Guns and public health

There are too many guns in the United States.

Last October Christopher Ingraham wrote in the Washington Post’s Wonkblog

It’s tough to know exactly how many guns we have in the United States. Most estimates of the number of guns in the U.S. use federal tallies of the firearms manufactured, imported and exported by U.S. gunmakers. A 2012 Congressional Research Service report published exactly one month before the Sandy Hook school shooting put the number of civilian firearms at 242 million in 1996, 259 million in 2000, and 310 million as of 2009.

If that 310 million number is correct, it means that the first year of Barack Obama’s presidency was an inflection point: It marked the first time that the number of firearms in circulation surpassed the total U.S. population.

It is clear that the Obama years have been a boon to gun manufacturers regardless of whether the number of guns is 245 million, 270 million, or 300 million.

guns

Do they keep us safe?  Some gun owners point to falling homicide rates, but there are studies showing that places with few guns have lower rates.  Ingraham writes

It’s important to note that even as the number of guns has increased since the early-to-mid-90s, the per-capita gun homicide rate has fallen by nearly half over the same time period. On the other hand, it’s also true that when you make comparisons between states and countries, you see that places with more guns have more gun homicides, as research from the Harvard School of Public Health shows.

These two seemingly unreconcilable facts form the factual basis for much of the contemporary gun policy debate. Defenders of gun rights can point to falling homicide rates and rising gun numbers and argue that the solution to gun violence is more guns. Gun control advocates, meanwhile, can point out the correlations between gun ownership and gun crime and push for tighter restrictions on gun ownership.

Ingraham concludes

Is there a way to reconcile these divisions? It’s hard to tell. I keep coming back to this quote, from the Economist earlier this year in response to the Charleston massacre.

Those who live in America, or visit it, might do best to regard [mass shootings] the way one regards air pollution in China: an endemic local health hazard which, for deep-rooted cultural, social, economic and political reasons, the country is incapable of addressing.

Which brings me to Margaret Talbot’s comment in the January 18 issues of The New Yorker.  Talbot writes about President Obama’s Executive Order on background checks.

Last week at the White House, as President Obama announced a set of executive actions aimed at blunting gun violence, he seemed anything but numb. He wept as he invoked the first graders killed at Sandy Hook Elementary School, in Newtown, Connecticut—a response for which some gun advocates mocked him. He quoted Martin Luther King, Jr.,’s words about the “fierce urgency of now.” But he also acknowledged the numbness that can overcome people in the face of one mass shooting after another. That numbness puts proponents of unfettered gun rights at an advantage. People can easily start thinking of gun violence as something native to America’s angry, intractable soul—the armed, anti-federalist takeover of wildlife-refuge buildings in Oregon this month seemed like proof. And when, time and again, Congress thwarts gun reforms that are supported by majorities of Americans it can be hard to imagine that the status quo will ever change.

If numbness benefits gun-rights absolutists, uninformed numbness might serve them even better. In 1993, The New England Journal of Medicine published a study showing that “keeping a gun in the home was strongly and independently associated with an increased risk of homicide” in that home. The researchers had been funded by the C.D.C.’s National Center for Injury Prevention, and the N.R.A. responded by trying to get the prevention center defunded. It didn’t succeed, but, in 1996, Congress amended an appropriations bill to the effect that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” It was a little like saying that no research on the health effects of smoking should be interpretable as anti-smoking. Congress also removed $2.6 million from the C.D.C.’s budget—the precise amount that had gone to the prevention center’s research—and then restored it, earmarked for an entirely different purpose. As a result, one of the study’s authors said in a public-radio interview last spring, “many, many people stopped doing gun research.”

With gun research, maybe we could have safer weapons as we have safer cars.  Maybe we would better understand the dangers of gun ownership.  Maybe we wouldn’t have to read about the six year old who finds Daddy’s gun and kills his two year old sister.

Jay Dickey, the Republican representative and N.R.A. member from Arkansas who sponsored the amendment, came to regret it. Dismayed by the continuing toll of gun violence, he was eventually persuaded that firearm deaths could be reduced without violating the Second Amendment. He now believes that research on gun violence can help prevent it, much as similar work on highway safety resulted in innovations like seat belts, air bags, highway dividers, and minimum drinking ages, and prevented hundreds of thousands of traffic deaths. In December, in a letter to Mike Thompson, the chairman of the House Democrats’ Gun Violence Prevention Task Force, Dickey wrote, “Research could have been continued on gun violence without infringing on the rights of gun owners, in the same fashion that the highway industry continued its research without eliminating the automobile.” He added, “We should slowly but methodically fund such research until a solution is reached. Doing nothing is no longer an acceptable solution.”

Talbot cites a recent study (not government funded) comparing the repeal of a permit and background check law in Missouri and the initiation of more stringent laws in Connecticut:  Gun homicides dropped around 40% in Connecticut and rose by a similar percentage in Missouri.

Those opposed to background checks, bans on weapons with large capacity magazine, or even trigger locks often say that the issue is one of mental health not guns.  I think our national obsession with guns IS the mental health issue.  They are a public health issue.  Talbot concludes

In part, Obama is trying to reframe the gun discussion not as a Second Amendment issue but as one of public health. This approach acknowledges that, while we can’t eliminate gun crime, we can reduce it, and that doing something is better than fatalistically doing nothing.

Photograph:  M&R Glasgow/Flickr

 

Looking at President Obama

The annual Gallup poll of the most admired man has just picked President Obama.  Even among Republicans he tied with Pope Francis.  But to hear some Republican elected officials and pundits, Barack Obama is the devil incarnate.  If he says the sky is a little cloudy, they will say it is clear.  So what is going on?  Are people finally catching on to what he has accomplished?  Are people starting to look beyond the media’s short attention span?  I don’t have any answers, but I know that the President has managed more than one could ever imagine given the Tea Party and solid Republican opposition to everything he proposes. Even people like Paul Krugman, who one would think would be a supporter, was not.  But Krugman has changed his mind and in October wrote a widely circulated defense.

When it comes to Barack Obama, I’ve always been out of sync. Back in 2008, when many liberals were wildly enthusiastic about his candidacy and his press was strongly favorable, I was skeptical. I worried that he was naive, that his talk about transcending the political divide was a dangerous illusion given the unyielding extremism of the modern American right. Furthermore, it seemed clear to me that, far from being the transformational figure his supporters imagined, he was rather conventional-minded: Even before taking office, he showed signs of paying far too much attention to what some of us would later take to calling Very Serious People, people who regarded cutting budget deficits and a willingness to slash Social Security as the very essence of political virtue.

I certainly haven’t agreed with everything Obama has proposed or done, but no one agrees with anyone else 100% of the time.  And there have been some scary moments.  Remember the “Grand Bargain”?  But we can list as accomplishments the Affordable Care Act, Dodd-Frank financial reform (despite the reluctance of Congress to fund the Consumer Protection Bureau and the recent gutting of the prohibitions on banks and derivatives.), the steady improvement of the economy (the only one in the world not on the verge of tanking again) and the ending of our combat roles in the wars in Iraq and Afghanistan.  But I just don’t understand the continuous bashing by everyone.  Plus, I firmly believe that the mid-term elections would not have been quite so bad if the Democrats had had the guts to run on the President’s record.

Krugman writes

But now the shoe is on the other foot: Obama faces trash talk left, right and center – literally – and doesn’t deserve it. Despite bitter opposition, despite having come close to self-inflicted disaster, Obama has emerged as one of the most consequential and, yes, successful presidents in American history. His health reform is imperfect but still a huge step forward – and it’s working better than anyone expected. Financial reform fell far short of what should have happened, but it’s much more effective than you’d think. Economic management has been half-crippled by Republican obstruction, but has nonetheless been much better than in other advanced countries. And environmental policy is starting to look like it could be a major legacy.

I think one of the problems the President has is that he is a canvas on which each person paints the picture of what they want him to be.  Michelle Bachmann sees him as a non-Christian, non-American.  Cornel West thinks he is a ‘counterfeit progressive”, meaning, I guess a conservative in progressive clothing.  The problem is people do not look at facts.  And they certainly don’t understand the character of the man.  I found this description of him on the golf course very apt.

One of the golfers who played with Mr. Obama said the way the president carried himself on the course provided significant insight into his character.

“If you came down from Mars and saw his disposition on the golf course, you would think he would be a pretty good president,” the golfer said. “He’s honest, he keeps his composure through terrible adversity, he’s unruffled, he smiles, and he doesn’t quit.”

Obama

This is why after the mid-term elections, President Obama was able to have what Kevin Drum writing in Mother Jones magazine was able to call “a Hellava month”.  Drum lists his accomplishments during November and December.  Here are a few from his list.

  • November 11: Concluded a climate deal with China that was not only important in its own right, but has since been widely credited with jumpstarting progress at the Lima talks last week.

  • November 20: Issued an executive order protecting millions of undocumented workers from the threat of deportation.

  • November 26: Signed off on an important new EPA rule significantly limiting ozone emissions.

  • December 17: Announced a historic renormalization of relations with Cuba.

Plus a number of judicial and other nominees were approved by the Senate before they went home for the holidays. Jennifer Bendery explains in the Huffington Post.

If there’s one thing from 2014 that will define President Barack Obama’s legacy after he’s left the White House, it’s the number of lifetime judges he put on the federal bench.

In its final act of the year, the Senate blew through a dozen U.S. district court nominees on Tuesday night. That puts Obama at a whopping 89 district court and circuit court confirmations for the year, and means he’ll wrap up his sixth year in office with a grand total of 305 district court and circuit court confirmations — a tally that puts him well beyond where his predecessors were by this point in their presidencies.

It may be that, in the end, his biggest effect on the judiciary isn’t sheer numbers as much as the diversity of his judges. Forty-two percent of Obama’s confirmed judges are women, 19 percent are black and 11 percent are Hispanic, according to data provided by the White House. Eleven of his confirmed judges are openly gay or lesbian.

Even the 12 nominees confirmed Tuesday night will make a mark: Robert Pitman will be the first openly gay judge to serve in the Fifth Circuit, which includes Texas, Louisiana and Mississippi. Loretta Biggs will be the first black woman to serve as a district judge in North Carolina.

The most interesting part of the nominee confirmation story is that the last were made possible by Senator Ted Cruz who probably had no idea what he was doing.

Democrats spent the final days of the lame duck thanking Sen. Ted Cruz (R-Texas) for inadvertently helping to expedite votes on Obama’s nominees. On Friday, Cruz derailed a plan by party leaders to leave for the weekend and come back Monday in an effort to force a show vote on Obama’s immigration executive action. The stunt kept senators in session all day Saturday, with hours to kill. So, Senate Majority Leader Harry Reid (D-Nev.) used the time to tee up votes for the 12 district court nominees still on the calendar.

With two years to go, I don’t think any of us should write President Obama off as a “lame duck”.  He seems to be freed by not having to run for office again.  We all need to stay tuned to see what he does next.

Photograph:  Uncredited from Mother Jones.

 

 

When spouses are both in politics

I’m not necessarily referring to Bill and Hillary Clinton and whether his actions, both while governing and personally (think Monica) should be fair game if Hillary decides to run.  I’m thinking today about David Barron and his wife, Juliette Kayyem, who is running for the Democratic nomination for Governor of Massachusetts.  I happen to be a Kayyem supporter although she is fighting an uphill battle.  And I wonder if it just got even more uphill.

David Barron was just confirmed to the 1st Circuit Court of Appeals which is New England.  His nomination was held up because he is the author of the infamous “drone” memo.  The New Yorker’s Ryan Lizza had an interesting piece about Barron and the memo today.

On July 16, 2010, David J. Barron, a lawyer at the Department of Justice, sent Eric Holder, the Attorney General, a lengthy memorandum. Barron, who had celebrated his forty-third birthday earlier that month, was a professor at Harvard Law School, on leave for a couple years to work for President Barack Obama. Barron, like many young lawyers who arrived in Washington with the new Administration in 2009, had impeccable liberal credentials. As a Harvard undergraduate on the Crimson, the campus newspaper, he wrote sympathetic pieces about Jesse Jackson’s 1988 Presidential campaign. During the summer of 1993, before his third year at Harvard Law School, he interned with the N.A.A.C.P. in Washington. After graduating, he clerked for Supreme Court Justice John Paul Stevens, a leader of the court’s liberal wing, and then worked in the Clinton Justice Department. During the Bush years, he was a relatively prominent critic of the Administration’s national-security polices, especially its embrace of torture.

In 2006, while Bush’s Justice Department lawyers were tweaking a new legal regime allowing for bulk-collection surveillance and what they called “enhanced interrogation,” Barron helped review the bylaws of the Botanic Gardens Children’s Center. As a professor in Cambridge, he raised money for the campaign of Deval Patrick, who has been governor of Massachusetts since 2007. That same year, 2007, he even attended the YearlyKos convention, a sort of South by Southwest for left-leaning bloggers and activists trying to push the Democratic Party in a more unabashedly progressive direction. During his legal career, he has signed amicus-curiae briefs in several highly political cases, including one defending a living-wage ordinance in Santa Fe, New Mexico, and another defending a major campaign-finance reform law. In 2008, during an NPR interview, he mused that articles of impeachment could be justified against a President who purposely misled the country into war.

 

Juliette Kayyem

Juliette Kayyem

His wife has similar liberal credentials.  I first met her right after the World Trade Center bombings.  Everyone was in a panic about the possibility of more incidents, about loss of civil liberties, the prospect of some kind of martial law, and whether we were safe.  I can’t remember the exact words she used, but she was reassuring with ideas that one did not have to curtail civil liberties to combat terrorism.  After that I read her column in the Boston Globe and found, for the most part, that she had a pretty commonsense approach to things.  But I know that a number of supporters of other Democratic candidates want to tar her with the David Barron’s memo justifying the drone strike that killed an American citizen living in Yemen and involved in terrorism.

His July, 2010, missive, which was one of the last that he wrote during his eighteen months running O.L.C., was historic and—to many—troubling: yes, Barron argued, the President of the United States could kill an American citizen named Anwar al-Awlaki. And, as a rule, the memo argued, the President could kill any American citizen abroad connected to Al Qaeda or an associated group—without a trial or other legal proceedings—if he deemed that person an imminent threat.

This post is not meant to debate the memo or whether we should have killed Anwar al-Awlaki without a trial, but whether Barron’s memo is fair game for his wife’s political opponents.  None of us know what he wrote or what kind of justification he used:  We only know that al-Awalki is dead.  We don’t know if Kayyem agreed with what he wrote or if she even knows any more about the contents of the memo than the rest of us.  I do know the fact that he wrote has already been raised against her.  It is likely that if she does manage to get the nomination that some part of the progressive community will not work for her.

Boston Magazine has already raised the question.  The article opens

Gubernatorial candidate Juliette Kayyem has run into some trouble with Massachusetts Democrats over what some characterize as hawkish views on the use of tough measures in the cause of national security, her area of expertise. So, with the Democratic state convention less than six weeks away, she probably doesn’t need the trouble that’s stirring up around her husband on the issue—regardless of how irrelevant it may be to her, and how she might run the Commonwealth.

And ends with this.

None of which, of course, should have anything to do with supporting Kayyem for governor. They’re not her memos; it’s not her decision whether to release them; it’s not her nomination. But with her gubernatorial campaign hinging on what those delegates do in mid-June, this is probably a distraction she would rather have behind her.

We need to think about what happens when both spouses are politically involved.  Are they two people or do they only count as one person?  Should we assume that they agree on everything?  Are they responsible for each other’s actions?  I don’t have the answers, but we have to think about these things as we are going to see more political couples like the Clintons and like Juliette Kayyem and David Barron.

Photograph: Boston.com

Solving the pay equity problem: Not that easy

white-house-wage-gapIs the gender gap in wages a myth or is it as the President said yesterday just math?  If a company pays, as does the White House and most other government agencies, equally for the same job, why is there still a gap in total pay?  Is that as Christina Hoff Summers would argue, not a wage gap since the cause is that women are in different job?  Christopher Ingraham wrote in the Washington Post

The American Enterprise Institute caught the White House flat-footed yesterday with its finding that female White House workers earned roughly 88 cents to the dollar compared to male employees. This came the day before two high-profile executive orders aimed at narrowing the gender wage gap among federal contractors.

When asked about the discrepancy by reporters, spokesman Jay Carney said that those figures are based on the total of all staff jobs, and that women tend to fill more lower-paying positions than men. When you break it out by position, “men and women in equivalent roles here earn equivalent salaries,” Carney said. Incidentally, this is the pretty much the same argument that AEI scholar Christina Hoff Summers makes to argue that the gender wage gap is a myth.

Human Resource people (of which I was once one) would say it is all about classifying jobs.  There is an endless debate about what jobs require more skills, more effort, more responsibility.  Is the woman who comes to help your sick mother as a home health aide worth less than the man who manages the local convenience store? (Neither gets paid very well.)  Is a pre-school teacher worth less than the CEO of Facebook?  Ok.  I can hear people saying that I’m comparing apples and oranges, but these are the kind of things we need to consider as we look at not only the gender issues but also at low wage jobs generally.  If you look at the Washington Post chart, you can see that the national wage gap is pretty constant, but the general trend of the White House gap is down.

There are really several problems at work here.  First is the failure to pay women an equivalent wage for the same work done by a man.  This may be deliberate or the women may simply be given a different job title and classification.  The second is what the Institute for Women’s Policy Research calls occupational segregation.

Pay equity may also be impacted by other more subtle factors than workplace discrimination. IWPR’s research shows that, irrespective of the level of qualification, jobs predominantly done by women pay less on average than jobs predominantly done by men. Women have made tremendous strides during the last few decades by moving into jobs and occupations previously done almost exclusively by men, yet during the last decade there has been very little further progress in the gender integration of work. This persistent occupational segregation is a significant contributor to the lack of significant progress in closing the wage gap.

The third problem is one that speaks mainly to women in the private sector at high levels:  Women appear to be less willing to ask for more in salary negotiations.  While this is unimportant and insignificant, more women are hurt by the first two problems.

In the late 1970s I was working as a research analyst for the Virginia State Equal Opportunity Office.  We got a complaint from a woman professor at a state college who suspected that she was being paid less than a male colleague who started around the same time as she did.  They were, I think, both coming up for tenure.  This was the age before editable spreadsheets were common, but I managed to make a chart showing hire dates, educational levels, teaching load and teaching evaluations among other factors I can’t remember now for that department.  When laid out, it became very clear that the women, including the complainant were being paid less.  This set off a request for an analysis of the entire school as well as requests from several other state colleges and universities.  I ended up teaching people from the schools how to do this themselves since there was no way I could tackle such a large project on my own.  Problems were corrected, but I don’t recall that we ever compared  salary levels at the Department of Physics (probably mostly men) to the School of Nursing (mostly women).

I tell this story for two reasons.  One, the problem and issue has been around a long, long, time.  And second, I think we need to look harder at occupational segregation and, if we can’t totally solve that, we need to look at how we, as a society, value what we call “women’s work.”  In the end, that is the only way to cure the pay equity problem.

 

 

 

 

As the dust settles

on the first enrollment period of the new Affordable Care Act, we are learning that a lot more people than a lot of people predicted have signed up for insurance.  President Obama is claiming 7.1 million people signed up on the health insurance exchanges – along with unknown numbers of others who signed up directly with insurance companies.  There was a claim yesterday that 90% of the enrollees had actually paid a first premium, a crucial step to being able to actually use the insurance.  We all know that there will be hassles when people go to their medical provider, when insurance cards don’t arrive in the mail, when someone with expanded Medicaid goes to a doctor who doesn’t accept that plan, but then, there have always been hassles with health insurance.  This will be nothing new.  What will be new is the massive number of new people suddenly looking for a provider.  Adjustments will have to be made all around.

But the biggest losers as of this morning would seem to be the opponents of the ACA or Obamacare as they call it.  Here is Dan Wasserman’s cartoon from this morning’s Boston Globe.

obamacare wasserman

 

And then there is this story from Politico.

Back in the fall, conservatives seized on the flubbed Obamacare rollout as proof that President Barack Obama’s brand of liberalism doesn’t work.

Now, the law’s opponents aren’t about to say that critique was wrong — but they’ve lost the best evidence they had.

On Tuesday, Obamacare sign-ups passed 7 million, six months after the launch of a federal website that could barely sign up anybody. There are still a lot of questions about how solid that figure is, but the idea that the law could even come close to the original goal after such a disastrous start would have been laughable even a few weeks ago.

That’s left the critics questioning the early numbers or changing the subject. It’s a reminder that the attacks on the website were more than complaints about technology, but a proxy for a much deeper argument about what government should do and what it can’t do

But the Republicans do seem to be suffering from a compulsion disorder.  Here is Representative Paul Ryan quoted in the Politico story

And House Budget Committee Chairman Paul Ryan, who on the same day released a budget plan that would repeal the law, wasn’t fazed by the enrollment news.

“I think Obamacare is a slow-rolling fiasco. I think it’s a Pyrrhic victory,” the Wisconsin lawmaker said during a conference call with reporters Tuesday, at the same time that Obama was giving his victory speech in the Rose Garden.

But it was so much easier when they could just say the federal government can’t tie its own shoelaces. Now, they have to acknowledge that the government fixed the problem — and enrollment came roaring back.

Louisiana Governor Bobby Jindal is set to release his health care plan – I guess he is running for President.  According to the Washington Post

Louisiana Gov. Bobby Jindal will announce Wednesday a plan to repeal and replace President Obama’s health-care law, an effort by the Republican to insert himself into the increasingly competitive early maneuvering for his party’s presidential nomination.

In his 26-page plan, Jindal lays out a lengthy critique of the health law — which he refers to throughout as “Obamacare” — and reiterates his belief that it needs to be entirely done away with. In its place, he sets forth a bevy of ideas that have run through conservative thought for years, in some cases renaming them and in other cases suggesting new variations on old themes.

These themes appear to include giving those on Medicare a subsidy to buy private insurance and giving Medicaid money to the states to provide whatever care they decide on.  I have a feeling that this every-state-for-itself  idea will be proven to be a real problem as people in states that didn’t accept the expanded Medicare under the ACA are faced with citizens who won’t understand why Uncle Charlie can get health insurance subsidies and they can’t.  I don’t think this is a plan people will go for – especially after they get a feel for what is covered under ACA – but at least Jindal has something.

President Obama’s poll numbers are creeping up.  Democrats running for re-election would do well to be cautious about running away from the ACA, and optimistic me says that Nate Silver might just be wrong this time with is prediction that the Republicans have the edge in the mid-terms.  It won’t be easy for the Democrats:  They have to turn out their base in larger numbers than is usual for a mid-term, but it can be done.  Nate did favor Duke which lost in the first round of the NCAA men’s basketball tournament.

Random thoughts on the state of the world on the first day of spring

Today, the first day of spring, is warmish outside.  I think it actually broke 50!  We had a few hours of sun, but now it is mostly cloudy.  I finally purchased John Grisham’s “Sycamore Row”.  I had been resisting but succumbed because I loved “A Time to Kill” and I ended up getting 45% off the cover price.  Don’t know if a new Grisham is a sign of spring or not, but I’m going to take it as one.

It is hard for me to concentrate on much the last few days.  There is just too much news! Between the missing Malaysian airliner, Crimea, and worrying about the Democrats retaining Congress in the fall, things are pretty depressing even for someone who tends to be an optimist.

Unfortunately, I think that time ran out a long time ago for the passengers on the airliner and now all we can do is watch as the world tries to locate the remains of the plane and the black box.  While everyone points out that they did eventually find the Air France plane that went down in the Atlantic, it was very difficult even though we had a much better of idea of where it went down.  I see the families on television and wonder what I would feel if I just didn’t know what happened.  At this point one almost has to treat it as a forensic mystery to be solved.

I don’t think we are on the verge of a war over Russia and the Crimea, but I do think that things will be difficult internationally for a while.  This will affect negotiations in Iran and Syria as well as people in the Ukraine and Crimea.  But the ultimate losers may be the Crimeans.  David M. Herszenhorn had an article in the New York Times yesterday which pointed out that the troubles there may just be starting.

Many A.T.M.s in this sun-dappled seaside resort city in Crimea, and across the region, have been empty in recent days, with little white “transaction denied” slips piling up around them. Banks that do have cash have been imposing severe restrictions on withdrawals.

All flights, other than those to or from Moscow, remain canceled in what could become the norm if the dispute over Crimea’s political status drags on, a chilling prospect just a month before tourist season begins in a place beloved as a vacation playground since czarist times.

He points out that Ukraine could cut off electricity and water supplies and that there is no direct overland route between Crimea and Russia.  The story ends with this

Some Crimeans said they were already feeling the financial sting from political instability.

As crowds in the cities of Simferopol and Sevastopol held raucous celebrations well into Monday morning after the vote, here in Yalta, Ihor B., the owner of a small travel business, went to bed with a growing sense of dread: The roughly two dozen bookings that he had received since the start of the year had all disappeared.

“I got 10 requests from Germany, and 10 assignments from Ukrainian agencies for Western tourists; a couple of requests from Dutch tourists and cruise ships,” said Mr. B, who asked that his last name not be used for fear of reprisal by the new Russian government. “At the moment, all of them, absolutely all of them, are canceled.”

In the same issue of the Times was a long cautionary story about South Ossetia which was liberated from Georgia five years ago.  But things have moved on and South Ossetia is not doing very well.

When Russia invaded Georgia, repelling a Georgian attack on South Ossetia and taking control of the separatist enclaves of South Ossetia and Abkhazia, it seemed most unlikely that the Kremlin was thinking about long-term consequences.

As in Crimea, the war was presented to Russians as a humanitarian effort to protect its citizens, and more broadly as a challenge to encirclement by the United States, which was aligned with Georgia. Television stations gave the intervention blanket coverage, and it was wildly popular in Russia, lifting the approval ratings of Dmitri A. Medvedev to the highest point of his presidency.

The aftermath of recognition, however, has presented Russia with a long series of headaches. This week, economists have warned repeatedly that Crimea, if it is absorbed, will prove a serious drag on Russia’s budget, but their arguments have been drowned out in the roar of public support for annexation.

Aleksei V. Malashenko, an analyst at the Carnegie Moscow Center, said Russian officials “will be shocked” with the challenges they face when trying to manage Crimea — reviving its economy, distributing money and influence among its ethnic groups, and trying to control the corruption that accompanies all big Russian projects. And, judging from precedent, the public’s euphoria will fade, he said.

“I think that in Russia, the majority of the society forgot about Ossetia, and if it weren’t for the Olympics, the majority of the society would also forget about Abkhazia,” Mr. Malashenko said. “Of course, Crimea is not Ossetia. But anyway, the popularity of Crimeans, and the Crimean tragedy, will be forgotten in a year.”

So maybe we don’t need to do anything except some sanctions and make sure that Russia and Putin’s next move is not to march into eastern Ukraine.  Forget John McCain’s mockery and advice.

As for domestic politics, I recalled Andrew Sullivan’s March 13th blog entry on The Dish. The Boring, Relentless Advance Of Obama’s Agenda.  To read the entire piece one has to subscribe [which I would encourage you to do], but here is his conclusion.

…One side is theater – and often rather compelling theater, if you like your news blonde, buxom and propagandized. The other side is boring, relentless implementation. At any one time, you can be forgiven for thinking that the theatrics have worked. The botched roll-out of healthcare.gov, to take an obvious example, created a spectacular weapon for the GOP to hurl back at the president. But since then, in undemonstrative fashion, the Obama peeps have rather impressively fixed the site’s problems and signed up millions more to the program. As the numbers tick up, the forces of inertia – always paramount in healthcare reform – will kick in in defense of Obamacare, and not against it. Again, the pattern is great Republican political theater, followed by steady and relentless Democratic advance.

Until the theater really does create a new majority around Republican policies and a Republican candidate, Obama has the edge. Which is to say: he has had that edge now for nearly six years. Even if he loses the entire Congress this fall, he has a veto. And then, all he has to do is find a successor able to entrench his legacy and the final meep-meep is upon us. And that, perhaps, is how best to see Clinton. She may not have the stomach for eight years in the White House, and the barrage of bullshit she will have to endure. But if you see her as being to Barack Obama what George H.W. Bush was to Reagan, four years could easily be enough. At which point, the GOP may finally have to abandon theater for government, and performance art for coalition-building.

Plus, it is spring.

Mutts by Patrick McDonnell

Mutts by Patrick McDonnell

Healthcare confusion

Let’s start with Jen Sorensen

Jen Sorenson

A lot of people are confused about what the Affordable Care Act does and don’t seem to realize that their insurance will actually come from a combination of Medicaid (or Medicare (for those who qualify) and a private insurer or just from a private insurer.  This is  the kind of insurance many got (I understand there are fewer offered these days) when they retired and got Medicare Advantage from a private insurer through their former employer as I do.  My retiree’s Medicare Advantage is partly subsidized by the City of Boston but I pay a monthly premium just as I pay a monthly premium for Medicare.  The ACA changes none of this for me.  And it changes nothing about employees who get qualified plans through their employers.  But to hear some of the Republicans carry on you would think that some staffer from the Department of Health and Human Services – or maybe Kathleen Sebelius herself will be performing medical exams.

As Gail Collins explained in her New York Times column today

The Democrats are depressed. The Republicans enjoy pointing out that the Obamacare rollout has been a mess. But they obviously can’t pretend to be upset that people are finding it hard to sign up for a program their party wanted to kill, eviscerate and stomp into tiny pieces, which would then be fed to a tank of ravenous eels.

Well, actually, they can.

“I haven’t heard one of you apologize to the American public,” Representative David McKinley of West Virginia sternly told government contractors who had worked on the HealthCare.gov Web site. McKinley’s party recently shut down everything from the national parks to preschool programs, while costing the economy an estimated $24 billion. Nobody apologized. Perhaps they’ll write a note this weekend.

“I’m damned angry that I and 700,000 Texans I represent have been misled, misled and misled,” said Representative Pete Olson. The only thing that could conceivably make Olson angrier would be if the Obamacare site was working so well that Texans could get health insurance as easily as they can order a chrome scarf holder from Amazon.com.

I thought these guys would be happy that people couldn’t get insurance and that the whole enterprise was a flop.  But maybe it is just the technical failures with the website that they don’t like.  I’m very confused.  As Andy Borowitz posted ” I guess once the Obamacare website is fixed the Republicans will be totally on board.”

But I don’t think the news will be good in the long run for the Republicans who want to repeal the ACA even if access to the sign-up website gets fixed.  This post from Sarah Kliff on Ezra Klein’s Wonkblog is likely just the start.

More than 330,000 people have managed to get deep enough into new government health insurance Web sites to learn how much financial assistance they will receive purchasing coverage, the Internal Revenue Service said Saturday.

That figure is arguably the most robust measure released to date by the Obama administration of how many Americans are successfully applying for financial help in purchasing a private insurance plan.

Calculations of financial assistance is a step that follows filing an application and tells applicants how much of a tax credit–if any–they can use to purchase a private health plan. This figure does not include shoppers who were found to likely qualify for Medicaid earlier in the shopping process.

The IRS said it has also received and responded to more than 1.3 million requests from the marketplace for personal data used to apply for Affordable Care Act programs, such as household income and family size.

The IRS said it is currently receiving about 80,000 such data requests each day. It is one of about a half-dozen agencies that send information to a federal data hub, along with the Department of Homeland Security and the Social Security Administration.

“Our IT systems are working well and providing both the historical tax data and the computation service accurately and quickly through the government’s data hub,” IRS spokesman Terry Lemons said. “The requests are being processed within seconds.”

This federal data hub determines eligibility for premium tax credits for the 36 states using the federal insurance marketplace and also for some, but not all, of the state-based exchanges. California, for example, opted to use its own technology to determine who qualifies for which programs.

The federal data hub was built by the contracting firm QSSI. The Obama administration announced Friday that QSSI would take on a new role as HealthCare.gov’s general contractor, overseeing efforts to fix the Web sites’ problems.

HealthCare.gov pings this federal data hub to verify a consumer’s identity and also when shoppers indicate in their applications that they would like to apply for financial assistance with coverage. Health and Human Services has said that, as of Thursday, 700,000 applications have been filed through the federal and state insurance exchanges.

People were slow to sign up when Massachusetts rolled out Romeycare and now there is close to universal coverage.  ACA sign-up, despite the problems is going even faster.

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