Belated Thoughts on the Health Care Summit

FactCheck has a rundown of some of the more egregious errors and distortions here.

I think the president came off looking pretty bad in his dust up with John McCain. I was particularly taken aback by this response:

We can have a debate about process or we can have a debate about how we're going to help the American people at this point. And the latter debate is the one I think they care about a little bit more.

I don't know whether the "American people" concerned about product more than process at this point, but the president's snarky dismissal of McCain's point set me on edge.

One of the reasons that I voted for Senator Obama was because he seemed to actually care about the process. Transparency was one of the central planks in his platform. He continually railed against special-interests and backroom deal-making. He called for honesty and integrity in politics. And he eschewed the Machiavellian tactics of the Clinton campaign.

For him to now play the world-wise pragmatist is a bit disconcerting. Process is, in my view, just as essential as product.

And McCain is right -- there was no justification for provisions like the "Cornhusker Kickback" or any of the myriad of exemptions and special privileges that Democratic lawmakers carved out for their individual states.

But it's not just the sweetheat deals. I also have to agree with Ross Douthat here:

I look at liberal commentators and see a group that’s intent on being on-side against Republicans, and that’s willing to downplay significant weaknesses in major legislation (be it the stimulus, cap-and-trade, or now health care) in the quest to get things done.

I understand the frustration that most progressives feel. This has been a long, drawn-out debate, and many of the Republican attacks have been unjustified and unsportsmanlike. John Boehner's remarks toward the end of the Summit -- which seemed to begin magnanimously, but quickly descended into fear-mongering -- perfectly illustrate why so many on the left want to see health care reform forced through in reconciliation.

But I fear that, while Republicans appear to be balking at everything, Democrats remain single-mindedly focused on passing something -- regardless of whether it's good policy. Both parties deserve immense criticism here. The Republican antics are despicable, but the response from Democrats has been shameful . . . and politically troubling to those of us who actually care about how things get done.

It's just as dangerous to be overzealous as obstructionist.

On Rape and False Reporting

This is probably the best and most balanced article I've read on the subject of false rape accusations:

But isn't the rate of false rape charges an empirical question, with a specific answer that isn't vulnerable to ideological twisting? Yes and no. There has been a burst of research on this subject. Some of it is careful, but much of it is questionable. While most of the good studies converge at a rate of about 8 percent to 10 percent for false rape charges, the literature isn't quite definitive enough to stamp out the far higher estimates. And even if we go by the lower numbers, there's the question of interpretation. If one in 10 charges of rape is made up, is that a dangerously high rate or an acceptably low one? To put this in perspective, if we use the Bureau of Justice Statistics that show about 200,000 rapes in 2008, we could be looking at as many as 20,000 false accusations.

. . .

We're left to draw the following conclusion: False allegations of rape aren't rampant. But they don't have to be to cause terrible trouble. This is a problem that a men's rights movement shouldn't trump up. And also one that feminists can't dismiss.

Hat tip: Connor Friedersdorf.

Olbermann, Race, and the Right

I'm sometimes asked why I spend my time criticising Keith Olbermann when conservative commentators like Sean Hannity are much more belligerent and over-the-top. The truth is that I can't help but hold pundits on the left to a higher standard of integrity.

To me, a man like Sean Hannity is an obvious parody. His irrationalism is so transparent that it's just not worth illuminating. I don't know anyone who thinks that Sean Hannity is reasonable or intelligent, and perhaps more importantly, I don't know anyone who takes any of his arguments seriously. Even if I did, pointing out that a public option is not socialism would quickly get tiresome, just as the constant run-down of Sarah Palin's distortions came to occupy far too much of Andrew Sullivan's blogging time.

Of course, this doesn't mean that there aren't members of the electorate who eat up every morsel that Sean Hannity and Sarah Palin spit out. It just means that I don't willingly associate with any of those people.

I do, however, routinely associate with people who believe that Keith Olbermann is both intelligent and reasonable. Many of my friends and classmates seem to find Olbermann's arguments extremely seductive. Some even contend that Olbermann's points are "irrefutable."

The clip above -- in which Olbermann casually remarks that "the whole of the anger against government movement" is predicated solely on racism -- illustrates why I continue to go after Olbermann.

Is it really fair to charge that everyone who is angry with the Obama administration -- everyone attending the Tea Party rallies -- is motivated by racism? Does Olbermann really provide the evidence to substantiate such a sweeping charge?

Olbermann's conclusion rests on three central propositions. First, there are undeniably racist sentiments being voiced during many of the Tea Party rallies. Second, the concerns of the those in the Tea Party movement are largely illegitimate. Third, black faces are virtually absent from these protests.

The initial premise obviously does not, on its own, support the conclusion. (This would be an example of the fallacy of composition.)

The second premise is a bit more enticing. Why weren't the people who are now clamoring for deficit reduction acting out during the Bush administration? Does this apparent hypocrisy on its own suggest that racism is lurking beneath the surface? There are a number of sensible reponses to this. You could argue that the deficits during the Bush administration were not even remotely comparable to the projected deficits under President Obama. You could argue that conservatives were more comfortable with wartime deficits than with deficits brought on by stimulus spending and entitlement extensions. But I think the most practical response is that partisan hypocrisy simply does not imply racism. In fact, if partisan double standards are evidence of bigotry, then Keith Olbermann is doesn't come off looking so good.

The final premise is facially absurd. The Tea Party Movement is clearly dominated by conservatives. And while it's true that many black Americans tend to be socially conservative, there hasn't been a strong black presence in the conservative movement for well over two decades. Would anyone expect to see black faces at an anti-Clinton rally during the 1990s? While it may be legitimate to criticize the lack of diversity on the right, there are many reasons why black voters' preferences are no longer aligned with the Republican Party, only some of which have to do with past racial discrimination. Either way, this does not offer any thing like the kind of evidence that Olbermann would need to substantiate his across-the-board accusation.

Olbermann's comments begin sensibly, but ultimately devolve into an unfair assault on an entire group of people. The basic problem is that Olbermann can't seem to bring himself to root out racism where it may exist -- and I believe that it clearly does exists in some corners of the Tea Party Movement -- without extrapolating his arguments far beyond reason. Certainly, we should be condemning the vicious attacks against the president. But is it fair to smear all those who engage in peaceful protests against the administration as racists?

I obviously can't read Olbermann's mind, but I think Olbermann legitimately believes that the right has no meaningful arguments. Olbermann may be smarter than Sean Hannity, but like Sean Hannity, Olbermann believes that he has the One Truth on his side.

It's easy to see why he can't seem to bring himself to acknowledge that any of those who disagree with him could possibly be acting in good faith.

Krugman Gets Nostalgic

Paul Krugman has a good column today railing against secret holds -- a procedure that enables a small number of Senators to temporarily (and anonymously) block a motion from reaching the floor.

No one really seems to be too fond of holds . . . until they're in the minority:

What gives individual senators this kind of power? Much of the Senate’s business relies on unanimous consent: it’s difficult to get anything done unless everyone agrees on procedure. And a tradition has grown up under which senators, in return for not gumming up everything, get the right to block nominees they don’t like.

Krugman's point is well-taken. But, of course, he couldn't resist throwing in some partisan hackery:

Readers may recall that in 1995 Mr. Gingrich, then speaker of the House, cut off the federal government’s funding and forced a temporary government shutdown. It was ugly and extreme, but at least Mr. Gingrich had specific demands: he wanted Bill Clinton to agree to sharp cuts in Medicare.

Today, by contrast, the Republican leaders refuse to offer any specific proposals. They inveigh against the deficit — and last month their senators voted in lockstep against any increase in the federal debt limit, a move that would have precipitated another government shutdown if Democrats hadn’t had 60 votes. But they also denounce anything that might actually reduce the deficit, including, ironically, any effort to spend Medicare funds more wisely.

This seems a little unfair. The key feature of the Republican alternative health care proposal is tort reform, and the CBO examined this aspect of the Republican proposal in detail:

[I]mplementing a typical package of tort reform proposals nationwide would reduce total U.S. health care spending by about 0.5 percent (about $11 billion in 2009). That figure is the sum of a direct reduction in spending of 0.2 percent from lower medical liability premiums and an additional indirect reduction of 0.3 percent from slightly less utilization of health care services. (Those estimates take into account the fact that because many states have already implemented some of the changes in the package, a significant fraction of the potential cost savings has already been realized.)

Enacting a typical set of proposals would reduce federal budget deficits by roughly $54 billion over the next 10 years, according to estimates by CBO and the staff of the Joint Committee of Taxation. That figure includes savings of roughly $41 billion from Medicare, Medicaid, the Children’s Health Insurance Program, and the Federal Employees Health Benefits program, as well as an increase in tax revenues of roughly $13 billion from a reduction in private health care costs that would lead to higher taxable wages. [My emphasis]

These aren't huge savings, but if Democrats were really interested in bipartisan compromise, why did they exclude any meaningful tort reform provisions from the final version of their bill? There doesn't seem to be any good reason for this. A clear majority of American support caps on medical malpractice lawsuits, and these caps would reduce the deficit and curb health care inflation.

Refusing to incorporate the Republicans' central idea into the health care bill -- even when that idea is popular and sensible -- seems just as petty as anything the Republicans have done.

Update: Ruth Marcus has a wonderful op-ed on this subject:

[A] summit aspiring to be more than show would require Obama to deliver his promised break from politics as usual. A cardinal rule of political negotiation is never to give something for nothing. But what if the president were to offer Republicans an inducement -- say tort reform? He has pointed to defensive medicine as one contributor to rising health costs. If "that's a real issue," as Obama told doctors last June, why not add it to the existing Democratic plans?

I can see them in the White House now, snickering. Would this kind of preemptive strike entice Republicans to cooperate? Not en masse, but enough such flexibility might pick off a few. It would show a Democratic Party willing to stand up to its own special interests for the public good, and a Republican Party -- assuming it balks -- unwilling to compromise.

If you're going to serve chicken soup, Mr. President, you might as well ladle some meat into the bowl.

Ezra Klein scoffs:

Indeed, one of the notable elements of this process is that at no time has a Republican or a group of Republicans released a specific list of policies that Democrats could add to the bill to ensure their vote. Concessions might be good for PR purposes -- unilateral bipartisanship and all that -- but that's all they seem able to do in this process.

This makes almost no sense. Maybe Democrats could, uh, look at the Republican alternative health care proposal to get some sense of the specific policies that they endorse? Or maybe they could listen to what Mitch McConnell said on Meet the Press. It's pretty clear what the Republicans want: tort reform and interstate competition.

There is no question that most Republicans are being deliberately defiant. And it's probably true that many Republican senators will not vote for a health care reform bill, even if clear concessions are made. But the majority doesn't need many Republicans. They need one or two.

Making sensible concessions could easily sway some more moderate Republicans.

Defending Larry Summers

GMU's Alex Tabarrok has an interesting post on the sex ratio on U.S. campuses, which led me to this older post defending Larry Summers:

For the past week or so the newspapers have been trumpeting a new study showing no difference in average math ability between males and females. Few people who have looked at the data thought that there were big differences in average ability but many media reports also said that the study showed no differences in high ability.

The LA Times, for example, wrote:

"The study also undermined the assumption -- infamously espoused by former Harvard University President Lawrence H. Summers in 2005 -- that boys are more likely than girls to be math geniuses."

Scientific American said:

"So the team checked out the most gifted children. Again, no difference. From any angle, girls measured up to boys. Still, there’s a lack of women in the highest levels of professional math, engineering and physics. Some have said that’s because of an innate difference in math ability. But the new research shows that that explanation just doesn’t add up."

The Chronicle of Higher Education said:

"The research team also studied if there were gender discrepancies at the highest levels of mathematical ability and how well boys and girls resolved complex problems. Again they found no significant differences."

All of these reports and many more like them are false. In fact, consistent with many earlier studies (JSTOR), what this study found was that the ratio of male to female variance in ability was positive and significant, in other words we can expect that there will be more math geniuses and more dullards, among males than among females.

. . .

Does this mean that discrimination is not a problem? Certainly not but we need the media and academia to accurately present the data on ability if we are to understand how large a role other issues may play.

Andrew Sullivan's more polemical defense of Summers can be found here.

Tancredo Lays on the Crazy

I don't think that all of the people attending the tea-party rallies are ignorant and crazy.

But it's hard to avoid applying the "crazy" label when the opening act at the Tea Party Convention begins by issuing these remarks:

"[P]eople who could not even spell the word 'vote', or say it in English, put a committed socialist ideologue in the White House. His name is Barack Hussein Obama."

. . .

"So the race for America is on right now. The president and his left-wing allies in Congress are going to look at every opportunity to destroy the Constitution before we have a chance to save it. So put your running shoes on. Because I'll tell you, I've heard we need a revolution. My friends, we already had it. We lost. I mean, what happened to us in that last election was a revolution . . . ."

Quick Thought on Repealing DADT

The moral case for repealing Don't Ask, Don't Tell is pretty straightforward: It is a discriminatory policy and discrimination is inherently wrong, regardless of its practical necessity.

There is also a more nuanced ethical argument in favor of repealing DADT, which Hilzoy outlines pretty effectively here:

It has always seemed obvious to me that Don't Ask, Don't Tell is immoral and discriminatory. But I've never understood why it isn't clear that it's also an insult to the professionalism of the military. The very idea that our soldiers should not be quite capable of subordinating their personal beliefs to the needs of their unit is as insulting. The idea that if some of them can't, we should fire the people they object to rather than the ones who cannot be counted on to put their jobs first, is just bizarre.

I'm sympathetic to both of these arguments. In addition, I think that calling on some members of the armed forces to lie about their sexuality seems to (at least) violate the spirit of the Uniform Code of Military Justice.

But there is another case for repealing DADT of which I'm far more suspicious. Over the past few years, many left-wing pundits have argued that DADT is simply bad policy because it turns away good soldiers for no sensible reason. In other words, DADT has made our country less safe by effectively decreasing the size of our military.

The problem with this argument is that it doesn't allow for any consideration of the counterfactual scenario. It's undeniable that DADT has had an effect on and recruitment rates. However, if this is a primary concern for policymakers, then the real question is: How would repealing DADT impact retention and recruitment rates?

Are the kinds of men who join the military disproportionately likely to be ultramasculine homophobes? Or religious zealots? Or perhaps just strong social conservatives? If so, would these men be less likely to sign up for duty if DADT is overturned?

It's difficult to foresee a circumstance in which repealing DADT wouldn't cause at least a mild decline in retention and recruitment among certain demographic groups. But would repealing DADT make the military worse off than under current law?

I think that opponents of DADT should stick to making the moral case. Because the answers to these practical policy questions are far less clear than advocates might suggest.

Dumb Controversy of the Week

Are people really griping about this?

From AP:

Nevada lawmakers lashed out at President Barack Obama on Tuesday after he made another reference to Las Vegas while explaining how people should make tough choices on spending.

The issue is sensitive to Sin City because its economy is largely based on tourism, and several lawmakers said they were shocked that Obama singled out Las Vegas again after commenting one year ago about bailed-out banks holding meetings here.

"When times are tough, you tighten your belts," Obama said, according to a White House transcript of his appearance Tuesday at a high school in North Nashua, N.H.

"You don't go buying a boat when you can barely pay your mortgage," Obama said. "You don't blow a bunch of cash on Vegas when you're trying to save for college. You prioritize. You make tough choices."

The comments quickly sparked a flurry of reaction from federal, state and local lawmakers in the Silver State, which had an unemployment rate of 13 percent in December.

"I'll do everything I can to give him the boot," Las Vegas Mayor Oscar Goodman said during a hastily called news conference, adding that he was incensed when he heard about the comments and said he would no longer welcome the president here if he visits.

"This president is a real slow learner," said Goodman, who is not affiliated with a political party.

"Enough is enough!" Democratic Congresswoman Shelley Berkley said in a statement. "President Obama needs to stop picking on Las Vegas and he needs to let Americans decide for themselves how and where to spend their hard-earned vacation dollars."

Nevada's economy has been hit hard with foreclosures, unemployment and bankruptcies during the past two years as consumers everywhere tighten leisure spending and companies spend less on meetings and conventions.

Harry Reid, Democratic Senate majority leader and one of Obama's closest allies, issued a statement headlined "Reid to Obama: 'Lay off Las Vegas'" and was unusually blunt in his reaction.

"The President needs to lay off Las Vegas and stop making it the poster child for where people shouldn't be spending their money," Reid said. "I would much rather tourists and business travelers spend their money in Las Vegas than spend it overseas."

Can the president say anything without being attacked? This is beyond ridiculous.

Stewart Slams Olbermann

Since I've sort of gone after the Daily Show before, it's only fair that I show Jon Stewart some love for this:

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Special Comment - Keith Olbermann's Name-Calling
http://www.thedailyshow.com/
Daily Show Full Episodes Political Humor Health Care Crisis

I'm glad that someone on the left finally had the guts to point out how absurd, over-the-top, and - at times - downright hypocritical Olbermann's rants have become. (While I'm at it, I should also give belated props to PetPluto for this post.)

Maybe Olbermann will take a hint from Jon Stewart. But if this doesn't do it, perhaps a 44 percent drop in ratings among 25 to 54 year-olds will.

Abstinence-Only Education Doesn't Work . . . Any Better Than Comprehensive Sex Education

Ross has another wonderful opinion piece in today's NYT on the debate over abstinence-only education:

So last week’s news that teenage birthrates inched upward late in the Bush era, after 15 years of steady decline, was greeted with a grim sort of satisfaction. Bloggers pounced; activists claimed vindication. On CBS News, Katie Couric used the occasion to lecture viewers about the perils of telling kids only about abstinence, and ignoring contraception. The new numbers, declared the president of Planned Parenthood, make it “crystal clear that abstinence-only sex education for teenagers does not work.”

In reality, the numbers show no such thing. Abstinence financing increased under Bush, but the federal government has been funneling money to pro-chastity initiatives since early in Bill Clinton’s presidency. If you blame abstinence programs for a year’s worth of bad news, you’d also have to give them credit for more than a decade’s worth of progress.

More likely, neither blame nor credit is appropriate. The evidence suggests that many abstinence-only programs have little impact on teenage sexual behavior, just as their critics long insisted. But most sex education programs of any kind have an ambiguous effect, at best, on whether and how teens have sex. The abstinence-based courses that social conservatives champion produce unimpressive results — but so do the contraceptive-oriented programs that liberals tend to favor.

. . .

If the federal government wants to invest in the fight against teenage pregnancy, the funds should be available to states and localities without any ideological strings attached. (And yes, this goes for the dollars that currently flow to Planned Parenthood as well as the money that supports abstinence programs.) Don’t try to encourage Berkeley values in Alabama, or vice versa.

America’s competing visions of sexuality — permissive and traditional, naturalist and sacralist — have been in conflict since the 1960s. They’ll probably be in conflict for generations yet to come.

As far as I know, the only independent longitudinal study comparing abstinence-only education to comprehensive sex education was carried out by Mathematica Policy Research, Inc. The study found no statistically significant differences between students in abstinence-only programs and comprehensive sex education programs. (The final report can be read here.)

The sample groups were randomly assigned. In addition, the researchers used a data-analytic approach (looking at regression-adjusted means) to statistically control for various "individual demographic and background characteristics."

The study's conclusion:

Findings indicate that youth in the program group were no more likely than control group youth to have abstained from sex and, among those who reported having had sex, they had similar numbers of sexual partners and had initiated sex at the same mean age. Contrary to concerns raised by some critics of the Title V, Section 510 abstinence funding, however, program group youth were no more likely to have engaged in unprotected sex thancontrol group youth. [My emphasis]

I'm not opposed to comprehensive sex education -- if nothing else, I think kids should be exposed to information -- but I think Ross makes an excellent point. There doesn't seem to be any sensible reason to force more socially conservative communities to teach their children about contraception.

On this issue, at least, we should stay out of each other's backyards.

Update: A coworker directed me to this recently-published study, which was highlighted in the Washington Post today. The findings suggest that some carefully-crafted abstinence-only programs may, in fact, be significantly more effective than certain comprehensive sex education programs.

I think this only bolsters Ross's point. Different communities should be able to try different things.

Update II: Ross responds to this post by Hanna Rosin, and offers his views on the study that was featured in the Washington Post:

Does this prove that abstinence-based education always lowers teen sexual activity? No — it proves that one abstinence program designed in a particular way, implemented by a particular group of teachers, and aimed at a particular age group in a particularly area was considerably more effective than a contraception-based approach. And that’s all that any controlled experiment is likely to prove. The data on this question are necessarily deeply particular, and partisans on both sides will probably always be able to find studies that “prove” the superiority of their preferred approach. (Here’s a recent entry for the pro-comprehensive sex ed side, for instance.) Which suggests, to my mind, the virtues of both widespread experimentation and local control, rather than an inevitably polarizing quest for a one-size-fits-all solution.

. . .

The idea that only a federally-mandated health curriculum can save America’s teens from sexual ignorance strikes me as a vast overstatement of the federal government’s power. And the dream of constructing a program that’s somehow perfectly “neutral” on such a deeply fraught, inherently values-laden subject seems like a recipe for endless controversy, and little real progress.