Archive for November, 2010
The ‘Public Health’ Confusion Again
The National Transportation Safety Board is calling on states to require motorcycle riders to wear federally approved helmets.
“Too many lives are lost in motorcycle accidents,” Christopher A. Hart, NTSB vice chairman, said in announcing that helmets had been added to the board’s annual “most-wanted list” of safety improvements. “It’s a public health issue.”
No, it’s not. Motorcycle deaths are not a public health problem. If motorcyclist A doesn’t wear a helmet, that has no impact on cyclist B. Riding a motorcycle without a helmet may be a bad idea, but it is an individual and non-contagious problem.
The meaning of “public health” has sprawled out lazily over the decades. Once, it referred to the project of securing health benefits that were public: clean water, improved sanitation, and the control of epidemics through treatment, quarantine, and immunization. Public health officials worked to drain swamps that might breed mosquitoes and thus spread malaria. They strove to ensure that water supplies were not contaminated with cholera, typhoid, or other diseases. The U.S. Public Health Service began as the Marine Hospital Service, and one of its primary functions was ensuring that sailors didn’t expose domestic populations to new and virulent illnesses from overseas.
Those were legitimate public health issues because they involved consumption of a collective good (air or water) and/or the communication of disease to parties who had not consented to put themselves at risk. It is difficult for individuals to protect themselves against illnesses found in air, water, or food. A breeding ground for disease-carrying insects poses a risk to entire communities.
The concern back in 2007 over a tuberculosis patient on an airplane raised public-health issues. You might unknowingly find yourself in an enclosed space with a TB carrier. But nobody accidentally rides a motorcycle without a helmet. And your helmetless ride doesn’t threaten me. That’s why riding a motorcycle without a helmet is not a public health issue, even though it may be a bad choice for an individual. As I wrote before,
Language matters. Calling something a “public health problem” suggests that it is different from a personal health problem in ways that demand collective action. And while it doesn’t strictly follow, either in principle or historically, that “collective action” must be state action, that distinction is easily elided in the face of a “public health crisis.” If smoking and obesity are called public health problems, then it seems that we need a public health bureaucracy to solve them — and the Public Health Service and all its sister agencies don’t get to close up shop with the satisfaction of a job well done. So let’s start using honest language: Smoking and obesity are health problems. In fact, they are widespread health problems. But they are not public health problems.
UPDATE: An astute reader asks: But what about the costs to the taxpayer if an uninsured, helmetless motorcyclist is injured? That’s still not a public health problem, and it’s not the claim NTSB is making. It might be a public finance problem, but libertarians have generally argued that a free market in health insurance is a better response to that problem than a smothering nanny state that bans all dangerous behavior on the grounds of socialized medical costs.
Another Tax-Hike Scheme from Another ‘Bipartisan’ Group of Washington Insiders
I’ve already commented on the proposal from the Chairmen of President Obama’s Fiscal Commission (including a very clever cartoon, if it’s okay to pat myself on the back).
Now we have a similar proposal from the so-called Debt Reduction Task Force. Chaired by former Senator Pete Domenici and Clinton Administration Budget Director Alice Rivlin, the Task Force proposed a series of big tax increases to finance bigger government. I have five observations.
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Notwithstanding a claim of $2.68 trillion of “spending cuts” during the 2012-2020 period, government gets a lot bigger during the decade. All of the supposed “cuts” are measured against an artificial baseline that assumes bigger government. In other words, the report is completely misleading in that spending increases get portrayed as spending cuts simply because government could be growing even faster. Interestingly, nowhere in the report does it show what total spending is today and what it will be in 10 years, presumably because the authors realized that the fiction of spending cuts would be hard to maintain if people could see real-world numbers showing the actual size of government now and in the future.
This chart shows what it would actually take to balance the budget over the next 10 years — and these numbers assume all of the tax cuts are made permanent and that the alternative minimum tax is extended.
- The Task Force proposes a value-added tax, which is estimated to generate more than $3 trillion between 2012 and 2020. They call this new tax a “debt reduction sales tax” and I can just imagine the members giggling as they came up with this term. They may think the American people are a bunch of yokels who will get tricked by this language, but one can only wonder why they think making our tax system more like those in Europe will lead to anything other than more spending and less growth.
- The Task Force proposes to dramatically increase the scope of the Social Security payroll tax. Since this is something Obama called for in the campaign and also something endorsed by the President’s Fiscal Commission, this proposed tax hike should be viewed as a real threat. I’ve explained elsewhere why this is bad tax policy, bad fiscal policy, bad entitlement policy, and bad Social Security policy.
- To add “stimulus” to the package, the Task Force proposes a one-year payroll tax holiday. The good news is that they didn’t call for more spending. The bad news is that temporary tax cuts have very little pro-growth impact, especially if a tax cut will only last for one year. Unfortunately, the Task Force relied on the Congressional Budget Office, which blindly claimed that this gimmicky proposal will create between 2.5 million-7.0 million jobs. But since these are the geniuses who recently argued that higher tax rates boost growth and also claimed that Obama’s faux stimulus created jobs, those numbers have very little credibility.
- While the Task Force’s recommendations are unpalatable and misleading, there is a meaningful distinction between this plan and the Obama Administration’s fiscal policy. The Task Force assumes that government should get even bigger than it is today, but the Obama Administration wants government to grow at a much faster rate. The Task Force endorses massive tax hikes, but generally tries to avoid marginal tax rate increases that have especially large negative supply-side consequences. The Obama White House, by contrast, is fixated on a class-warfare approach to fiscal policy. One way of characterizing the different approaches is that the Task Force represents the responsible left while the Obama Administration represents the ideological left.
When The Government Is The False Advertiser
I had an op-ed in the Washington Times yesterday on government’s growing participation in public-health scare campaigns demonizing everyday foods that are fattening, salty, or thought to be bad for us in other ways. In particular, I singled out Mayor Michael Bloomberg’s New York City Department of Health, which has followed up one scientifically dubious ad campaign on sweetened soft drinks (“What can we get away with?” asked one official) with an even worse — in fact, grossly misleading and manipulative — attack on salt in processed foods:
It shows a can of soup bursting at the seams with table salt, whole mounds and piles of it. The city’s underlying point is not 100 percent off-base – healthful in most other ways, conventional canned soup is a relatively salty food – but the actual amount of salt in a can is more like 1 teaspoon, not the third of a cup or more depicted in the city’s ridiculously exaggerated photo. Not to put too fine a point on it, but the Bloomberg soup ad is built on a visual lie.
What would happen if a private advertiser tried to get away with imagery as misleading as this? Well, in 1970, in a case still taught in business schools, Campbell’s got caught manipulating the soup pictures in its ads; its photographers had put marbles at the bottom of the bowl so that the pleasing vegetables would be more visible on top. The Federal Trade Commission filed a deceptive-advertising complaint to make the company stop.
The FTC’s authority would not extend so far as to ordering New York City to cease its misrepresentations, and for various reasons (including the principle that states and localities ought largely to retain independence from federal dictation) we should be glad it doesn’t. But couldn’t we at least ask that the federal taxpayer not be made to subsidize the false advertising?
Last month, the federal Centers for Disease Control – headed by Bloomberg’s own [former health commissioner Dr. Thomas] Frieden – announced a $412,000 grant to assist the city in its anti-salt efforts.
The full piece is here. Incidentally, via the American Council on Science and Health comes word of a new Harvard study finding that Americans’ intake of salt is almost exactly the same as it was 50 years ago; it also seems that international studies find that people in other countries tend to pursue and attain very similar levels of salt intake. If accurate, that would cast doubt on two key themes of public health alarmism, namely that America is experiencing some sort of epidemic of exposure to salty processed foods, and that such an epidemic underlies rising hypertension rates (which, as the article explains, may owe more to obesity than to salt intake). I could not resist a chuckle at the name of the press outlet reporting the results of the new study: Bloomberg Business Week.
Will the Deficit Compel Congress to Cut Military Spending?
Over at National Journal‘s National Security Experts blog, Megan Scully notes the military spending cuts contained within a proposal by Erskine Bowles and Alan Simpson, the co-chairs of the president’s deficit reduction commission. Scully asks: “How feasible would it be for lawmakers to make these kinds of cuts to defense?…What kind of sway will fiscal hawks have in the next Congress – and will it be enough to push through sweeping defense cuts over the objections from pro-defense members of their party?”
Government spending across the board must be cut, I explain, beginning especially with entitlements. I continue:
Other spending must also be on the table, however, and that includes the roughly 23 percent of the federal budget that goes to the military. This often poses a particular challenge for Republicans given their traditional support for military spending and their professed commitment to fiscal discipline. But it need not be particularly difficult. If Republicans reaffirm that the core function of government, many would say one of the only core functions of government, is defense (strictly speaking), then the path to a politically sustainable and economically sound defense posture is clear: a military geared to defending the United States and its vital national interests, and not permanently deployed as the world’s policeman and armed social worker. Such a posture would allow for a smaller Army and Marine Corps as the wars in Iraq and Afghanistan are drawn to a close (as they should be), deep cuts in the Pentagon’s civilian work force, which has grown dramatically over the past 10 years, and sensible reductions in the nuclear arsenal. More modest cuts are warranted in intelligence and R&D. Finally, significant changes in a number of costly and unnecessary weapons and platforms, including terminating the V-22 Osprey and the Expeditionary Fighting Vehicle, and greater scrutiny of the F-35 program, for example, must also be in the mix….
Serious cuts to military spending… must be part of a broader strategic reset that ends the free-riding of wealthy and stable allies around the world, and that takes a more balanced and objective view of our relative strategic advantages and our enviable security.
You can read the rest of my response here.
Ortega Picks On Costa Rica to Rally Support At Home
For the past couple of years, Nicaragua’s president Daniel Ortega has been desperately seeking to subvert his country’s constitution and feeble democratic institutions in order to stand for re-election next year. Since the Nicaraguan constitution bars him from running for a third term (he was president in 1985-1990), Ortega tried unsuccessfully to have the constitution amended by the National Assembly, where his Sandinista party lacks a majority to do so. However, through judicial shenanigans facilitated by a Supreme Court and an Electoral Tribunal packed with Sandinista allies, Ortega is likely to run again next year. Mary O’Grady of the Wall Street Journal and The Economist have documented the case.
Despite seemingly getting away with it, Ortega faces strong challenges at home from the independent media, civil society groups, and the opposition parties, which have all bitterly denounced his illegal maneuvers. His candidacy might be assured; his re-election not so.
Enter my home country: Costa Rica.
Unfortunately throughout both countries’ histories, it has become a norm that the Nicaraguan political class picks conflicts with Costa Rica in order to distract attention from domestic problems and rally nationalist support at home. Ricardo Jiménez, a Costa Rican president in the early 20th century, once said that Costa Rica had three seasons during the year: the rainy season, the dry season, and the season of conflicts with Nicaragua.
This time around hasn’t been different. Approximately 20 days ago, a dredging project of the San Juan River, whose right bank serves as the border between both countries, led to an incursion of the Nicaraguan army into Costa Rican territory. The conflict area is an uninhabited island (approximately 60 square miles) at the mouth of the San Juan River. Aerial pictures show the destruction of tropical forest in the island—which is part of a protected area in Costa Rica—in what seems like an effort to detour the San Juan River at the expense of Costa Rican territory.
Postal Service Announces $8.5 Billion Loss
The U.S. Postal service has announced a net loss of $8.5 billion for fiscal 2010. Since 2006, the USPS has lost $20 billion, and the organization is close to maxing out its $15 billion line of credit with the U.S. Treasury. Although the USPS has achieved some cost savings, they haven’t been enough to overcome a large drop in revenue due to the recession and the greater use of electronic alternatives by the public.
The USPS is required to make substantial annual payments to pre-fund retiree health care benefits. Last year, Congress allowed the USPS to postpone $4 billion of its fiscal 2009 into the future. However, Congress did not provide similar relief on this year’s required payment of $5.5 billion.
Critics of the retiree health care pre-funding requirement argue that no other federal agencies or private companies face such obligations. The argument is largely irrelevant for two reasons. First, the federal government’s financial practices are nothing to emulate. Second, very few private sector workers even receive retiree health care benefits.
In 2008, only 17 percent of private sector workers were employed at a business that offered health benefits to Medicare-eligible retirees, down from 28 percent in 1997. The actual number of private sector workers receiving these benefits is even lower as not all employees employed at the 17 percent of businesses that offers retiree health benefits are eligible to receive them.
The retiree health care benefit pre-funding requirement has become a rallying cry for the postal unions, as any threat to USPS solvency is a threat to the excessive compensation and benefits they’ve been able to extract from the postal service for their membership over the years.
Policymakers should properly view the retiree health care benefit as a symbol of postal labor excess, which continues to weigh the USPS down like an anchor. Therefore, they should avoid allowing the USPS to further postpone these payments into the future, which could lead to a taxpayer bailout. Instead, policymakers should recognize that the USPS’s financial woes require bolder action: privatization.
The Security Logic Clarifies the Question
A new post on the TSA blog gets the logic behind the strip/grope combination correct.
[I]f you’re selected for AIT and choose to opt-out, we still need to check you for non-metallic threats. That’s why a pat-down is required. If you refuse both, you can’t fly.
Any alternative allows someone concealing something to decline the strip-search machine, decline the intimate pat-down, and leave the airport, returning another day in hopes of not being selected for the strip-search machine. The TSA reserves the right to fine you $11,000 for declining these searches.
So the question is joined: Should the TSA be able to condition air travel on you permitting someone to look at or touch your genitals?
I’ve argued that the strip/grope is security excess not validated by risk management. It’s akin to a regulation that fails the “arbitrary and capricious” standard in adminstrative law. But the TSA is not so constrained.
Body Scanner Blues
I’ve got a piece in today’s New York Post that points out some inconvenient truths about the body scanners now installed at airports across the country. Building on Jim Harper’s excellent post, body scanners are not being installed because of a well-reasoned risk analysis.
As Timothy Carney pointed out in the Washington Examiner, this is a sop to the companies that make the body scanners. The machines don’t work as well as advertised – a March GAO Report determined that it is not certain the technology would have found Farouk Abdulmutallab’s suspicious package, and that a cost-benefit analysis needed to be conducted before spending $340 million each year to run the labor-intensive equipment.
The same report found that cargo screening was a weak spot that ought to be addressed, but it took terrorist cargo bomb plots to get the TSA to momentarily escape the clutches of regulatory capture and tend to this threat. The British have been much more candid about the limitations of this technology as applied to low-density explosives, noting that the scanners probably wouldn’t have stopped the 2006 liquid bomb plot at Heathrow.
Of course, you can always opt out of the body scanners in favor of a groping on par with the one that motivated my colleague Penn Jillette to report his sexual assault to the police.
You could opt out entirely. TSA Director John Pistole says you won’t fly, but if you publicize your objections, the TSA may try to fine you $11,000.
Keep a stiff upper lip. I’m sure that this will all be much smoother and less invasive when TSA screeners unionize.
The GM ‘Turnaround’ in Bastiat’s View
GM’s long-rumored initial public stock offering will take place Thursday and self-anointed savior of the U.S. auto industry, Steven Rattner, is pretty bullish about the prospect of investors turning out in droves.
I’ve been saying for a while that I thought the government’s exposure [euphemism for taxpayer losses] in the auto bailout was in the $10-billion to $20-billion range.
But since investor interest has pushed the initial price up from the $26-to-$29 per share range to the $32-$33 range, Rattner now believes:
[T]his exposure is in the single-digit billion range, and arguably potentially better.
I won’t argue with Rattner’s numbers. After all, they affirm one of my many criticisms of the bailout: that taxpayers would never recoup the value of their “investment.” My bigger problem is with Rattner’s cavalier disregard for the other enduring—and arguably more significant—costs of the auto bailouts.
Rattner is like the foil in Frederic Bastiat’s excellent, but not-famous-enough, 1850 parable, That Which is Seen and That Which is Unseen. Rattner touts what is seen, namely that GM and Chrysler still exist. And they exist because of his and his colleagues’ commitment to a plan to ensure their survival, along with the hundreds of thousands (if not millions, as some “estimates” had it) of jobs that were imperiled had those companies vanished. (For starters, I very much question even what is seen here. I am skeptical of the counterfactual that GM and Chrysler would have disappeared and that there would have been significantly more job loss in the industry than there actually was during the recession and restructuring. But I’ll grant his view of what is seen because, frankly, the specifics are irrelevant in the final analysis).
RomneyCare’s ‘Connector’ a ‘Legal Pit Bull’ Forcing Fed-Up Mass. Residents to Pay
According to the Boston Herald:
The state’s health insurance connector — the highly touted agency that aims to bring cheap medical care to the masses — has turned into a legal pit bull by aggressively going after a growing number of Bay Staters who say they can’t afford mandated insurance — or the penalties imposed for not having it.
The Commonwealth Health Insurance Connector Authority is cracking down on more than 3,000 residents who are fighting state fines, and has even hired a private law firm to force the health insurance scofflaws to pay penalties of up to $2,000 a year.
All told, more than 7,700 people have appealed state fines for not having health insurance, according to connector spokesman Richard Powers. The agency has hired several private attorneys at $50 an hour to hear many of the appeals, and some 3,150 of them have been denied — and the losers told to pay up.
The connector has also hired the Hub law firm Bowman & Penski — at $125 an hour — to defend itself against 13 lawsuits filed by fed-up taxpayers who insist they can’t afford state required insurance premiums or the escalating fines.
For more on RomneyCare, see “The Massachusetts Health Plan: Much Pain, Little Gain.”
Lame-Duck Menace: The Paycheck Fairness Act
At Compensation Cafe, Stephanie Thomas explores some of the “nonsensical implications” of a misnamed bill that’s a high Obama administration priority in the lame duck session:
Let’s assume that John and Jane have identical characteristics (education, work experience, etc.) except for gender. ABC Company makes offers of employment to John and Jane on the same day, for the same position, for the same starting salary: $45,000. Jane accepts the offer, but John negotiates the salary, and ends up with $50,000. Under the current equal pay laws, there’s no problem; John is earning more because he negotiated and Jane did not. Makes sense, right? Under the Paycheck Fairness Act, ABC Company would be guilty of gender discrimination.
Here’s another example. Assume that Sam and Sally have the same education, work experience, etc., and are both hired by WidgetCo on the same day. WidgetCo sets Sam and Sally’s starting salary at $2,500 more than they were making at their previous job. Sam was earning $37,500 at his previous job, and Sally was earning $36,000; their starting salaries at WidgetCo are $40,000 and $38,500. Seems reasonable, doesn’t it? Under the Paycheck Fairness Act, WidgetCo would be guilty of gender discrimination.
One final example. Assume that Brad and Bridget both work for Alpha Inc., have the same job title, same level of responsibility, etc., and they are both earning $100,000 per year. Brad asks for a 5% raise, but Bridget doesn’t ask for a raise. Brad gets the raise and ends up earning more than Bridget. Again, no problems here, right? Wrong – under the Paycheck Fairness Act, Alpha Inc. would be guilty of gender discrimination.
“Making matters worse, under the new law, damage awards would be uncapped, and class-action procedures loosened. Bring on the trial lawyers,” notes a Chicago Tribune editorial. For more on this very bad bill, check out the papers and presentations from a panel last week put on by our friends at the Hudson Institute. Earlier here and, at Overlawyered, here, here, etc.
The Moral Equivalent of Monarchy
Matt Yglesias plumps for monarchy, based on — what else? — human nature:
[I]t seems inevitable in any country for some individual to end up serving the functional role of the king. Humans are hierarchical primates by nature and have a kind of fascination with power and dignity. This is somewhat inevitable, but it also cuts against the grain of a democracy. And under constitutional monarchy, you can mitigate the harm posed by displacing the mystique of power onto the powerless monarch. We follow the royal family with fascination, they participate in weird ceremonies, they have dignity, they symbolize the nation, we all talk about them respectfully, etc. Meanwhile, the Prime Minister gets to be just another politician. Admittedly the one who’s most important at this given moment in time. But that’s no reason not to jeer at him during Question Time. He’s not the symbol of the nation who’s owed deference. He’s a servant of the people and people who feel he’s serving them poorly should say so.
Dignity and power?
Dignity, sure. I admit, I am fascinated by dignity. I delight when formerly servile people regain it. I love, without apology, the dignity of being an American, under which our “weird ceremonies” happen chiefly of our own volition. I love the dignity of the immigrant shopkeeper — she might not have much, but what she has is hers, she’s worked for it, and she knows it. I love the dignity of a good book, a well-baked loaf of bread, or Dvořák’s Ninth. I love the dignity of suburbia, and of bohemia. I’ve known them both, and what they have in common is this — large stretches of time in which you are left to your own devices. That’s dignity.
But power? In a wide swath all around it, power destroys dignity. That’s not just an unfortunate side-effect. That’s the whole point of power. That’s what it does. It’s telling that Yglesias manages to praise power unstintingly — but only among a group of preposterous twits who’ve long ago stopped wielding any significant power themselves. Except, evidently, the power to fascinate the power-hungry.
Is it human nature to love power? Maybe for some. Indeed, I could hardly explain otherwise the continued presence of coercion in the world. Thinkers far greater than I have come to the same conclusion, so let’s just leave it at that.
Not everyone, though, is quite so keen on power. As Ravi Iyer, Jonathan Haidt, et al. have recently suggested, one self-identified group — libertarians — has a high degree of skepticism regarding authority, tradition, and conformity. Self-described libertarians place a high value on individualism, personal choice, and reason, even sometimes at the expense of other values, like emotion or community. In short, when we see a king, we don’t say “Wow!” We say — “Why?”
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