Category: Health
Taxing Smokes and Drinks
Smoking is bad for you. Sugar-sweetened sodas are probably bad for you too. But taxes on cigarettes and sugary drinks are dumb and mean-spirited, and liberals should oppose them.
Smoking causes cancer, heart disease and emphysema. Despite this knowledge, some adults still want to smoke – and their decision should be respected, even if most other adults dont understand it. Levying punitive taxes on tobacco – as high as 400% on a pack of cigarettes – as if to help others make the “right” decision, is paternalistic and obnoxious. It’s well known that smoking causes disease – helping it cause poverty too is gratuitous.
Many are familiar with the argument: since society ultimately picks up the tab for the health consequences of smoking, society can rightfully tax it to reduce smoking rates. Milton Friedman rightly critiqued this as a slippery-slope to tyranny – that the sum of such policies will greatly erode liberty. But few realize that the math doesnt work either: smoking probably reduces government spending because smokers live shorter lives, and so collect less social security than they would otherwise. We should be glad to pay a premium for liberty – but it’s nice to know that we can let smokers smoke in peace without fretting over the bill.
Conservatives look stupid when rejecting gay love or marriage – seemingly unable to make the rather simple inference that gays can naturally and normally have romantic feelings for members of the same sex, even though such feelings can seem strange or repugnant to some heterosexuals. The inability to tolerate – much less acknowledge the validity of – preferences different from their own, reveals a fundamental lack of insight and imagination.
But liberals look just as stupid when they beat up on the working-class over their Marlboros and Coke Classic. Driving without a seatbelt is idiotic – but if informed adults want to go that way, they should have at it, free of state intrusion. It is in fact NOT at all obvious how one goes about weighing the trade-offs between unhealthy behaviors and shortened lives. You dont have to understand why someone else is willing to give up 10 or 20 years to smoke, eat badly, ride a motorcycle or skydive – but as a liberal, you must accept their informed decision, else you fall into the same species of error that conservatives make on gay rights.
There’s also a more modern, fancier slippery slope: that since smoking is addictive, we can dismiss the choice of adults to smoke because their decision is not consensual. We might treat smokers as people who have been duped into an addiction, and so disregard their apparent preference, and look for ways to help set them straight. Despite the efficacy of medical models for the treatment of drug abuse and addiction, invalidating the considered, informed decisions of adults is dangerous business. A liberal society demands that adults be given the benefit of the doubt.
Liberals are sometimes rightly critiqued as elites who are so sure they know better than other people, that they’re willing to substitute their judgement for those they deem to be in need of guidance. Smoking and obesity patterns follow class lines, with poor, uneducated working people far more likely to smoke and be overweight. Cigarette taxes thus seem as paternalistic as they are regressive, and feed the perception that liberals are out of touch with the working class.
Respecting other people means, above all, recognizing that their choices on activities that impact their own lives are valid per se. It is the government’s role to disseminate information so people can make the best possible decisions. But manipulating prices through tax policy to impact preferences is simply not a proper role for a liberal government. The decisions of informed adults should be respected, even if they are not understood.
GMO Labeling
People have been modifying the genes of food plants and animals for thousands of years. The process traditionally relies on selective breeding – what Darwin called “artificial selection.” More recently, science has facilitated a faster approach: altering genes directly, adding completely new, foreign sequences to an organism’s genome; knocking out or deactivating others. Plants can now be changed in ways never before imagined, and change is effected far more rapidly.
While in theory one can produce toxic plants via artificial selection, in practice the reverse has frequently occurred: plants that were toxic have been made edible through domestication. Almonds are one example: undomesticated trees commonly produce fruit containing lethal amounts of cyanide. Some today are concerned that so-called “genetically modified organisms” (GMOs) might adversely impact human health. While their concerns have a theoretical basis, they remain empirically baseless. Despite the widespread use of genetically modified corn, soybeans, and numerous other fruits, there is absolutely no evidence that human health has been harmed. Meanwhile enormous benefits have been conferred, with food production costs dramatically reduced, productivity increased, and several crops saved from destruction.
The debate often centers around labeling requirements. Numerous western countries require that foods containing GMOs say so on their label. The US is not among them – but some states are independently entertaining such laws, including New York, where a bill is now pending. Advocates for labeling often couch their arguments in terms of consumer choice – but in the absence of any evidence that GMOs differentially impact human health, consumers’ desire to avoid them is a “pure preference”, without a basis in health, nutrition or otherwise. As such, it is proper to defer to the market to meet this particular consumer demand, and not legislate that market into existence.
The reason why these laws do not exist in the US is because of aggressive corporate lobbying against them – outspending proponents several times over. Counter-intuitive though it may be, not everything that agribusiness wants is bad. (!) Proponents include purveyors of so-called “organic” produce, who have also grown into big businesses, and have their own profit-motives.
One major advantage of liberalism is that one does NOT need to hide from the facts to maintain one’s positions. Those who pursue truth before any agenda can, in any case, make no exceptions. Liberals who take the scientific high road against conservatives on topics as varied as sexual education, evolution and climate science, should be true to their principles, and take the same approach on this issue. If GMOs were indeed harmful, we should expect to see some evidence of harm. In the utter absence of any, we can reasonably defer consideration of labeling requirements until circumstances warrant. As the facts now stand, required labeling for GMOs is capricious and unreasonable.
One must also consider the challenge of feeding a world of 7 billion people – expected to reach 8 billion in 10 years, and 9 billion in 25 years. GMOs are among our most valuable tools toward that end.
Refs:
http://en.wikipedia.org/wiki/Genetically_modified_food
http://en.wikipedia.org/wiki/Genetically_modified_organism
http://www.learner.org/courses/biology/textbook/gmo/gmo_6.html
http://en.wikipedia.org/wiki/World_population#Projections
and for what it’s worth, the plants and animals we keep around us have in turn modified our genes.
Medicare For All
The notion that a country can pay LESS for healthcare and get BETTER outcomes is not theoretical – it is demonstrable. Nearly every western country pulls off this feat vis-a-vis the US every year. The notion that government-run health insurance can outperform private insurers is likewise NOT theoretical, but demonstrable, both between and within countries. Other countries’ publicly financed healthcare systems beat the US privately financed system, as measured both in lower costs and longer lives. So there’s no need for ex ante theorizing – we’re left to the task of explaining post hoc why US private insurers get outdone year-in and year-out.
Medicare (public) beats Medicare Advantage (private), no matter how you measure it. Medicare has lower costs, slower cost growth, lower overhead, and even has better outcomes. Medicare Advantage’s net cost to taxpayers has been estimated at about $10 billion per year – that’s the extra amount that Americans end up paying simply because 30% of seniors are enrolled in Medicare Advantage instead of conventional Medicare. And CBO projects that the situation will only worsen over time, as Medicare continues to do a far superior job at containing cost growth.
But Medicare Advantage has become big business for insurers, who use a fraction of insurance premiums to lobby Congress to keep the party going. Lobbying and advertising costs, incidentally, are not counted in the overhead estimate for private insurers, which run about eight times higher than overhead for traditional public Medicare.
The solvency of Medicare’s trust fund is not about health or economics, but politics. That insurers are quicker to jack your premiums than politicians are to fund Medicare is a matter of cultural idiosyncrasy, not the reality of paying to heal the sick. Americans lay out about $8000 per person per year on health care – double the OECD average. Conservatives would have you think that people prefer paying $8000 in fees and premiums to insurers and providers, instead of $4000 in taxes to the government for the same services. Given all that we know about public versus private health insurers, an all-public system – Medicare-for-all – would almost certainly have lower costs and better outcomes than the current mostly-private system.
Surely there other factors that partially explain inferior health outcomes in the US. Relative to other westerners, Americans are more likely to be obese, poor, drive without seatbelts, own guns and abuse drugs. But they are also less likely to smoke, and more likely to exercise. Observing, for instance, that even Americans who are not obese live shorter lives than their non-obese counterparts abroad, the most comprehensive study on point concludes that the US health care apparatus is itself one likely partial explanation for lower US life expectancy.
The ACA is a step in the right direction, in that it will bring insurance to many who previously lacked it. But the ultimate goal should be Medicare for all.
Refs:
big report (300pp+): obssr.od.nih.gov/pdf/IOM%20Report.pdf
report brief (4pp): http://www.iom.edu/~/media/Files/Report%20Files/2013/US-Health-International-Perspective/USHealth_Intl_PerspectiveRB.pdf
http://www.thefiscaltimes.com/Columns/2014/04/16/Medicare-Advantage-Isn-t-Reducing-Health-Care-Costs
http://healthaffairs.org/blog/2011/09/20/medicare-is-more-efficient-than-private-insurance/
Coal (literally) Blows
Each year, from its smokestacks, a typical coal plant blows off 200 lbs of arsenic, 170 lbs of mercury, 100 lbs of lead, 4 lbs of cadmium, smaller amounts of thorium and uranium, plus an extraordinary 1 MILLION lbs of assorted particulate junk, perfectly sized to fit into your lungs’ alveoli. Remarkably, coal contains 76 of the 92 naturally-occurring elements on planet Earth – so when it’s burned, clouds of toxins are released into the environment, to settle on lakes, farms and cities, to find their way into our bodies through the food we eat and the air we breath. We havent even mentioned the coal ash that gets left behind – which is so radioactive that, kW for kW, coal delivers 100 times more radioactivity into the environment than nuclear power.
And so even if coal released no CO2 at all – as in the case of so-called “clean coal” (which doesnt exist) – it would still spectacularly suck. But coal billows CO2 into the atmosphere like nothing else. Few are aware that even though natural gas and coal create electricity via similar processes, coal is so inefficient that it releases DOUBLE the CO2 per unit of energy generated.
Obama this week released a plan to reduce American CO2 emissions. Given that 40% of all such emissions come from electric power plants, and 40% of all American electricity is generated by burning coal, any such plan will involve transitioning out of coal. But what makes the transition so economically attractive in the short term isnt about CO2 – it’s about the 25,000 premature deaths and MILLIONS of days of work lost each year in the US because of all the other stuff released when we burn coal.
Quite reasonably, rich and poor countries have different attitudes toward environmentalism. In rich countries, people have huge individual stockpiles of human capital, and so it’s extremely costly when workers get sick and are unable to work – and even more costly if they die prematurely, taking their human capital with them. In poor countries, coal may make economic sense, because workers are less productive, and so you can come out ahead trading off health for cheaper fuel. Even poor areas within rich countries may likewise be tempted by cheap energy. The logic driving the demand for coal in China also drives demand in Kentucky.
In rich countries, coal is only cost-effective because health and environmental costs incidental to its use are not internalized by users. Coal would not be cheap if the electric companies who burn it, and their customers, bore the cost of the harm that their activities impose on others. Again, it isnt just about the CO2 they pump into the atmosphere, adversely affecting climate for everyone on the planet – it is no less about the people downwind from coal-fired plants who are sickened and killed. One major problem with the US federal system – and Obama’s state-by-state plan – is that the costs and benefits of coal use sprawl across state lines. Coal might be mined in West Virginia, burned in Ohio, to generate cheap electricity in Pennsylvania and lung disease in New Jersey.
Environmentalism disproportionately benefits middle class people in wealthy countries. The poor would often prefer to have a bit more income, at the cost of their health – ask any coal-miner. The rich frequently have the means to buy their way out of environmental degradation, e.g., by moving to someplace cleaner, or by filtering their air and water. It’s the middle class who gain the most by sacrificing a fraction of their income for a cleaner environment.
And thus conservative opposition to environmentalism usually takes the form of the wealthy and powerful drumming up support from low-wage workers – which, for the GOP, is simply business as usual. Environmentalism for Americans of ordinary means is common sense. Many of the tradeoffs conservatives cite in opposition to environmentalism generally – and the move to cleaner fuels specifically – are false in rich countries. American lives are too valuable to be compromised by a 19th century fuel source, which made sense in its time and place, but is today an anachronism. Coal indeed helped America become rich – but to continue to improve our lives, we as a nation must move on to cleaner energy.
Refs:
http://news.yahoo.com/u-unveil-sweeping-rules-cut-power-plant-pollution-101054675–finance.html
http://en.wikipedia.org/wiki/Environmental_impact_of_the_coal_industry#Annual_excess_deaths
http://www.desmogblog.com/coal-power-industry-united-states-facts
http://www.psr.org/resources/coals-assault-on-human-health.html
http://motherboard.vice.com/blog/whats-the-deadliest-power-source
http://www.scientificamerican.com/article/coal-ash-is-more-radioactive-than-nuclear-waste/
http://www.euractiv.com/climate-environment/europe-loses-5-working-days-year-news-528512
http://en.wikipedia.org/wiki/Fossil-fuel_power_station#Environmental_impacts
Get Out and Stay Out (of the hospital)
America doesnt have one problem with its healthcare apparatus*, but many – including shorter lives, higher costs, and inadequate access to care. The ACA is likewise meant to ameliorate not one but several problems. One change the ACA introduced are penalties for underperforming hospitals, whose patients have a tendency to go back to the hospital within a short time of being discharged.
Hospitals are the most expensive place to render healthcare, with per-patient costs typically approaching $2000 per day, and the aggregate amounting to about one-third of all US national health expenditures. Medicare noticed that, all too often, shortly after someone is discharged from a hospital, they get readmitted for reasons that were entirely avoidable. And while high readmission rates dont speak well of patients’ health, they’re great for the health of a hospital’s bottom line, because hospital stays are highly profitable – and two stays pay twice as much as one. Churning patients out and ignoring them is great business for hospitals, but awful for patients, and costly to insurers. But under new ACA readmission rules for Medicare patients, that jig is up.
Across the country, so-called “readmission rates” vary considerably place to place and hospital to hospital. The ACA made changes in Medicare to penalize hospitals with high readmission rates – to give them a stiff incentive to see to it that their patients remain healthy after discharge – so that physically leaving a hospital does NOT also mean leaving their care altogether. The new rules only apply to Medicare patients who go to the hospital for 3 specific conditions: heart attack, heart failure or pneumonia. If, after discharge, such a patient is readmitted to any hospital within 30 days, it’s counted against the original hospitals’ readmission stats. If the rate goes too high, penalties accrue – with the size of the fine commensurate with hospital performance.
The good news is that hospitals are altering their post-discharge procedures for the better. To ensure that patients understand post-discharge care instructions, hospitals are following up with phone calls. They’re dispatching nurses to make house calls. They are GIVING AWAY FREE MEDS to their poorest patients! While all of this costs money, overall these new policies are cost-effective, simply because hospitalizations are so outrageously expensive that you can spend a small fortune avoiding them and still come out ahead. The fines are meant to get hospitals on the same page with patients and their insurers.
So far so good: According to a CEA report, growth in healthcare costs during 2010-13 were the lowest ever recorded in any 3 year period in US history, with Medicare leading the way, and hospitalizations performing especially well. In the years ahead, Medicare plans to add other diseases to the no-fly list for readmissions – and private insurers are expected to phase in their own penalties for underperforming hospitals. The US healthcare apparatus is multi-faceted, and solutions to its many issues will require creativity. But the new Medicare readmission policy so far is working as planned – for the good of senior’s health, and for the good of the nation’s financial health as well.
Refs:
* some, CT included, use the term “US healthcare system” – but “system” is simply too flattering. “apparatus” is itself too kind, if easier to type than “thingamabobby.”
Of a Healthcare System on the Moon
A nation might build the universe’s greatest hospital on the moon – but in the absence of a lunar lander, the claim that that nation has the “best medical care” cannot be made without irony. But this is what conservatives who defend America’s national healthcare apparatus must do every day. The US healthcare system, by design, keeps needed care out of reach for a large fraction of the US population. And so millions of Americans get told every day that America has “the best healthcare in the world” – though they themselves are unable to access it. For them, it might as well be on the moon – which only a lunatic could envy.
In theory, any country could improve healthcare for a fraction of its population by excluding another fraction from care. Putting aside the morality of such a system, you dont come out ahead in the bargain anyway, because you tend to lose more at the bottom than you gain at the top. The metrics, which count everyone, betray the true cost of such policies, as seen in higher American mortality, from birth through till age 75.
American babies are more likely to die before their 1st birthday than babies in other rich countries. American children are more likely to die before age 5 than children in other rich countries. American adults at all ages are more likely to die than adults in other rich countries. It’s only Americans surviving till age 75 who compare favorably with 75 year-olds elsewhere – and we’re left to wonder whether it’s their single-payer government-provided universal health insurance (aka Medicare) that’s responsible – or if it’s merely selection bias: that it’s so much harder for Americans to make it to 75 without dying, that those who succeed are hardier.
We might parse out health outcomes by income, and find the same result. Wealthy Americans live shorter lives than their wealthy counterparts in other rich countries. Poor Americans live MUCH shorter lives than their poor counterparts in other rich countries. White babies born in America are more likely to die before their 1st birthday than white babies born in other rich countries.
To put it differently, it is NOT the case that the US has a bimodal distribution of life expectancy, with rich Americans doing better and poor Americans doing worse. ALL Americans do worse – it’s just a matter of degree. Hey, if living long is important to you, it definitely helps to be born rich, white and female – but it’s also beneficial to be born elsewhere.
To give it a Rawlsian twist: imagine yourself as an Unincorporated Spirit, hovering in the ether, about to be inserted into some body to live out a life. You are given a choice of populations to be cast into randomly. If life expectancy is your sole criterion – the US would be about 30th on your list of preferred destinations. As Regina sings it: it’s all about the moon.
Refs:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661456/
Cynicism with a Body Count
The government shutdown and the downgrading of the nation’s creditworthiness over the debt-ceiling was the previous high water mark for GOP cynicism. But now the GOP has outdone themselves – the toll for their refusal to expand Medicaid in 24 states might as well be measured not in dollars, but in corpses.
A new study out of Harvard Medical School estimates that between 7,000 and 17,000 people will die as a result of states’ refusal to expand Medicaid. And how much money will those states save, to justify that loss of life? Nothing at all! Zero, zippo, nada. As a kicker, businesses within those states will be subject to fines of $2,000 per uninsured – and workers within those states will still pay the same federal taxes to benefit the residents of the 26 other states who opted into expanded Medicaid. To score political points, the GOP is today killing poor working people – while local business pays for the fun. Expanded Medicaid is already paid for – state officials just have to sign on the dotted line to start receiving benefits – but conservatives would rather pay the bill and refuse the benefit, ensuring that thousands of poor people will needlessly die.
People with incomes between 100% and 138% of the federal poverty line do NOT qualify for federal subsidies to purchase private insurance. (Subsidies only go to people between 138% and 400% of the poverty line.) Their solution was Medicaid expansion. When the Supreme Court rewrote the law to let states opt out, those people were given no alternative – they were categorically shut out of the system. Plan B for the working poor is Dont get sick. Many of them now will not get screened for breast or cervical cancer; many diabetics will have to do without medicine; many others will be at greater risk of depression; many will be bankrupted by catastrophic medical expenses. And many will die – needlessly.
This study is not alone. More modest studies scrutinizing individual states tell a similar story. When a state opts out of Medicaid expansion, people die, businesses get hit with penalties, and Federal taxes effectively siphon money out of the state – paying for a benefit that they obtusely refuse to receive!
Still more studies are already documenting how opting out adversely affects the numbered of uninsured. Opt-out states have seen rates of uninsured drop by just 1.5% since September – while opt-in states have seen that rate fall by 4%. As of March, the rate of uninsured for opt-in states was 12.4% – while for opt-out states it was 18.1%.
Medicaid expansion is a sweetheart deal for states. For the first 3 years of the program, states pay nothing at all. Their share gradually increases thereafter, but will never exceed 10%. And since expansion is likely to offset other state expenditures, states’ effective share of the program is likely to be even less than 10% over the long haul. Adding perversity to perversity, conservative refusal to expand Medicaid serves to regressively redistribute wealth out of poor (GOP) states and into rich (DNC) states – yet another opportunity for the GOP to sock it to their own constituents for a hollow ideological purpose.
Refs:
http://www.cbpp.org/cms/?fa=view&id=3801
http://pnhp.org/blog/2014/01/30/state-medicaid-opt-out-will-cost-over-7000-lives-maybe-17000/
http://orlandoweekly.com/news/the-perils-of-florida-s-refusal-to-expand-medicaid-1.1665144?pgno=2
http://www.wral.com/new-studies-medicaid-opt-out-costly-for-nc/13349683/
http://www.cbsnews.com/news/obamacares-impact-differences-emerge-between-states/
http://www.thenation.com/blog/168634/supreme-court-upholds-mandate-mixed-ruling-medicaid-expansion
What the Living Owe the Not Yet Alive
If it werent for the fact that real, live women are people already – complete with feelings, desires and free will – the abortion issue would be a purely intellectual matter. But recognizing the rights of zygotes, embryos and-or fetuses is a zero-sum game that necessarily abrogates the rights of the women carrying them – women whose thoughts, sensibilities and volition are NOT mere theoretical constructs, nor the invention of medieval mythologies, but observable facts. The question ultimately posed by the issue of abortion is: What duty should we place on existing people to bring subsequent people into existence?
Best we can reckon, the great preponderance of material in the universe is unconscious and dumb – water, dirt, sunlight, air. Entities like you and your dog – with the ability to see, feel, think, desire, enjoy and fear – are spectacularly rare. Instinctively to us all, life has inherent value – and accordingly, actions that create or destroy life are vested with significance. Abortion is problematic because it terminates the developmental path of a discreet, identifiable entity that had the potential to become just like us – alive, awake, aware – turning it back to the mass of dumb and insensate material that comprises the bulk of everything.
The issue as to where that path begins, or where on that path lie its most significant markers, is not easily resolved. The Monte Python bit, “Every Sperm is Sacred”, pokes fun at the absurdity of tracing the path too far back. Similarly, while seeking to make a larger point about the double standard for men and women, Oklahoma State Senator Constance Johnson tried to illegalize male masturbation. The text of her amendment read, “Any action in which a man ejaculates or otherwise deposits semen anywhere but in a woman’s vagina shall be interpreted and construed as an action against an unborn child.” All are surpassed by Bill Maher’s satirical proclamation: “Life begins at erection!”
Conception isnt nearly a guarantee of achieving anything resembling life as we value it (seeing, feeling, thinking, etc.) The data is murky, but the most thorough study suggests that miscarriage rates are greater than 30%. (The rate most frequently cited is 15-20% – but that figure is for detected pregnancies. Perhaps half of all miscarriages end pregnancies that were never detected.) If we back it up another step, we find that in any given month, 25% of women seeking to become pregnant will succeed – and so when one forgoes sex, or uses contraception, there’s an excellent chance of preventing pregnancy (which is why birth control is so popular), ending someone’s potential journey from non-existence to conscious being.
Other than birth and fetal viability, there isnt one discernibly ascendent moment in the long process through which new people are made. The imposition of Christian mythology is particularly unhelpful in resolving the matter, since it relies solely on magical thinking, not reason, fact or science. The notion of “souls” leaping into newly formed zygotes is of the same species of inanity as the theory that malevolent fairies cause laryngitis when they leap into the throat. For centuries, Christian “thinkers” deemed the quickening (when the fetus is first felt to kick) to be the magic moment of “ensoulment”, after which abortion was not permitted. This changed abruptly in 1869, when Pope Pius IX declared it to be conception. Both positions are fundamentally arbitrary, primitive expressions of animism.
Debate must exclude opinions based solely on religion, because as articles of faith they cannot be engaged rationally, and so cant be discussed, but only offered for belief without evidence or argument. The extreme zealot’s position – if you conceive it, you’re stuck with it – cannot be given any weight in a non-sectarian, polyglot society, which depends on reason as a universal language to resolve differences.
Beautiful though life may be, rights bestowed on zygotes, embryos, and-or fetuses come at the cost of rights lost by women. And so any argument for forcing women to continue an unwanted pregnancy must, at a minimum, bear a substantial burden, and be supported by fact-based, logical reasoning, not mere recourse to mythology. Since distinctions among abstinence, contraception, and termination of an early-term pregnancy are based primarily on magical thinking – not science, and surely not rationality – they do not meet the minimum standard for inclusion in the debate.
Refs:
http://www.dailykos.com/story/2011/03/26/960283/-Life-Begins-at-Erection-It-s-all-about-the-Sperm
http://www.buzzfeed.com/mjs538/pro-choice-oklahoma-senator-adds-amendment-to-pro
http://global.christianpost.com/news/pro-choice-oklahoma-politican-proposes-masturbation-ban-69236/
http://www.nytimes.com/1988/07/27/us/study-finds-31-rate-of-miscarriage.html
http://www.huffingtonpost.com/2013/10/17/miscarriage-cause_n_4116712.html
http://miscarriage.about.com/od/pregnancyafterloss/qt/miscarriage-rates.htm
PS Death isnt an end, so much as life is a pause – between two comparably infinite stretches of nonexistence. Take a moment to look out your window, walk down your street or hold your children, and wonder at it. Life is an exceedingly brief window, between the darkness we left and the same darkness to which we’ll return. When contemplating what it will be like, consider that everyone alive today will probably experience the year 2200 the same as they experienced the year 1800, during which there were some great parties, a few disasters, some notable events, some perhaps involving family members – all of which slipped by undetected to us.
Given the brevity of it, it’s extraordinary, bizarre, miraculous and FORTUNATE – that people can get so bent out of shape by the minutia of the quotidian. (We should be grateful for our ability to be so easily distracted.) Analogously, it’s difficult to assess or express the tragedy of beings who never even attain consciousness for the short time life affords it…. Have a nice Memorial Day weekend. Make sure you take 5 to grab a beer and a hot dog, chill, and gaze into the sky. Repeat if necessary.
Legalize It (All of It)
No issue better captures conservative vapidity than drugs. Their supposed “fear of big government” is somehow not triggered by a US police state, which over the past 40 years has eviscerated the bill of rights, subverted democracy at home and abroad, and given the US the highest incarceration rate and largest prison population in the world.
The US police state went into launch mode decades ago. Though crime rates have been falling for more than 20 years since their 1991 peak, incarceration rates have continued to rise, seemingly independent of the drop in crime. The US incarceration rate is now over 700 per 100,000 – by comparison, the rate in many European countries in under 100. When you include probation and parole, you find that 3% of the US population is under correctional supervision. Drug crimes incarcerate about half of all federal prisoners, and about a quarter of all people in all US prisons.
Press a conservative on his inane opposition to drug legalization, and you’ll hear the squeaky voice of a paternalist with no love for freedom, and no respect for the judgment of other adults on how they choose to organize their lives. Like socialists, conservatives have no trouble subjugating individual liberty to the perceived needs of the collective.
The most common conservative rationale for drug prohibition is the protection of OTHER people from the consequences of an individual’s choice to use drugs. It’s curious that analogous social concerns are never seen in the context of food stamps or welfare – in which conservatives happily let children of poor parents endure severe material privation in the name of “individual responsibility.”
But of course conservatives’ “suffer the little children” feint on drug issues is just lipstick for the pig. Conservatism’s defining trait is its lack of principle. Conservatism is NOT a political philosophy – it’s 10 lbs of shit packed into a 5 lb bag by historical accident. Lacking any principles, conservative positions hover in the ether, without foundations. A trillion dollars spent on the war on drugs hasnt saved lives, reduced usage, or even increased drug prices. And it doesnt protect children. (Ever hear of liquor store owners hawking booze in or around schoolyards?) Conservatives essentially oppose drug legalization in the same way they oppose gay marriage – for no reason at all. Like every other conservative policy position, it isnt about a convincing argument, a principle, or (heaven forbid) observational data or scientific analysis. They oppose it because they oppose it.
Three year olds behave the same. They point their finger and declare “I want that.” A three year isnt interested in the particularities of fairness, history, propriety or decency. They dont give a damn about facts or logic – they know what they want, and naked desire is the alpha and omega of their universe. A three year old’s opinion on who’s turn it is to play with the dolly (mine!) is as immutable as a conservative’s opinion on drug legalization for EXACTLY the same reason. An opinion not based in fact nor derived from logic is amenable to neither.
Refs:
great all-around source: http://www.sentencingproject.org/template/index.cfm
including these greatest hits:
http://www.sentencingproject.org/template/page.cfm?id=107
http://www.sentencingproject.org/template/page.cfm?id=128
other sources:
http://en.wikipedia.org/wiki/List_of_countries_by_incarceration_rate
http://fcnl.org/resources/newsletter/septoct11/mass_incarceration_massively_wrong/
http://www.motherjones.com/politics/2008/07/slammed-welcome-age-incarceration
http://content.time.com/time/magazine/article/0,9171,2109777-1,00.html
http://www.csmonitor.com/2003/0818/p02s01-usju.html
http://www.nytimes.com/2008/04/23/world/americas/23iht-23prison.12253738.html?pagewanted=all
PS: In response to several readers’ queries on whether Wile E. Coyote (Eatus almost anythingus) ever finally caught and ate the Road-Runner (Velocitus delectiblus), I’m posting this link, in the hope that it settles the matter conclusively: https://www.youtube.com/watch?v=EuE-GpNV0sY
Texas, Messed
Texas is fairly described as a state for the young and hungry. Among US states, it has the 2nd lowest average age, and the 2nd largest under-18 population. It also has among the highest rates of child poverty and food insecurity.
Frequently trotted out as a national exemplar of conservatism, Texas does indeed have a small state government, and has seen excellent economic growth since the Great Recession. But prosperity is not shared – Texas also has one of the worst rates of income inequality, the country’s highest fraction of minimum-wage and sub-minimum wage workers – and is afflicted by social ills at rates typical of much poorer states.
We begin with poverty – Texas has the 5th highest rate in the country, which is striking because Texas is not an especially poor state. The states near Texas in poverty rankings – Mississippi, Louisiana, Alabama, Arkansas, New Mexico, Oklahoma, West Virgina – are all among the bottom 10 states for median household income and per capita income, so their poverty rates are not surprising. Texas is the odd man out, ranking 25th and 30th in those same income measures. While the other 7 states are very poor by any measure, Texas is a middle-income state that has a lot of poor people because its income in unequally distributed.
With its tiny state government – ranking near the bottom for both per capita tax collection and public spending – Texas does little to ameliorate the plight of its many poor. Texas isnt even willing to spend OTHER PEOPLES’ money to help them! Of the state’s 5 million uninsured, fully 1.5 million of them would be insured, if only Texas signed on to Medicaid Expansion, the cost of which would be borne by the Federal Government. Texas declined.
Texans’ health plight only begins with its national-worst rate of health insurance coverage, and its second-worst rate of children’s health insurance coverage. Texas teenagers have the 3rd highest pregnancy rate and the 3rd highest birth rate. Texas children are in the bottom 10 for food insecurity. Life expectancy is in the bottom half of US states.
Remarkably, Texas is the only state in which workers’ compensation is not mandatory – employers are free to opt out – and about 40% do, leaving injured employees to fend for themselves. As you might expect, Texas has among the worst records for workplace injuries and fatalities. When a fertilizer plant blew up a year ago, killing 15 people and injuring 150 more, we learned that Texas has no state fire code. Neither was there a county code where the plant was situated.
While crime has dropped in recent years, Texas is among the nation’s top 5 for incarceration rates, and has the second highest execution rate. Some conservatives point out that if Texas were its own country, it’s economy would rank 14th in the world, just ahead of South Korea. They rarely mention that if Texas were its own country, it would rank 8th in executions – just ahead of North Korea.
Environmentally, Texas has some of the worst air quality in the US, with Houston and Dallas among the 10 worst cities for ozone pollution. Texas coal- and oil-fired electric plants release more CO2 than the next two largest states combined. Rick Perry has come a long way since working for Al Gore’s 1988 presidential campaign – as Texas Governor, he’s slashed the state environmental protection budget, and sued the EPA to prevent it from regulating greenhouse gas emissions.
A few factors advantaged Texas relative to the rest of the US since the Great Recession hit in 2007. Because Texas experienced a smaller run-up in housing prices, the housing crisis left the state with a relatively small fraction of distressed properties. Also, the high, sustained price of oil over the past several years has brought windfalls to oil producers, and rescued the state from the huge budget deficits it was facing. Texas rates of unemployment – good for about 17th best in the US, about 1 pct. pt. better than the national average – fail to convey that Texas jobs come in quantity, not quality, with the largest fraction of minimum wage and sub-minimum wage workers in the country.
And so people should take notice of Texas – as a cautionary tale. From extreme inequality, to the sad state of its children, to its miserable environmental record, to a disregard for workers and workplace safety – what prosperity Texas has recently seen has been enjoyed by the few, amidst widespread poverty, and the swelling ranks of the working poor.
Refs:
poverty/income:
http://en.wikipedia.org/wiki/List_of_U.S._states_by_poverty_rate
http://en.wikipedia.org/wiki/List_of_U.S._states_by_income
health/hunger:
http://www.huffingtonpost.com/2013/06/19/us-child-hunger-rates-by-state_n_3460942.html#slide=2587846
http://247wallst.com/special-report/2013/09/05/states-where-the-most-people-go-hungry/3/
http://kff.org/other/state-indicator/teen-birth-rate-per-1000/
http://www.livescience.com/27417-teen-pregnancy-rates-by-state.html
http://www.npr.org/templates/story/story.php?storyId=113042669
http://en.wikipedia.org/wiki/Workers%27_compensation#United_States
environment:
http://www.stateoftheair.org/2013/city-rankings/most-polluted-cities.html
crime:
http://www.deathpenaltyinfo.org/state-execution-rates
http://en.wikipedia.org/wiki/List_of_U.S._states_by_incarceration_rate
government:
http://kff.org/other/state-indicator/per-capita-state-spending/
http://www.governing.com/gov-data/State-Expenditures-per-Capita-2009.html#
http://en.wikipedia.org/wiki/State_tax_levels_in_the_United_States
http://taxfoundation.org/article/state-tax-collections-capita-fiscal-years-2007-2011
economic measures:
http://en.wikipedia.org/wiki/List_of_U.S._states_by_unemployment_rate
http://en.wikipedia.org/wiki/List_of_U.S._states_by_Gini_coefficient
articles:
http://www.huffingtonpost.com/bob-burnett/texas-americas-dream-or-n_b_3515896.html
http://www.huffingtonpost.com/christopher-brauchli/perry-and-the-poor_b_3398827.html
http://www.huffingtonpost.com/2011/10/17/rick-perry-environment-epa_n_1015273.html
Carlton Thurman's Liberal Field Guide 