Dan Braganca

In honor of Paul Ryan’s fantasy budget let’s take a look at actual changes in government spending in this edition of Graphs that Subvert Conventional Wisdom.

You might be wondering, “How can this be? I thought that socialist Obama is spending us into fiscal armageddon! Hasn’t the deficit skyrocketed?”

Sorry, those graphs cluttering your inbox from your right-wing uncle misled you. They fail to explain that the deficit is higher because the economy went into recession. GDP is smaller so spending when measured as a percentage of GDP appears like it’s jumped more than usual. The deficit is higher because of huge tax cuts by Obama, less revenue from a weak economy, a temporary stimulus and other measures to help people hurt by the recession. The 44th President hasn’t radically departed from those before him… turns out he’s actually been pretty modest.

Ezra Klein has an insightful piece about the New York Times’ report that gene sequencing will soon become much more affordable. He argues it will sort purchasers of insurance into high cost and low cost groups too efficiently. Since insurance companies can’t discriminate based on genetic information by law, it will cause an unsustainable spiral.

Eventually, genomic testing will be a powerful predictor of future illness. And it raises the potential that young people will get themselves tested and then purchase insurance based off the result. So those with a clean genomic result might go for a cheap catastrophic plan, while those with a high risk of developing pricey illnesses will opt for more comprehensive insurance.

The result would be, in insurance terms, an “adverse-selection death spiral,” as the healthy opt out of expensive insurance, the sick opt into it, and premiums spin out of control.

Undoubtably, Klein is correct. But I’d like to point out that this is already a flaw in a private insurance markets. Private insurance companies have no incentive to cover high-risk or sick people (unless under totally unaffordable and unrealistic rates). That’s why anyone that thinks insurers should cover people with pre-existing conditions must favor government intervention that requires healthy consumers to buy in and spread the cost out.

As the graph makes clear, the majority of healthcare spending comes from patients with chronic conditions (half of total spending comes from only 5% of the population). Unless the government covers those patients directly or spreads the cost out to the healthier population through mandates, we won’t have a workable healthcare model for treating the people who need it most. Well… unless you think charities can make up the hundreds of billions of dollars in shortfall?

An activist tries to make justice go viral:

It’s important to shine light on crimes against humanity so I applaud the effort. I don’t know enough about the situation in Uganda so let me outsource some more nuanced coverage of this campaign and the LRA in particular.

(h/t Natalia)

As the political world obsessively checks every latest poll to see which candidate voters are supporting, whether they’re enthusiastic, if they think the country is moving in the right direction, and on and on I save myself some time. Here’s the “poll” that matters:

If personal income continues to on this path (it was revised upward as better economic data came in), the president will see 4 more years.

(h/t Kevin Drum)

[Of course this metric would really be the best]

I’m not in the political prediction business -and it looks like Romney might be back on top of the polls in Michigan- but if Santorum squeezes out a win in the Mitten State that will certainly be embarrassing for Mitt and will lead to more embarrassing political controversies over reproductive rights and “social issues” that should be settled by now. That said, I understand reasonable people can disagree about a tricky topic like abortion rights. I know Santorum and Gingrich oppose secularism, but in order to get past this moral impasse as a public policy issue let’s appraise the moral foundation of a woman’s right to reproductive control.

Placing an ethical premium on personal autonomy provides a vital safeguard against harm for individuals. The state should only infringe on that autonomy to the extent that a person’s free decision causes measurable suffering to others. Abortion opponents doubtlessly believe that ending a pregnancy harms the “unborn.” They’re wrong.

Our moral concern need only extend to conscious creatures with the ability to perceive experiences. It’s the reason landscapers don’t face an ethical dilemma every time they mangle and sever live grass with steel blades. An unborn blastocyst lacks a brain and nervous system (it doesn’t even have neurons yet); without those faculties a blastocyst cannot suffer. In contrast, developed conscious women can suffer and can experience pleasure. Pro-life activists want the state to restrict the personal autonomy of a full human person. Then, against her will, the pregnant woman must suffer all the consequences and risks in order to protect an entity that, by definition, does not suffer.

The later stages of pregnancy may complicate the biological picture, but no moral obligation yet develops. Despite the growth of a nervous system and brain, a fetus has no awareness that is critical for our moral concern.

[The] fetus is actively sedated by the low oxygen pressure (equivalent to that at the top of Mount Everest), the warm and cushioned uterine environment and a range of neuroinhibitory and sleep-inducing substances produced by the placenta and the fetus itself: adenosine; two steroidal anesthetics, allopregnanolone and pregnanolone; one potent hormone, prostaglandin D₂; and others.

The closest parallel may be surgery under anesthesia. Surgical patients do not perceive their experience or conscious pain because, as my nurse anesthetist friend explains, “the brain is unable to receive or remember pain… the nervous system is still intact and signals are still being sent to the sleeping brain.”  A fetus never awakens into consciousness – it won’t notice… it can’t notice or miss its life or its termination anymore than a sperm does.

I thought it’d be unnecessary to discuss, but since Newt Gingrich made the ridiculous, false, and offensive charge that “Barack Obama voted in favor of legalizing infanticide” I might as well explain why infants merit our moral care. Using a comparable moral framework, Will Wilkinson of The Economist believes infants are not persons, but still accepts that the prohibition on infanticide is “wise.” Yet I think he sells the strength of his case a bit short. Wilkinson argues that “birth is a metaphysically arbitrary line.” That’s not entirely false, but it’s less arbitrary than he suggests. Here’s Christof Koch from the Scientific American again:

The dramatic events attending delivery by natural (vaginal) means cause the brain to abruptly wake up, however. The fetus is forced from its paradisic existence in the protected, aqueous and warm womb into a hostile, aerial and cold world that assaults its senses with utterly foreign sounds, smells and sights, a highly stressful event.

As Hugo Lagercrantz, a pediatrician at the Karolinska Institute in Stockholm, discovered two decades ago, a massive surge of norepinephrine—more powerful than during any skydive or exposed climb the fetus may undertake in its adult life—as well as the release from anesthesia and sedation that occurs when the fetus disconnects from the maternal placenta, arouses the baby so that it can deal with its new circumstances. It draws its first breath, wakes up and begins to experience life.

In other words, at birth, infants begin to experience conscious awareness. After delivery, the infant is an autonomous entity that no longer directly risks harm to the mother. The newborn’s ability to perceive harm and pleasure demands that we foster the child’s wellbeing.

Since blastocysts and fetuses can’t consciously experience the consequences of a woman’s decision, any government intervention unnecessarily infringes on personal liberty and causes harm and risk. The only refuge left for abortion opponents is to invent vacuous principles to protect such as “dignity.” Depending on the application, this religious concept is a “vague restatement” of other useful and more precise ethical metics at best or is an attempt to elevate the interests of nobody above the interests of conscious autonomous persons at worst. In our moral calculus, it’s dispensable.

Secular reason leads us to care for living conscious women against the illiberal assault on their personal autonomy. It’s the moral position.

(image: fetal brain development)

On a recent episode of Real Time with Bill Maher, Reihan Salam argued that it’d be better for gay marriage’s “stabilty” if it was passed democratically rather than by court order. In a certain sense, he’s onto something. It’s almost tautological: if a majority of citizens in a democracy support gay marriage, we don’t have to worry about the majority undermining gay marriage.

To bolster his argument Salam and The Economist’s Zanny Minton Beddoes compare gay marriage rights to abortion politics. Salam and Beddoes suggest that without persuading a majority first and passing it democratically, gay marriage rights won’t seem as legitimate and we’ll be left with a tension similar to the one that’s followed Roe v Wade for 40 years.  As you can see, although public opinion waxes and wanes in the short term, support hasn’t changed dramatically.

I don’t fully disagree with their case; it’d certainly be wonderful and especially validating if marriage equally was reached by popular vote. Yet, we don’t need to look at abortion or any other social issue for speculation.

The Massachusetts Supreme Court ordered marriage equality in 2003. At the time, “50 percent [of the Mass residents] agreed with the justices’ decision, and 38 percent opposed it.” Nine years later the Massachusetts’ public isn’t unsettled by court-mandated gay marriage, risking its stability; instead, 60% now believe same-sex marriage should be legal. Living with equality has increased support to a 2 to 1 margin over opponents. Now, maybe it will be different in states like South Carolina where 20% of likely Republican primary voters think interracial marriage should be illegal! But the trends in all states seem positive any time marriage rights are expanded for race or sexuality. The most likely reason why?

I hope and am confident public opinion will continue to shift toward equality, yet if the Supreme Court gets there before voters do, there is no need to worry. We’ll just have to celebrate with our fellow citizens a bit earlier.

There is no more important question when evaluating our personal beliefs, public policy, or science than, “What evidence would cause me to change my opinion?” If you can’t answer that question you are being, by definition, unreasonable.

Will Wilkinson on the Democracy in America blog at The Economist plays the game with some hot-button political issues in response to Charles Murray’s argument that says,

Data can bear on policy issues, but many of our opinions about policy are grounded on premises about the nature of human life and human society that are beyond the reach of data. Try to think of any new data that would change your position on abortion, the death penalty, legalization of marijuana, same-sex marriage or the inheritance tax. If you cannot, you are not necessarily being unreasonable.

That’s as clear-cut of an admission of irrationality as I’ve seen.

I largely agree with Wilkinson so I won’t cover the topics above, but I think it’d be entertaining to go through some others:

Read more…

On March 20th The Shins new album will be released. Here’s one of their brand new songs:

(via The A.V. Club)

Remember when the big conservative explanation for the lack of recovery was “policy uncertainty?” Funny you don’t hear that as much anymore… I wonder why?

Dow Jones Industrial Average

Anyone that cares about women’s rights and health is rightly upset at the Susan G. Komen Foundation’s break with Planned Parenthood. The decision to stop grants to Planned Parenthood was clearly motivated by anti-abortion politics, but E.G. from the Democracy in America blog wonders why the healthcare provider receives such a high level of aggression:

The bulk of its activities are focused on contraception, STI screening, and cancer screening, and it places a particular emphasis on providing reproductive health care to people who otherwise wouldn’t have access. They also provide abortions, which are controversial, obviously, but legal, obviously. And insofar as access to contraception and other family-planning services reduces the demand for abortion, Planned Parenthood also prevents abortion. In my view, it is an important part of civil society. Even from a pro-life position, I would think it qualifies: being pro-life is a coherent moral position, and not one that necessarily implies a lack of concern for women’s health. So I really don’t understand why Planned Parenthood gets so much grief from the right.

It’s difficult to understand because most of the pro-life right is not anti-abortion because of a reasoned moral opinion, but rather because of religious dogma. So when E.G. looks at a moral calculation based on the consequences of behavior and policy and she notices that contraception services reduce the number of abortions it seems inconsistent to disapprove. However, if you recognize that fundamentalist religious ethics is based on a rule-based system that says abortion, contraception, and church-unapproved sexual activity are all evil in principle it makes “sense.” I wouldn’t go so far as to say the religious consciously don’t care about the effects on actual people, but religious ethical dogma is not concerned about the effects on actual people. It’s not morality. It’s fundamentalism.