, which means it has to deal with complaints from the neighbors to their elected officials. Who wants to live across the street from a mini-prison?

A physical building means full-time staffing. That costs money. And neither the building nor the staff disappears if the population shrinks, so creating a halfway house is a long-term fiscal commitment. In most jurisdictions, the houses aren’t public agencies; they’re run by non-profits, raising a host of issues about contracting, governance, and accountability, especially when the contractor is free to lobby and to make campaign contributions. (What the enthusiasts for “contracting-out” often miss is that managing a contractual relationship well is more demanding, in terms of public administration, than managing an agency directly. A jurisdiction that could run its own program tolerably well might be able to find contractor who could do it better; a jurisdiction too incompetent to run its own programs will generally find that the contractors do even worse, even if they’re not simply stealing the money. And no, having them be non-profits rather than for-profits doesn’t do much to solve that problem.)

A halfway house is also a correctional institution; it’s closed, even though it doesn’t have bars, and what me might call the “halfway-in-mates” are under institutional discipline, with staff telling them what to do. Moreover, they’re living with other offenders – not obviously the best way to encourage them to form useful pro-social relationship networks – in congregate housing. It’s better preparation for free life than a cellblock, but that’s about the all that you can say for it as a means of reducing “re-entry shock.”

In the graduated re-entry program that Angela Hawken, Ross Halperin, and I are trying to develop, there’s no single physical facility; instead, there are ordinary-looking apartments, rented from private landlords, scattered around the neighborhood. That doesn’t leave much of a target for the NIMBYs. Living in your own apartment is much more like real life than living in a halfway house. In particular, there’s no reason an ex-offender who graduates out of graduated re-entry couldn’t decide to keep paying rent on the same unit (while the program rents another unit for a new participant). That would make the transition from graduated re-entry to freedom virtually seamless, by contrast with the situation of someone who is released from a halfway house and immediately needs to find new housing.

Some successful halfway-house operations, such as Stefan LoBuglio’s Montgomery County Pre-Release Center, stress jobseeking, and the good results of those efforts gives us reason to think that the employment aspects of graduated re-entry could be made to work well. Others are combined with supported-work programs, though the evaluations of supported work for ex-offenders aren’t especially encouraging. But the combination we propose – close supervision, supported non-congregate housing, and supported work transitioning to non-supported work – is, as far as we know, original.

Compared to a good halfway house – and, again, not all of them are good – a graduate re-entry program might be less successful in delivering certain services (mental health, for example, or job-readiness) simply because all the subjects aren’t immediately available together. And for some participants the addition supervision by live staff and the presence of a ready-made social group might make halfway-house life easier than life on graduated re-entry. Indeed, LoBuglio, whose long experience in this business gives his opinion weight, doubts that graduated re-entry can be made to work. (Of course, in principle, you could do re-entry in phases, with the individual apartment being the next step after the halfway house.) 

But the key point about halfway houses is how few of them there are. I can’t find a number for the total halfway-house population at any one time, but the scattered numbers I’ve identified strongly suggest that the total is well south of 100,000. Expanding that, even substantially in percentage terms, wouldn’t put much of a dent in the 2.3 million Americans now behind bars.

I love pilot programs. But they’re only useful where they can, if successful, be brought up o the relevant scale. Otherwise you get a bunch of attractive but essentially irrelevant boutique programs, which has been the fate of the drug-court idea. Graduated re-entry, if it works, is scalable.

So yes, graduated re-entry is just like a halfway house, but without the house, in the same sense that it’s a prison but without the prison. Analogies can clarify, but they can also obscure.

[Cross-posted at The Reality-Based Community]

Ten Miles Square Archive