31 March 2011
Immigration Reform on a State Level
Helene Slessarev-Jamir, a blogger at Sojourners God's Politics blog, says that after a trip to Washington to meet with lawmakers regarding immigration reform, she is confident that federal immigration reform will not happen anytime soon. She contends here for fighting for immigration reform at the state level, where laws such as those in Arizona and Utah have set an example that many other states are considering imitating. This morning's Diane Rehm Show takes up the topic, comparing and contrasting the harsh Arizona law with the more progressive Utah law. You can listen to the broadcast here.
History shows that economic downturns almost always result in a fingering of immigrants. This go round, those immigrants happen to be Latin American. Robert Bentley stated during his campaign that he would consider an Arizona-style immigration legislation for Alabama. With a Republican-dominated government, he shouldn't have too much resistance. Should Alabama follow the model of Arizona, whose law has already resulted in numerous Hispanic parents keeping their children out of school in order to avoid prosecution? Certainly no one would assert that there is any long term benefit of an uneducated cohort of minority citizens (recall that children born in the US, even to an undocumented immigrant) is good for the long-term well-being of the country or state. And are Republicans willing to alienate the largest and fastest growing minority group in America for the sake of winning the next few elections?
I don't have the answers. I know that immigration reform is essential, and I am called to hospitality towards the alien and the outcast. Is there a way to enforce law while remaining humane? I think the Utah law comes much closer to this goal, though admittedly with shortcomings.
History shows that economic downturns almost always result in a fingering of immigrants. This go round, those immigrants happen to be Latin American. Robert Bentley stated during his campaign that he would consider an Arizona-style immigration legislation for Alabama. With a Republican-dominated government, he shouldn't have too much resistance. Should Alabama follow the model of Arizona, whose law has already resulted in numerous Hispanic parents keeping their children out of school in order to avoid prosecution? Certainly no one would assert that there is any long term benefit of an uneducated cohort of minority citizens (recall that children born in the US, even to an undocumented immigrant) is good for the long-term well-being of the country or state. And are Republicans willing to alienate the largest and fastest growing minority group in America for the sake of winning the next few elections?
I don't have the answers. I know that immigration reform is essential, and I am called to hospitality towards the alien and the outcast. Is there a way to enforce law while remaining humane? I think the Utah law comes much closer to this goal, though admittedly with shortcomings.
29 March 2011
Resident Work Hours
With all the fuss about medical residents' work hours, including the change this year to limit intern hours to 16 per shift, what evidence is there that patient safety improves? Not much. Well what about physician quality? Not much good evidence there, either. It turns out that physicians, who are charged with making evidence-based decisions regarding patient care, haven't done likewise in the realm of physician training, as discussed in the MedPage Today article No Harm From Cuts in Residents' Hours.
27 March 2011
Death and Taxes
For the past few months, we have been participating in a book club at the home of Mikey and Lindsay Hannon, where we have had the great fortune of getting to know Shelly Douglass. Shelly is wonderful, a bona fide hippie who has spent her life trying to live a life consistent with her reading of the New Testament - sharing what she has with those who need it, loving her neighbor as herself and going to jail for protesting nuclear weapons. Shelly and her husband, Jim, run a Catholic Worker hospitality house in Ensley, Alabama called Mary's House.
In a couple of weeks, Rachel and I will participate in Mary's House Lenten Retreat. Shane Claiborne is the guest speaker, and he will be talking about The Gospel in the Empire: Consistent Living in the Belly of the Beast (As you can probably guess from the title, Shane's reading of Revelation most likely does not line up with that of John Hagee or Tim LaHaye).
Anyway, I didn't know much about Shane Claiborne before I heard about the retreat, but recently I have read a little bit of his stuff, and he seems pretty smart. He's a staunch opponent of what he would call an empire characterized by an ethic of death. He's not wild about military spending, and he is advocating this year for Christians to engage in civil disobedience on one of the two sure things (taxes) in response to it's role in precipitating the other (death). You can read his interesting post here.
As a good hippie, our friend Shelly and her husband intentionally make just below the taxable income so that they don't contribute to the military industrial complex. Given that you (like me) are not interested in cutting income to below that of the poverty line, what do you think? How do you feel about withholding from the government a small amount in protest of their use of your funds? As tax day approaches (April 18, for those who share my gift for tardiness) and in the wake of the most recent US military action in Libya, would you be willing to engage in what he calls the "third way?"
In a couple of weeks, Rachel and I will participate in Mary's House Lenten Retreat. Shane Claiborne is the guest speaker, and he will be talking about The Gospel in the Empire: Consistent Living in the Belly of the Beast (As you can probably guess from the title, Shane's reading of Revelation most likely does not line up with that of John Hagee or Tim LaHaye).
Anyway, I didn't know much about Shane Claiborne before I heard about the retreat, but recently I have read a little bit of his stuff, and he seems pretty smart. He's a staunch opponent of what he would call an empire characterized by an ethic of death. He's not wild about military spending, and he is advocating this year for Christians to engage in civil disobedience on one of the two sure things (taxes) in response to it's role in precipitating the other (death). You can read his interesting post here.
As a good hippie, our friend Shelly and her husband intentionally make just below the taxable income so that they don't contribute to the military industrial complex. Given that you (like me) are not interested in cutting income to below that of the poverty line, what do you think? How do you feel about withholding from the government a small amount in protest of their use of your funds? As tax day approaches (April 18, for those who share my gift for tardiness) and in the wake of the most recent US military action in Libya, would you be willing to engage in what he calls the "third way?"
25 March 2011
Friday Pick of the Week
I love a cover. Perhaps it was all those collegiate years standing on coolers at band parties singing along with stirring renditions of "You Never Even Call Me By My Name" and "California Love." Regardless, there is something special about someone who can take a classic and make it their own, all the while honoring the original artist. Today's pick certainly meets the criteria of classic, and I think the Civil Wars make it their own. I first saw the duo with Rachel, as well as Courtney and Ivan Wright, when they put on a free afternoon show at Urban Standard last summer. They released their first full album in February to much critical acclaim. Check them out.
23 March 2011
It's not exercise, it's training
The shit is going to go down. Probably.
A few years ago, I suddenly noticed the need to purchase pants a waist-size bigger. I was out of college and generally inactive, while my diet had remained consistent with the high metabolism that led a high school football coach to suggest an intestinal worm infestation. Enter Christopher Barefield. An old friend, Chris and I began growing closer as we committed ourselves not to regular exercise, but to training. Why do we train? We train for when the shit goes down.
What, might you ask, does this shit going down entail? And how might one train for it? We're not sure. But over the span of human history, it seems as though for many societies, it happens. So we train.
That training has taken many forms over the years, from regular pre-dawn runs through Highland's parks to hours spent pulling plastic at the climbing gym. And while preparation for the imminent going down of said shit is an important motivator, the sheer satisfaction of physical fitness is what must drive any training. Now don't get me wrong - I'm certainly not a meat-head and I fall far short of training with the intensity I'd like. I am in full agreement with Tyler Durden of Fight Club when he says, "Self improvement is masturbation." But I find a much needed escape from the boxes of my world in challenging and improving my physical fitness.
In recent years, Chris has taken an interest in Mountain Athlete, a training gym in Jackson, Wyoming. He passed along this article, "Everything You Know About Fitness is a Lie," which calls us to reconnect with the simple training methods that are the foundation of any real training program. I find it both convicting and affirming.
A few years ago, I suddenly noticed the need to purchase pants a waist-size bigger. I was out of college and generally inactive, while my diet had remained consistent with the high metabolism that led a high school football coach to suggest an intestinal worm infestation. Enter Christopher Barefield. An old friend, Chris and I began growing closer as we committed ourselves not to regular exercise, but to training. Why do we train? We train for when the shit goes down.
What, might you ask, does this shit going down entail? And how might one train for it? We're not sure. But over the span of human history, it seems as though for many societies, it happens. So we train.
That training has taken many forms over the years, from regular pre-dawn runs through Highland's parks to hours spent pulling plastic at the climbing gym. And while preparation for the imminent going down of said shit is an important motivator, the sheer satisfaction of physical fitness is what must drive any training. Now don't get me wrong - I'm certainly not a meat-head and I fall far short of training with the intensity I'd like. I am in full agreement with Tyler Durden of Fight Club when he says, "Self improvement is masturbation." But I find a much needed escape from the boxes of my world in challenging and improving my physical fitness.
In recent years, Chris has taken an interest in Mountain Athlete, a training gym in Jackson, Wyoming. He passed along this article, "Everything You Know About Fitness is a Lie," which calls us to reconnect with the simple training methods that are the foundation of any real training program. I find it both convicting and affirming.
22 March 2011
20 March 2011
Are US Medical Graduates Turning to Primary Care?
Robert Centor, an internist and an Associate Dean at UAB School of Medicine, publishes a blog on internal medicine, american health care and health education called db's Medical Rants. This week he posted on the results of the US medical graduate match. For those unfamiliar, the match is run by the National Residency Matching Program, and functions frighteningly similarly to the undergraduate sorority matching system, but replacing ice-water teas with interviews and "squeal day" with match day. After a lengthy application and interview process, residents-to-be list out programs in order of their preference, and programs rank the applicants, and then a computer (not quite so sophisticated as Watson) runs the numbers and determines who will be placed where and for which specialty training. For instance, I had friends match nearby at UAB in fields from internal medicine to radiation oncology, and as far away as Portland, Maine, and Portland, Oregon in emergency medicine and otolaryngology. Anyway, recent trends have shown increases in the number of US medical school graduates filling residency spots in specialties considered to be primary care, including pediatrics, family medicine and internal medicine. For years, these have been among the least attractive fields for US seniors (in terms of percentage of spots filled) due to a variety of factors, including lower earning potential and what is perceived to be a more stressful working environment.
Centor is encouraged that this year's preliminary results show an increase in the number of US medical seniors choosing primary care specialties. However, I disagree with his analysis of the data. In fact, the results are nothing more than a numbers game. In the last decade, most medical schools expanded class size by about 10%, and a few new schools popped up. As he Centor points out, there has been no correlating expansion in residency spots. The only place for the excess US grads to go is into less competitive specialties – those where US graduate matching rates are below 60%, like internal and family medicine. An important point to remember is that US medical grads are not the only applicants competing for spots - osteopathic medical school graduates can also apply to those spots, as can international medical graduates (including US citizens trained at off-shore medical schools). I don't believe the results reflect a growing appeal of primary care so much as necessary spillover. Students are still overwhelmed by the weight of debt with which they graduate, and they are still drawn to specialties that assure "good" compensation. So long as dermatologists make half again a pediatrician's salary without working on Fridays, rest assured that the specialty will remain that much more competitive. You also make a excellent point that the number of primary care physicians cannot grow until residency training spots increase. All in all, the results are good PR for medical schools and residency programs, but lacking in real substance.
Centor is encouraged that this year's preliminary results show an increase in the number of US medical seniors choosing primary care specialties. However, I disagree with his analysis of the data. In fact, the results are nothing more than a numbers game. In the last decade, most medical schools expanded class size by about 10%, and a few new schools popped up. As he Centor points out, there has been no correlating expansion in residency spots. The only place for the excess US grads to go is into less competitive specialties – those where US graduate matching rates are below 60%, like internal and family medicine. An important point to remember is that US medical grads are not the only applicants competing for spots - osteopathic medical school graduates can also apply to those spots, as can international medical graduates (including US citizens trained at off-shore medical schools). I don't believe the results reflect a growing appeal of primary care so much as necessary spillover. Students are still overwhelmed by the weight of debt with which they graduate, and they are still drawn to specialties that assure "good" compensation. So long as dermatologists make half again a pediatrician's salary without working on Fridays, rest assured that the specialty will remain that much more competitive. You also make a excellent point that the number of primary care physicians cannot grow until residency training spots increase. All in all, the results are good PR for medical schools and residency programs, but lacking in real substance.
18 March 2011
Friday Pick of the Week
This week is the 25th iteration of South By Southwest, an annual music, film and media festival held in Austin, Texas. SXSW is perhaps the nation's premier venue for indie bands. Four Birmingham bands will be representing Alabama this week, and I had the good fortune to catch them this past weekend at Birmingham Magazine's Second Saturday Listening Party at Urban Standard. The bands are Delicate Cutters, Green Seed, Through the Sparks and Great Book of John. The last is the source for this Friday Pick of the Week. Happy travels.
Find more artists like The Great Book of John at Myspace Music
17 March 2011
Nuclear Meltdown and Libertarianism
Harold Meyerson recently published an editorial in the Washington Post on three supposedly infallible structures - the American financial system, deep-water oil drilling and nuclear power. He sites our current faith in the infallibility of science and technology as a potential Achilles heel, as evidenced in the recent economic recession, BP disaster and Japanese nuclear crisis. He sites the danger of a hands-off, libertarian policy towards such structures, calling instead for regulation in the realms of food safety, economic and environmental policy. A quote:
"The market may in time punish bad actors, which is the ostensible safeguard that libertarians prefer to regulation. Yet as the people sealed inside their homes in the vicinity of Japan’s malfunctioning nuclear plant could tell us, untold numbers of innocents may pay a much higher price, more quickly, than the executives and shareholders of offending companies. "
While I believe his calls for "active, disinterested government regulation" are a bit naive (government is never disinterested), I think he makes a sound point against libertarian philosophy that assumes inherent morality in the free market.
So, the question remains, what do we do with nuclear power? Many of the old-guard environmental activists have, in recent years, converted to a pro-nuclear stance. They site the cleanliness of the energy and rising energy demands fueled by development and population growth. I am reluctant to make decisions on policy in the midst of turmoil, but in the wake of Japan's emergency, what do we do with the obvious risks posed by nuclear energy production?
Props to Jim Rice of God's Politics for the Meyerson link.
"The market may in time punish bad actors, which is the ostensible safeguard that libertarians prefer to regulation. Yet as the people sealed inside their homes in the vicinity of Japan’s malfunctioning nuclear plant could tell us, untold numbers of innocents may pay a much higher price, more quickly, than the executives and shareholders of offending companies. "
While I believe his calls for "active, disinterested government regulation" are a bit naive (government is never disinterested), I think he makes a sound point against libertarian philosophy that assumes inherent morality in the free market.
So, the question remains, what do we do with nuclear power? Many of the old-guard environmental activists have, in recent years, converted to a pro-nuclear stance. They site the cleanliness of the energy and rising energy demands fueled by development and population growth. I am reluctant to make decisions on policy in the midst of turmoil, but in the wake of Japan's emergency, what do we do with the obvious risks posed by nuclear energy production?
Props to Jim Rice of God's Politics for the Meyerson link.
16 March 2011
The End of Poverty
One of my winter reads was Jeffrey Sachs The End of Poverty, a book promoting a worldwide plan to end extreme poverty by 2025. The head of Columbia University's Earth Institute, Sachs is an economist who stumbled somewhat backwardly into the realm of international economic development. He has since become a leading voice calling for debt forgiveness and other policies aimed at freeing the poorest countries from the cycle of poverty. Sachs plays an interesting role: on the one hand, he is a harsh critic of the International Monetary Fund, the World Bank and the wealthy countries that use foreign aid to accomplish their political ambitions, and on the other hand he is an unashamed capitalist singing the praises of industrialization and free-trade. He is a firm believer in the United Nations Millennium Development Goals (he helped draft them), and much of the book is dedicated to calling rich countries to fulfill their promises to the rest of the world.
Most Americans believe that upwards of 20% of our federal budget is dedicated to foreign aid. With disasters like we've seen in the Haiti earthquake and Indonesian tsunami, the US is on the forefront in promising emergency relief. However, Sachs points out that despite all of our promises, the US gives only approximately 0.2% of our Gross Domestic Product to international economic development. In fact, the US agreed in 1993 to raise expenditures in foreign aid to 0.7% of GDP, a standard that the rest of developed nations agreed to in the 1970s. Since pledging that number, foreign aid has actually declined, and much of that which is given funds "consultants" from the World Bank or IMF. For those of you who prefer visual aids, the budget office provides a lovely pie chart here.
Sachs also does a brilliant job of outlining the need for economists who think like physicians. Economic emergencies require experts that can examine a country, develop a diagnosis and apply a specific treatment plan for the country. He outlines how this model was used with success during the Bolivian tin crisis and in Poland during the fall of the Soviet Union.
While my optimistic/pragmatic side agrees with many of Sachs' assertions and his overall plan, I must confess that his relentless industrial capitalism is a bit concerning. My thoughts immediately return to the voice of Wendell Berry:
Most Americans believe that upwards of 20% of our federal budget is dedicated to foreign aid. With disasters like we've seen in the Haiti earthquake and Indonesian tsunami, the US is on the forefront in promising emergency relief. However, Sachs points out that despite all of our promises, the US gives only approximately 0.2% of our Gross Domestic Product to international economic development. In fact, the US agreed in 1993 to raise expenditures in foreign aid to 0.7% of GDP, a standard that the rest of developed nations agreed to in the 1970s. Since pledging that number, foreign aid has actually declined, and much of that which is given funds "consultants" from the World Bank or IMF. For those of you who prefer visual aids, the budget office provides a lovely pie chart here.
Sachs also does a brilliant job of outlining the need for economists who think like physicians. Economic emergencies require experts that can examine a country, develop a diagnosis and apply a specific treatment plan for the country. He outlines how this model was used with success during the Bolivian tin crisis and in Poland during the fall of the Soviet Union.
While my optimistic/pragmatic side agrees with many of Sachs' assertions and his overall plan, I must confess that his relentless industrial capitalism is a bit concerning. My thoughts immediately return to the voice of Wendell Berry:
"We must see that the standardless aims of industrial communism and industrial capitalism equally have failed. The aims of productivity, profitability, efficiency, limitless growth, limitless wealth, limitless power, limitless mechanization and automation can enrich and the empower the few (for a while), but they will sooner or later ruin us all. The gross national product and the corporate bottom line are utterly meaningless measures of the prosperity or health of the country."
Despite my fondest affections for philosophy of Berry, I will admit that his calls to agrarianism are, unfortunately, unrealistic. But I do believe his call to reflection is a critical component of any plan for development. Sachs' unashamed cry that capitalism holds the answers left me uncomfortable throughout the book. Over the years, he has been a voice crying for justice, fighting against the structures and powers of oppression. And while his plans couple the words development and sustainable, I question whether the marriage between the two are realistic. I think the fundamental question lies at how one defines development in the first place.
All in all, the book is challenging and encouraging, and despite my mistrust of some of his underlying premises, I believe he raises important issues and calls for movement in a necessary direction. What say you?
All in all, the book is challenging and encouraging, and despite my mistrust of some of his underlying premises, I believe he raises important issues and calls for movement in a necessary direction. What say you?
11 March 2011
Irrational Economics
One of my favorite professors in undergrad was Bryant Shaw, chairman of the Troy Department of History. I gleaned numerous nuggets of wisdom from Dr. Shaw ("read broadly"), but perhaps my favorite was his take on knowledge: "Information is gathered within a discipline; knowledge occurs at the intersection of disciplines."
Thus, perhaps my favorite thing about classes at UAB's School of Public Health is the breadth of disciplines that cross over in my curriculum. I have been lectured by physicians and psychologists, by statisticians and economists, by chemists and engineers, by sociologists and epidemiologists. This semester we've been assigned a pair of behavioral economics readings, one of which I recently finished. Dan Ariely's Predictably Irrational is a fun, quick read that explains behavioral economic theory in simple terms.
From the days of Adam Smith, economic theory has assumed one simple idea - that humans make rational decisions. For some reason it took centuries for economists to come to a different realization: we don't. Humans are irrational. This is why trans-disciplinary collaboration is so important. Psychologists have long realized that people are irrational (it is why the field exists). Anyway, Ariely provides some great insight into irrational decisions we make, and offers some solutions to how we can protect against them.
Ariely does an outstanding job of translating scientific experiments into easy to understand anecdotes, all the while preserving the meat of the research (A quick glance at a scientific journal reveals this is no easy task). His experiments range from the fallacies of supply and demand to alterations in our decision-making depending on our level of sexual excitement. His precepts could be quickly adapted to enhance a business's bottom line, but more importantly, they outline some important considerations when planning public policy. Ariely does an excellent job of weaving his story through the book, and I quickly saw myself in some of the examples he lays out. I highly recommend the book.
Ariely does an outstanding job of translating scientific experiments into easy to understand anecdotes, all the while preserving the meat of the research (A quick glance at a scientific journal reveals this is no easy task). His experiments range from the fallacies of supply and demand to alterations in our decision-making depending on our level of sexual excitement. His precepts could be quickly adapted to enhance a business's bottom line, but more importantly, they outline some important considerations when planning public policy. Ariely does an excellent job of weaving his story through the book, and I quickly saw myself in some of the examples he lays out. I highly recommend the book.
A Bastion of Structural Discrimination - Labor Unions?
Who exactly do unions protect? According to Morgan O. Reynolds, the answer is not minorities.
"Despite considerable rhetoric to the contrary, unions have blocked the economic advance of blacks, women, and other minorities. That is because another of their functions, once they have raised wages above competitive levels, is to ration the jobs that remain. The union can discriminate on the basis of blood relationships or skin color rather than auctioning off (openly selling) the valuable jobs to the highest-bidding applicants." (You can read the rest of the post here: Labor Unions)
Reynolds contends that because unions are not subject to federal taxation and antitrust laws, they are not obligated to abstain from discrimination (as corporations are). Essentially, the unions are wholly democratic structures, meaning that the prejudices of the majority can oppress those subjected to that bias. As there is no protection for women, blacks or other minorities within a union, they cannot demand fair hiring and advancement practices. Reynolds even cites union opposition by Booker T. Washington and W.E.B. Du Bois, two early civil rights leaders with very different ideas on how to enhance the standing of African Americans in society.
On the issues of unions, I am still conflicted. There is no question that the organizations were essential in freeing workers from ungodly conditions in the early part of the 20th century. And I certainly maintain that Scott Walker's actions in Wisconsin are nothing more than a political stunt aimed at garnering political support and paying back some of his big-money backers. But I think Reynolds raises a point that must be considered as the landscape of organized labor is drastically changing under current economic conditions.
Also, just a bit more on Morgan O. Reynolds: he was Chief Economist at the US Department of Labor under G.W. Bush, and gained some national attention in 2005 as a founding member of Scholars for 9/11 Truth, a group which contends that 9/11 was an inside job and that 747s never actually flew into the World Trade Towers. Take that for what it is worth. Props to Abraham Sangha at The Institute for linking this Library of Economics and Liberty post.
"Despite considerable rhetoric to the contrary, unions have blocked the economic advance of blacks, women, and other minorities. That is because another of their functions, once they have raised wages above competitive levels, is to ration the jobs that remain. The union can discriminate on the basis of blood relationships or skin color rather than auctioning off (openly selling) the valuable jobs to the highest-bidding applicants." (You can read the rest of the post here: Labor Unions)
Reynolds contends that because unions are not subject to federal taxation and antitrust laws, they are not obligated to abstain from discrimination (as corporations are). Essentially, the unions are wholly democratic structures, meaning that the prejudices of the majority can oppress those subjected to that bias. As there is no protection for women, blacks or other minorities within a union, they cannot demand fair hiring and advancement practices. Reynolds even cites union opposition by Booker T. Washington and W.E.B. Du Bois, two early civil rights leaders with very different ideas on how to enhance the standing of African Americans in society.
On the issues of unions, I am still conflicted. There is no question that the organizations were essential in freeing workers from ungodly conditions in the early part of the 20th century. And I certainly maintain that Scott Walker's actions in Wisconsin are nothing more than a political stunt aimed at garnering political support and paying back some of his big-money backers. But I think Reynolds raises a point that must be considered as the landscape of organized labor is drastically changing under current economic conditions.
Also, just a bit more on Morgan O. Reynolds: he was Chief Economist at the US Department of Labor under G.W. Bush, and gained some national attention in 2005 as a founding member of Scholars for 9/11 Truth, a group which contends that 9/11 was an inside job and that 747s never actually flew into the World Trade Towers. Take that for what it is worth. Props to Abraham Sangha at The Institute for linking this Library of Economics and Liberty post.
Friday Pick of the Week
This week's pick is courtesy of music connoisseur Joshua Wooden. He passed along an email with the following link to this music video (yes, they still make them) of the song "Garden" by Sean Hayes. A folk singer in the San Francisco scene, Hayes has genre-fitting selections with titles like "Rattlesnake Charm" and "No No Guantanamo." You can find some more samples of his music here. Enjoy.
07 March 2011
Supply and Demand (and Ecstasy)
One quarter of the world's prison population resides in US prisons. Comparatively, 3% of the world's population lives in the US. I think we are doing something wrong. The prison population began expanding rapidly in the 1980s as a repercussion of President Reagan's War on Drugs. Under the new policy, drug possession and trafficking took on severe penalties, leading to a boon in the prison population (not to mention the prison building and private prison industries). The implications are particularly stark for the African-American population, where one in four black men will serve time during his third decade.
Much work on drug addiction and policy has been done in the realm of behavioral economics. Behavioral Economics is a trans-disciplinary field, combining concepts from B.F. Skinner's Behavioral Psychology and Consumer Demand theory in microeconomics (For an introduction to Behavioral Economics, I highly suggest Dan Ariely's Predictably Irrational. It is a quick read, and it does a great job of presenting the science in a clear format.) If protecting a population from the dangers of illegal drug use is our objective, then there are two sides that must be controlled - supply reduction strategies and demand reduction strategies.
From the beginning of the war on drugs, the US has focused a disproportionate amount of resources to supply reduction strategies. We have flexed our foreign muscle to force countries into coca, reefer and opium eradication programs while neglecting the US demand for drugs. Our foreign policy on drugs has resembled the imperialistic cowboy style that demands other countries to get in line. However, we have neglected the cause of elastic demand for street drugs in the US - addiction. The RAND Corporation 1995 table below shows US expenditures on drug policy.
Much work on drug addiction and policy has been done in the realm of behavioral economics. Behavioral Economics is a trans-disciplinary field, combining concepts from B.F. Skinner's Behavioral Psychology and Consumer Demand theory in microeconomics (For an introduction to Behavioral Economics, I highly suggest Dan Ariely's Predictably Irrational. It is a quick read, and it does a great job of presenting the science in a clear format.) If protecting a population from the dangers of illegal drug use is our objective, then there are two sides that must be controlled - supply reduction strategies and demand reduction strategies.
From the beginning of the war on drugs, the US has focused a disproportionate amount of resources to supply reduction strategies. We have flexed our foreign muscle to force countries into coca, reefer and opium eradication programs while neglecting the US demand for drugs. Our foreign policy on drugs has resembled the imperialistic cowboy style that demands other countries to get in line. However, we have neglected the cause of elastic demand for street drugs in the US - addiction. The RAND Corporation 1995 table below shows US expenditures on drug policy.
The strategy has served to inflate street drug prices in the US as supply decreases and demand remains constant. As risk increases, so to does price. For reference, you can review recent Mexican history to understand the climate shaped by our drug policy. Meanwhile, un-addicted but bored middle class white kids are steering clear of the heavy penalties associated with cocaine and heroine, choosing instead gray-market "herbal supplements" or new designer chemical substances they can get on the internet, or crystal meth they can make at home.
04 March 2011
Friday Pick of the Week
With Mardi Gras just around the corner, what better way to head into the weekend than under the soulful sounds of the The Radiators. This Bob Dylan cover of "Rainy Day Women #12 & 35" is from a live 2005 set played at New Orleans' famous Tipitina's. May your weekend be filled with Moon Pies.
03 March 2011
Fiscal Conservatism?
In the firestorm that has surrounded government budget debates on the state and federal level, folks from all sides are chiming in. Tea Party-supported "fiscal conservatives" have entered the scene on a mission. I am a firm believer in fiscal discipline, but much of the controversy has been over what amounts to politics as usual. As I've discussed in recent posts, states everywhere are slashing programs that are social investments - research, public media, education and healthcare. Scott Walker is using the budget crisis in Wisconsin to strip state employees of collective bargaining rights, describing their benefits as luxurious and their salaries as disproportionate to the private sector (by the way, 60% of public employees have college degrees versus 20% of non-government workers). The problem with his argument is that stripping collective bargaining has nothing to do with the current budget. It is nothing more than manipulating a current crisis to change the rules of the game.
The federal government is following suit, as new Republicans are vying to make good on pledges of cutting $100 billion from the 2010 budget. Refusing to touch the sacred cows of defense and Medicare (which along with Social Security account for 88% of the federal budget), they take aim at "discretionary spending," namely things that people who vote for Democrats use. All of this is done in the name of "fiscal conservatism," but as blogger Jim Wallis of God's Politics points out, what is being sold as fiscal conservatism is simply politics as usual:
This is not fiscal conservatism. It's just politics.
The federal government is following suit, as new Republicans are vying to make good on pledges of cutting $100 billion from the 2010 budget. Refusing to touch the sacred cows of defense and Medicare (which along with Social Security account for 88% of the federal budget), they take aim at "discretionary spending," namely things that people who vote for Democrats use. All of this is done in the name of "fiscal conservatism," but as blogger Jim Wallis of God's Politics points out, what is being sold as fiscal conservatism is simply politics as usual:
This is not fiscal conservatism. It's just politics.
02 March 2011
Healthcare and Immigration
It looks like Alabama is not the only one making short-sighted decisions regarding the health of children. Arizona lawmakers, looking to one-up the controversial bill they passed in 2010 targeting illegal immigrants, have brought to the floor an omnibus immigration bill with repercussions reaching deep into the unknown. The bill extends to healthcare, with stiff penalties aimed at healthcare providers and hospitals that would dare treat Hispanics without demanding to see their documentation. The bill will certainly draw vocal support from fiscal conservatives and anti-immigration proponents, though it has little basis in reality.
The Arizona Republic highlights the bill's shortcomings in an article by Mary K. Reinhart and Ken Alltucker: "Tucson neonatologist Carlos Flores said the legislative proposals, including co-payments for prenatal care and no-show fees, show a "lack of understanding" about the state's health-care network. Nearly half of Flores' patients are on AHCCCS, and he said barriers to prenatal care and other health services would cost taxpayers more in the long run."
As seems to be more and more common in the current political climate, when financial times get tough, people lose their minds. Conservative commentators continually discuss the federal budget in light of the way a middle class family would run their home - "When things get tight, you've got to make cuts." However, the cuts they are willing to make are chosen in light of two, four or six-year election cycles, with little perspective for the future. "We can't leave our children with any more debt!" is the cry. But stripping programs that are innately long term investments - such as funding for the healthcare of children and scientific research - is like breaking into the kids' college accounts so that you can maintain one's current standard of living. The cuts being demanded by Tea Partiers and libertarians might make the budget look more solvent now, but they will cost future generations.
The Arizona Republic highlights the bill's shortcomings in an article by Mary K. Reinhart and Ken Alltucker: "Tucson neonatologist Carlos Flores said the legislative proposals, including co-payments for prenatal care and no-show fees, show a "lack of understanding" about the state's health-care network. Nearly half of Flores' patients are on AHCCCS, and he said barriers to prenatal care and other health services would cost taxpayers more in the long run."
As seems to be more and more common in the current political climate, when financial times get tough, people lose their minds. Conservative commentators continually discuss the federal budget in light of the way a middle class family would run their home - "When things get tight, you've got to make cuts." However, the cuts they are willing to make are chosen in light of two, four or six-year election cycles, with little perspective for the future. "We can't leave our children with any more debt!" is the cry. But stripping programs that are innately long term investments - such as funding for the healthcare of children and scientific research - is like breaking into the kids' college accounts so that you can maintain one's current standard of living. The cuts being demanded by Tea Partiers and libertarians might make the budget look more solvent now, but they will cost future generations.
01 March 2011
Alabama's Choices
The Decatur Daily published an editorial on Alabama's coming legislative session, one in which heavy budget cuts are anticipated, with lawmakers taking particular aim at programs benefiting children. Education and healthcare are the most prominent targets. The editorial raises the question: how much more can the budget be cut? Alabama, as of 2006, has the lowest per capita taxes in the country, with the poor bearing a high portion of the burden. Why do we emphasize low taxes at the cost of the future of our state? Is it because the policy makers know that their children will be well educated in private or suburban schools, with gracious health insurance plans to protect them as they mature into the roles their parents now hold? Hits to rural and urban school systems and to Medicaid and the SCHIP program serve to ensure that kids depending on those programs will not be competing for power positions.
I completely understand populist resistance to taxes, but what is amazing is how the wealthy can so easily sell the middle class on a tax structure that blatantly benefits high-income earners. Perhaps the promise of the American Dream is sufficient to convince blue collar social conservatives that they need to resist tax reform so that once they arrive they can reap the benefits. The sad part of that promise is that it is a lie. The income gap between the wealthiest Americans and the middle class has grown drastically over the past 25 years, and trends show no signs of relenting. Why do we refuse to demand a political system that promotes justice?
Props to Clark Powell for passing along this link: The New Normal
I completely understand populist resistance to taxes, but what is amazing is how the wealthy can so easily sell the middle class on a tax structure that blatantly benefits high-income earners. Perhaps the promise of the American Dream is sufficient to convince blue collar social conservatives that they need to resist tax reform so that once they arrive they can reap the benefits. The sad part of that promise is that it is a lie. The income gap between the wealthiest Americans and the middle class has grown drastically over the past 25 years, and trends show no signs of relenting. Why do we refuse to demand a political system that promotes justice?
Props to Clark Powell for passing along this link: The New Normal
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