Relevant and even prescient commentary on news, politics and the economy.

Paying people to get vaccinated?

Apparently there are proposals circulating to pay people to get vaccinated. (Summary here.) The pro/con story is familiar enough. Monetary incentives might increase the uptake rate; but they might also increase suspicion and backfire, or at least not be very effective. Given the large cost involved – the number cited in the linked article is $1,000, which could cost well over a hundred billion depending on eligibility – a small increase in vaccination rates might not be worth it.

Here is an alternative suggestive. When people get vaccinated, give them cash cards worth $100 that can only be used to purchase restaurant food for 10 days, beginning 5 days after they get vaccinated. The framing of this might be more positive than a simple cash incentive – we are paying you to go out and help jump start your local economy, especially the businesses that have been struggling so much in the epidemic. It helps to emphasize the pro-social aspect of getting vaccinated. Plus it would be much cheaper than giving everyone $1,000, and support from restaurants might help push it into the end zone in Congress.

I have covid . . .

I’m fairly certain I picked it up this past Tuesday.   Wednesday night I had a slight throat-clearing cough.  Not sure if this was covid related or not.  Saturday I had a fever of 100.5, along with some achiness.  I got tested on Saturday and received the positive test result on Sunday.  Last night was a bit worse than the night before.  I had chills and aches.  When I am not sick I am usually more or less pain free; when I get a cold or flu all my old aches and pains come back for an encore.  That happened last night.  In addition, the cough moved into my lungs and became deeper, and I got just a bit wheezy.  This morning with the help of acetaminophen I feel pretty good – if you dropped me into my body without telling me that I had covid it might take me a while to notice that I was sick.  I don’t have any other symptoms.

My initial reaction to my diagnosis was fairly optimistic.  I thought it was likely I would have a mild case and would soon be able to visit family and friends again, including a favorite uncle who is quite sick.  Having read a bit on disease progression, I think my initial take may have been a bit optimistic.  I am still early in the course of the disease; things could definitely go south over the next 3 to 5 days.  My sense is that I have a small chance (maybe 10% to 20%) of ending up in the hospital, and other than that an even chance of skating through relatively unscathed or spending several days struggling to breath but pulling through at home. Having the cough move to my chest last night was sobering.

Although I hope to get through this relatively easily and to enjoy a real benefit from immunity (I would not be vaccine-eligible for months) I would not have chosen to get sick.  The prospect of gasping for breath for a several days at home is very unappealing, choking to death alone would be oh-so-much worse.  I would rather have waited for a vaccine.  Be careful out there!

Should we worry about hospitals being overwhelmed with COVID-19 Patients? Libertarian: Nah.

Our friend Donald Boudreaux is at it again, dispensing misleading statistics that just so happen to favor libertarian outcomes.

Two days ago Boudreaux posted some data on hospital capacity that seem to suggest that we do not need to worry about hospitals getting overwhelmed with COVID patients because capacity utilization over time is flat.  As Boudreaux puts it:

The bottom line is that, when broken down to the state level – at least for the period November 4th through December 4th – there is no evidence that hospitals in the U.S. are close to running out of beds for patients.

Of course, there are other possibilities that Boudreaux does not flag for his readers.  For example, to take a wild possibility at random, it may be that hospitals are not admitting as many sick COVID patients as they fill up. 

Ashish Jha in the Washington Post:

What is happening is pretty simple: As hospitals fill up, they are admitting fewer and fewer people. As any doctor or nurse will tell you, as the demand for beds soars, the threshold for admission rises with it. . . .

One theory that some have advanced is that better treatment is leading to fewer hospitalizations or that more testing is identifying milder cases, and that’s why hospitalization rates are dropping. But outpatient treatment of covid has not changed meaningfully in the past month. The most promising potential outpatient treatment, monoclonal antibodies, has yet to see wide usage. Testing has increased, with more than 2 million tests conducted on some recent days, but case numbers and test positive rates have been rising even more steeply, indicating that we are still missing many more cases — especially mild and asymptomatic cases — so there is no evidence that more testing explains the change in rates of hospitalization.

What is happening is that patients who would have been admitted to hospitals earlier in the year are not being admitted now. Indeed, by my best calculation, between a third and half of covid-19 patients who would have been admitted in the beginning of October are now being sent home instead. This is really bad for patients. Some will get much sicker at home. Some may die there.

And from the Grey Lady:

More than a third of Americans live in areas where hospitals are running critically short of intensive care beds, federal data show, revealing a newly detailed picture of the nation’s hospital crisis during the deadliest week of the Covid-19 epidemic.

Hospitals serving more than 100 million Americans reported having fewer than 15 percent of intensive care beds still available as of last week, according to a Times analysis of data reported by hospitals and released by the Department of Health and Human Services. . . . 

There is some evidence physicians are already limiting care, Dr. Tsai said. For the last several weeks, the rate at which Covid-19 patients are going to hospitals has started decreasing. “That suggests that there’s some rationing and stricter triage criteria about who gets admitted as hospitals remain full,” he said.

We can debate what is happening and how the government should respond.  But Boudreaux just can’t seem to acknowledge that there might, possibly, be a reasonable case for aggressive public health measures to slow the epidemic.  Instead, he keeps the anti-government rhetoric dialed up to 11 (“tyranny!”), and continues to stoke outrage with misleading statistics.  This is especially perverse given the rise in right wing extremism and the fact that vaccines will soon become widely available.  

Credit where credit is due

I am often critical of libertarian economist Donald Boudreaux. This morning, I sent him an email criticizing a post of his in which he cited a study claiming that pcr tests for covid have a false positive rate of 80% or more. I pointed out that this is obvious nonsense, since overall test positivity rates, which include both false and true positives, have generally been in the 4% to 10% range. I also criticized him quite harshly for passing this (mis)information on in an uncritical manner. To his considerable credit, he published my comment in full on his blog and removed the link from his initial post.

Where do libertarians stand on race? Glad you asked.

Almost all Americans agree that the government should not actively discriminate against blacks and other racial groups, and most believe that private race discrimination should be prohibited as well.  Many people would go further and support efforts to reduce the large racial disparities that persist in America despite formal legal injunctions against discrimination.  Some believe that schools and employers have a responsibility to eradicate subtle forms of discrimination and to create environments in which black students and employees can reach their potential.  Some believe that individuals should “call out” specific acts that are racially insensitive or biased.  Many believe that government policy should be sensitive to the unequal burdens that facially neutral policies and institutions – such as the criminal justice system – impose on blacks and other historically disfavored groups.  Others think that government decision makers should focus on disparate burdens so that they are aware of situations, such as COVID, where blacks (and other groups) need tailored assistance.  Some believe in affirmative action.  Some advocate for reparations for slavery, while others favor race-neutral, income-based policies that help all disadvantaged people.

Recently, Donald Boudreaux posted this:

Libertarians and Trump, one last chance for redemption

Progressive websites and even the mainstream media have been surprisingly blunt in their reporting on Trump’s attempt to steal the 2020 election.  Many reporters and commentators have rejected bothsidesism and said openly that Biden has won and Trump is trying to steal the election.  Quite a few have gone further and emphasized that his behavior is a threat to the survival of American democracy.

One group that has not been so outspoken?  Libertarian economists.  Of course, it is difficult to prove a negative, but I follow several libertarian thinkers, and so far, it’s been nothing but crickets.  My observation is consistent with the discussion of conservative economists by Saldin and Teles in their book Never Trump.

What accounts for the silence of the libertarian economists?  I can think of two possible explanations; they are not mutually exclusive.

The first explanation is that libertarians genuinely do not believe that Trump poses a threat to American democracy.

How much should we trust the polls?

Matthew Yglesias has a good discussion of why the poll-based models that give Biden a high probability of winning are probably right, despite the well-known polling errors in 2016.  Nonetheless, it seems reasonable to believe that the poll based models (538, The Economist) are overstating Biden’s chances, for several reasons.

Turnout this year will be unusually difficult to predict.  How will the surge in mail in balloting affect turn out?  Will it lead to a large increase in voting, likely favoring Democrats, or are many voters likely to leave their ballots on the dining room table, or mail them in too late to be counted?  Will weather effects on voting have a partisan slant (in either direction, potentially), given that Republicans are more likely to vote in person?  How will COVID affect in person turn out?  Any increase in uncertainty favors Trump, given that he is behind in projections.

We don’t know how effective voter suppression efforts will be.  How will long lines affect turnout?  How widespread and effective will outright intimidation be?  Will efforts to intimidate backfire and increase Democratic turnout?  Voter suppression tactics have changed enormously in the past few years due to Shelby County, so the current state of affairs may not be reflected in data from prior elections.

Finally, we don’t know what the Courts will do, and how their rulings will affect the vote.  The biggest uncertainty is probably what happens to late mail in ballots, but other issues will arise.

As Andrew Gelman (creator of The Economist model) says, poll-based models are of “vote intentions, not of votes as counted.”

A shot across the Court’s bow

From Mark Tushnet:

Here’s a thought in the event that there is a Biden appointed commission on court reform.  What about a Joint Resolution on Judicial Power: “No court shall hold a federal statute unconstitutional unless it concludes that the statute is manifestly unconstitutional.”

Tushnet discusses this suggestion and some limitations here.

I am somewhat sympathetic to this idea.  I certainly agree with the substantive idea that underlies it; we have way too much judicial review of social and economic legislation in this country.  Tushnet’s proposal is not at all a cure for conservative judicial activism by the Roberts Court, but it sends the right message:  “We’re on to you.  We know what you’re doing:  using specious legal reasoning to reach results you favor on ideological grounds.  Knock it off.”  It’s not a substitute for enlarging the Court – nothing is – but it is a useful shot across the Court’s bow.

Similar tactics could be used to pressure the Court in other ways.  For example “When addressing statutory ambiguity and potential drafting errors, the Court shall interpret statutes to achieve their public regarding purposes.  Rulings that force Congress to rewrite existing legislation shall be strongly disfavored.”  The Administrative Procedure Act could be amended to formalize Chevron deference.

Congress should also tell (or remind) the Court that it must defer to Congressional findings of fact unless they are clearly erroneous or there is reason to suspect an illegitimate (racist, sexist, etc.) motivation.  In Shelby County, Roberts opined that the preclearance provisions of the Voting Rights Act were no longer necessary to prevent racially motivated election law “reforms”.  His arrogant personal fact finding was contradicted by the Congressional record and immediately exposed as nonsense when the decision was handed down.  Congress could explicitly call out Roberts for substitution of his “factual” judgment for that of Congress when it attempts to reinstate the Voting Rights Act.

While potentially useful, these examples also illustrate why Court enlargement is the only reliable method for reining in the Roberts Court.  As Tushnet notes, his proposal would probably be declared unconstitutional by the Court, a problem that plagues almost all reform proposals other than enlarging the Court (term limits, panel systems, jurisdiction stripping).  More fundamentally, these examples illustrate that legal reasoning about the constitution, the administrative state, and complex legislation is way too open-ended and discretionary to be substantially hemmed in with words.  There is no substitute for good motives, but motives cannot be legislated.  We need better Justices.

Yes, there is a Republican ideology. That is the problem . . .

From the NYT editorial board:

Of all the things President Trump has destroyed, the Republican Party is among the most dismaying.

“Destroyed” is perhaps too simplistic, though. It would be more precise to say that Mr. Trump accelerated his party’s demise, exposing the rot that has been eating at its core for decades and leaving it a hollowed-out shell devoid of ideas, values or integrity, committed solely to preserving its own power even at the expense of democratic norms, institutions and ideals.

Tomato, tomahto. However you characterize it, the Republican Party’s dissolution under Mr. Trump is bad for American democracy.

A healthy political system needs robust, competing parties to give citizens a choice of ideological, governing and policy visions. More specifically, center-right parties have long been crucial to the health of modern liberal democracies, according to the Harvard political scientist Daniel Ziblatt’s study of the emergence of democracy in Western Europe. Among other benefits, a strong center right can co-opt more palatable aspects of the far right, isolating and draining energy from the more radical elements that threaten to destabilize the system.

Today’s G.O.P. does not come close to serving this function. It has instead allowed itself to be co-opted and radicalized by Trumpism. Its ideology has been reduced to a slurry of paranoia, white grievance and authoritarian populism. Its governing vision is reactionary, a cross between obstructionism and owning the libs. Its policy agenda, as defined by the party platform, is whatever President Trump wants — which might not be so pathetic if Mr. Trump’s interests went beyond “Build a wall!”

The editorial rightly criticizes Trump’s corruption and contempt for the rule of law, and it criticizes the knowing complicity of his Republican enablers in Congress.  But the claim that the Republican party has no ideology or policy agenda is completely wrong.

The policy agenda of the GOP is to cut taxes on the rich and to dismantle regulation and social insurance programs.  This agenda is driven by the libertarianism of the party’s plutocratic donor class.  The two major legislative initiatives of the Trump presidency were 1) a large, regressive cut in corporate taxes (which passed) and 2) the repeal of the ACA without replacement (which failed).  These extreme and highly unpopular priorities did not reflect a lack of ideas or values or an ideology, they reflect the capture of the party by a wealthy libertarian elite.  And the libertarian ideology of the Republican party is not due to Trump; it preceded him and will quite likely continue to animate the party when he leaves the scene.

It is the extremism of the Republican economic vision that threatens our democracy.  It is their economic extremism that forces Republicans to stoke racism and xenophobia to win votes.  It is their economic extremism that leads Republicans to reject the legitimacy of Democratic governance and to undermine free and fair elections.  Reasonable people can and will disagree about exactly how much to spend on social insurance or the best way to tackle climate change.  But Republicans reject the premises of these debates.  Given their uncompromising moral beliefs – that regulation is misguided and overbearing, that taxation is theft, and that most Americans are “takers” – what ground is there for reasonable differences of opinion that can be resolved through elections?

It is a serious problem that so many people – including, evidently, the New York Times editorial board – do not understand what is driving the extreme and anti-democratic behavior of the Republican party.  The sickness that afflicts our body politic is all too real, and curing the illness will be much more difficult without an accurate diagnosis.

Let’s make a coronavirus deal?

Latest on the relief negotiations is here.  Short version, Pelosi and Mnuchin are still negotiating over a $1.9 trillion bill; McConnell is floating the idea of a $500 billion dollar bill, but it is far from clear he can or even wants to pass anything.

If Pelosi can get to a deal with Mnuchin, that’s great.  I still think that the House should pass a bill with or without sign off from Mnuchin and challenge Trump and Senate Republicans to pass it.

But I would add now that the House should consider passing a $500 billion bill and calling McConnell’s bluff.  Part of the impetus for hanging tough on a big bill was to limit the ability of Senate Republicans to sabotage a Biden presidency by withholding any further relief (which they would surely do).  But it looks increasingly likely that the Democrats will take the Senate and be able to pass their own bill in January.  Of course this is not guaranteed, but we need to play the probabilities.  If the polling holds up on the Senate, the main aim should be to get through the next 3 months without too much human suffering and economic damage.  $500 billion is not enough, but properly targeted it would be a lot better than nothing.  Passing an inadequate bill would not help the Republicans politically, and it might help the Democrats drive home how intransigent and destructive Republicans are being on coronavirus relief.