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In Defense of Coastal Elites

Philadelphia, PA (cc photo by cptspock)

Philadelphia, PA (cc photo by cptspock)

I liked this bit near the end of Christopher Hitchens’ review of Matt Continett’s Sarah Palin book:

The United States has to stand or fall by being the preeminent nation of science, modernity, technology, and higher education. Some of these needful phenomena, for historical reasons, will just happen to concentrate in big cities and in secular institutions and even—yes—on the dreaded East Coast.

Quite so. Cultural/political tensions between metropolitan types and provincial types are a perennial feature of politics. But actually one of the nice things about the United States is that it’s very big and spread out and we don’t have an overweening “main city” in the manner of Paris. But as a nation we’re long past the point when our prosperity depended primarily on the productivity of our agriculture and the vast extent of our rural land. The research universities and major business enterprises that our the foundation of our way of life are, overwhelmingly, in major metropolitan areas. Not because there’s anything wrong with the people of rural Alaska, but because that’s how the world works. The idea of making dislike of metropolitan American (or perhaps all of metropolitan America except Houston) the basis of your approach to governing is pretty nuts.

Media

Broder on Afghanistan: Better a Quick Choice Than the Right One

It’s pretty clear, I think, that the Obama administration’s decision-making process on Afghanistan has left something to be desired. At the same time, given that the initial round of policy reviews didn’t lead to a satisfactory outcome I certainly think it’s better for the administration to try to take its time crafting a policy that it stands behind rather than to rush to rubber-stamp something purely in order to make the policy look smoother. But Steve Benen finds that David Broder actually thinks “the urgent necessity is to make a decision — whether or not it is right.”

I can’t believe he actually thinks that. But, again, this is one of these moments when you wonder what the editors of newspaper opinion sections are for. Surely this would have been a good opportunity for someone to say “David, you don’t really mean that do you?”

Yglesias

Criminals and Warriors

kahlidmuhammad1 1

Alongside the various nonsensical efforts to convince people that KSM is too scary to be put in trial, the right objects to bringing him to justice on the grounds that this represents a problematic “law enforcement” approach to terrorism. I think it’s pretty clear that international terrorism has some dimensions that go well-beyond ordinary law enforcement, but if you have to put the whole thing in either the “crime” box or the “war” box, there’s a pretty strong case for erring on the side of crime.

In political terms, the right likes the war idea because it involves taking terrorism more “seriously.” But in doing so, you partake of way too much of the terrorists’ narrative about themselves. It’s their conceit, after all, that blowing up a bomb in a train station and killing a few hundred random commuters is an act of war. And war is a socially sanctioned form of activity, generally held to be a legally and morally acceptable framework in which to kill people. What we want to say, however, is that this sporadic commuter-killing isn’t a kind of war, it’s an act of murder. To be sure, not an ordinary murder—a mass murder—but nonetheless murder. It’s true that if al-Qaeda were something like the “blowing up train stations” arm of a major country with which we were otherwise at war, it might make the most sense to think of al-Qaeda as fitting in with spies and saboteurs; criminal adjuncts to a warrior enterprise.

After all, do we really want to send the message to the world that a self-starting spree killer like Nidal Malik Hasan is actually engaged in some kind of act of holy war? It seems to me that we don’t. A lot of people in the world are interested in glory, and willing to take serious risks with their lives for its sake. Insofar as possible, we want to drain anti-American violence of the aura of glory. And that means by-and-large treating its perpetrators like criminals.

Politics

Report: In her memoir, Palin says she doesn’t believe in evolution.

In the past, former Alaska governor Sarah Palin has been cagey about her views on creationism and evolution, saying that she believes “we have a creator” but she didn’t want “to pretend I know how all this came to be.” But in her new memoir, Going Rogue, Palin apparently writes that she doesn’t believe in evolution. New York Times reviewer Michiko Kakutani writes:

Elsewhere in this volume, she talks about creationism, saying she “didn’t believe in the theory that human beings — thinking, loving beings — originated from fish that sprouted legs and crawled out of the sea” or from “monkeys who eventually swung down from the trees.” In everything that happens to her, from meeting Todd to her selection by Mr. McCain for the Republican ticket, she sees the hand of God: “My life is in His hands. I encourage readers to do what I did many years ago, invite Him in to take over.”

While running for governor in 2006, Palin said that she was “a proponent of teaching both” evolution and creationism in Alaska’s schools. ” In September 2008, she told Fox News’ Sean Hannity that because she grew up “in a school teacher’s house with a science teacher as a dad,” she has “great respect for science being taught in our science classes and evolution to be taught in our science classes.”

Politics

McCain urges town hall attendees to cut up their AARP membership cards.

McCain 2008 Last week, the AARP, a nonpartisan organization that advocates on behalf of those aged 50 and over, endorsed the House health care bill. “We can say with confidence that it meets our priorities for protecting Medicare, providing more affordable health insurance for 50- to 64-year-olds and reforming our health care system,” AARP vice president Nancy Leamond said. At a town hall meeting in Arizona on Friday, Sen. John McCain (R-AZ) vowed to “fight with every fiber of my body” to oppose a similar health care reform bill in the Senate. He then claimed that Medicare will actually be “cut” and reportedly urged the town hall attendees to tear up their AARP membership cards:

The 2,000-page bill would mean more regulation and mandates, he said. People wouldn’t be able to keep the coverage they had. It would also increase taxes and the cost of Medicare, he said.

The bill claims to save $500 billion in waste from Medicare, he said.

“I don’t think so,” McCain said. “I think it’s going to cut it.”

He encouraged audience members to cut up their AARP cards and send them back.

Yglesias

Birth Control in Afghanistan

The underlying idea that lowering Afghanistan’s fertility rate would help it develop economically makes a lot of sense. Especially in an overwhelmingly rural country, the tendency is for a rapid increase in population to lead to falling living standards.

CFB988 1

That said, the specific method of trying to do this by talking to male religious leaders about birth control seems to me to be at odds with most of what we know about this subject. As a recent Economist story on fertility trends emphasized, women in the developing world generally have more children than they want to. When we see falling fertility rates, it’s normally a result of women being empowered to make more decisions about their own lives:

A surprising amount is known about how many children parents want, thanks to a series of surveys by the Demographic and Health Surveys programme. The picture it paints is of huge numbers of unplanned pregnancies. In Brazil, for example, the wanted fertility rate in 1996 (the most recent year available) was 1.8; the actual fertility rate then was 2.5. In India the wanted rate in 2006 was 1.9, the actual one, 2.7. In Ghana the figures for 2003 were 3.7 and 4.4. The rule seems to be that women want one child fewer than they are having (except in some rich countries, where they say they want more). [...]

That points to another big reason why fertility is falling: the spread of female education. Go back to the countries where fertility has fallen fastest and you will find remarkable literacy programmes. As early as 1962, for example, 80% of young women in Mauritius could read and write. In Iran in 1976, only 10% of rural women aged 20 to 24 were literate. Now that share is 91%, and Iran not only has one of the best-educated populations in the Middle East but the one in which men and women have the most equal educational chances. Iranian girls aged 15-19 have roughly the same number of years of schooling as boys do. Educated women are more likely to go out to work, more likely to demand contraception and less likely to want large families.

Of course, the case of China and the one-child policy does show that massive coercion works as well. But the problem in Afghanistan is almost certainly the view that how many children a woman should have is a decision that should be made by men. Just talking to men about making that decision in a different way is unlikely to address the issue. Of course, sending girls to school is a controversial issue in Afghanistan, but if the Islamic Republic of Iran was capable of overseeing a massive increase in women’s educational opportunities, then such things can’t be inconsistent with culturally conservative Islamism in any particularly straightforward sense.

Politics

Liz Cheney floats her father Dick as potential 2012 presidential candidate.

Liz Cheney, the daughter of former Vice President Dick Cheney, sat on this morning’s Fox News Sunday panel. The topic turned to President Obama’s respectful bow before Japanese Emperor Akihito, for which the president is being attacked mercilessly by conservatives. Host Chris Wallace aired a videotape of Vice President Cheney choosing not to bow before the Emperor in Feb. 2007, and then asked the panel what they thought of “bow-gate.” Liz saw an opportunity to make a case for her father:

LIZ CHENEY: You could also look at the comparison and think, Cheney 2012.

WALLACE: Really?! How far do you want to go with that?

KRISTOL: Let Liz make news. Cheney/Palin.

WALLACE: Or Palin/Cheney — don’t be sexist.

Watch it:

Liz Cheney and fellow Fox co-panelist Bill Kristol sit together on the board of Keep America Safe, an ostensibly partisan organization created for the purpose of crafting national security attack ads on Democrats. Fox, of course, never disclosed Cheney and Kristol’s common affiliation.

Update

Liz has previously suggested that she herself may be interested in a run for political office.

Health

What The CMS Report Tells Us About The House Health Bill

costcont2On Friday, the Center on Medicare and Medicaid Services (CMS) released a new “estimate of the financial and coverage effects of the non-tax provisions” in the House health care bill. According to the report, “total national health expenditures in the U.S. during 2010-2019 would increase by about 0.8 percent.” The cost-containment measures in the bill “would not have a significant impact on future health care cost growth rates”:

The increase in total NHE is estimated to occur primarily as a net result of the substantial expansions in coverage under H.R. 3962, together with the expenditure reductions for Medicare…..The availability of coverage would typically result in a fairly substantial increase in the utilization of health care services, with a corresponding impact on total health expenditures. These higher costs would be partially offset by the sizable discounts imposed on providers by State Medicaid payment rules, together with the significant discounts negotiated by private and public health insurance plans.

Higher utilization from the additional 34 million newly insured enrollees will bend the cost curve slightly up, and, with the exception of the proposed reductions in Medicare payment updates for hospitals, the bill does not do enough to manage utilization or the cost of health care services, the report concludes. It’s a valid point, and one that the Senate health care bill will address with an excise tax on Cadillac health care plans and a Medicare Commission tasked with controlling Medicare-related spending. CMS doubts that the health care industry could “improve their own productivity to the degree achieved by the economy in large” and predicts that the productivity adjustments in the House bill could lead some Medicare providers “for whom Medicare constitutes a substantive portion of their business” to stop seeing Medicare patients.

But the report is not without its positives, and lawmakers must accept the bad with the good. If the CMS analysis suggests that reform legislation should adopt robust cost-containment provisions, it also applauds the bill for expanding coverage by building and strengthening the current public/private system. The report is a wake-up call for reformers as much as it is a full and complete rejection of critics who argue that the House bill will undermine the existing health care system:

- The bill covers 34 million Americans.

- Overall out-of-pocket spending would decline more than $200.

- It extends the life of the Medicare trust fund by 5 years until 2022.

- It invests in comparative effectiveness research without “rationing care.” Such research will reduce national health expenditures by $8 billion between 2010 and 2019.

- The number of Americans in employer-sponsored coverage will increase by 2.5 million.

- Rather than crowding-out private insurers, the public plan would compete on a level playing field and attract about 6 million enrollees. (The report concludes that public plan premiums would be 4% higher than private because it would attract sicker applicants)

- Public expenditures could rise by just 3 percentage points in 2019, or stay the same. Expenditures from private health insurance could actually increase.

- Under the bill, expenditures through Medicare and Medicaid would reduce national health expenditures by roughly 2.1% in 2019.

The CMS report confirms that the House health care bill is a fairly modest proposal that expands access to insurance and builds on what works in the current system. Now, honest lawmakers — who believe in health care reform — must ensure that reform also lowers costs for families and reduces long term health care spending.

Rather than complain about a fictitious government takeover of health care and rationing care to seniors, Sens. Olympia Snowe (R-ME), Susan Collins (R-ME), Joe Lieberman (I-CT) and other ‘moderate’ lawmakers should use this report to insert stringent cost-control mechanisms into the final bill. The report relieves them of their deepest fears (and Luntz-inspired talking points) and challenges them to address the real problems in the health care reform bill.

Yglesias

The Surreal World

I’m in a bit of a hungover haze at the moment, but as I understand it the two big new attacks on the President are that he (a) bows at formal meetings with Japanese people and (b) wants to see terrorists tried for their crimes. Is that right? Really? Strange times.

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