Not More Extremism. . .

It's just easier to see:

We live in a complex world and I don't mean to oversimplify this too much. But it seems to me that, rather than a change in underlying sentiments -- that is, more prevalence of quote-unquote extreme, alienated, nonmainstream, populist, pox-on-both-their-houses viewpoints -- what has instead changed is that these viewpoints have become much more visible. And the reason has to do with technology -- to some extent cable news but to a much greater extent the Internet.

Take the Tea Parties, for example. . . .

. . . .The change we are seeing is perhaps principally a technological one.

Nate has the rest.

Strawberries

From Pandagon:

. . . Certainly, the discussion of welfare has always been bogged down by moralistic hand-wringing over the idea that the poor might scratch out some pleasure they don’t “deserve”, because it’s supposed to be reserved for what Sarah Palin likes to call Real Americans---white, middle class, politically conservative. A long time ago, I read an essay by a woman on food stamps that really opened my eyes to how much this is true. She was describing how she got glares from people in the supermarket for having items as innocuous as strawberries in her cart. I’m sure if those people were confronted, they would say that they don’t want to pay for someone who is wasteful and that strawberries are just too expensive and don’t go far enough. But this argument is bullshit, because strawberries are nutrient dense compared even to most fruits. You get a lot of bang for your strawberry buck in terms of fiber and vitamin C. I think they even have more calories than most fruit. Clearly, the objection to strawberries is that they’re so pleasurable, and someone on food stamps is viewed as someone who doesn’t deserve even the smallest pleasures.

Healh Care Take-Away

Via Ezra Klein

Cash, Not Cans

From the NYT:

Ann Kansfield, who runs a weekly food pantry at the Greenpoint Reformed Church in Brooklyn, cannot bring herself to tell you this, so I will: She doesn’t want your cans. As uncharitable as it sounds, she doesn’t want your holiday food drives. Don’t be offended. She knows you are well meaning; just misguided, perhaps misinformed. . .

Read the rest.

"Democracy is Not a Spectator Sport"

From the History Channel, The People Speak.

Perry v. Schwarzenegger

"Like Brown v. Board of Education or Roe v. Wade, it has the potential to change American life."

Nicely Done

Josh K. publishes his Op-Ed. Anyone else having any luck?

Costs and Benefits

Tony Judt, in the New York Review of Books (emphasis mine):

I suggested above that the provision of train service to remote districts makes social sense even if it is economically "inefficient." But this, of course, begs an important question. Social democrats will not get very far by proposing laudable social objectives that they themselves concede to cost more than the alternatives. We would end up acknowledging the virtues of social services, decrying their expense...and doing nothing. We need to rethink the devices we employ to assess all costs: social and economic alike.

Let me offer an example. It is cheaper to provide benevolent handouts to the poor than to guarantee them a full range of social services as of right. By "benevolent" I mean faith-based charity, private or independent initiative, income-dependent assistance in the form of food stamps, housing grants, clothing subsidies, and so on. But it is notoriously humiliating to be on the receiving end of that kind of assistance. The "means test" applied by the British authorities to victims of the 1930s depression is still recalled with distaste and even anger by an older generation.

Conversely, it is not humiliating to be on the receiving end of a right. If you are entitled to unemployment payments, pension, disability, municipal housing, or any other publicly furnished assistance as of right—without anyone investigating to determine whether you have sunk low enough to "deserve" help—then you will not be embarrassed to accept it. However, such universal rights and entitlements are expensive.

But what if we treated humiliation itself as a cost, a charge to society? What if we decided to "quantify" the harm done when people are shamed by their fellow citizens before receiving the mere necessities of life? In other words, what if we factored into our estimates of productivity, efficiency, or well-being the difference between a humiliating handout and a benefit as of right? We might conclude that the provision of universal social services, public health insurance, or subsidized public transportation was actually a cost-effective way to achieve our common objectives. Such an exercise is inherently contentious: How do we quantify "humiliation"? What is the measurable cost of depriving isolated citizens of access to metropolitan resources? How much are we willing to pay for a good society? Unclear. But unless we ask such questions, how can we hope to devise answers?

28, 15, and 8 percent

From the NYT:

From the ailing resorts of the Florida Keys to Alaskan villages along the Bering Sea, the program is now expanding at a pace of about 20,000 people a day.

There are 239 counties in the United States where at least a quarter of the population receives food stamps, according to an analysis of local data collected by The New York Times.

The counties are as big as the Bronx and Philadelphia and as small as Owsley County in Kentucky, a patch of Appalachian distress where half of the 4,600 residents receive food stamps.

In more than 750 counties, the program helps feed one in three blacks. In more than 800 counties, it helps feed one in three children. In the Mississippi River cities of St. Louis, Memphis and New Orleans, half of the children or more receive food stamps. Even in Peoria, Ill. — Everytown, U.S.A. — nearly 40 percent of children receive aid.

. . . . Now nearly 12 percent of Americans receive aid — 28 percent of blacks, 15 percent of Latinos and 8 percent of whites. Benefits average about $130 a month for each person in the household, but vary with shelter and child care costs.

Read the rest.

Regarding Our Profiling Discussion

Shalom points us here:



UPDATE: Also, see this: "Right and Left Join Forces on Criminal Justice"

"It's Shaking us to the Core"

Two Smart Talks

And Rick Perlstein, if the wonky video continues to refuse to be embedded below.

"Welfare and the Poorest of the Poor"

Peter Edelman on TANF -- must reading, I think, for those of you in SWK 6201. An excerpt:

. . . Nonetheless, the main message was to downsize the rolls, and downsize they did. The palpable result thirteen years later is the virtual disappearance in many states of cash assistance for low-income mothers with children, with caseloads going down by well over 90 percent. Overall, the rolls shrank from 14.3 million mothers (and a few fathers) and children in 1994 to under four million in 2007. In 1995, nine million of the 14.5 million children then poor were in families that received welfare. By 2006, only four million of the 12.8 million poor children were in families getting TANF. That the gap bespeaks a failure to respond to legitimate need seems obvious.

These are the techniques of radical reduction: shut the front door almost completely; staff the back door with the equivalent of a tough nightclub bouncer; and, in between, hassle applicants to the point where they just give up and go away.

At the front door many states just say no, evoking memories of the pre-1960s period, when unbridled discretion ruled. Some cloak the turndown with the euphemism of “diversion,” which means, “You look able-bodied. Go out and look for a job.”

At the back door there is sanctioning—kicking people off the rolls because they were late to a work assignment (no excuses for sick children, late buses, or car breakdowns) or didn’t show up for an appointment at the welfare office (no excuses for failure to receive notice of an appointment or inability to understand English). In some states multiple infractions of this sort can result, legally, in lifetime disqualification.

In between there are requirements to bring an entire dossier of documents in order to navigate the application maze, intrusive questions about the applicant’s private life, assignments to demeaning work programs that sometimes ask people to work without necessary protective equipment, regular and irregular summonses to come in for redetermination of eligibility, and much more. Many needy people refuse to undergo the indignities associated with asking for help.

Since the current recession began, it has become even more obvious that TANF is not responsive to the real level of need. The number of people receiving food stamps, to which there is a statutory right, now exceeds thirty-three million, while the number receiving TANF has remained stuck at around four million. The numbers have increased somewhat in some states in recent months, but even a 25 percent average increase nationwide would bring the total caseload up to something like five million. And there are states where an eligibility administrator will routinely approve an application for food stamps and just as routinely turn away the same person’s application for TANF. A sideshow barker might say, “Step right up, step right up. Only a nickel to see the incredible shrinking TANF program.

”

17 Million Households, 49 Million People

WASHINGTON, Nov. 16, 2009 - USDA's Economic Research Service's (ERS) today released its annual report on Household Food Security in the U.S., which revealed that in 2008, 17 million households, or 14.6 percent, were food insecure and families had difficulty putting enough food on the table at times during the year. This is an increase from 13 million households, or 11.1 percent, in 2007. The 2008 figures represent the highest level observed since nationally representative food security surveys were initiated in 1995. The full study is available at www.ers.usda.gov/features/householdfoodsecurity/

An Inconvenient Truth

An Inconvenient Truth - Al Gore @ Yahoo! Video

Energy and the Environment

A good collection of data and analyses on environmental policy is at Public Agenda. And note this also, posted handily right below, and follow the links. Grim, indeed. Oh, and you might as well look at Pew's Center on Global Climate Change and these two CRS reports on energy policy. (Add in Rushefsky, Chapter 6, and that's what the week look like for you POL 1105 folks. As I said, Grim.) [UPDATE: For a good primer on the state of the science of global climate change, see this Brief. And here's the IPCC Report. And this meta-analysis of the published research.]

You know you're in for a bout of grim reading when the international agency charged with worrying about how we power the planet starts off its fact sheet with a question like this: "Why is our current energy pathway unsustainable?"

That's the message from the International Energy Agency, which issued its World Energy Outlook report, the organization's annual examination of the big picture. That picture itself hasn't changed all that much. The fundamental challenge is still to meet surging worldwide demand for energy while at the same time coming up with ways to avoid global warming and keep energy relatively affordable.

Basically, the IEA says everything depends on whether or not world leaders get serious about climate change, very soon.

If we do nothing, then worldwide energy demand is projected to soar by 40 percent by 2030. The vast majority of that increase is going to come in the developing world, as people in China, India and throughout Asia see their standard of living rise. Even keeping up with that demand would require investing another $26 trillion. And unless things change, most of that energy is going to come from fossil fuels, which means "dire consequences for climate change" and air pollution, the IEA said.

On the other hand, if world leaders committed to fighting climate change with cap-and-trade policies, increased energy efficiency, and greater use of renewable energy, that would cost another $10.5 trillion (on top of the $26 trillion). But energy demand growth could be cut in half, and greenhouse gases would decline.

Not that the prospects for this look particularly good right now. Most observers say hopes for a real deal out of next month's Copenhagen climate conference are fading, one major reason being that the United States still hasn't figured out what it wants to do. There's a chance the Obama administration will put something in place on its own even if Congress doesn't act, but in any case, it's unlikely a deal with be struck without American leadership.

Chances are you've never heard of the IEA. While the agency has enormous influence among policymakers, and while there are bitter disputes over its estimates, it barely registers with the public. But despite the IEA's wonky tone and elite audience, the report has one great strength when it comes to getting the public involved: it focuses on choices and alternatives.

The world has decisions to make about energy. Everything we've learned about how people get engaged in making policy decisions shows that choices are essential. Nothing's perfect, and there are always tradeoffs to everything. Setting those options out fairly to the public is critical to building public support for change.

The IEA actually lays out the cost of those alternatives for policymakers. We can only hope that policymakers will turn around and do the same for the public.

Some Context

As we think about the potential costs if various reform plans; from the Washington Post's not terrible 8 Questions about Health care Reform.

Legalized Bribery?

Or something else? From FAIR:

As powerful lawmakers debate healthcare legislation of enormous potential impact, corporate media have largely failed to explore the problem of health and insurance industries attempting to influence many of these legislators with a flood of campaign contributions.

Despite Deep Throat’s urging journalists to “follow the money,” there’s a longstanding media taboo against discussing the role of campaign contributions in healthcare initiatives (Extra!, 1–2/04). This reluctance is particularly striking this year, when health industry spending on lobbying efforts and political contributions is unprecedented.

In what the Washington Post (7/6/09) referred to as “a record-breaking influence campaign by the healthcare industry,” $1.4 million is spent on lobbying every day. According to the Center for Responsive Politics, lobbying expenditures for all health and insurance sectors total $263 million so far this year, while those sectors have directly donated more than $23 million to federal lawmakers.

Some of the greatest beneficiaries of these donations also happen to be pivotal arbiters in the shaping of healthcare legislation. Yet corporate media have rarely raised the issue of these lawmakers’ potential conflicts of interest.

. . . . . .

Baucus has received nearly $3.4 million in campaign contributions from health and insurance industries since 2003—more than any other member of Congress. These donations represent about 23 percent of Baucus’ total fundraising (including from his PAC) during that time. This includes “$853,000 from pharmaceutical and health products, $851,000 from health professionals, $467,000 from hospitals and nursing homes, $466,000 from health service and HMO interests, and $784,000 from insurance” (Montana Standard, 6/14/09). Baucus also ranks fourth all-time in financial contributions from pharmaceutical companies (Capital Eye, 6/25/09). A Nexis search for “Max Baucus” among the seven outlets in the survey found mentions in over 100 healthcare-related stories from June 1–September 1, 2009, but Baucus’ financial ties to the healthcare industry came up only six times (Washington Post, 7/6/09, 7/21/09, 7/25/09; New York Times, 6/24/09, 8/19/09; ABC World News, 8/14/09).

Only two of these reports noted that Baucus continued to collect campaign donations from health and insurance industries even as he chaired the Finance Committee’s work on a healthcare reform bill. The July 21 Washington Post noted: “Top health executives and lobbyists continued to flock to the senator’s often extravagant fundraising events in recent months.” Aides to Baucus told the Post that he had refused donations from healthcare PACs after June 1. “But the policy does not apply to lobbyists or corporate executives, who continued to make donations.” The New York Times (6/24/09) reported that Baucus’ fundraising after June 1 also included “industry interests” like “drug companies and insurers.”

More often, though, news accounts portrayed Baucus’ industry-friendly approach to the healthcare issue—including his dismissal of a single-payer approach and his opposition to a public option—as a reflection of his “more cautious approach” (New York Times, 6/16/09), his “long history of collaborating with Republicans” (New York Times, 7/23/09) or his “pursuit of a centrist compromise” (New York Times, 6/8/09). Or he was portrayed as simply bowing to political reality (Washington Post, 8/7/09). . . . .

Read the rest here.

UPDATE: And yet. . . . .

For the Lazy

Comparing Health Reform bills: here, here, here, and here. UPDATE: See also this. And, again, there's always the CBPP and Ezra. UPDATE II: CBO estimates, HR 3962, Baucus bill, Kennedy/HELP bill. See also, more generally, the CBO here. UPDATE III: To clarify, reports are that there will be a CBO estimate of the unified/merged Senate bill soon, but likely too late for it to be of any use for our discussion.

ADDING: Ezra Klein makes the case that a poor bill is better than no bill -- camel's nose/thin end of the wedge and all that, mostly.

OH, AND: Some handy charts.

Aaron Burr's Lost Hamilton Rap is Found, Finally

New Study

Familiar findings.

Estimating the Risk of Food Stamp Use and Impoverishment During Childhood

Mark R. Rank, PhD; Thomas A. Hirschl, PhD

Arch Pediatr Adolesc Med. 2009;163(11):994-999.

ABSTRACT

Objective To estimate the lifetime risk that an American child will reside in a household receiving food stamps and, as a result, will encounter poverty and a heightened exposure to food insecurity.

Design Thirty years of longitudinal data from the Panel Study of Income Dynamics survey data set.

Setting Nationally representative sample of the US population.

Participants Approximately 90 000 childhood years of information are pooled together to create a series of life tables that span the ages of 1 to 20 years.

Main Outcome Measure Self-reporting measure of whether survey households received the Food Stamp Program during the prior year.

Results Between the ages of 1 to 20 years, nearly half (49.2%) of all American children will, at some point, reside in a household that receives food stamps. Households in need of the program use it for relatively short periods but are also likely to return to the program at several points during the childhood years. Race, parental education, and head of household's marital status exert a strong influence on the proportion of children residing in a food stamp household.

Conclusions American children are at a high risk of encountering a spell during which their families are in poverty and food insecure as indicated through their use of food stamps. Such events have the potential to seriously jeopardize a child's overall health.

UPDATE: Nice new succinct precis on the Food Stamp (now SNAP) program from CBPP.

The Opt-Out

A Panoply of Policy Papers

Well, actually, they're books reviews (but I seemed to need the alliteration today -- dreary out). All are from the most recent NYRB, and all are worth your attention (the first two, especially). The subjects:

• Criminal Justice
• Education
• Climate Change

And then, as a reward, read this lovely essay on Dorothea Lange.

Some Health Care Links

For useful background as we approach the finish line??

FRONTLINE: Sick Around the World (a TV documentary highlighting the comparison between the US and other nations' approached to health care)

NRP: Interview with T.R. Reid, "Looking Overseas for the Healing of America"

Washington Post, T.R. Reid, "5 Myths About Health Care Around the World"

For ongoing analysis as bills move through Congress, see Ezra Klein, Kaiser Health News and CBPP.

Finally, The Commonwealth Fund compares the two current bills (click on "Interactive Features" for a nifty comparison tool. Yes, I said nifty. Sue me.)

Energy Information Resources

Public Agenda provides a list.

Ezra Sums Up

On Healthcare:

Among the many implicit precepts directing health-care reform are the following:

(1) The employer-based system doesn't work, either to assure coverage or control cost.

(2) The employer-based system must be preserved.

(3) A strong public option would offer consumers lower premiums and attract a lot of customers.

(4) A strong public option cannot be included because private insurers cannot effectively compete with it.

(5) Among the worst economic distortions of the system is the fact that employers choose insurance for their employees, and thus employees don't really understand the cost of coverage.

(6) The exchange cannot initially be open to employees, and may never be opened to employees, because they might leave employer-based insurance in order to shop for their own policies more aggressively.

You can go on in this vein, of course. It's a bit of a problem.

Do You Miss the Society for Inoculating the Poor Gratis?

Andrew Wehrman in the Boston Globe:

Watching the current debate in Washington, it’s tempting to think of health care reform as something radical and new - an issue that could force a profound shift in national identity. But America has been through this already. More than 200 years prior to this year’s push for a new national health policy, Americans were already becoming incensed about how they paid for health care, and who got access to it.

Health care in Colonial America looked nothing like what we’d consider medicine today, but the debates it triggered were similar. The danger of smallpox and the high cost of its prevention led to divisive questions about who should pay, whether everyone deserved equal access, and if responsibility lay at the feet of the individual, the state, or the nation. Epidemics forced the early republic to wrestle with the question of the federal government’s proper role in regulating the nation’s health.

Colonial leaders and ordinary people alike possessed a similar sense that a proper solution to these issues would determine the brightness and shape of America’s future. At times conflicts over public health threatened the social and political fabric of communities. Did these rowdy Colonials, with the aid of the Founding Fathers, solve these dilemmas? Hardly. But their observations, questions, and compromises offer a useful lesson for what we can expect as we find ourselves again with health care in the forefront of the national conversation.

The rest here.

Broadway to Washington Square

From the NYT:

Ms. White never mentioned to the others who slept in the park that she had been nominated for a Tony award when she performed, alongside Glenn Close, in “Barnum,” in 1980; nor did she ask about their pasts. Severely depressed, she was too proud to reach out to social services, and kept the extent of her problems from friends. “Most of them are barely getting by in their tiny apartments as it is,” she said. “People in New York, they need their patterns. You can’t interrupt them.”

To avoid the police, Ms. White usually alternated sleeping for an hour with walking for an hour, which is what she was doing when she ran into Officer David Taylor on Grove Street at 4 a.m. one day last fall. Officer Taylor had come to know Ms. White when he was patrolling the West Village. He admired her energy, and, off-duty, came to see her perform. He had never seen her looking like she did on Grove Street. “She is usually someone who lifts your energy if you’re feeling down,” he said. “That night she looked soulless. I was concerned for her — scared.”

Read the rest.

For Our Discussion Today

"Some Will Have to Die"

Changing the Subject

"From Welfare to Poverty to a Living Income," by Peter Edelman. h/t Poverty Law Blog

Shrewd Politics Meets Sound Policy?

". . . .Pelosi wants to back the so-called fiscally responsible Blue Dogs into a corner by giving them a bill that the CBO scores well and includes a robust public option as well as bills with a trigger or a weak public option that score worse, so that to reject it, they would have to actually accept a larger price tag. . . ."

"NO! Why Would You Leave it There?! There is a Terrible Place to Leave It!"

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
CNN Leaves It There
www.thedailyshow.com
Daily Show Full Episodes Political Humor Ron Paul Interview

Faces of Poverty

Poor in NYC

A summary of new data:

The Bronx remained the country’s poorest urban county; the income gap in Manhattan was still higher than in any other county; and the poverty rate in Connecticut rose faster than in any other state.

And the relatively positive part of the local economic picture was tempered by the fact that the latest census figures from the rolling American Community Survey captured only the start of the recession.

In New York City, the poverty rate in 2008 was 18.2 percent — the lowest this decade — compared with 18.5 percent in 2007. Median household income was unchanged, at $51,116, but median family income rose to $56,552 from $54,846.

Those figures masked vast disparities, though, based on race, ethnicity and geography.

In the Bronx, the median household income was $35,033, and nearly 28 percent of the borough’s residents — and 47 percent of its households headed by women with children — were living in poverty.

Citywide, the poverty rate for racial and ethnic groups stayed relatively unchanged in 2008 compared with the previous year: 11 percent for non-Hispanic whites, 17 percent for Asians, 21 percent for blacks and 26 percent for Hispanics.

The proportion of people receiving food stamps increased in New York State by about a percentage point, to 10.6 percent.

Not Left or Right

But inside vs. outside?

UPDATE: Nate Silver sort of weighs in. UPDATE II: James Poulos responds to Nate.

Remember Who the Real Victims Are

Protect Insurance Companies PSA from Will Ferrell

"So much food. . .

. . . so much hunger."

What Does the Congressional Budget Office Do?

An Interview.

Some Commentary on Today's Bartels Readings

With thanks to David T. for the first two:

• Jim Manzi at the American Scene
• Tyler Cowen at Marginal Revolution
• Andrew Gelman at the Monkey Cage
• Economics of Contempt, some more Gelman
• And, Bartels responds to some critiques at Dani Rodrik's

If you find others worth looking at, post a link in comments. The takeaway? Identifying patterns can be hard. Demonstrating causation can be monstrously hard. [Updated]

. . . . And how does this fit in with the post-1973 data below?

What happened in 1973? . . . . .

"Entirely Arbitrary"

A good example of the kind of policy analysis (ahem) that shapes policy making in the actual world of politics.

New Census Data

Income down, official poverty at highest level since 1997, child poverty up to 19 percent, and women still earn 3/4 of what men do for the same work. Monea and Sawhill, at Brookings, have more:

Using data from the Congressional Budget Office (CBO) and others about the likely trajectory of the recession, we find that, absent other changes, the poverty rate will increase rapidly through 2011 or 2012, at which point about 14.4 percent of the country will be in poverty, up from 12.5 percent in 2007. As the recession ends and employment levels increase, the poverty rate will begin to steadily decrease though it will not, at least over the next decade or so, reach its 2007 level. In short, our results show that recessions can have long-term scarring effects for all workers but especially for the most disadvantaged, whose skills and attachment to the work force are already somewhat marginal. A prolonged lack of jobs reduces the amount of on-the-job training or experience that people receive, discourages them from making the effort needed to climb out of poverty, and can even lead to a deterioration in their health or family life that adversely affects opportunity.

UPDATE:

"Eight Questions About Health Care Reform"

Actual discussion of the substance of the policy issue, rather than the politics of it, from the Washington Post, no less.

One Stimulus Analysis

From the WSJ.

Budget Docs

For POL 1105, some potentially useful links and docs for the next few sessions:

• Budget of the U.S. Gov't, Updated Summary Tables (May 2009)
• U.S. Federal Budget, the Wiki
• Budget Explorer, with some simulations and budget-balancing exercises
• Introduction to the Federal Budget Process, from CBPP
• Treasure Trove of Tools to Understand the Federal Budget Process, from Congress Matters
• OMB, CBO, Recovery.gov (track A.R.R.A., the "stimulus bill")

And, for another visual take, from the NYT (8/25/2009):

Income and Ideology

From The Monkey Cage, where Andrew Gelman writes of these charts: "There are some differences between the different measures of ideology, but the take-home point for me is that the patterns are basically consistent: liberal Democrats by any measure are pretty well distributed across the income scale, and conservative Republicans are more concentrated among the upper incomes."

Some Budget Basics

REVENUES: Federal, NYS, NYC

EXPENDITURES: Federal, NYS [for NYC, go HERE to p. 37]

"Money's important, but it depends what you gotta do for it"

Man In Van from Sean Dunne on Vimeo. h/t Kottke

All Policy is Local?

H.R. 3200, America's Affordable Health Choices Act of 2009, District by District Impact

Outlays and Revenues Since 1968

The Future of the Fed

Five weigh in.

POTUS-tracker

THIS is kind of fascinating. . . .

The Status of Women: One Measure

h/t/ Daily Dish

Understanding Upcoming Deficit Estimates

from CBPP:

Next week, the President’s Office of Management and Budget (OMB) and the Congressional Budget Office (CBO) will update their economic and budget projections for fiscal year 2009, which ends on September 30, and the next ten fiscal years.[1] Some analysts and pundits will try to use the new projections to support their arguments that the February stimulus package is (or is not) working, that Congress must (or must not) proceed with health care reform, and that any number of other policies should (or should not) be pursued. In fact, however, it will be extremely hard to draw any reasonable conclusions about such questions. Instead, the new estimates are likely to provide more evidence that we are in a highly uncertain economic and budgetary environment, in which the estimates can fluctuate significantly for a variety of reasons that have little to do with the desirability of undertaking new policy actions such as health care reform.

1. Both reports will undoubtedly show that this year’s deficit will be the largest since the end of World War II, relative to the size of the economy. This is no surprise, since CBO and OMB projected a post-war record deficit for this year as long ago as January and February. The new projections almost certainly also will continue to show deficits improving over the next few years as the economy recovers, although the projected improvement will likely be slower than in previous recoveries and deficits will remain troublingly high.

2. There will be no simple answer to the question of whether the new projections are bigger or smaller than was expected earlier this year. This is because OMB and CBO have each produced at least four different sets of projections over the last eight months, ranging from $1.19 trillion (CBO’s estimate in January if current policies were continued) to $1.84 trillion (estimated by CBO in March and OMB in May). Those estimates vary according to which organization produced them, what policies it assumed in making them, and when it made them. (See Appendix for a description of the various deficit estimates made by OMB and CBO since January.)

The new estimates for 2009 will certainly be higher than $1.19 trillion. The Department of the Treasury reported earlier this month that in the first ten months of fiscal year 2009 (through July), the deficit already totaled $1.27 trillion. Although the federal government normally runs a surplus in September because of quarterly income tax payments, it is unlikely to do so this year, and it is inconceivable that any September surplus would be enough to offset more than a fraction of the likely large addition to the deficit in August.

It is not clear whether the new estimates will exceed $1.84 trillion (although as noted in footnote 1, it has been reported that OMB’s estimate will be $1.58 trillion). Some observers have suggested that recent data revisions showing the economy was weaker in 2008 and in the first quarter of this year than previously reported indicate that the fiscal year 2009 deficit will be higher than earlier projections. But the actual performance of the economy through March has already been reflected in the revenues collected and expenditures made to date, which will be the primary basis for OMB’s and CBO’s new deficit estimates. Thus, the revisions themselves are likely to have little effect on any changes made in this round of estimates of the 2009 deficit.

3. Whether the new estimates exceed $1.84 trillion will likely depend on the amounts recorded for a particularly volatile category of spending: assistance to troubled financial institutions. CBO’s March estimate of a $1.84 trillion deficit included more than $330 billion in spending for the Troubled Asset Relief Program (TARP) enacted last fall,[2] plus $125 billion from legislation the President was seeking to provide additional authority for TARP activities.[3] However, Congress has not considered the legislation providing new authority for TARP, and through July the Treasury Department had recorded only $169 billion in TARP costs under existing authorities for 2009.

Similarly, the costs recorded for the federal government’s support of two ailing government- sponsored enterprises — the Federal National Mortgage Association (Fannie Mae) and the Federal Home Loan Mortgage Corporation (Freddie Mac) — will substantially affect the deficit for 2009. Government-sponsored enterprises are privately owned organizations that generally are not considered part of the federal government; their transactions with the public are not included in the budget. CBO believes, however, that the decision last year to put Fannie Mae and Freddie Mac into conservatorship under the control of the Federal Housing Finance Agency essentially represents a federal takeover of the two organizations. CBO argues that the activities of the two organizations should now appear in the budget and that the long-term costs related to Fannie’s and Freddie’s commitments as of the takeover, as well as the full costs of their ongoing activities, should be recorded in the budget as a cost in 2009. CBO estimates these costs exceed $290 billion.

OMB, in contrast, continues to treat Fannie Mae and Freddie Mac as private entities that are not fully reflected in the budget. It includes only direct payments from the Treasury to Fannie and Freddie as a budget expense. So far this year, the Department of the Treasury has recorded just over $80 billion in such costs.

4. The new projections won’t provide any evidence about whether the stimulus legislation is working or whether Congress and the President should continue to pursue health care reform. Not only will it be hard to say whether the projections clearly show an improvement or worsening in the fiscal outlook (better or worse than what?), but the factors that are likely to determine the final size of the deficit in 2009 — the costs recorded for TARP and for Fannie Mae and Freddie Mac — have nothing to do with questions that some are hoping the new projections will answer.

Lower-than-anticipated costs for TARP may indicate that the problems in the financial system have stabilized, but they will not provide any evidence one way or the other about the impact of the stimulus legislation. In fact, it is hard to know in general what a bigger or smaller deficit would mean about the stimulus. On the one hand, a bigger deficit might mean that the stimulus package’s tax cuts and spending increases are taking effect faster than expected — repudiating claims that the stimulus bill is not working because it is taking too long to implement. On the other hand, some could regard a bigger deficit as an indication that the stimulus is not producing the intended improvement in the economy.

5. The only clear conclusion that should be drawn from the new deficit estimates is the continued need for action on long-term deficits. The new estimates should not spur efforts to reduce deficits in the next few years beyond what Congress has already endorsed in its budget resolution for fiscal year 2010. The extremely high deficits projected for 2009 and the next few years largely result from the most serious economic downturn since the Great Depression and the steps taken to keep it from becoming even worse. Trying to reduce deficits in the short run would be counterproductive to those efforts and could stall or reverse the economic recovery.

The estimates should, however, reinforce the message that the current fiscal path is unsustainable over coming decades. (The policy path was unsustainable before the economic downturn; in fact, the downturn will add relatively little to the size of the long-term problem.[4]) Changes in current policies — such as to ensure adequate revenues and help slow the rapid growth of public and private health care costs — must be made to keep deficits from growing rapidly in coming decades to levels substantially higher than this year’s, even if the economy is operating at full capacity. The President and Congress should begin immediately to demonstrate they are serious about bringing deficits in the medium term (five to ten years from now) down to reasonable levels and avoiding an explosion of deficits in the longer term.

U.S. vs. Them

"How Does the Quality of U.S. Healthcare Compare Internationally," from the Urban Institute and Robert Wood Johnson Foundation.

An analysis from the Urban Institute looks at the evidence on how quality of care in the United States compares to that in other countries and provides implications for health reform. Authors Elizabeth Docteur and Robert Berenson find that international studies of health care quality do not in and of themselves provide a definitive answer to this question.

What they do show is that the evidence for American superiority in quality of care (or lack thereof) is a mixed bag, with the nation doing relatively well in some areas—such as cancer care—and less well in others—such as mortality from treatable and preventable conditions.

And while evidence base is incomplete and suffers from other limitations, it does not provide support for the oft-repeated claim that the “U.S. health care is the best in the world.” In fact, there is no hard evidence that identifies particular areas in which U.S. health care quality is truly exceptional.

Addressing the American public’s widespread concern about the potential negative impact of health reform on the quality of care they currently receive, the authors conclude that reform should in fact be seen as an opportunity to systematically improve quality of care, rather than a threat to the existing system. It provides an opportunity to build on strengths and correct weaknesses in U.S. health care, working towards aims for improvement that the care provided is safe, effective, patient centered, timely, efficient and equitable.

Families USA

makes the case for health care reform. Succinctly.

Actual Flowchart

to go with the verbal one below:

"Making welfare work. . . .

. . . and making work pay."

Health Reform Flow Chart

I want to be Kathleen Hall Jamieson. . .

. . . when I grow up. And so should you. One of the best discussions about the health policy debate (such as it is) you are likely to encounter while sitting in your home: Jamieson and Kaiser Family Foundation President Drew Altman. Watch here. And then go here, as David Frum offers the thoughtful conservative's analysis of both health care policy and health care politics. Together, they may comprise the smartest hour of television you'll see this month (yeah, I know, it's a low bar, but still. . . . . ).

How'd this Happen?

From the NYT. Yglesias made a pie chart:

Health Care Reform

An Online Guide. Good collection of resources.

Lessons from Abroad

National Health Insurance in Canada, Germany, France, UK, Japan and Australia, from the Century Foundation. Good, succinct overview. Here.

"Los Angeles banked on the idea that no one would care"

"It can be difficult to grasp that areas that are not pretty, like Skid Row, are home to people."

Ten Things You Need to Know. . .

. . . to live on the streets.

Summer Hunger

From the Food Research and Action Center:

The number of low-income children who are

receiving free and reduced-price lunch during the

regular school year is an excellent indicator of the

need for the Summer Nutrition Programs, so FRAC

uses it as a benchmark to measure summer

participation nationally and in the states. While the

total number of children participating in Summer

Nutrition grew by more than 49,000, or 1.7

percent, from July 2007 to July 2008, the number

of children enrolled in the regular year school lunch

program grew faster so that the reach of Summer

Nutrition decreased slightly. In July 2008, 17.3

children received Summer Nutrition for every 100

low-income students who received lunch in the

2007-2008 school year, compared to a ratio of

17.5:100 children in July 2007.

The disparities in participation among the 50 states

plus the District of Columbia are dramatic. Only 10

states managed to reach at least one quarter of

their low-income children in July 2008. The District

of Columbia, followed by New Mexico, South

Carolina, Nevada and New York had the highest

rates for Summer Nutrition participation by lowincome

children.

Eleven states failed to even serve one-tenth of

their low-income children through their Summer

Nutrition Programs in 2008. Mississippi, Oklahoma,

Kansas, Louisiana, and Colorado had the lowest

rates for Summer Nutrition participation by lowincome

children in July 2008.

The full Report is here.