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three bad ideas which I think would be political winners for Democrats

Matthew Yglesias commands,
I obey. Now I just have to come up with three bad ideas.

1) $25 minimum wage. I am not sure about the $15 dollar proposal. I’m pretty sure that $25 would be too high. I guess it would be popular too.

2) Protection that’s what you’re here for . I am sure that total protectionism is a bad idea, and hinting at it worked pretty well for Trump.

3) Eliminate all taxes on the lower 99%.

I tend to wonder if maybe this isn’t such a bad idea, but I suspect that it would imply either huge deficits, undesireable cuts to Federal spending, or taxes on the top 1% which are higher than optimal.

In any case, I am rock solid certain that many Republicans are sure that Democrats are soon going to propose this and win all future elections. They wouldn’t argue against class warfare in the complete absense of any class warfare (except for theirs on behalf of the rich) if they weren’t terrified.

4) I would say health care reform with coverage of pre-existing conditions, gauranteed issue, Community rating and no mandate (to promise all the nice things without the necessary costs and destroy the individual insurance market entirely) except that Obama has already done that (the Barack Hussein Obama Jr was elected president of the USA, so don’t even think of tyring to tell me that bad policy is bad politics).

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Chait vs Roy on Baicker not really vs Baicker

Jon Chait has a brilliantly ruthless takedown of the absurd defences of the AHCA (house obamacare replacement) and BCRA (Senate version) . His main point is that Republicans are lying claimiing the huge cuts to Medicaid aren’t cuts to Medicaid and that the huge increase in the number of uninsured will actually be zero.

He also criticizes Avik Roy. This quarrel has become very interesting. Roy praised the BRCA. He refused to answer when Chait asked if he had also written it. Roy will not say if he is commenting on his own work without noting the conflict of interest.

Jonathan Chait‏Verified account @jonathanchait
Update: @avik tells me his policy is to not disclose his role in crafting legislation.

Chait notes that Roy praises the bill for increasing deductibles and also notes that Republicans denounced the Obamacare deductibles — for being too high. This just shows hypocrisy ( ok psychopathic dishonesty) or GOP politiicians. I’m sure Roy believes dedcutibles should be high, and Republicans in Congress have revealed a preference for high deductibles.

Chait also objects to Roy’s claim that Medicaid doesn’t cause improved health. Interestingly I had the same debate with someone on twitter yesterday. In both debates, the case against Medicaid is based on a citation of Baicker et al (2013) the report on the Oregon Medicaid experiment.

Chait (and I) responded by citing Somers Gawande and Baicker (2017) who wrote

Insurance coverage increases access to care and improves a wide range of health outcomes. Arguing that health insurance coverage doesn’t improve health is simply
inconsistent with the evidence.

and

One head-to-head quasi-experimental study of Medicaid versus private insurance, based on Arkansas’s decision to use ACA dollars
to buy private coverage for low-income adults, found minimal differences.11

So is it Chait’s experts against Roy’s experts ?

Not at all. Roy bases his argument on Baicker et al and Chait on al et Baicker. Katherine Baicker PhD (who should know) does not think that Baicker et al (2013) showed that Medicaid doesn’t work.

Indeed she concedes much less than Chait does. He wrote “The study was unable to detect better physical health outcomes.” This is false. The study found better physical health outcomes in the treatment group than in the control group. What Chait should have written was “the study was unable to detect statistically signficicantly better physical health outcomes”.

Treating a statistically insignificant evidence improvement as evidence that there was no improvement is a gross error. It is also almost universal (I have doubts only about the “almost”). In fact Baicker et al found statistically significant effects on access to health care, diagnosis of diabetes, and treatment of diabetes. They did not find new proof that standard treatment of diabetes is better than no treatement. In every other context, this is not treated as an open question. The study did not find statistically signficant evidence that the benefit was smaller than predicted based on other studies either.

But the motto of the New England Journal (and all serious scientific journals) is first make no claims which go beyond the data.

Statistically insignificant is not an assertion. It doesn’t mean zero. It doesn’t mean small. So it is always favored. Then it is read as meaning small or zero.

Chait understands this. He argues that the Baicker et al (2013) study had low power so the fact that “The study was unable to detect better physical health outcomes.” [failed to reject the null of zero effect on physical health] doesn’t tell us much. But even in the context of a discussion of power, he refuses to distinguish zero from statistically insignificantly different from zero. I think there is some rule that people writing for general audiences must not use technical terms like “statistically insignificant”. The result is that they write falsehoods.

Tens of thousands of people a year may die partly because people just will not accept that the Neyman Pierson framework is what it is.

In any case, Roy is reduced to arguing that he understand Baicker et al (2013) and Baicker doesn’t. He is not in great shape totally aside from the question about unreported conflicts of interest.

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BCRA CBO Score

WASHINGTON (AP) — Congressional Budget Office sees 22 million more uninsured by 2026 under Senate health bill.

Toher Spiro appears to be snipping and tweeting the key bits of the CBO report

Premiums for a 64-year old with middle income go from $6,800 under ACA to $20,500 under BCRA

Deductibles for plans eligible for tax credits go from $3,600 under ACA to $6,000 under BCRA

death spiral

open thread.

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Welfare Reform Kills ?

This is an update of this post in which I expressed immense confidence that welfare reform killed people in Florida .

The post is based on
https://www.ncbi.nlm.nih.gov/pubmed/23733981

Muennig P1, Rosen Z, Wilde ET. (2013) “Welfare programs that target workforce participation may negatively affect mortality.”

Abstract

During the 1990s reforms to the US welfare system introduced new time limits on people’s eligibility to receive public assistance. These limits were developed to encourage welfare recipients to seek employment. Little is known about how such social policy programs may have affected participants’ health. We explored whether the Florida Family Transition Program randomized trial, a welfare reform experiment, led to long-term changes in mortality among participants. The Florida program included a 24-36-month time limit for welfare participation, intensive job training, and placement assistance. We linked 3,224 participants from the experiment to 17-18 years of prospective mortality follow-up data and found that participants in the program experienced a 16 percent higher mortality rate than recipients of traditional welfare. If our results are generalizable to national welfare reform efforts, they raise questions about whether the cost savings associated with welfare reform justify the additional loss of life.

It’s not in the abstract, but they also analysed a larger data set and got a larger point estimate of 26% higher deaths due to participation in welfare reform.

The authors have since conceded that they unreasonably underesimated the standard errors of their point estimate. They used cluster robust standard errors with only 2 clusters (2 counties). This is not valid (the estimate of the variance of the point estimate of 16% more deaths is biased down). A reader noticed (as I should have) that the large difference between 16% and 26% would be extremely unlikely if the analysis had been correct.

using a reasonable fixed effects estimator (without the cluster robust consistent but biased down standard errors) they get

In the article we also presented combined results including participants in both Escambia and Alachua Counties, again controlling for year of birth, year of assignment, and site location and clustering the standard errors on location. The point estimate for that analysis is 1.26 (95 percent CI: 1.10, 1.45). Without clustering the standard errors around location, while controlling for location fixed effects as well as the other covariates, the new point estimate is 1.26 (95 percent CI: 0.96, 1.66).

So the more reasonably estimated stardard errors are roughly twice as large as the biased down ones. This means that the null of no effect (ratio of mortality rates =1) isn’t rejected at the 5% level. It is close. But the p-level of a t-statistic of a bit less than 4 is tiny (hugely significant).

The corrected standard errors imply evidence that welfare reform killed people, but not strong evidence. Hence the question mark in the updated title.

Like the authors, I apologize. I should have read the paper more carefully.

I thank Douglas Hess @douglasrhess for pointing out the published correction

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Did Conway Con Herself

This is remarkable even for the Trump administration. Kellyanne Conway claimed that the Medicaid slashing BCRA proposed by the gang of 13 doesn’t include “cuts to Medicaid”.

The Trump administration position appears to be that Trump could sign it in to law and keep his promise to protect Medicaid from cuts. Wow.

I am not President of the USA, but this doesn’t seem to be good strategy to me. It makes it clearer than ever that Trump will throw representatives and senators who vote yes under the bus if the horrible bill becomes even more unpopular as a horrible law causing horrible suffering. It also makes it clear that they will have to deal with the debate about whether $ 800 billion is zero. They could choose to repeatedly say that Trump is a liar (which will hurt them as much as voting no) repeatedly tell blatant lies about the suffering they caused, or they can avoid that debate by voting the bill down. To me the third option looks very attractive.

Already Susan Collins has had to say that she “disagrees” with Conway. She should understand that a yes vote will only be the beginning of dignity wraithdom.

It’s a small thing compared to tens of thousands of deaths a year, but Senators don’t like to be humiliated at all. I hope this makes some difference.

Update: Also Price

“HHS Secretary Tom Price making a bold delararion to @DanaBashCNN: “We would not have individuals lose coverage.” “

We know he’s shameless, but how many seantors representatives are willing to stand up for such absurd lies.

Also I don’t think insulting the CBO is optimal strategy right now. For one thing they are working very hard over the weekend to get a report which the Senate needs in order to consier the BRCRA. If someone treated me as Price treats them, I would be very very lazy (trivially true as I am, have always been and will always be very lazy). Also they can calculate effects on coverage outside the 10 year window first (they are doing this) and work backwards.

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McConnell’s AHCA Kabuki

he McConnell Obamacare repeal and replace “discussion draft” is worse than I imagined possible even taking into account that it would be worse than I imagined possible. I fear he made sure it was horrible so moderate Senators could win staged battles and claim they had saved people (needless to say I am not the first to write of this possibility).

I guess a vox explainer is always useful and Sarah Kliff is very smart thorough and reliable.

The bill is surprisingly aweful in two ways. First it doesn’t slow the phasing out of the ACA Medicaid expansion over 7 years but rather does it in 3 (from 2021 through 2024). Several relatively non reactionary Republican senators stressed how important of 7 year phaseout was to them. Also the bill contains no additional funding to deal with the opioid addiction crisis. Many of those senators specifically proposed this increased funding.

I fear that this is all theater. That the so called moderates will get their 7 years and their opioid treatment funding and then vote yes. Not including them in the “discussion draf” will make this more dramatic, allow the self described moderates to claim credit, and give them cover.

The Senators in question are almost saying this is their price.
I will include phone numbers in case any reader is interested in calling to say he or she is not falling for it. All are from the very useful
https://www.trumpcaretoolkit.org/

The Senators include
Robert Portman of Ohio (202-224-3353) who wrote
portman

This almost explicitly says his price is an extended Medicaid phaseout and, especially, money for treatment of opioid addiction.

Shelley Moore Capito of West Virginia (202-224-6472 called senator Capito with the accent on the a not on the i as in the Italian word for understood)
She has a very strong position on increased opioid treatment funding. West Virginia (like Ohio) is hard hit by the epidemic.

Her web page includes

Earlier today, I posted a link to the health care discussion draft on my website for all West Virginians to read. Over the course of the next several days, I will review the draft legislation released this morning, using several factors to evaluate whether it provides access to affordable health care for West Virginians, including those on the Medicaid expansion and those struggling with drug addiction.

Which, again, is very clear. I want to mention that I guessed there was a press release similar to Portman’s before checking, and why, lo and behold, there is (it’s almost as if they coordinated).

Dean Heller of Nevada (202-224-6244 is another self described moderate (and up for election in 2018 and very vulnerable)

His web page has

“Throughout the health care debate, I have made clear that I want to make sure the rug is not pulled out from under Nevada or the more than 200,000 Nevadans who received insurance for the first time under Medicaid expansion. At first glance, I have serious concerns about the bill’s impact on the Nevadans who depend on Medicaid. I will read it, share it with Governor Sandoval, and continue to listen to Nevadans to determine the bill’s impact on our state. I will also post it to my website so that any Nevadans who wish to review it can do so. As I have consistently stated, if the bill is good for Nevada, I’ll vote for it and if it’s not – I won’t.”

Again quite clear. The phrase “the rug is not pulled” is almost explicit that slowly sliding it out from under them would be OK. The reference to Sandoval is important, as Sandoval is very popular in Nevada and signed a letter opposing the House AHCA and generally arguing for bipartisan compromise (so did Gov. Kasich of Ohio whom Portman didn’t mention).

update 3: This is interesting. John Ralston is a very highly respected expert on Nevadan politics. He tweeted

“I don’t think so. And will say he [Heller] votes No after consulting with @GovSandoval.”
replying to another top reporter, Ronald Brownstein, who tweeted “#AHCA reduces # covered by Medicaid in NV by 45%. #SenateHealthCareBill proposes > l/t cuts. Can @SenDeanHeller vote Y? @RalstonReports”
end update:

OK how about Lisa Murkowski (202-224-6665 only interested in voice mail from Alaskans) ?
Nothing yet. I actually find this promising. She might not have decided on the price of her vote.

Finally (for moderates for now) Susan Collins of Maine (202-224-2523) Nothing on the McConnell discussion draft yet. A lot on the Opioid crisis (very bad in Maine too). Also “bipartisan” is her favorite word. Actually the web page section on health looks OK. Her voting record doesn’t. Collins and Murkowski strongly support funding for Planned Parenthood. Neither have said they will vote no if the elimination of that funding stays in the bill (most likely they propose an amendment and it goes down 50-51 including Pence). I do not want to count on Senator Collins growing a spine.

update: Collins spoke with the press instead of having a staffer write a press release. Her comments as reported by Tierney Sneed are mildly interesting

Sen. Susan Collins (R-ME) gave the Senate health care bill released Thursday a mixed review, but zeroed in on its major cuts to Medicaid as a potential problem for her.

She took issue with how the Senate bill, starting in 2025, used a rate of growth for federal funding for Medicaid that is significantly slower than the typical increases of costs for the program.

“I’m very concerned about the inflator that would be used in the out years for the Medicaid program,” she told reporters in the Capitol a few hours after the bill was released. “It’s lower than the cost of medical inflation and would translate into literally billions of dollars of cuts.”

She added that she was concerned about how the cuts would negatively affect rural hospitals or prompt states to restrict Medicaid eligibility.

This might amount to something. Unlike “pulling the rug out” Heller, Collins is talking about the long term and a huge amount of money. The ceiling on Medicaid spending amounts to a huge cut over 10 years. It is they key measure used to finance the bill’s tax cuts for the rich. Unlike the 3 year Medicaid extension phase out it can’t be fudged. The case for Heller, Capito, Portman Kabuki is strongly supported by the fact that they don’t specifically address the ceiling.

It is vital that people who had no problem before the ACA understand that they will have huge problems if the AHCA passes, because of the huge cuts of legacy (pre-ACA-expansion) Medicaid spending. The fact that Collins discusses this would be a hint that she might actually vote no (if she weren’t actually Senator Susan Collins (R-Maine) who always always caves).

end update:

update 2: Collins is stealing the stage. I think she is torturing us. She said she can’t vote for a bill which deprives tens of millions of health insurance (I’ll believe she can’t if she votes no and not before)


ehd update 2:

Separately 4 right wing Senators said the McConnell draft is too close to the ACA: Ted Cruz, Mike Lee, Ron Johnson (Wisconsin) and Rand Paul (Kentucky).

I think Paul might really mean it. He is extreme and resistent to party discipline. Also the ACA has benefited Kentucky enormously. Blocking the repeal bill would be good for Rand Paul (and Mitch McConnell). Blocking it for not being extreme enough could be crazy like a fox 11- dimensional Aqua Buddha chess.

Ron Johnson has been hinting a no for a long time. He was just re-elected. Here I think that senators with 6 safe years might be more likely to vote no. Failure to pass a bill with hurt Republicans in the short run. Passing a horrible bill will hurt them in the long run.

I’m pretty sure Cruz and Lee are play acting. My guess is that they said no to establish a bargaining position — if McConnell is the right most position, the bill will move further left than if they pretend they might vote no. I read somewhere thatCruz had an individual statement in which he made it almost clear he was going to get to yes.

Summing up, I have no prediction for how this will end. But I do very strongly suspect that Heller, Capito and Portman will win two (staged) battles and get 7 year phaseout and some opioid money, declare victory and vote yes.

update 4: My prediction was wrong (as usual). Heller denounced the bill. He described many of its horrible aspects, definitely including the long term cuts to legacy Medicaid. This is not an issue which can be fudged, because the amount of money involved is huge. He still might cave, but it would be an authentic cave not a staged victory. This is very good news. Also there is even better news reported by The Washington Post

Sen. Dean Heller (R-Nev.) announced that he could not vote for the legislation without revisions, singling out the measure’s long-term spending cuts to Medicaid as the reason for his opposition. The announcement caught some Republicans in Senate Majority Leader Mitch McConnell’s orbit by surprise.

If McConnell had been counting on Heller, his count could be off. In particular, he might have counted to 49 and assumed he could get one more from a senator unwilling to decide the victory for the Democrats. Heller’s announcement takes pressure off of her (she is named Lisa or Susan).

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The London Bridge Attack

reader alert: I am going to quote and discuss Trump tweets

“Do you notice we are not having a gun debate right now? That’s because they used knives and a truck!”

My immediate reaction was to tweet this this is why we should have a gun debate right now. The fact that 3 terrorists killed 7 victims not 70 shows the benefits of UK gun control. In the USA a single terrorist killed 49 people . My reactions to the horrible news from London included the thought that UK gun control is a very good thing as shown by the fact that the depraved killers were armed only with a truck and knives.

As is often the case, I think we learn something from Trump about the defects in human cognition. When something horrible happens, it is not at all natural to think that it could have been even worse. However, it is often useful.

I worry about writing this post. It seems (even to me) that I am heartless — that if I could grasp the suffering of people who loved the 7 victims — I couldn’t think that things could have been worse. I think that this reaction of distaste for my post (or disgust) which I feel myself is a problem. Reducing the number of deaths due to terrorism requires pragmatic thinking which involves moral arithmetic.

On the other hand, at least Trump is simple. In addition to a refusal to consider how the number of deaths was reduced by gun control, Trump also immediately connected the attack to the policy debate with

“We need to be smart, vigilant and tough. We need the courts to give us back our rights. We need the Travel Ban as an extra level of safety!”

This tweet was very widely denounced as an effort to exploit a tragedy for political advantage (which it was) and a sign that, for Trump, it is always all about Trump. Fewer people (including @mattyglesias) noted that the tweet makes no sense. Trump doesn’t know if the terrorists are refugees, immmigrants or travellers from the banned countries. The argument is a Sir Humphrey syllogism: we must do something, the travel ban is something, we must do the travel ban.

Notably, the tweet shows that the travel ban is an expression of islamaphobia. The London terrorists said “Allah”. To Trump that means that the attack is evidence in favor of a ban designed to keep moslems out of the USA. He didn’t think that he is supposed to deny that the ban is about religion not nationality (he also didn’t remember that he isn’t supposed to call the ban a “ban”). The reaction (which I am sure is sincere) is that we have to do more to protect ourselves from them when they are an undifferentiated alien threat including UK born citizens of the UK and “ourselves” include other UK born citizens of the UK.

One immediate fear is that this instinctive reaction is universal and the absense of any filter between Trump’s lizard brain and his twitter feed strengthens him. He certainly didn’t act like a normal politician. In this case, I prefer the normal politicians reaction, but I think I understand why many voters prefer the irrational impulsive Trump response, which was sincere. I think this is how people can know he lies all the time and also say that he is not afraid to speak the truth.

But somehow Trump manages to unite two defects. The emotional reaction in which the horror of 7 deaths prevents one from considering that 70 would have been ten times as horrible (an observation which is, I think, both accurate and appalling) and also the appalling instant effort to use a tragedy to win a debate.

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Moving to Opportunity: Katz, Ludwig, Chetty and Hendren — discussant Bruce Springsteen

This very important paper “Moving to Opportunity” is well summarized by the discussant.

Baby this town rips the bones from your back
It’s a death trap, it’s a suicide rap
We gotta get [them] out while [they]’re young
`Cause tramps like us, baby we were born to run
[regressions]

As noted by the discussant, the authors find that the benefits for young children of moving out of high poverty areas are very large. In contrast moving in ones teens helps girls but not teenage boys many of whom have already begun “steppin’ out over the line” & are harmed by increased access to “suicide machines”.

As noted, the paper is excellent and important, but I think the more striking fact is that the discussant has managed to summarize it so briefly and accurately while rhyming and playing a guitar.

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$ 2.1 trillion here $ 2.1 trillion there and soon you’re talking real money

I didn’t think they could shock me. Then I read that the Trump OMB made a $2,000,000,000,000 arithmetic mistake

Jon Chait explains “One of the ways Donald Trump’s budget claims to balance the budget over a decade, without cutting defense or retirement spending, is to assume a $2 trillion increase in revenue through economic growth. This is the magic of the still-to-be-designed Trump tax cuts. But wait — if you recall, the magic of the Trump tax cuts is also supposed to pay for the Trump tax cuts. So the $2 trillion is a double-counting error.”

Amazing, I thought. Also Chait is much better at snark even than Paul Krugman who made it sound boring “@paulkrugman
It appears that Trump budget involves two scoops of voodoo economics: faster growth *and* tax cuts without a fall in revenue as % of GDP”

But I was wrong. Chait and Krugman are discussing two different errors (3 scoops of voodoo). Mulvaney et al both counted 2.1 trillion twice *and* assumed tax cuts don’t cause any reduction in the ratio of tax revenues to GDP.

Binyamin Applebaum explains.

One example of the budget-ledger legerdemain: Mr. Trump has pledged to end estate taxation. His budget, however, projects that the government will collect more than $300 billion in estate taxes over the next decade. Indeed, the Trump administration projects higher estate tax revenue than the Obama administration did because it expects faster economic growth.

Mr. Trump, in other words, is proposing to balance the federal budget in part by simultaneously increasing estate taxation and eliminating estate taxation.

Then later and separately explains another error.

The budget’s presentation of the benefits of the administration’s economic policies also raised questions. White House officials said that tax cuts and other changes, like reductions in regulation, would push annual economic growth to 3 percent by 2020, well above the 2 percent annual average since the recession. The budget projects that the increase in economic growth will produce $2.1 trillion in additional federal revenue.

The Trump administration appears to be counting this windfall twice. It needs the money to offset the cost of the tax cuts, but in the budget, the $2.1 trillion is also recorded as a separate line item above and beyond the steady growth of tax revenues.

They are into deep Voodoo.

See also Larry Summers

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Did Recep Tayyip Erdogan Make War on the USA ?

I assume the reader is familiar with the recent violence at the Turkish embassy & Turkish ambassador’s residence in Washington DC. “Body guards” (really thugs) brought by Turkish president Recep Tayyip Erdogan attacked peaceful demonstrators. It is clear how the fight started, a rather thin not too tall man in a suit attacked. He has a receeding hairline, a mustache and wore a black suit and a dark blue tie.

Phillip Bump (of the Washington Post) says this is the moment it started.

The striking thing is that seconds earlier someone in the back seat of the car in which Erdogan was sitting said something to a middle aged man who leaned over to hear. That man said something to a young thin man with a receeding hairline and a mustache who was wearing a black suit and a dark blue (or purple) tie. That young man nodded twice and walked off briskly to the demonstration just before the fight started.

He returned a minute later and said something to Erdogan (who had gotten out of the car).

Is this man who takes instructions from someone who took them from Erdogan the man who started the brawl ?
ymm3

The brawl starts with a man in a suit punching a man wearing a blue t-shirt.

ymwm

The assailant has a receeding hairline and a mustacheymwm

Here @pbump shows the order coming from the car

Here a longer clip shows the young man with a mustache get some instruction, walk briskly towards the demonstration then return and report to Erdogan in person.

Here notice that the man who started the brawl by punching the man in a blue t-shirt leaves (heading generally in the direction of Erdogan) while the brawl continues. Cowardice or mission accomplished ?ymm4

These stills are from this youtube video

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