August 24, 2011

Senator Coburn's misguided political philosophy

Harold Pollack

Senator Tom Coburn got into hot water with his odd town hall musings about President Obama’s intent “as an African-American male” “to create dependency because it worked so well for him.” In a delightful Freudian inversion, Coburn labeled President Obama’s political philosophy “goofy and wrong.”

Senator Coburn is a good man, but his narrow social vision is deeply misguided. If you want to see why, watch this two-year-old CNN clip, and then read below


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August 10, 2011

Sen. McCaskill Opposes Unemployment Extension

Harold Pollack

As David Goldstein reported last year,

Black voters were pivotal to McCaskill's Senate victory in 2006 over former Republican Sen. Jim Talent. She won 91 percent of African-American votes.

More importantly, the black share of the overall voter turnout in Missouri rose to 13 percent in 2006, up from 8 percent two years before…

That was an important victory, because Missouri’s African-American community needs help. Indeed, the African-American jobless rate in greater Saint Louis was ranked third-worse among the nation’s top fifty metropolitan areas.

So it's especially disappointing to hear (via Dan Strauss at the Hill) that Senator McCaskill has come out against the extension of UI benefits. Her stance will hurt the American economy. It will hurt her party. Most important, it will hurt her own core supporters, who must rightly wonder why they turned out in force to help her win a close election five years ago.

Many moderate politicians seem to believe that they can court swing voters by neglecting the human pain being experienced among poor people and among working-class Americans. I think this is bad politics. It is also disgraceful. In this case, it will only mar Senator McCaskill's own mixed political legacy.

July 28, 2011

Graph of the Day: Tax Cuts and Deficits

Benjamin Landy

As the debate over the debt ceiling slogs along in Washington, it's instructive to step back and look at how the federal balance sheet has evolved since the end of World War II. Until the 1970s, tax revenues and spending levels were fairly closely aligned. Significant deficits began to arise in the aftermath of the OPEC oil shocks, which sent the economy into a period of high inflation and low growth. But deficits became much larger during the Reagan administration, caused mainly by his huge tax cuts and escalation of defense spending. Even though he was subsequently forced to raise taxes eleven times, Reagan was still unable to make a dent in the staggering $2.3 trillion debt that the United States accrued during his tenure.

Taxes and spending 1948-2016 gray projected area Source: Office of Management and Budget, Historic tables              

Large deficits persisted through the George H.W. Bush administration, despite the tax increases he  approved. But after the budget deal that Bill Clinton signed into law in 1993 without a single Republican vote in Congress, which included tax increases and spending reductions, deficits began to decline. Aided by a vibrant economy in the second half of the decade, deficits actually transformed into surpluses. Contrary to what supply-side ideology predicted, real GDP growth averaged 4 percent for the rest of the 1990s.

The sizable budget surplus of the Clinton years was intentionally erased by the Bush tax cuts of 2001 and 2003, reducing revenue by at least $2.9 trillion over the last decade, according to a recent Congressional Budget Office report; another $3.5 trillion in lost revenues is attributable to slowed economic growth. The additional cost of two wars and an unfunded Medicare drug benefit combined to create shortfalls that were even wider then during the Reagan era. According to conservative economist Bruce Bartlett,  the interest cost on the deficits created by the Bush tax cuts are responsible for increasing the national debt by $3.2 trillion, or "27 percent of the fiscal deterioration since 2001." With the Great Recession, government revenues have crashed further even as spending on social safety net programs has risen, leading to even deeper deficits.

Still, the GOP continues to hammer away at the same, disproved talking-points. "There's no evidence whatsoever that the Bush tax cuts actually diminished revenue," Mitch McConnell (R- Kentucky) said last year. "They increased revenue because of the vibrancy of these tax cuts in the economy." Former Minnesota Governor and Republican presidential candidate Tim Pawlently recently echoed the sentiment: "Keep in mind, whether it be the Bush tax cuts, the Reagan tax cuts, or other tax cuts, they always produce an increase in revenue." But if that were true, you would expect tax revenues to be on the rise. Just the opposite: this year, in spite of some of the lowest tax rates in the nation's history, the CBO estimates that revenues will be just 14.4 percent of GDP, the lowest percentage since 1950.


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July 26, 2011

I'm Feeling Some Genuine Love for….Herbert Hoover?

Harold Pollack

I've been driving around Chicago for work, listening to David Kennedy's fantastic history, Freedom from Fear. The first few chapters have gotten me to a place that even No Labels may fear to tread. I'm feeling some new sympathy and respect for Herbert Hoover.

Okay, this somewhat overstates things. Still, Hoover emerges as a surprisingly poignant figure in David Kennedy's telling. Hoover was an outstanding American who might have been an excellent president in a different time. An accomplished humanitarian who fed millions of hungry people during World War I, he was a proponent of government-business cooperation and sensible mine safety regulation. He was markedly more progressive than his predecessors Warren Harding and Calvin Coolidge. As he struggled to address a deepening economic catastrophe, Hoover pushed the boundaries of his personal ideology and the limited capacities of the federal government further than many Republicans or Democrats of the time wanted to go. 

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July 14, 2011

Graph of the Day: America's Prison Problem, Ctd.

Benjamin Landy

Following Tuesday’s post on America’s disturbing incarceration rate – the highest in the world by a wide margin – it is worth taking a closer look at the true economic cost of keeping one out of every 48 working-age men in prison or jail.

According to a 2010 report by the Center for Economic and Policy Research (CEPR), federal, state, and local governments spent about $75 billion on corrections in 2008, most of which paid the high cost of keeping inmates incarcerated. CEPR estimates show that reducing the number of non-violent offenders in prisons and jails would lower this cost by almost $17 billion per year, with most of the savings going towards the most financially strapped states and local governments. And, according to the report, “every indication is that these savings could be achieved without any appreciable deterioration in public safety.” This is because, as the below graph demonstrates, while incarceration rates have remained unacceptably high, the violent crime rate has been dropping since 1992.

Violent Crime v Incarceration Rate

The gap between the number of people in U.S. prisons and the violent crime rate has been diverging significantly since violent crime peaked in 1992. While the incidence of violent crime has been decreasing for almost two decades, incarceration rates have continued to rise, reaching nearly 600% of their 1975 levels in 2008. Currently, non-violent offenders make up over 60 percent of the prison and jail population, with drug offenders accounting for about a quarter. That is a staggering 250% increase since 1980, when less than 10 percent of the prison population were non-violent drug offenders.

The cost of housing each individual inmate, according to the Center for Effective Public Policy, is approximately $35,000 a year. With the recession taking a particularly harsh toll on local governments, many states have been forced to reconsider the policies that lead them to imprison so many people. Appearing "tough on crime," usually an uncomplicated position for politicians during election years, has begun to look increasingly unsustainable.

However, the problem of America's overcrowded prisons represents not only a fiscal crisis, but also a humanitarian one. On May 23rd, the Supreme Court upheld in a 5-4 decision the ruling of a lower court that ordered California's prisons to reduce their number of inmates by 30,000, citing the Eighth Amendment's ban on cruel and unusual punishment. The lower court had written that "an inmate in one of California's prisons needlessly dies every six or seven days due to constitutional deficiencies."


OvercrowdedA gym used as a dormitory in an overcrowded prison in Chino, California, in 2007. Source: NYT.               


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June 27, 2011

“Leading from Behind”—Not a Bad Obama Strategy, Actually, for Gay Marriage

Harold Pollack

(Cross-posted on the Reality-Based Community)

Governor Cuomo is getting well-deserved praise for his active leadership in passing gay marriage legislation in New York. President Obama’s supportive but basically passive stance on the same issue has received somewhat lower marks. I’m all in for marriage equality. I’ve criticized the president for his timidity regarding other issues. Still, I believe he’s getting a bit of a bum rap here.

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June 12, 2011

The Promise and Limitations of Collaborative Governance

Harold Pollack

(Cross-posted at the Reality Based Community)

Last week, I attended a meeting at a federal agency to discuss how one safety-net provider screens for substance abuse. I met with two nonprofits that provide school-based youth development and athletic enrichment services. I hustled to another thing with several agencies and nonprofits working to provide summer jobs for youth. Government and sometimes foundation money financed most of what we discussed. Public purposes were pursued, but through a web of formal and informal arrangements, contracts, and negotiations to leverage many resources inside and outside government.

Public-private collaboration, for better and for worse, is the way of American government. Sometimes this is done very well. Sometimes—see Fannie Mae & Freddie Mac, and private rating agencies in the financial crisis—this is done very badly. Elected officials and public managers need to learn to do this more effectively, because that’s the way their work will get done.

John Donahue and Richard Zeckhauser provide a great starting point to ponder these issues in their new book, Collaborative Governance: Private Roles for Public Goals in Turbulent Times. As they note (about health reform and many other things): “The performance of America’s government depends on its ability to engage private players to accomplish public work.”

Donahue is perhaps most famous for writing one of my favorite public management books: The Privatization Decision. Applying agency theory to this critical, then-neglected subject, the privatization decision had a big impact at many levels of government. Zeckhauser is perhaps most famous for helping with my least-favorite book: my own doctoral dissertation.

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April 14, 2011

Bad Medicine: TriCare’s Noncoverage of Evidence-based Opiate Maintenance Therapy

Harold Pollack

(This is cross-posted at the Reality Based Community)

Sunday’s New York Times included heart-wrenching accounts of newborn babies enduring opiate drug withdrawal. The story provided only one cause for optimism: Both babies and their painkiller-dependent mothers can benefit dramatically from long-term maintenance treatment on medications such as methadone or buprenorphine.

Unless, of course, these mothers were among the ten million active-duty or retired military personnel or dependents insured through the Department of Defense’s TRICARE insurance program. TRICARE limits methadone and buprenorphine prescriptions to short-term detoxification. Echoing the anti-methadone attitudes of the 1970s, TRICARE regulations baldly state, “Drug maintenance programs when one addictive drug is substituted for another on a maintenance basis (such as methadone substituting for heroin) are not covered.”

This is a huge mistake, especially given the military’s escalating problems of prescription painkiller misuse. For more, see Keith Humphreys and I, writing in today’s American Prospect.

April 11, 2011

Health Policy Experts Really,Really Dislike the Ryan Plans

Harold Pollack

(This column is cross-posted at the Reality based Community)

More than 190 health policy experts really, really hate the Ryan proposals. This is a pretty distinguished group: Hank Aaron, David Cutler, Judy Feder,, Jacob Hacker, Harold Pollack, Uwe Reinhardt, Theda Skocpol, Paul Starr–you know, people like that.

In a letter to congressional leaders, these scholars had this to say about Medicaid:

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March 11, 2011

Donald Berwick's Predicament: Do We Want Excellence in American Government?

Harold Pollack

Maggie Mahar has a terrific piece on Donald Berwick.

My Kaiser Health News piece with Chris Lillis provides a useful complement. Aside from the partisan implications, the spectacle of excellent people being treated like this is going to chase many excellent people from government. Both Democrats and Republicans have good reason to worry about this.