New American Horseshit

Earlier this week, the think tank New America expelled a subsidiary called Open Markets, led by Barry Lynn. New America is funded in large part by Google. In June, Open Markets put out a press release lauding the European Union’s multi-billion dollar sanctions against Google. You connect the dots. Here’s a backgrounder.

New America’s leader, Ann-Marie Slaughter, has been furiously and ineffectively spinning this week. (Atrios’ one sentence on her leadership pretty much says it all.) Her latest excuse-making exercise includes this gem:

Nothing we say is going to convince the many people who want to believe a David versus Goliath story of Barry Lynn versus big bad Google. On the contrary, Barry’s new organization and campaign against Google is the opening salvo of one group of Democrats versus another group of Democrats in the run-up to the 2020 election, at a time when I personally think the country faces far greater challenges of racism, violence, a broken political system, and geographic and partisan divisions so great that we are losing any common sense of what we stand and strive for as a country.

Translation: if we don’t shut up about my little think tank imbroglio, we may lose the 2020 election.

That really is some prime bullshit. First, monopolies contribute to our “broken political system”. Raising consciousness about the way that monopolies make our lives shitty, and being the party with a solution, is an election winner in 2018, 2020 and beyond. Second, if our party is so fucking delicate that a little debate in 2017 is going to sink our 2020 chances, maybe we need to talk about that instead of sweeping it under the rug. Third, I think we’re on the way to party unity over a key set of policies that are going to have broad appeal to our traditional constituencies. For proof of that, see the recent unity over Medicare for all between Kamala Harris and Bernie Sanders.

Frankly, I’m sick of shit stirring and fear mongering with the goal of shutting people up. The only fear I have after reading Slaughter’s piece is that someone will think that she has some insight into the Democratic party. She needs to find a way to save her $500K a year gig that doesn’t involve claptrap like this.

So Step Away With Your Fist Fight Ways

This ain’t back in the day:

Many Americans can’t remember anything other than an economy with skyrocketing inequality, in which living standards for most Americans are stagnating and the rich are pulling away. It feels inevitable.

But it’s not.

A well-known team of inequality researchers — Thomas Piketty, Emmanuel Saez and Gabriel Zucman — has been getting some attention recently for a chart it produced. It shows the change in income between 1980 and 2014 for every point on the distribution, and it neatly summarizes the recent soaring of inequality.

It’s been 40 years since the right wing long game to destroy the middle class and the poor began, and they are winning. Unprecedented propaganda efforts have coal miners slapping “Friends of Coal” bumper stickers on their cars, broken workers are chanting “right to work” as they struggle to crush the unions that would and once did protect them, and the courts have been stocked with corporate friendly judges. In my state, literally. There are things we can do about it (if we band together and chip away at the GOP stranglehold in Washington):

The problem is that wealth and capital income are not distributed evenly. In 2014, the average wealth of the bottom half was $349. For the top one percent, it was over $16 million.

Rich people in our society don’t just have high capital income levels. They also have high capital income shares. That is, a large portion of the income collected at the top of our society comes from capital rather than from labor. In 2014, just 5.1 percent of the bottom half’s income came from capital. For the top one percent, around 58.9 percent of income came from capital.

It is worth emphasizing just how much income at the top of society comes from passive ownership of investments rather than from working. The top 0.01 percent of individuals in society have an average income of $28 million. Three-fourths of that income, or $21 million, came from capital in 2014.

If we want to get serious about creating a fair and egalitarian society, we must confront capital directly. Wage levels are important. Benefit levels are important. But getting those things right will not be enough so long as nearly one-third of the national income flows out passively to a handful of people at the top of society.

Current liberal efforts to tackle wealth inequality are woefully inadequate. Policies aimed at building the assets of low-income families, the typical approach to this issue, rarely succeed on their own terms and, even if they did succeed, would only be an insignificant drop in the bucket. For wealth and capital income to become more fairly distributed throughout society, the ownership of existing assets must be reordered towards that end.

But, as we know, the perfect was the enemy of the good in the last election, and we have this:

Different policies could produce a different outcome. My list would start with a tax code that does less to favor the affluent, a better-functioning education system, more bargaining power for workers and less tolerance for corporate consolidation.

Remarkably, President Trump and the Republican leaders in Congress are trying to go in the other direction. They spent months trying to take away health insurance from millions of middle-class and poor families. Their initial tax-reform plans would reduce taxes for the rich much more than for everyone else. And they want to cut spending on schools, even though education is the single best way to improve middle-class living standards over the long term.

Most Americans would look at these charts and conclude that inequality is out of control. The president, on the other hand, seems to think that inequality isn’t big enough.

I don’t know what it is going to take to unite “the left”- whatever that means anymore. Hell, I don’t even know what to call myself anymore because I support single payer, higher tax rates, higher capital gains, decriminalization, demilitarization, reinstatement of the draft, am pro-choice, etc., ad nauseum, but because I voted for Hillary I’m apparently a neoliberal. At any rate, I thought the election of Trump would unify “the left,” but it has apparently made us more fractious than ever. But we need to get our shit together, because things done changed.

It’s Baaaaacccckkkk (Sort Of, Maybe)

It is impossible to overstate the Republican commitment to ripping health care from millions, while taking a chainsaw to our medical system.

Rand Paul has just announced that he will vote “Yes” on the Trumpcare motion to proceed as long as he is given a clean vote on his amendment, which would simply repeal the ACA (which, given the CBO evaluation of a similar proposal, would lead to something on the order of 17 million without health care next year, and 32 million Americans left in the cold by 2026).

That’s still not enough to get Trumpcare to the floor if the other declared “Noes” hold out, but each senator McConnell can peel away significantly increases the pressure on those who remain opposed.  And certainly, Paul’s cave reminds us that counting on any Republican to maintain a party-base-unpopular position as a matter of principle is a mug’s game.

This won’t be over until the GOP loses its majority in one house or the other.

Image: Workshop of Lucas Cranach the Elder, Massacre of the Innocents, c. 1515

Degrading the public sphere (data edition)

Hannah Recht is one hell of a data visualizer and story teller on healthcare. She is assembling the bare county maps for Bloomberg and then she tweeted the following on Wednesday:

She goes on to explain how and why the government map is fundamentally wrong. It is a combination of people not being familiar with the data and an intent to deceive through malice or laziness.

American public data resources are an incredible asset. They are being degraded as we speak. This is why everyone who could yank a file from November 9-January 20, 2017 yanked files. We feared that there would be massive data degradation. And the solution of archiving public resource files on non-government servers is a reasonable solution to the feared problem of forgetting the past. It does nothing for the ongoing fear that current files will not be collected, corrupted or hideously and deliberately mis-interpreted.

This is just one small example in a domain where I have knowledge and passion. We know it is happening elsewhere such as the EPA and voting rights too. I think the safe assumption is that it is happening everywhere.

High deductible health plan incentive impacts

The theory of change for a health savings account based insurance system is that people are far more sensitive to spending their own money for needless care than spending someone else’s money for low value care. And from there, we should expect to see a massive compression of healthcare spending without negative health impacts as low value care is driven out of the system and consumers can harness the power of markets to get better value. That is the theory of change.

The biggest problem is that people are absolutely horrendous at discerning low value and high value care. There is incredible information asymmetry between the doctor or other medical professional and most consumers of medical care who are quaintly known as patients. We don’t know. Secondly, we’re just not rational beings with infinite time horizons and the ability to rapidly shift consumption from the future to the present or from the past into the future. Not everyone has savings or easy credit that can absorb a one time $5,000 or more shock much less an annual expenditure of $5,000 or more.Let’s

More subtly, we need to figure out who would be under the first dollar discipline of increased deductibles and how much money they could save working with the assumption that everyone is perfectly rational. We’re not, but it is a simplifying assumption. And here we run into a problem. The population of people who have incremental medical costs between a low deductible regime and a high deductible regime is limited.  That population is even smaller once we knock out the people with these types of medical costs who are already covered by high deductible insurance.

I used the 2014 data assembled by KFF at the Health System Tracker but broke it out a little differently. I also used the CMS National Health Expenditure to estimate average spending per group from the KFF HST with an estimate per capita 2014 Health expenditure of $9,442.

Let’s define low deductible as a deductible under $1,000.  Let’s also define as high deductible a deductible of at least $1,001 and no more than $7,000.  The maximum deductible is approximately equal to a 58% AV plan that is proposed by the Senate.

Who is hit by moving regimes and therefore who have changes to the incentives that they face?

Let’s start with the easiest two cases.  People in the bottom 50% of the spending distribution either don’t touch the medical system in a year or are barely connected to it.  I am one of those people (as I knock on wood and throw salt over my shoulder).  In 2016, I had a $600 deductible.  I used a single PCP visit that did not have cost sharing apply to it.  Moving my plan from a low deductible to a maximum deductible plan won’t change my behavior, assuming I stay lucky and healthy.

The other extreme is easy too.  An individual with hemophilia or cystic fibrosis or any other long term, chronic condition that puts them into the top 1% of spending is going to blow through their deductible at some point in the first month of care.  Catastrophic events like a cancer diagnosis or a gun shot wound will also lead to $100,000 claims very quickly.  It won’t change their incentives either.

Read more

The Price of Everything and the Value of Nothing

While we focus on the various obvious bathetic catastrophes (from blowing secrets to the Russians to the big man’s collapsing in a heap after a mere one day on the road) committed by the shitgibbon and his band of merry (but never gay — oh no! not that) men, it’s important to keep at least some attention on the rolling, very real damage the Trump administration wreaks on a daily basis.

I’m so far behind on a book project that I can’t really keep up, and I certainly can’t blog with anything remotely resembling depth and insight, so I’m going to try instead to throw up quick posts as various bits of policy news cross my magpie’s field of vision.

This morning’s treat comes via a Saturday story in FTFNYT.*  Under Scott Pruitt, it seems, the EPA has become the Captain Renault of environmental regulators: everything has its price, and the Captain is always eager to make a deal:

Devon Energy, which runs the windswept site, had been prepared to install a sophisticated system to detect and reduce leaks of dangerous gases. It had also discussed paying a six-figure penalty to settle claims by the Obama administration that it was illegally emitting 80 tons each year of hazardous chemicals, like benzene, a known carcinogen.

But something changed in February just five days after Scott Pruitt, the former Oklahoma attorney general with close ties to Devon, was sworn in as the head of the Environmental Protection Agency.

Devon, in a letter dated Feb. 22 and obtained by The New York Times, said it was “re-evaluating its settlement posture.” It no longer intended to move ahead with the extensive emissions-control system, second-guessing the E.P.A.’s estimates on the size of the violation, and it was now willing to pay closer to $25,000 to end the three-year-old federal investigation.

The administration’s response?

The E.P.A. has not yet made a public response to Devon’s new posture, and Mr. Pruitt declined to comment for this article.

Want to bet on how it will turn out?

In just the last three months, with Mr. Pruitt in charge, the E.P.A. postponed a long-planned rule requiring companies like Devon to retrofit drilling equipment to prevent leaks of methane gas — a major contributor to climate change — and to collect more data on how much of the gas is spewing into the air.

The Interior Department, meanwhile, announced this month that it would reconsider a separate rule limiting the burning of unwanted methane gas from wells drilled on federal and Indian lands, a process called flaring. That announcement came the same day the Senate narrowly rejected industry calls to repeal the same rule.

Interior officials have also announced their intention to repeal or revise a contentious rule requiring companies like Devon to take extra steps to prevent groundwater contamination caused by hydraulic fracturing, also known as fracking, a drilling technique in which chemicals and water are forced into rock formations.

You get the idea. Pruitt has a history of working with Devon Energy; the administration has both a pro-extractive industry bias and powerful faction and the always reliable motive of f**king with anything that Obama accomplished.  Some of what the shitgibbon’s people aim to do can, no doubt, be delayed, obstructed, tied up.  Much, perhaps most will go through, at least over the next year or so, up until the pressures of the next election begin to bite.

So:  constant vigilance and trust no Republican. They’ll load up anything they can on anything they can, transferring public goods (clean air, clean water, anything not nailed down) to private hands.

Over to y’all.

*Publication of such stories  is why I continue to subscribe. Their political desk is…dodgy…but they still field more fine reporters than just about anywhere else I can think of. YM, as always, MV.

Image: Elihu Vedder, Corrupt Legislation, mural in the Library of Congress, 1896.

Call and visit Congress today

The vote for the AHCA in the House is scheduled for sometime around 1:00pm today.

Call your Congressional office today.

If you are in the DC Area there is a protest at the Hill at noon time.

If you are out and about, see if you can visit your Congressional district office to let them know that a vote for the AHCA will result in their names added to an Arya Starkesque mantra.